New Classification Criteria for SLE: Proposed ACR/EULAR Criteria aim for high sensitivity & specificity

How to Use the Criteria
The development team’s goal is for the criteria to include a mobile app and online tool that defines each criterion and adds up the patient’s score, said Karen Costenbader, MD, director of the lupus program at Brigham and Women’s Hospital in Boston. She showed the audience how to score several patient cases.

“Within each domain, there is a system of criteria in ascending order of importance. You only count the most heavily weighted criterion within that domain,” said Dr. Costenbader. “We are relying on your clinical acumen. If you feel there’s a more likely explanation for this patient to have a certain manifestation, you would not score it. If you think it’s as likely to be SLE as something else, then score it.”

Despite their many strengths, these criteria have some limitations, so discussion is welcome, she said.

“SLE is a complex, heterogeneous disease with many overlap syndromes. There is also incomplete lupus, pre-lupus, cutaneous-only lupus and early lupus,” said Dr. Costenbader. Patients with overlap syndromes may be classified as SLE if they meet the criteria, but excluded in specific studies. “Also, newer biomarkers and assays, such as complement deposition products and interferon signatures, may be very helpful in the classification of SLE, but they’re not widely available at this time.”

Susan Bernstein is a freelance journalist based in Atlanta.

References

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