Looking at data from early SLE cohorts, “it appears that a number of classical lupus manifestations do distinguish SLE from mimickers, notably kidney disease, oral ulcers, pleuritis and alopecia,” she said.4 An interesting new finding was that non-classical, less specific manifestations, such as arthralgia, fever and fatigue, also distinguish early SLE from mimickers. “Finally, we looked to the patients. They also reported arthralgia, fever and fatigue as manifestations they experienced early in their disease.”5
A panel of SLE experts reviewed the criteria in development. Their recommendations included developing precise definitions for each criterion and clustering criteria related to the same organ systems into domains or buckets. Both recommendations were validated by the committee and applied.
“Because they are interrelated, it would be inappropriate to doubly count criteria within a domain,” she added. After ranking and scoring by a different expert panel, the criteria were tested in a derivation cohort and found to have a sensitivity of 98% and a specificity of 97%—higher than both the 1997 ACR and 2012 SLICC criteria, she said. The criteria will now be validated against a large cohort.