MADRID—Systemic lupus erythematosus (SLE) experts in North America and Europe are working together to refine the classification system for the disease, with the goal of producing a new set of criteria that is simpler to use and more scientifically rigorous than any classification approach previously published, speakers involved with the process said at the 2017 Annual European Congress on Rheumatology (EULAR).
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The system, a joint effort between the ACR and EULAR, is slated to include criteria in clinical and immunological domains, and validation of draft criteria is ongoing. Presentations at the conference pointed to the challenges involved, and showed in detail the lengths to which the experts have gone to produce reliable criteria and how they’ve used technology as a critical tool.1
The nature of SLE makes it a notoriously difficult disease to classify, said Martin Aringer, MD, chief of rheumatology at University Medical Center Carl Gustav Carus in Dresden, Germany, who is helping lead the effort. “Multi-organ, multi-antibody disease is challenging for classification,” he said, speaking at a scientific session.
The 1982 ACR classification criteria, which were updated in 1997, require four of 11 criteria to be met for an SLE classification. These criteria have had great influence in the field over the past two decades. They promote the concept of the disease as multiple antibody and multiple organ, and put all the criteria on equal footing with equal weight, making it easy to use and memorize.