Through the group discussions, Dr. Johnson said, the definitions for arthritis and pericarditis were modified. Also, cranial neuropathy and Class IV lupus nephritis were removed as criteria, because they weren’t found to be helpful in the classification process.
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“We have defined a system of criteria that produces the relative probability that a particular case—that is, a combination of clinical features—has systemic lupus erythematosus,” Dr. Johnson said.
The criteria are still in draft form and in flux, she cautioned. They are now being validated using 1,000 cases and 1,000 controls from 36 international SLE sites, she noted.
Classification criteria are generally used to standardize groups of patients for clinical trials. This can lead to the availability of better therapeutic options, if trials go well and more therapies are approved by the FDA. Thus, Dr. Aringer is hopeful the new system will lead to better care.
“If successful, ANA of at least 1–80 and weighted criteria will lead to better performance, particularly in early disease, and give us a system that is, hopefully, intuitive enough to convey an idea of the disease,” he said.
Thomas R. Collins is a freelance writer living in South Florida.
- Tedeschi1 S, Johnson S, Boumpas D, et al. Multicriteria decision analysis for developing new classification criteria for systemic lupus erythematosus (absract OP0002). Annual European Congress of Rheumatology. 2017 Jun 15. Madrid, Spain.
- Petri M, Orbai AM, Alarcón GS, et al. Derivation and validation of Systemic Lupus International Collaborating Clinics Classification Criteria for systemic lupus erythematosus. Arthritis Rheum. 2012 Aug;64(8):2677–2686. doi: 10.1002/art.34473.