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Background New ACR-EULAR SLE criteria have been proposed in order to attempt to improve classification for clinical and translational research (1, 2). Objectives We evaluated the performance of the proposed 2017 ACR-EULAR classification criteria in a cohort of SLE patients with neuropsychiatric (NP) symptoms and compared to previous classification criteria. Methods Medical records of patients visiting the NPSLE clinic of the Leiden University Medical Center (LUMC) between 2007-2017 were retrospectively evaluated. The performance of the proposed 2017 ACR-EULAR criteria, the 2012 SLICC criteria and the 1997 ACR criteria was evaluated by calculating sensitivity and specificity. Results 360 patients were included, of which 294 were clinically diagnosed with SLE. The newly proposed 2017 ACR-EULAR showed a sensitivity of 87% (95% CI: 83-91%) and a specificity of 74% (95% CI: 62-84%), as shown in Table 1. The 2012 SLICC criteria had a sensitivity of 85% (95% CI: 80-89%) and a specificity of 76% (95% CI: 64-85%). The 1997 ACR criteria had a sensitivity of 89% (95% CI: 85-92%) and a specificity of 89% (95% CI: 80-96%). Sixty out of 294 patients fulfilled the proposed NP domain (delirium/psychosis/epilepsy). Using more specific criteria for NP symptoms related to SLE, as previously proposed by Bortoluzzi et al. (3), only 37 patients fulfilled this domain. However, this did not improve specificity, which remained 74% (95% CI: 62-84%). In addition, the performance of the newly proposed criteria was evaluated including patients with more than 10 points, but negative ANA. This led to an increase of sensitivity to 90% (95% CI 86-94%), but also did not influence specificity. Conclusion In a cohort of SLE patients with NP symptoms, the proposed 2017 ACR-EULAR classification criteria showed similar sensitivity as the 1997 ACR and the SLICC 2012 criteria, but lower specificity. Including ANA negative patients improved sensitivity. References [1] 2018ACR/ARHP Annual Meeting Abstract Supplement. Arthritis Rheumatol, 2018.70Suppl 9: p.1-355. [2] Tedeschi SK, et al., Developing and Refining New Candidate Criteria for Systemic Lupus Erythematosus Classification: An International Collaboration. Arthritis Care Res (Hoboken), 2018. 70(4): p.571-581. [3] Bortoluzzi A, et al., Development and validation of a new algorithm for attribution of neuropsychiatric events in systemic lupus erythematosus. Rheumatology (Oxford), 2015. 54(5): p.891-8. Disclosure of Interests Rory Monahan: None declared, H.J.L. Beaart: None declared, Maka Gegeneva: None declared, E.G. Brilman: None declared, L.J.J. Beaart- van de Voorde: None declared, Cesar Magro Checa: None declared, Thomas Huizinga Consultant for: Merck, UCB, Bristol Myers Squibb, Biotest AG, Pfizer, GSK, Novartis, Roche, Sanofi-Aventis, Abbott, Crescendo Bioscience Inc., Nycomed, Boeringher, Takeda, Zydus, Epirus, Eli Lilly, G.M. Steup-Beekman: None declared |
