To compare the diagnostic usefulness of the 2019 European League Against Rheumatism/American College of Rheumatology (2019‐EULAR/ACR) classification criteria for systemic lupus erythematosus (SLE) to that of the 1997‐ACR classification criteria for SLE (1997‐ACR) when applied to youths (≤ 21 years) with SLE.

Data were extracted from electronic health records of patients followed at a large academic pediatric hospital. Treating a rheumatologist’s SLE diagnosis served as the standard criterion for identifying SLE patients (cases). Controls were patients with juvenile dermatomyositis (JDM), juvenile scleroderma (jSc), or juvenile systemic sclerosis (jSSc). The 2019‐EULAR/ACR criteria and the 1997‐ACR criteria were tested against the standard criterion.

A total of 112 SLE patients aged 2‐21 years and 105 controls aged 1‐19 years (66% JDM, 34% jSc or jSSc) were available for analysis. The 2019‐EULAR/ACR criteria had significantly higher sensitivity (85% vs 72%; p=0.023) and similar specificity (83% vs 87%; p=0.456) than the 1997‐ACR criteria. The mean±SD 2019‐EULAR/ACR classification summary scores were significantly higher among non‐White than White cases (22.41±10.04 vs. 17.59±9.19; p<0.01). The sensitivity of the 2019‐EULAR/ACR criteria in non‐White/White cases was 92%/80% (p=0.08) vs. 83%/64% (p<0.02) for the 1997‐ACR criteria. The sensitivity of the 2019‐EULAR/ACR criteria was not affected by age or gender.

The 2019‐EULAR/ACR criteria efficiently classify youths with SLE, irrespective of age, gender, and race. Compared to the 1997‐ACR criteria, the new criteria are significantly more sensitive and similarly specific to SLE youths.

Ref: https://onlinelibrary.wiley.com/doi/10.1002/acr.24430

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