2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus
Martin Aringer,Karen H. Costenbader,David I. Daikh,Ralph Brinks,Marta Mosca,Rosalind Ramsey-Goldman,Josef S Smolen,David Wofsy,Dimitrios T. Boumpas,Dimitrios T. Boumpas,Diane L. Kamen,David Jayne,Ricard Cervera,Nathalie Costedoat-Chalumeau,Betty Diamond,Dafna D. Gladman,Bevra H. Hahn,Falk Hiepe,Søren Jacobsen,Dinesh Khanna,Kirsten Lerstrøm,Elena Massarotti,Joseph M. McCune,Guillermo Ruiz-Irastorza,Jorge Sanchez-Guerrero,Matthias Schneider,Murray B. Urowitz,George Bertsias,Bimba F. Hoyer,Nicolai Leuchten,Chiara Tani,Sara K. Tedeschi,Zahi Touma,Gabriela Schmajuk,Branimir Anić,Florence Assan,Tak Mao Chan,Ann E. Clarke,Mary K. Crow,László Czirják,Andrea Doria,Winfried Graninger,Bernadett Halda-Kiss,Sarfaraz Hasni,Peter M. Izmirly,Michelle Jung,Gábor Kumánovics,Xavier Mariette,Ivan Padjen,José M. Pego-Reigosa,Juanita Romero-Diaz,Íñigo Rúa-Figueroa Fernández,Raphaèle Seror,Georg Stummvoll,Yoshiya Tanaka,Maria G Tektonidou,Carlos Vasconcelos,Edward M Vital,Edward M Vital,Daniel J. Wallace,Sule Yavuz,Pier Luigi Meroni,Marvin J. Fritzler,Ray Naden,Thomas Dörner,Sindhu R. Johnson,Sindhu R. Johnson +66 more
TLDR
These new classification criteria for systemic lupus erythematosus have excellent sensitivity and specificity, and were developed using rigorous methodology with multidisciplinary and international input.Abstract:
Objective To develop new classification criteria for systemic lupus erythematosus (SLE) jointly supported by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR). Methods This international initiative had four phases. (1) Evaluation of antinuclear antibody (ANA) as an entry criterion through systematic review and meta-regression of the literature and criteria generation through an international Delphi exercise, an early patient cohort and a patient survey. (2) Criteria reduction by Delphi and nominal group technique exercises. (3) Criteria definition and weighting based on criterion performance and on results of a multi-criteria decision analysis. (4) Refinement of weights and threshold scores in a new derivation cohort of 1001 subjects and validation compared with previous criteria in a new validation cohort of 1270 subjects. Results The 2019 EULAR/ACR classification criteria for SLE include positive ANA at least once as obligatory entry criterion; followed by additive weighted criteria grouped in seven clinical (constitutional, haematological, neuropsychiatric, mucocutaneous, serosal, musculoskeletal, renal) and three immunological (antiphospholipid antibodies, complement proteins, SLE-specific antibodies) domains, and weighted from 2 to 10. Patients accumulating ≥10 points are classified. In the validation cohort, the new criteria had a sensitivity of 96.1% and specificity of 93.4%, compared with 82.8% sensitivity and 93.4% specificity of the ACR 1997 and 96.7% sensitivity and 83.7% specificity of the Systemic Lupus International Collaborating Clinics 2012 criteria. Conclusion These new classification criteria were developed using rigorous methodology with multidisciplinary and international input, and have excellent sensitivity and specificity. Use of ANA entry criterion, hierarchically clustered and weighted criteria reflect current thinking about SLE and provide an improved foundation for SLE research.read more
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2019 Update of the Joint European League against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis
Antonis Fanouriakis,Myrto Kostopoulou,Kim Cheema,Hans-Joachim Anders,Martin Aringer,Ingeborg M. Bajema,John Boletis,Eleni Frangou,Frédéric Houssiau,Jane L Hollis,A. Karras,Francesca Marchiori,Stephen D. Marks,Gabriella Moroni,Marta Mosca,Ioannis Parodis,Manuel Praga,Matthias Schneider,Josef S Smolen,Vladimir Tesar,Maria Trachana,Ronald F van Vollenhoven,A E Voskuyl,Y K Onno Teng,Bernadette Van Leew,George Bertsias,David Jayne,Dimitrios T. Boumpas,Dimitrios T. Boumpas +28 more
TL;DR: The EULAR recommendations for the management of LN are updated to facilitate homogenization of patient care and transplantation is the preferred kidney replacement option with immunosuppression guided by transplant protocols and/or extra-renal manifestations.
Journal ArticleDOI
Clinical course of coronavirus disease 2019 (COVID-19) in a series of 17 patients with systemic lupus erythematosus under long-term treatment with hydroxychloroquine.
Alexis Mathian,Matthieu Mahévas,Julien Rohmer,Mathilde Roumier,Fleur Cohen-Aubart,Blanca Amador-Borrero,Audrey Barrelet,Cecile Chauvet,T. Chazal,Michel Delahousse,Mathilde Devaux,Romain Euvrard,Jehane Fadlallah,Nans Florens,Julien Haroche,Miguel Hie,Laurent Juillard,Raphael Lhote,Thibault Maillet,Gaelle Richard-Colmant,Jean Baptiste Palluy,Micheline Pha,Laurent Perard,Philippe Remy,Etienne Rivière,Damien Sène,Pascal Sève,Capucine Morélot-Panzini,Jean François Viallard,Jean Simon Virot,Neila Benameur,Noël Zahr,Hans Yssel,Bertrand Godeau,Zahir Amoura +34 more
TL;DR: Hydroxychloroquine (HCQ), a drug that is currently part of the long-term, standard-of-care treatment for SLE, has been reported to possess antiviral activity in vitro, and recent results from a preliminary clinical trial might support its use in curative or even prophylactic treatment for COVID-19.
Journal ArticleDOI
Global epidemiology of systemic lupus erythematosus
Megan R.W. Barber,Cristina Drenkard,Titilola Falasinnu,Alberta Hoi,Anselm Mak,Nien Yee Kow,Elisabet Svenungsson,Jonna Peterson,Ann E. Clarke,Rosalind Ramsey-Goldman +9 more
TL;DR: In this article, the authors summarize and discuss the existing evidence on the incidence, prevalence and mortality of systemic lupus erythematosus across different world regions, with a focus on studies from the past 5 years.
Journal ArticleDOI
New insights into the role of antinuclear antibodies in systemic lupus erythematosus
TL;DR: The authors re-examine the role of ANAs in SLE and discuss changing attitudes towards using ANAs as biomarkers, suggesting that more regular serological testing could illuminate changes relevant to pathogenesis and disease status.
Journal ArticleDOI
Anti-CD19 CAR T cell therapy for refractory systemic lupus erythematosus
Andreas Mackensen,Fabian Müller,Dimitrios Mougiakakos,Sebastian Böltz,Artur Wilhelm,Michael Aigner,Simon Völkl,David Simon,Arnd Kleyer,Luis E. Muñoz,Sascha Kretschmann,S. Kharboutli,Regina Gary,H. Reimann,Wolf Rösler,Stefan Uderhardt,Holger Bang,Martin Herrmann,Arif B. Ekici,Christian Buettner,Katharina Habenicht,Thomas Winkler,Gerhard Krönke,Georg Schett +23 more
TL;DR: Results from a study of five patients with refractory systemic lupus erythematosus, who were treated with anti-CD19 CAR T cell therapy under a compassionate-use program, demonstrate remission of SLE disease with follow-up of up to 17 months, suggesting that CD19CAR T cell transfer is feasible, tolerable and highly effective in SLE.
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TL;DR: The Systemic Lupus International Collaborating Clinics (SLICC) group revised and validated the American College of Rheumatology (ACR) systemic lupus erythematosus (SLE) classification criteria in order to improve clinical relevance, meet stringent methodology requirements, and incorporate new knowledge regarding the immunology of SLE.
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