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2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. 2019
Martin Aringer, and
Karen Costenbader, and
David Daikh, and
Ralph Brinks, and
Marta Mosca, and
Rosalind Ramsey-Goldman, and
Josef S Smolen, and
David Wofsy, and
Dimitrios T Boumpas, and
Diane L Kamen, and
David Jayne, and
Ricard Cervera, and
Nathalie Costedoat-Chalumeau, and
Betty Diamond, and
Dafna D Gladman, and
Bevra Hahn, and
Falk Hiepe, and
Søren Jacobsen, and
Dinesh Khanna, and
Kirsten Lerstrøm, and
Elena Massarotti, and
Joseph McCune, and
Guillermo Ruiz-Irastorza, and
Jorge Sanchez-Guerrero, and
Matthias Schneider, and
Murray Urowitz, and
George Bertsias, and
Bimba F Hoyer, and
Nicolai Leuchten, and
Chiara Tani, and
Sara K Tedeschi, and
Zahi Touma, and
Gabriela Schmajuk, and
Branimir Anic, and
Florence Assan, and
Tak Mao Chan, and
Ann Elaine Clarke, and
Mary K Crow, and
László Czirják, and
Andrea Doria, and
Winfried Graninger, and
Bernadett Halda-Kiss, and
Sarfaraz Hasni, and
Peter M Izmirly, and
Michelle Jung, and
Gábor Kumánovics, and
Xavier Mariette, and
Ivan Padjen, and
José M Pego-Reigosa, and
Juanita Romero-Diaz, and
Íñigo Rúa-Figueroa Fernández, and
Raphaèle Seror, and
Georg H Stummvoll, and
Yoshiya Tanaka, and
Maria G Tektonidou, and
Carlos Vasconcelos, and
Edward M Vital, and
Daniel J Wallace, and
Sule Yavuz, and
Pier Luigi Meroni, and
Marvin J Fritzler, and
Ray Naden, and
Thomas Dörner, and
Sindhu R Johnson
University Medical Center and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany.
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). 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 1,001 subjects and validation compared with previous criteria in a new validation cohort of 1,270 subjects. 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 7 clinical (constitutional, hematologic, neuropsychiatric, mucocutaneous, serosal, musculoskeletal, renal) and 3 immunologic (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. 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 reflects current thinking about SLE and provides an improved foundation for SLE research.
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Nathalie Costedoat-Chalumeau, and
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Dafna D Gladman, and
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Søren Jacobsen, and
Dinesh Khanna, and
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Elena Massarotti, and
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Jorge Sanchez-Guerrero, and
Matthias Schneider, and
Murray Urowitz, and
George Bertsias, and
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Nicolai Leuchten, and
Chiara Tani, and
Sara K Tedeschi, and
Zahi Touma, and
Gabriela Schmajuk, and
Branimir Anic, and
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Tak Mao Chan, and
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Mary K Crow, and
László Czirják, and
Andrea Doria, and
Winfried Graninger, and
Bernadett Halda-Kiss, and
Sarfaraz Hasni, and
Peter M Izmirly, and
Michelle Jung, and
Gábor Kumánovics, and
Xavier Mariette, and
Ivan Padjen, and
José M Pego-Reigosa, and
Juanita Romero-Diaz, and
Íñigo Rúa-Figueroa Fernández, and
Raphaèle Seror, and
Georg H Stummvoll, and
Yoshiya Tanaka, and
Maria G Tektonidou, and
Carlos Vasconcelos, and
Edward M Vital, and
Daniel J Wallace, and
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Josef S Smolen, and
David Wofsy, and
Dimitrios T Boumpas, and
Diane L Kamen, and
David Jayne, and
Ricard Cervera, and
Nathalie Costedoat-Chalumeau, and
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Matthias Schneider, and
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Chiara Tani, and
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László Czirják, and
Andrea Doria, and
Winfried Graninger, and
Bernadett Halda-Kiss, and
Sarfaraz Hasni, and
Peter M Izmirly, and
Michelle Jung, and
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Xavier Mariette, and
Ivan Padjen, and
José M Pego-Reigosa, and
Juanita Romero-Diaz, and
Íñigo Rúa-Figueroa Fernández, and
Raphaèle Seror, and
Georg H Stummvoll, and
Yoshiya Tanaka, and
Maria G Tektonidou, and
Carlos Vasconcelos, and
Edward M Vital, and
Daniel J Wallace, and
Sule Yavuz, and
Pier Luigi Meroni, and
Marvin J Fritzler, and
Ray Naden, and
Thomas Dörner, and
Sindhu R Johnson
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Arthritis & rheumatology (Hoboken, N.J.),
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David Daikh, and
Ralph Brinks, and
Marta Mosca, and
Rosalind Ramsey-Goldman, and
Josef S Smolen, and
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Dimitrios T Boumpas, and
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Falk Hiepe, and
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Elena Massarotti, and
Joseph McCune, and
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Jorge Sanchez-Guerrero, and
Matthias Schneider, and
Murray Urowitz, and
George Bertsias, and
Bimba F Hoyer, and
Nicolai Leuchten, and
Chiara Tani, and
Sara K Tedeschi, and
Zahi Touma, and
Gabriela Schmajuk, and
Branimir Anic, and
Florence Assan, and
Tak Mao Chan, and
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Mary K Crow, and
László Czirják, and
Andrea Doria, and
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Ivan Padjen, and
José M Pego-Reigosa, and
Juanita Romero-Diaz, and
Íñigo Rúa-Figueroa Fernández, and
Raphaèle Seror, and
Georg H Stummvoll, and
Yoshiya Tanaka, and
Maria G Tektonidou, and
Carlos Vasconcelos, and
Edward M Vital, and
Daniel J Wallace, and
Sule Yavuz, and
Pier Luigi Meroni, and
Marvin J Fritzler, and
Ray Naden, and
Thomas Dörner, and
Sindhu R Johnson
January 2023,
Journal of the American Academy of Dermatology,
