Background The 1980's ACR classification criteria for systemic sclerosis (SSc) show low sensitivity for diagnosing the disease. A new set of classification criteria by the ACR/EULAR has been developed along 2013.
Objectives To compare the performance of both set of classification criteria. To assess the proportion of SSc and its cutaneous subsets classified with both criteria and to analyse the degree of agreement between them.
Methods Cross-sectional multicentric study with patients from the RESCLE database from the Spanish Group of Systemic Autoimmune Diseases (GEAS) in April 2013. All patients fulfilled LeRoy-Medsger SSc criteria. Epidemiological, clinical, immunological and capillaroscopic variables were collected. 23 pre-selected criteria were first analysed. The ACR/EULAR criteria were compared with the ACR criteria by the proportion of patients fulfilling each criteria and by Cohen's Kappa coefficient. A p<0.05 was considered significative.
Results 1222 SSc patients were included and 1157 were selected for comparing both set of criteria (65 excluded for incomplete data). The most prevalent preselected items were Raynaud's phenomenon (95%), skin thickening (91%), ANA+ antibodies (91%), abnormal nailfold capillaroscopy (89%) and reduced carbon oxide diffusion (78%). Table 1 shows number of patients classified as SSc with both criteria
Table 2 shows patients classified as SSc and its Kappa index in their different cutaneous subsets.
Conclusions New ACR/EULAR classification criteria show better accuracy than the old ACR ones. A greater number of patients are classified as SSc, specially in their limited cutaneous, sine and pre-scleroderma subsets.
Subcommittee for Scleroderma Criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee. Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis Rheum 1980;23:581–90.
van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Ann Rheum Dis 2013;72: 1747-1755.
Fransen J, Johnson SR, van den Hoogen F, et al. Items for developing revised classification criteria in systemic sclerosis: results of a consensus exercise. Arthritis Care Res (Hoboken) 2012;64:351–7.
Disclosure of Interest None declared