RT Journal Article
SR Electronic
T1 Comparison of the American-European Consensus Group Sjögren's syndrome classification criteria to newly proposed American College of Rheumatology criteria in a large, carefully characterised sicca cohort
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 31
OP 38
DO 10.1136/annrheumdis-2013-203845
VO 73
IS 1
A1 Astrid Rasmussen
A1 John A Ice
A1 He Li
A1 Kiely Grundahl
A1 Jennifer A Kelly
A1 Lida Radfar
A1 Donald U Stone
A1 Kimberly S Hefner
A1 Juan-Manuel Anaya
A1 Michael Rohrer
A1 Rajaram Gopalakrishnan
A1 Glen D Houston
A1 David M Lewis
A1 James Chodosh
A1 John B Harley
A1 Pamela Hughes
A1 Jacen S Maier-Moore
A1 Courtney G Montgomery
A1 Nelson L Rhodus
A1 A Darise Farris
A1 Barbara M Segal
A1 Roland Jonsson
A1 Christopher J Lessard
A1 R Hal Scofield
A1 Kathy L Moser Sivils
YR 2014
UL http://ard.bmj.com/content/73/1/31.abstract
AB Objective To compare the performance of the American–European Consensus Group (AECG) and the newly proposed American College of Rheumatology (ACR) classification criteria for Sjögren's Syndrome (SS) in a well-characterised sicca cohort, given ongoing efforts to resolve discrepancies and weaknesses in the systems. Methods In a multidisciplinary clinic for the evaluation of sicca, we assessed features of salivary and lacrimal gland dysfunction and autoimmunity as defined by tests of both AECG and ACR criteria in 646 participants. Global gene expression profiles were compared in a subset of 180 participants. Results Application of the AECG and ACR criteria resulted in classification of 279 and 268 participants with SS, respectively. Both criteria were met by 244 participants (81%). In 26 of the 35 AECG+/ACR participants, the minor salivary gland biopsy focal score was ≥1 (74%), while nine had positive anti-Ro/La (26%). There were 24 AECG−/ACR+ who met ACR criteria mainly due to differences in the scoring of corneal staining. All patients with SS, regardless of classification, had similar gene expression profiles, which were distinct from the healthy controls. Conclusions The two sets of classification criteria yield concordant results in the majority of cases and gene expression profiling suggests that patients meeting either set of criteria are more similar to other SS participants than to healthy controls. Thus, there is no clear evidence for increased value of the new ACR criteria over the old AECG criteria from the clinical or biological perspective. It is our contention, supported by this report, that improvements in diagnostic acumen will require a more fundamental understanding of the pathogenic mechanisms than is at present available.