Objectives: To validate the ACR-EULAR classification criteria for primary SS (pSS), and compare them to the American-European Consensus Group (AECG) and ACR criteria in a Dutch prospective diagnostic cohort. Methods: Consecutive patients (n = 129) referred for suspicion of pSS underwent a multidisciplinary evaluation, including a labial and/or parotid gland biopsy. Patients with an incomplete work-up (n = 8) or associated systemic auto-immune disease (n = 7) were excluded. The ACR-EULAR classification was compared with expert classification, AECG and ACR classification. Additionally, the accuracy of individual ACR-EULAR items in discriminating pSS from non-pSS was evaluated. The validity of criteria sets was described separately using parotid or labial gland biopsy results for classification. Results: Of the 114 evaluated patients, the expert panel classified 34 (30%) as pSS and 80 (70%) as non-pSS. Using labial gland biopsy results, ACR-EULAR classification showed 87% absolute agreement (κ = 0.73) with expert classification, with a sensitivity of 97% and specificity of 83%. Using the parotid gland biopsy results, the ACR-EULAR criteria performed excellently as well. Focus score, anti-SSA titre and ocular staining score showed good to excellent accuracy, whereas unstimulated whole saliva and Schirmer's test had poor accuracy. The ACR-EULAR and AECG criteria had equal validity. Compared with ACR classification, ACR-EULAR classification showed higher sensitivity but lower specificity. Conclusion: The ACR-EULAR criteria showed good agreement with expert classification, but some patients may be misclassified as pSS. Unstimulated whole saliva and Schirmer's test showed poor discriminative value. The ACR-EULAR criteria performed equally to the AECG criteria, and had higher sensitivity but lower specificity than the ACR criteria.
Objectives: To validate the ACR-EULAR classification criteria for primary SS (pSS), and compare them to the American-European Consensus Group (AECG) and ACR criteria in a Dutch prospective diagnostic cohort. Methods: Consecutive patients (n = 129) referred for suspicion of pSS underwent a multidisciplinary evaluation, including a labial and/or parotid gland biopsy. Patients with an incomplete work-up (n = 8) or associated systemic auto-immune disease (n = 7) were excluded. The ACR-EULAR classification was compared with expert classification, AECG and ACR classification. Additionally, the accuracy of individual ACR-EULAR items in discriminating pSS from non-pSS was evaluated. The validity of criteria sets was described separately using parotid or labial gland biopsy results for classification. Results: Of the 114 evaluated patients, the expert panel classified 34 (30%) as pSS and 80 (70%) as non-pSS. Using labial gland biopsy results, ACR-EULAR classification showed 87% absolute agreement (κ = 0.73) with expert classification, with a sensitivity of 97% and specificity of 83%. Using the parotid gland biopsy results, the ACR-EULAR criteria performed excellently as well. Focus score, anti-SSA titre and ocular staining score showed good to excellent accuracy, whereas unstimulated whole saliva and Schirmer's test had poor accuracy. The ACR-EULAR and AECG criteria had equal validity. Compared with ACR classification, ACR-EULAR classification showed higher sensitivity but lower specificity. Conclusion: The ACR-EULAR criteria showed good agreement with expert classification, but some patients may be misclassified as pSS. Unstimulated whole saliva and Schirmer's test showed poor discriminative value. The ACR-EULAR criteria performed equally to the AECG criteria, and had higher sensitivity but lower specificity than the ACR criteria.
Authors: Brij B Singh; Joyce Ohm; Fredice O Quenum Zanbede; Pooja Chauhan; Frans G M Kroese; Arjan Vissink; Julian L Ambrus; Bibhuti B Mishra Journal: Autoimmunity Date: 2020-05-25 Impact factor: 2.815
Authors: Jolien F van Nimwegen; Esther Mossel; Konstantina Delli; Martha S van Ginkel; Alja J Stel; Frans G M Kroese; Fred K L Spijkervet; Arjan Vissink; Suzanne Arends; Hendrika Bootsma Journal: Arthritis Care Res (Hoboken) Date: 2020-04 Impact factor: 4.794
Authors: Gwenny M Verstappen; Lu Gao; Sarah Pringle; Erlin A Haacke; Bert van der Vegt; Silvia C Liefers; Vishal Patel; Yanhua Hu; Sumanta Mukherjee; Julie Carman; Laurence C Menard; Frederik K L Spijkervet; Arjan Vissink; Hendrika Bootsma; Frans G M Kroese Journal: Front Immunol Date: 2021-07-06 Impact factor: 7.561
Authors: Maria C Edman; Srikanth R Janga; Zhen Meng; Mercy Bechtold; Alexander F Chen; Chongiin Kim; Luke Naman; Arunava Sarma; Neha Teekappanavar; Alice Y Kim; Sara Madrigal; Simranjit Singh; Elizabeth Ortiz; Stratos Christianakis; Daniel G Arkfeld; Wendy J Mack; Martin Heur; William Stohl; Sarah F Hamm-Alvarez Journal: Sci Rep Date: 2018-07-23 Impact factor: 4.379