title: Evaluation of the ACR and SLICC classification criteria in juvenile-onset systemic lupus erythematosus: a longitudinal analysis.
abstract: Objectives The Systemic Lupus International Collaborating Clinics (SLICC) group proposed revised classification criteria for systemic lupus erythematosus (SLICC-2012 criteria). This study aimed to compare these criteria with the well-established American College of Rheumatology classification criteria (ACR-1997 criteria) in a national cohort of juvenile-onset systemic lupus erythematosus (JSLE) patients and evaluate how patients' classification criteria evolved over time. Methods Data from patients in the UK JSLE Cohort Study with a senior clinician diagnosis of probable evolving, or definite JSLE, were analyzed. Patients were assessed using both classification criteria within 1 year of diagnosis and at latest follow up (following a minimum 12-month follow-up period). Results A total of 226 patients were included. The SLICC-2012 was more sensitive than ACR-1997 at diagnosis (92.9% versus 84.1% p < 0.001) and after follow up (100% versus 92.0% p < 0.001). Most patients meeting the SLICC-2012 criteria and not the ACR-1997 met more than one additional criterion on the SLICC-2012. Conclusions The SLICC-2012 was better able to classify patients with JSLE than the ACR-1997 and did so at an earlier stage in their disease course. SLICC-2012 should be considered for classification of JSLE patients in observational studies and clinical trial eligibility.
authors.affiliation: 1 Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, UK.|2 NIHR Alder Hey Clinical Research Facility, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
authors.forename: H
authors.initials: H
authors.lastname: Lythgoe
authors.affiliation: 1 Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, UK.
authors.forename: T
authors.initials: T
authors.lastname: Morgan
authors.affiliation: 3 Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
authors.forename: E
authors.initials: E
authors.lastname: Heaf
authors.affiliation: 3 Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
authors.forename: O
authors.initials: O
authors.lastname: Lloyd
authors.affiliation: 4 Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK.
authors.forename: E
authors.initials: E
authors.lastname: Al-Abadi
authors.affiliation: 5 Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
authors.forename: K
authors.initials: K
authors.lastname: Armon
authors.affiliation: 6 Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, UK.
authors.forename: K
authors.initials: K
authors.lastname: Bailey
authors.affiliation: 7 Royal Hospital for Sick Children, Edinburgh, UK.
authors.forename: J
authors.initials: J
authors.lastname: Davidson
authors.affiliation: 8 The Great North Children's Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.
authors.forename: M
authors.initials: M
authors.lastname: Friswell
authors.affiliation: 9 Royal Hospital for Children, Glasgow, UK.
authors.forename: J
authors.initials: J
authors.lastname: Gardner-Medwin
authors.affiliation: 10 Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
authors.forename: K
authors.initials: K
authors.lastname: Haslam
authors.affiliation: 11 Arthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK.
authors.forename: Y
authors.initials: Y
authors.lastname: Ioannou
authors.affiliation: 12 Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
authors.forename: A
authors.initials: A
authors.lastname: Leahy
authors.affiliation: 13 Leeds Children's Hospital NHS Trust, Leeds, UK.
authors.forename: V
authors.initials: V
authors.lastname: Leone
authors.affiliation: 14 Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Pilkington
authors.affiliation: 15 Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, UK.
authors.forename: S
authors.initials: S
authors.lastname: Rangaraj
authors.affiliation: 16 Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
authors.forename: P
authors.initials: P
authors.lastname: Riley
authors.affiliation: 17 Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, UK.
authors.forename: E J
authors.initials: EJ
authors.lastname: Tizard
authors.affiliation: 18 Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, UK.
authors.forename: N
authors.initials: N
authors.lastname: Wilkinson
authors.affiliation: 1 Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, UK.|2 NIHR Alder Hey Clinical Research Facility, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.|3 Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
authors.forename: M W
authors.initials: MW
authors.lastname: Beresford
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000145:classification* / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D012219:Rheumatology
keywords: ACR classification criteria; Juvenile-onset systemic lupus erythematosus; SLICC classification criteria