The new EULAR/ACR 2019 SLE classification criteria: A predictor of long-term outcomes

Abstract

ObjectivesTo determine the ability of a EULAR/ACR SLE criteria score ≥20 to predict damage accrual and mortality. MethodsInception SLE patients from the Toronto Lupus Clinic recruited in the first 12 months after diagnosis were included. A EULAR/ACR criteria score was calculated based on the baseline clinical and laboratory information. A EULAR/ACR score of 20 was used as a threshold to compare outcomes between groups (EULAR/ACR score <20 vs ≥20), based on receiver operating characteristic analysis. Results867 SLE patients were included. The group of patients with the higher score accrued more damage compared to the group with the lower score in the first 10 years after diagnosis (210 [46%] vs 167 [40%] for patients with a score ≥20 vs < 20 respectively p = 0.02). This was corroborated by multivariable regression analysis (HR 1.34, p = 0.007). Patients with a score of ≥20 had a higher risk of death (HR 2.34, p = 0.001).When excluding patients who had kidney involvement at baseline, the group with the higher score continued to be at a higher risk of damage accrued (HR 1.46, p = 0.006), although there was no difference in mortality between groups (p = 0.54). ConclusionA EULAR/ACR criteria score ≥20 at baseline is an indicator of long-term outcomes, especially damage accrual.