Background To study the relationship between the 2019 EULAR/ACR classification criteria and organ damage in patients with SLE

Methods Patients involved in a cross-sectional validation study of the EULAR/ACR criteria and judged by a panel to be clinical SLE were studied. Those who fulfilled the EULAR/ACR criteria (last visit) were stratified into 2 groups based on a cut-off score of 20. The last SLICC organ damage index (SDI) was compared between these two groups. Relationship among the domains of the EULAR/ACR criteria and SDI in all patients was studied by Spearman’s rank correlation.

Results 562 SLE patients were studied (93.6% women; age 36.5±14.1 years; disease duration 11.6±6.6 years). The mean and median EULAR/ACR criteria scores in those fulfilling the EULAR/ACR criteria (N=542) was 24.6±7.3 and 24 (IQR 19–30), respectively. 392 patients had EULAR/ACR scores of ≥20 (group 1) and 150 patients had scores of 10–19 (group 2). Group 1 had significantly higher prevalence of fever, alopecia, oral ulcers, acute lupus skin lesions, arthritis, serositis, seizure, hemolytic anemia, leukopenia and renal disease, and so were the anti-dsDNA, anti-Sm, antiphospholipid antibodies and low complement state. Organ damage (SDI score of ≥1) occurred in 232 (42.8%) patients. Patients in group 1 had significantly higher SDI scores in the renal, cardiovascular, dermatological and gonadal domains than group 2. The renal, neuropsychiatric and aPL antibodies domain scores of the EULAR/ACR criteria correlated positively with the total SDI. The renal domain of the EULAR/ACR criteria had the strongest correlation with renal damage (Rho 0.30; p<0.001). Patients who scored 10 points in the renal domain had significantly higher renal damage score than those scored 8 points or 4

Conclusions In addition to disease classification, the EULAR/ACR SLE criteria may have a role in.