Vasculitis & polymyalgia rheumatica
Evaluation of the ACR/EULAR 2022 criteria for classification of ANCA-associated vasculitis in a population-based cohort from Sweden
Authors' conclusion
EMA and ACR/EULAR classification give similar results. A small proportion of patients cannot be classified or fall into two categories. Some patients exhibiting granuloma, a key feature of GPA, are nevertheless classified as MPA, conflicting with the current view of histopathology of AAV. There is high agreement of ANCA-based classification with that of ACR/EULAR, reflected in the considerable weight granted to ANCA in the new criteria.
Study context
- Population
- Population-based cohort of ANCA-associated vasculitides (AAV) cases, Sweden47% female
- Participants
- 374 participants
- Exposure
- ACR/EULAR 2022 AAV classification criteria vs European Medicines Agency (EMA) algorithm vs ANCA serology-based classification
- Outcome
- Agreement between ACR/EULAR 2022 criteria and EMA algorithm (kappa statistic)
Methodological detailspopulation-based cohort, agreement analysis (kappa statistic)
- Population-based cohort
- Agreement analysis (kappa statistic)
Main finding
As reported in the abstract
| Group | Granulomatosis with polyangiitis (GPA) | Microscopic polyangiitis (MPA) | Eosinophilic granulomatosis with polyangiitis (EGPA) |
|---|---|---|---|
| EMA | 192 | 159 | 23 |
| ACR/EULAR | 199 | 136 | 22 |
Granulomatosis with polyangiitis (GPA)
Microscopic polyangiitis (MPA)
Eosinophilic granulomatosis with polyangiitis (EGPA)
- Observed agreement EMA vs ACR/EULAR, GPA
- 85%
- Observed agreement EMA vs ACR/EULAR, MPA
- 75%
- Observed agreement EMA vs ACR/EULAR, EGPA
- 96%
- Unweighted κ statistic
- 0.66 (95% CI: 0.60, 0.74)
Observational data: associations, not effects.
Further findings
ACR/EULAR classification by ANCA specificity
- PR3-ANCA positive (n=188) classified as GPA
- 186 (98.9%)
- MPO-ANCA positive classified as MPA
- 135 of 161 (83.9%)
Agreement of ANCA serology-based classification with ACR/EULAR
- GPA
- 99%
- MPA
- 88%
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →