Vasculitis & polymyalgia rheumatica
Performance of the 2022 American College of Rheumatology (ACR)/EULAR Classification Criteria in Comparison With the European Medicines Agency Algorithm in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis
Authors' conclusion
Among the patients classified as EMA-GPA or EMA-unclassifiable, older patients with MPO-ANCA and ILD tended to be reclassified as 2022-MPA. The 2022 ACR/EULAR criteria were more useful in prognostic prediction than the EMA algorithm.
Study context
- Population
- Consecutive, newly diagnosed patients with AAV per the 2012 Chapel Hill Consensus Conference, Keio University Hospital, March 2012–May 2022
- Participants
- 114 participants
- Exposure
- 2022 ACR/EULAR classification criteria vs European Medicines Agency (EMA) algorithm for AAV
- Outcome
- Sensitivity and specificity of the 2022 ACR/EULAR criteria vs the EMA algorithm as reference
Methodological detailssingle-centre, consecutive patients, reclassification study
- Single-centre
- Consecutive patients
- Reclassification study
Main finding
As reported in the abstract
- EGPA: sensitivity
- 100%
- EGPA: specificity
- 96%
- Granulomatosis with polyangiitis (GPA): sensitivity
- 40%
- GPA: specificity
- 97%
- Microscopic polyangiitis (MPA): sensitivity
- 90%
- MPA: specificity
- 49%
Observational data: associations, not effects.
Further findings
Reclassification of EMA-GPA or EMA-unclassifiable patients
- Approximately half reclassified as 2022-MPA; these were older, more often MPO-ANCA positive and had interstitial lung disease (ILD) more frequently than 2022-GPA or non-2022-MPA
- Some MPO-ANCA-positive patients with biopsy-proven granulomatous inflammation reclassified from EMA-GPA to 2022-MPA
Overall survival by classification group · mean observation period of 4.0 years
- Deaths
- 16
- Differed significantly across 2022 ACR/EULAR classification groups
- P = 0.02
- Did not differ across EMA algorithm classification groups
- P = 0.21
Original publication
Performance of the 2022 ACR/EULAR Classification Criteria in Comparison With the European Medicines Agency Algorithm in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis. J Rheumatol. Published 1 September 2024. doi:10.
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