New Classification Criteria Developed For Scleroderma PDF Print E-mail
Monday, 07 October 2013 09:37
The 2013 Classification Criteria for Systemic Sclerosis have been developed and validated by the American College of Rheumatology and EULAR and should allow patients to be identified and treated earlier, according to the professional bodies.

Published in Arthritis and Rheumatism, the new criteria will classify patients as having Systemic Sclerosis if they have thickening of the skin in the middle part of the fingers (from the proximal to the metacarpophalangeal joints) regardless of other features.

A further seven features need to be assessed to make a Scleroderma classification if this criterion is not met. These features include skin thickening of the fingers, fingertip lesions, telangiectasia, abnormal nailfold capillaries, pulmonary arterial hypertension and interstitial lung disease, Raynaud’s phenomenon and Systemic Sclerosis-related antibodies.

However, several items that are useful for recognising Systemic Sclerosis in clinical practice, such as Calcinosis, flexion contractures of the fingers, tendon or bursal friction rubs, oesophageal dilatation and dysphagia were not included in the criteria because they did not improve sensitivity or specificity.

According to the authors of the new classification system, the 1980 ACR criteria for systemic sclerosis were updated by clustering items and simplifying the weighting of the different criteria. “The 1980 ACR criteria were not sensitive enough to identify patients with early disease or limited cutaneous System Sclerosis,” said co-author Dr Frank van den Hoogen from the Netherlands.

When validated  by comparing with non-scleroderma control cases, the new criteria proved to have a sensitivity of 0.91 and specificity of 0.92, whereas the old ACR criteria had a sensitivity and specificity of 0.75 and 0.72 respectively. “The new classification criteria should correctly classify more patients with the disease,” said co-author Dr Janet Pope from Ontario.

“Criteria that are more specific will allow for earlier identification and better treatment for those with systemic sclerosis,” she said. The authors acknowledged that testing and validating the new criteria was difficult because there is no ‘gold standard’ to define a standard case of Systemic Sclerosis.  The ACR-EULAR committee therefore had to rely on a consensus of expert opinion, with a focus on controversial cases.

“the ACR/EULAR classification criteria for systemic sclerosis perform better than the 1980 ACR preliminary criteria in terms of both sensitivity and specificity,” the authors conclude. They are relatively simple to apply in individual subjects [and] may be endorsed as inclusion criteria for systemic sclerosis studies,” they added

Source: Rheumatology Update (2013)
 
More articles :

» Development of an Activity Index for Localized Scleroderma (Morphea)

E. Lanciano, A. CHIALà, E. Praino, V. Grattagliano, M. Covelli, F. Iannone, G. Lapadula Reumatologia Universitaria, Policlinico, Bari, ItalyAnn Rheum Dis 2011;70(Suppl3):481Background: Morphea is a skin disorder characterized by fibrosis. It...

» Rheumatologist Receives Scleroderma Foundation's Lifetime Achievement Award

In a recent article, it was reported that ,  Gerald P. Rodnan Professor of Medicine, , received the 's Lifetime Achievement Award in recognition of his service to the community. The award is the foundation's highest honor and is presented to...

» Quality Indicator Set for Systemic Sclerosis

D. Khanna, O. Kowal-Bielecka, P.P. Khanna, A. Lapinska, S.M. Asch, N. Wenger, K.K. Brown, P. Clements, T. Getzug, M.D. Mayes, T.A. Medsger Jr., R. Oudiz, R. Simms, V. Steen, P. Maranian, D.E. FurstBackground:Systemic sclerosis (SSc) is associated...

» Preliminary Results Show Beneficial Effects of Imatinib in Scleroderma

Imatinib (Gleevec), a drug that has significantly improved survival in chronic myelogenous leukemia and gastrointestinal stromal tumor, is showing beneficial effects on skin and lung manifestations in patients with diffuse cutaneous scleroderma....

» Promedior Announces Publication of New Research Demonstrating Pentraxin-2/SAP is a Potent Inhibitor of Pulmonary Fibrosis

Promedior, Inc., a clinical stage biotechnology company developing novel therapies to treat fibrotic and inflammatory diseases, announced today the publication of collaborative research in the International Journal of Biochemistry and Cell Biology...

» Dealing With Your Insomnia

Difficulty sleeping, also called insomnia, is a common and frustrating problem. If you are not sleeping well at night, it can be difficult to feel well during the daytime. Insomnia makes everything worse; it can lead to fatigue, depression, anxiety,...

Comments  

 
+1 #2 adelwyn 2013-10-08 07:02
Good Morning Robyn, we would like to thank you and your team for the comment and continued support. We will continue to do what we can, for all Scleroderma patients around the world.
Report to administrator
 
 
+2 #1 Robyn Sims 2013-10-08 02:22
We wish to thank you for your well resourced information. Scleroderma Australia appreciates being able to share your articles with our members.
Well Done.
Robyn Sims
President
Scleroderma Australia
Report to administrator