American College of Rheumatology criteria at inception, and accrual over 5 years in the SLICC inception cohort.

J Rheumatol 2014 May 1;41(5):875-80. Epub 2014 Apr 1.

From the Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada; Instituto Nacional de Ciencias Medicas y Nutricion, Mexico City, Mexico; Rheumatology Research Group, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Department of Rheumatology, Hospital for Rheumatic Diseases and Hanyang University Medical Center, Seoul, Korea; Divisions of Clinical Immunology/Allergy and Clinical Epidemiology, Montreal General Hospital and McGill University Health Centre, Montreal, Quebec, Canada; Centre Hospitalier Universitaire de Québec et Université Laval, Quebec City, Quebec, Canada; Division of Rheumatology, Department of Medicine and Department of Pathology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada; Centre for Rheumatology Research, University College, London, UK; Cedars-Sinai/David Geffen School of Medicine, University of California, Los Angeles, California, USA; Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK; Department of Clinical Pharmacology, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA; Department of Rheumatology, University Hospital Lund, Lund, Sweden; Division of Rheumatology and Immunology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA; Department of Medicine, Division of Clinical Immunology and Rheumatology, University of Alabama, Birmingham, Alabama, USA; Center for Rheumatology Research, Landspitali University Hospital, Reyjkavik, Iceland; Northwestern University and Feinber

Objective: To determine the frequency of each American College of Rheumatology (ACR) criterion met at time of enrollment, and the increase in each of the criteria over 5 years.

Methods: In 2000 the Systemic Lupus International Collaborating Clinics (SLICC) recruited an international inception cohort of patients with systemic lupus erythematosus (SLE; ≥ 4 ACR criteria) who were followed at yearly intervals according to a standard protocol. Descriptive statistics were used to assess the total and cumulative number of ACR criteria met at each visit. Regression models were done to compare the increase of individual and cumulative criteria as a function of race/ethnicity group, and sex.

Results: In all, 768 patients have been followed for a minimum of 5 years. Overall, 59.1% of the patients had an increase in the number of ACR criteria they met over the 5-year period. The mean number of ACR criteria met at enrollment was 5.04 ± 1.13 and at year 5 was 6.03 ± 1.42. At enrollment, nonwhite patients had a higher number of ACR criteria (5.19 ± 1.23) than white patients. The total number of criteria increased in both white and nonwhite ethnicities, but increased more among whites. Males had a slightly lower number of criteria at enrollment compared to females and males accrued fewer criteria at 5 years.

Conclusion: In this international inception cohort of SLE patients with at least 4 ACR criteria at entry, there was an accumulation of ACR criteria over the following 5 years. The distribution of criteria both at inception and over 5 years is affected by sex and ethnicity.

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May 2014
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