2017 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Adult and Juvenile Idiopathic Inflammatory Myopathies and Their Major Subgroups

Arthritis and Rheumatology - Tập 69 Số 12 - Trang 2271-2282 - 2017
Ingrid E. Lundberg1, Anna Tjärnlund1, Matteo Bottai2, Victoria P. Werth3, Clarissa Pilkington4, Marianne de Visser5, Lars Alfredsson2, Anthony A. Amato6, Richard J. Barohn7, Matthew H. Liang8, Jasvinder A. Singh9, Rohit Aggarwal10, Snjólaug Arnardottir2, Hector Chinoy11, Robert G. Cooper12, Katalin Dankó13, Mazen M. Dimachkie7, Brian M. Feldman14, Ignacio García‐De La Torre15, Patrick Gordon16, Taichi Hayashi17, James D. Katz18, Hitoshi Kohsaka19, Peter A. Lachenbruch20, Bianca Lang21, Yuhui Li22, Chester V. Oddis10, Marzena Olesińska23, Ann M. Reed24, Lidia Rutkowska‐Sak25, Helga Sanner26, Albert Selva-O’Callaghan27, Yeong Wook Song28, Jiří Vencovský29, Steven R. Ytterberg30, Frederick Miller31, Lisa G. Rider31
1Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
2Karolinska Institutet, Stockholm, Sweden
3Philadelphia VA Medical Center and Hospital of the University of Pennsylvania Philadelphia
4Great Ormond Street Hospital for Children NHS Trust, London, UK
5Academic Medical Centre, Amsterdam, The Netherlands
6Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
7University of Kansas Medical Center, Kansas City
8Brigham and Women's Hospital and Boston VA Healthcare Boston Massachusetts
9Mayo Clinic College of Medicine Rochester, Minnesota, and University of Alabama and Birmingham VA Medical Center Birmingham Alabama
10University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
11Central Manchester University Hospitals NHS Foundation Trust University of Manchester Manchester UK
12University of Liverpool, Liverpool, UK
13University of Debrecen, Debrecen, Hungary
14University of Toronto and The Hospital for Sick Children Toronto Ontario Canada
15Hospital General de Occidente Secretaría de Salud and University of Guadalajara Guadalajara Mexico
16King’s College Hospital NHS Foundation Trust, London, UK
17University of Tsukuba, Tsukuba, Japan
18National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH Bethesda Maryland
19Tokyo Medical and Dental University, Tokyo, Japan
20Oregon State University, Corvallis
21IWK Health Centre and Dalhousie University Halifax Nova Scotia Canada
22People's Hospital of Beijing University Beijing China
23National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
24Duke University, Durham, North Carolina
25Institute of Rheumatology, Warsaw, Poland
26Oslo University Hospital Rikshospitalet, Oslo, Norway
27Vall d’Hebron General Hospital, Barcelona, Spain
28Seoul National University College of Medicine, Seoul, Republic of Korea
29Charles University, Prague, Czech Republic
30Mayo Clinic, College of Medicine, Rochester, Minnesota
31National Institute of Environmental Health Sciences, NIH, Bethesda, Maryland

Tóm tắt

ObjectiveTo develop and validate new classification criteria for adult and juvenile idiopathic inflammatory myopathies (IIM) and their major subgroups.MethodsCandidate variables were assembled from published criteria and expert opinion using consensus methodology. Data were collected from 47 rheumatology, dermatology, neurology, and pediatric clinics worldwide. Several statistical methods were utilized to derive the classification criteria.ResultsBased on data from 976 IIM patients (74% adults; 26% children) and 624 non‐IIM patients with mimicking conditions (82% adults; 18% children), new criteria were derived. Each item is assigned a weighted score. The total score corresponds to a probability of having IIM. Subclassification is performed using a classification tree. A probability cutoff of 55%, corresponding to a score of 5.5 (6.7 with muscle biopsy) “probable IIM,” had best sensitivity/specificity (87%/82% without biopsies, 93%/88% with biopsies) and is recommended as a minimum to classify a patient as having IIM. A probability of ≥90%, corresponding to a score of ≥7.5 (≥8.7 with muscle biopsy), corresponds to “definite IIM.” A probability of <50%, corresponding to a score of <5.3 (<6.5 with muscle biopsy), rules out IIM, leaving a probability of ≥50–<55% as “possible IIM.”ConclusionThe European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for IIM have been endorsed by international rheumatology, dermatology, neurology, and pediatric groups. They employ easily accessible and operationally defined elements, and have been partially validated. They allow classification of “definite,” “probable,” and “possible” IIM, in addition to the major subgroups of IIM, including juvenile IIM. They generally perform better than existing criteria.

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Arthritis and Rheumatology

Tập 69 Số 12

2271-2282

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