Article Text

Download PDFPDF

Original research
Applying the 2019 EULAR/ACR lupus criteria to patients from an established cohort: a Latin American perspective
  1. Guillermo J Pons-Estel1,2,
  2. Manuel Francisco Ugarte-Gil3,4,
  3. Guillermina B Harvey5,
  4. Daniel Wojdyla5,
  5. Rosana Quintana1,2,
  6. Verónica Saurit6,
  7. Enrique R Soriano7,
  8. Eloisa Bonfa8,
  9. Loreto Massardo9,
  10. Mario Cardiel10,
  11. Luis M Vila11,
  12. Russell Griffin12,
  13. Bernardo A Pons-Estel1 and
  14. Graciela S Alarcón13
  15. On behalf of the Grupo Latino Americano De Estudio de Lupus (GLADEL)
  1. 1Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Santa Fe, Argentina
  2. 2Servicio de Reumatología, Hospital Provincial de Rosario, Rosario, Santa Fe, Argentina
  3. 3School of Medicine, Universidad Cientifica del Sur, Lima, Peru
  4. 4Servicio de Reumatología, Hospital Nacional Guillermo Almenara Irigoyen. EsSalud, Lima, Peru
  5. 5Escuela de Estadística, Facultad de Ciencias Económicas y Estadística, Universidad Nacional de Rosario, Rosario, Argentina
  6. 6Servicio de Reumatología, Hospital Privado Universitario de Córdoba, Córdoba, Córdoba, Argentina
  7. 7Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
  8. 8Rheumatology, Faculdade de Medicina da Universidade de São Paulo-USP, São Paulo, SP, Brazil
  9. 9Centro de Biología Celular y Biomedicina, Universidad San Sebastián, Santiago, Chile
  10. 10Centro de Investigacion Clinica de Morelia, Morelia, Michoacán, Mexico
  11. 11Division of Rheumatology, University of Puerto Rico, San Juan, San Juan, Puerto Rico
  12. 12Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
  13. 13Department of Medicine, Division of Clinical Immunology and Rheumatology, School of Medicine, The University of Alabama, Birmingham, Alabama, USA
  1. Correspondence to Dr Guillermo J Pons-Estel; gponsestel{at}


Objective To evaluate the performance of the 2019 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) systemic lupus erythematosus (SLE) criteria in terms of earlier patients’ classification in comparison to the 1982/1997 ACR or the 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria.

Materials and methods Patients from a Latin America, multiethnic, multicentre cohort, where SLE was defined using the physicians’ diagnosis, were included. To calculate the sensitivity of the 2019 EULAR/ACR criteria, the 1982/1997 ACR criteria were considered the gold standard. Additionally, comparison of the 1982/1997 ACR criteria and the 2012 SLICC criteria with the 2019 EULAR/ACR criteria was performed.

Results The sensitivity of the 2019 EULAR/ACR criteria when compared with the 1982/1997 ACR criteria as the gold standard was 91.3%. This new set of criteria allowed an earlier SLE patient classification in 7.4% (mean 0.67 years) and 0.6% (mean 1.47 years) than the 1982/1997 ACR and the 2012 SLICC criteria, respectively. Patients accruing the 2019 EULAR/ACR earlier than the 1982/1997 ACR criteria were more likely to have high anti-dsDNA titres; those accruing them later were less likely to have mucocutaneous and joint manifestations; this was not observed when comparing them with the 2012 SLICC criteria.

Conclusions The 2019 EULAR/ACR criteria classified earlier only a small proportion of Latin America patients than with the two other criteria sets in real-life clinical practice scenarios. Further studies in different patient populations are needed before these new criteria are adopted worldwide.

  • systemic lupus erythematosus
  • epidemiology
  • autoimmune diseases

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • Twitter @gponsestel, @mugartegil

  • GJP-E and MFU-G contributed equally.

  • Contributors All authors were involved in drafting or critically revising this manuscript for important intellectual content, and all authors approved the final version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval At the time this data was collected was not mandatory to sign an informed consent. The study was conducted according to the Declaration of Helsinki for research in humans, and following local institutional review board regulations.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplementary information.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.