Evidence map›Paper›PMID 39348240›Full record

ArticleACR open rheumatology2024

Evaluation of Progression From Preclinical to Systemic Autoimmune Rheumatic Disease: Novel Use of the European Alliance of Associations for Rheumatology/American College of Rheumatology Systemic Lupus Erythematosus Classification Criteria as an Outcome Measure.

Sindhu R Johnson, Hana Alahmari, Dennisse Bonilla, Zareen Ahmad, Arthur Bookman, Linda T Hiraki, Earl Silverman, Zahi Touma, Mohammad Movahedi, Joan E Wither

Abstract read
In one paragraph

Article in ACR open rheumatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sindhu R JohnsonToronto Western Hospital, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0003-0591-2976
Hana AlahmariSchroeder Arthritis Institute, Toronto Western Hospital and Mount Sinai Hospital, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0002-0833-9274
Dennisse BonillaDivision of Rheumatology, department of Medicine, King Khalid University, Abha, Saudi Arabia.
Zareen AhmadMount Sinai Hospital, Toronto, Ontario, Canada.
Arthur BookmanUniversity Health Network and University of Toronto, Toronto, Canada.
Linda T HirakiSick Children's Hospital and University of Toronto, Toronto, Canada.ORCID https://orcid.org/0000-0002-6690-8148
Earl SilvermanSick Children's Hospital and University of Toronto, Toronto, Canada.
Zahi ToumaSchroeder Arthritis Institute, Toronto Western Hospital and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0001-5177-2076
Mohammad MovahediInstitute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.
Joan E WitherUniversity of Toronto, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, and University of Toronto, Toronto, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveOur objective was to evaluate the development of a systemic autoimmune rheumatic disease (SARD) in undifferentiated and asymptomatic individuals with antinuclear antibodies (ANAs). We comparatively evaluated those who did and did not develop a SARD and fulfillment of classification criteria.

methodsWe conducted a cohort study of undifferentiated and asymptomatic patients with ANAs who were assessed for the development of a SARD. The primary outcome was a diagnosis of a SARD over a two-year period. We assessed fulfillment of classification criteria. Risk ratios (RRs) were used to evaluate differences among those who did and did not progress to a SARD.

resultsWe evaluated 207 asymptomatic ANA-positive or undifferentiated patients, of whom 23 (11%) progressed to a SARD, whereas 187 (89%) did not progress. Progressors developed systemic lupus erythematosus (SLE) (n = 11 [48%]), Sjögren disease (n = 5 [22%]), systemic sclerosis (n = 3 [13%]), rheumatoid arthritis (n = 1 [4%]), and from ANA-positive to undifferentiated connective tissue disease (n = 3 [13%]). Fever (RR 0.89, 95% confidence interval [CI] 0.8-0.93) and antiphospholipid antibodies (RR 0.89, 95% CI 0.87-0.93) occurred less frequently, whereas arthritis (RR 1.74, 95% CI 1.20-2.55) occurred more frequently in progressors. Progressors to SLE had arthritis (91%), whereas none developed delirium, psychosis, or nephritis. Among patients with SLE, 100% fulfilled the EULAR/American College of Rheumatology (ACR) SLE criteria (sensitivity 91.7%, specificity 100%), whereas 73% fulfilled the 1997 ACR SLE criteria (sensitivity 81.8%, specificity 98.9%).

conclusionMost undifferentiated/asymptomatic individuals with ANA do not progress to a SARD over a two-year period. SLE progressors appear to have mild disease in the short term. The EULAR/ACR SLE criteria have improved ability to identify those who develop SLE.

Identifiers

PMID39348240
PMCPMC11638143

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.