Abstract:
We read with interest the report by Whittall Garcia et al1 on ominosity, a proxy for the threatening role of the 2019 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) Systemic Lupus Erythematosus (SLE) Classification Criteria Score; in this article, the authors propose that a score of ≥20 predicts disease severity within 5 years of disease diagnosis. We would like to congratulate the authors for their novel approach in using these criteria as predictors. In their study, the authors included two cohorts: (1) a single-centre inception cohort that included 867 patients with SLE with a mean disease duration, from diagnosis to the first visit of 0.2 years in which they developed the concept, and (2) a validation cohort that included 807 patients from the multiethnic, multinational Systemic Lupus International Collaborating Clinics (SLICC) group cohort. They showed that achieving 20 or more points (threshold based on receiver operating characteristic (ROC) analysis) on the 2019 EULAR/ACR criteria at diagnosis was associated with a higher adjusted mean SLE Disease Activity Index 2000 scores, flares and the use of immunosuppressive drugs, while this threshold was also associated with having lower probability of achieving remission within the first 5 years after diagnosis...