Comparison of the 2022 ACR/EULAR classification criteria with the 1990 ACR classification criteria for Takayasu arteritis
Keywords:
Takayasu arteritis, classification, sensitivity, specificityAbstract
Background and aim: Takayasu arteritis (TAK) mostly affects the aorta and its major branches and has an unclear origin. This study aimed to compare the 1990 American College of Rheumatology (ACR) classification criteria with the 2022 ACR/European League Against Rheumatism (EULAR) classification criteria for TAK on the basis of clinical data analysis of patients with TAK and other major vascular diseases.
Methods: This retrospective study was conducted in a single-center. The results included 34 TAK patients routinely followed at a tertiary rheumatology center from October 2017 to February 2024. The accuracy, sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and area under the receiver operating characteristic (ROC) curve (AUC) of the classification criteria were compared.
Results: The sensitivity (91.2%), specificity (90.9%), PPV (93.9%), NPV (86.9%), accuracy (94.4%) and AUC (0.983 (0.957-0.998)) of the 2022 ACR/EULAR classification criteria for TAK were higher than those of the 1990 ACR classification criteria for TAK (76.4%, 86.3%, 88.9%, 64.2% and 0.75, respectively), and the difference in AUC was statistically significant (0.860 (0.757-0.963), p < 0.001).
Conclusions: This study found that the 2022 ACR/EULAR classification criteria were more suitable for our patient population and had better classification performance than those in 1990, which can be supported in clinical practice. Our study needs to be supported by future multicenter prospective studies with larger patient numbers.
References
1. Pugh D, Karabayas M, Basu N, et al. Large-vessel vasculitis. Nat Rev Dis Primers 2022;7:93. doi: 10.1038/s41572-021-00327-5
2. Dabague J, Reyes PA. Takayasu arteritis in Mexico: a 38-year clinical perspective through literature review. Int J Cardiol 1996;54(Suppl):S103–S109. doi: 10.1016/S0167-5273(96)88779-1
3. Hall S, Barr W, Lie JT, et al. Takayasu arteritis. A study of 32 North American patients. Medicine (Baltimore) 1985;64:89–99.
4. Mason JC. Takayasu arteritis—advances in diagnosis and management. Nat Rev Rheumatol 2010;6:406–415. doi: 10.1038/nrrheum.2010.82
5. Serra R, Butrico L, Fugetto F, et al. Updates in pathophysiology, diagnosis and management of Takayasu arteritis. Ann Vasc Surg 2016;35:210–225. doi: 10.1016/j.avsg.2016.02.011
6. Arend WP, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 1990;33:1129–1134. doi: 10.1002/art.1780330811
7. Seeliger B, Sznajd J, Robson JC, et al. Are the 1990 American College of Rheumatology vasculitis classification criteria still valid? Rheumatology (Oxford) 2017;56:1154–1161. doi: 10.1093/rheumatology/kex075
8. Grayson PC, Ponte C, Suppiah R, et al. 2022 American College of Rheumatology/EULAR classification criteria for Takayasu arteritis. Ann Rheum Dis 2022;81:1654–1660. doi: 10.1136/ard-2022-223482
9. Alibaz-Öner F, Aydın SZ, Direskeneli H. Recent advances in Takayasu’s arteritis. Eur J Rheumatol 2015;2:24–30. doi: 10.5152/eurjrheumatol.2015.0060
10. Inder S. Immunophenotypic analysis of the aortic wall in Takayasu’s arteritis: involvement of lymphocytes, dendritic cells and granulocytes in immuno-inflammatory reactions. Cardiovasc Surg 2000;8:141–148. doi: 10.1016/S0967-2109(99)00100-3
11. Svensson C, Eriksson P, Zachrisson H. Vascular ultrasound for monitoring of inflammatory activity in Takayasu arteritis. Clin Physiol Funct Imaging 2020;40:37–45. doi: 10.1111/cpf.12601
12. Oura K, Yamaguchi Oura M, Itabashi R, Maeda T. Vascular imaging techniques to diagnose and monitor patients with Takayasu arteritis: a review of the literature. Diagnostics (Basel) 2021;11:1993. doi: 10.3390/diagnostics11111993
13. Cao R, Yao Z, Lin Z, Jiao P, Cui L. The performance of the 2022 ACR/EULAR classification criteria for Takayasu's arteritis as compared to the 1990 ACR classification criteria in a Chinese population. Clin Exp Med 2023;23(8):5291–5297. doi: 10.1007/s10238-023-01140-y
14. Cao RJ, Yao ZQ, Jiao PQ, Cui LG. [Article in Chinese]. Beijing Da Xue Xue Bao Yi Xue Ban 2022;54:1128–1133. doi: 10.19723/j.issn.1671-167X.2022.06.012
15. Tomelleri A, Padoan R, Kavadichanda CG, et al. Validation of the 2022 American College of Rheumatology/EULAR classification criteria for Takayasu arteritis. Rheumatology (Oxford) 2023;62:3427–3432. doi: 10.1093/rheumatology/kead161
16. Betrains A, Moreel L, Blockmans D. The 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis and Takayasu arteritis: comment on the articles by Ponte et al. and Grayson et al. Arthritis Rheumatol 2023;75:1074–1074. doi: 10.1002/art.42444
17. Ha JW, Pyo JY, Ahn SS, et al. Application of the 2022 ACR/EULAR criteria for Takayasu arteritis to previously diagnosed patients based on the 1990 ACR criteria. Mod Rheumatol 2024;34:1006–1012. doi: 10.1093/mr/road105
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