Performance evaluation of the 2022 ACR/EULAR criteria in the classification of ANCA-associated vasculitis

Autores: Ignacio López, Oscar Gut, María Selva Pino, Diego Marino, Gustavo Medina

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Introduction: The classification of ANCA-associated vasculitis (AAV) remains challenging. Existing criteria (ACR 1990, EMA 2007) have limitations, which led to the development of the 2022 ACR/EULAR criteria.

Objective: To evaluate the performance of these criteria compared with clinical diagnosis in a cohort of patients with AAV.

Methods: Analytical, cross-sectional, retrospective study. Patients with a diagnosis of AAV were evaluated using the ACR 1990 criteria, the EMA 2007 algorithm, and the 2022 ACR/EULAR criteria. Descriptive statistics were performed.

Results: A total of 115 patients were included, with a mean age of 49 years; diagnoses were GPA in 72 patients (63%), MPA in 27 (23%), and EGPA in 16 (14%).

Classification matching the clinical diagnosis was achieved in 30% of patients with ACR criteria, 69% with EMA, and 82% with ACR/EULAR. Applying ACR/EULAR criteria changed the observed distribution of AAV subtypes (MPA [49%] > GPA [39%] > EGPA [4%]).

Conclusion: The 2022 ACR/EULAR criteria demonstrated superior classification performance for AAV and significantly altered the observed frequencies of AAV subtypes within our cohort.