Screening Factors Identifying Those at Higher Risk for Transition to Classified SLE

An elderly man talking to his doctor about some recent test results.
Researchers identified useful screening factors for identifying at-risk individuals for follow-up rheumatologic assessment or inclusion in prospective studies.

Screening individuals with the systemic lupus erythematosus (SLE) portion of the Connective Tissue Disease Screening questionnaire may be an effective method for identifying patients at increased risk for disease transition, according to study results published in Lupus.

Researchers conducted a follow-up study of 436 individuals who had a family history of SLE, but failed to meet the American College of Rheumatology (ACR) classification of SLE at baseline. After a mean follow-up of 6.3 years post-baseline, 56 participants had transitioned to ACR-classified SLE. The investigators used generalized estimating equations to examine associations between various screening characteristics, such as Connective Tissue Disease Screening questionnaire SLE score, antinuclear antibody (ANA) positivity, or number of ACR criteria and transitioning to SLE.

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After analysis, the researchers found that Connective Tissue Disease Screening questionnaire SLE score categorization of possible or probable SLE, ANA positivity, and increased number of ACR criteria at baseline were individually associated with transition to classified SLE. In addition, individuals with established immunologic criteria and ANA positivity at baseline saw the greatest specificity and positive predictive value for transition to SLE.

“One limitation of the current study is that we do not know the exact time when the study participants transitioned to classified SLE,” the researchers wrote.

“This cohort could help further understand SLE and potential subtypes by identifying new biomarkers and by defining SLE by mechanisms and pathways rather than more subjective outcomes,” they concluded.


Young KA, Munroe ME, Guthridge JM, et al. Screening characteristics for enrichment of individuals at higher risk for transitioning to classified SLE [published online March 7, 2019]. Lupus. doi:10.1177/0961203319834675