New ACR/EULAR Criteria Help ID SSc Among Raynaud’s Patients

Park JS, Park MC, Song JJ,et al., Application of the 2013 ACR/EULAR classification criteria for systemic sclerosis to patients with Raynaud's phenomenon.Arthritis Res Ther. 2015;1777. doi:10.1186/s13075-015-0594-5

Systemic sclerosis (SSc, scleroderma) often goes hand in hand with Raynaud’s phenomenon (RP) and RP may also be an early sign of SSc in some patients. New criteria for SSc may help identify those patients, say these researchers.

The 2013 criteria developed by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) name Raynaud’s as one of the early clinical features of SSc.

The current study of RP patients finds more than 26% actually have SSc, but would have been missed because they did not meet the 1980 ACR/EULAR criteria for the disease.

The study compares 64 consecutive patients (n=58 women, 6 men) with autoimmune diseases evaluated for RP at the Yonsei University Severance Hospital in Seoul, Korea, with 60 patients (n=52 women, 8 men) classified with SSc according to the 1980 criteria at the same institution.

The researchers applied the 2013 ACR/EULAR SSc classification criteria to both groups.

Among the Raynaud’s patients, 17 (all of them women) were reclassified as having SSc according to the new criteria. They’d all had RP for more than three years. All of those previously identified as having SSc also met the new criteria.

Among other early signs of SSc, all 17 reclassified patients show abnormal nailfold capillaries, a majority had puffy fingers, and more than a third had sclerodactyly.

They also show digital pitting scars, tip ulcers, telangiectasia, and anti-centromere antibodies (an antibody associated with SSc) more frequently than RP patients who were not reclassified.

There were no significant age or sex differences between those reclassified with SSc and those not reclassified.

“When patients visit the clinic, presenting with RP, we suggest that physicians should apply the new classification criteria for SSc, especially in patients who present with sclerodactyly or telangiectasia or who have anti-centromere antibody,” the researchers conclude.