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Classification Criteria for ANCA Associated Vasculitis – Ready for Prime Time?

Rathmann, Jens LU orcid and Mohammad, Aladdin LU (2024) In Current Rheumatology Reports 26. p.332-342
Abstract
Purpose of Review
This review aims to summarize the evolution and recent developments in the classification of ANCA associated vasculitis (AAV) and to summarize evaluations of the 2022 ACR/EULAR classification criteria of AAV in several cohorts.

Recent Findings
The classification of AAV has been a field of controversy for some time. The parallel existence of classification criteria and disease definitions produced some overlap in classification, leading to challenges when comparing different cohorts. The 2022 ACR/EULAR classification criteria derived from the largest study ever conducted in vasculitis account for significant changes in vasculitis classification with the integration of ANCA and modern imaging. These... (More)
Purpose of Review
This review aims to summarize the evolution and recent developments in the classification of ANCA associated vasculitis (AAV) and to summarize evaluations of the 2022 ACR/EULAR classification criteria of AAV in several cohorts.

Recent Findings
The classification of AAV has been a field of controversy for some time. The parallel existence of classification criteria and disease definitions produced some overlap in classification, leading to challenges when comparing different cohorts. The 2022 ACR/EULAR classification criteria derived from the largest study ever conducted in vasculitis account for significant changes in vasculitis classification with the integration of ANCA and modern imaging. These criteria show good performance compared to previous ones but also raise questions as ANCA serotypes have substantial impact on classification. In addition, there are some discrepancies with earlier agreed histopathological features of AAV disease phenotypes.

Summary
During the last 35 years, several sets of classification criteria have evolved to facilitate epidemiologic studies and clinical trials in AAV. While some of these criteria have been in use for many years, they were criticized due to either not using ANCA or not integrating surrogate markers for vasculitis but also due to overlapping when used in parallel. The long-awaited new ACR/EULAR criteria for AAV were published in 2022 and are the result of a large international study, introducing for the first time ANCA and modern imaging in the classification of AAV. Though the criteria show good performance, they bring several other challenges with practical application. (Less)
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author
and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Small vessel vasculitis, antineutrophil cytoplasmic antibodies, Classification, Granulomatosis with polyangiitis, Microscopic polyangiitis
in
Current Rheumatology Reports
volume
26
pages
332 - 342
publisher
Current Science, Inc.
external identifiers
  • pmid:38913291
  • scopus:85196761672
ISSN
1523-3774
DOI
10.1007/s11926-024-01154-9
language
English
LU publication?
yes
id
f4a6ccc3-b771-4f8e-87b3-2b82487b8120
date added to LUP
2024-08-19 16:27:42
date last changed
2024-08-21 11:59:45
@article{f4a6ccc3-b771-4f8e-87b3-2b82487b8120,
  abstract     = {{Purpose of Review<br/>This review aims to summarize the evolution and recent developments in the classification of ANCA associated vasculitis (AAV) and to summarize evaluations of the 2022 ACR/EULAR classification criteria of AAV in several cohorts.<br/><br/>Recent Findings<br/>The classification of AAV has been a field of controversy for some time. The parallel existence of classification criteria and disease definitions produced some overlap in classification, leading to challenges when comparing different cohorts. The 2022 ACR/EULAR classification criteria derived from the largest study ever conducted in vasculitis account for significant changes in vasculitis classification with the integration of ANCA and modern imaging. These criteria show good performance compared to previous ones but also raise questions as ANCA serotypes have substantial impact on classification. In addition, there are some discrepancies with earlier agreed histopathological features of AAV disease phenotypes.<br/><br/>Summary<br/>During the last 35 years, several sets of classification criteria have evolved to facilitate epidemiologic studies and clinical trials in AAV. While some of these criteria have been in use for many years, they were criticized due to either not using ANCA or not integrating surrogate markers for vasculitis but also due to overlapping when used in parallel. The long-awaited new ACR/EULAR criteria for AAV were published in 2022 and are the result of a large international study, introducing for the first time ANCA and modern imaging in the classification of AAV. Though the criteria show good performance, they bring several other challenges with practical application.}},
  author       = {{Rathmann, Jens and Mohammad, Aladdin}},
  issn         = {{1523-3774}},
  keywords     = {{Small vessel vasculitis; antineutrophil cytoplasmic antibodies; Classification; Granulomatosis with polyangiitis; Microscopic polyangiitis}},
  language     = {{eng}},
  month        = {{06}},
  pages        = {{332--342}},
  publisher    = {{Current Science, Inc.}},
  series       = {{Current Rheumatology Reports}},
  title        = {{Classification Criteria for ANCA Associated Vasculitis – Ready for Prime Time?}},
  url          = {{http://dx.doi.org/10.1007/s11926-024-01154-9}},
  doi          = {{10.1007/s11926-024-01154-9}},
  volume       = {{26}},
  year         = {{2024}},
}