The widespread adoption of testing for antineutrophil cytoplasmic antibodies (ANCA) in clinical practice exposed limitations to the 1990 ACR-endorsed classification criteria for vasculitis. That has led to the development of new classification criteria for the different forms of ANCA-associated vasculitis (AAV) — granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA).
These new criteria will be discussed during the symposium, ACR/EULAR Classification Criteria Update for ANCA-Associated Vasculitides in the Age of ANCA, on Wednesday, from 11:00 am – 12:00 pm, in Room 6 A. Symposium speakers include two of the lead investigators of the study to develop the new criteria — Ravi Suppiah, BHB, MBChB, PGDipSportMed, MD, FRACP, of Auckland Rheumatology and Sports Medicine in New Zealand, and Peter C. Grayson, MD, Head of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Vasculitis Translational Research Program in Bethesda, MD.
“The previous criteria were developed prior to the proliferation of ANCA testing, which forms the cornerstone of the new criteria,” Dr. Grayson said. “Additionally, microscopic polyangiitis was not yet recognized as a separate disease in 1990, another important reason the criteria needed to be updated.”
The ongoing project to develop the new criteria — the Diagnostic and Classification Criteria in Vasculitis Study (DCVAS) — includes data on more than 6,300 vasculitis patients from more than 100 sites worldwide. Draft criteria for GPA, the first set of criteria produced from the study, were presented in a session at last year’s ACR/ARHP Annual Meeting in Washington, D.C.
While the criteria are still a work in progress, Dr. Grayson said the feedback they received from that session was invaluable in refining the criteria and hopes to get similar feedback from this year’s audience.
“There is still some ongoing debate as to how best to split these diseases — whether to split them by clinical patterns of symptoms, or to split them by different types of ANCA autoantibodies,” Dr. Grayson said. “This session offers a great opportunity for us to present these new criteria to the broad rheumatology community so that we can again elicit a dialogue and discussion about them while they’re not yet set in stone.”