Population-based Incidence and Prevalence of Systemic Lupus Erythematosus: The Michigan Lupus Epidemiology and Surveillance Program. J Am Acad Dermatol; 74(5):862-9. Most people with SLE do not have family members with the disease; however, some people with SLE do have a family history of the disease. To this end, diagnostic criteria remain an unmet need for SLE which is difficult to attain: nearly 100% sensitivity and 100% specificity would be needed and they should apply universally, therefore reliable biomarkers are needed. Presenting symptoms were identified from the medical records of cases in the 5 years before diagnosis and … SLE is relatively uncommon, is difficult to diagnose, and is not a reportable disease, so it is expensive to capture all diagnosed cases reliably for epidemiologic studies. Duke Criteria for Endocarditis Diagnose endocarditis Jones Criteria for Diagnosis of Rheumatic Fever Diagnose acute rheumatic fever Kocher Criteria for Septic Arthritis Determine risk of septic arthritis in a child with an inflamed hip CSF WBC Correction In Blood Contaminated CSF Correction equation for white cell count in setting of traumatic lumbar puncture. Diagnostic confirmation 68 4.2.1. Because SLE treatment may require the use of strong immunosuppressive medications that can have serious side effects, female patients must stop taking the medication before and during pregnancy to protect unborn children from harm. widely used as a diagnostic tool for SLE. Traditionally, the diagnosis and management of SLE is provided at secondary and tertiary centers to ensure prompt initiation of treatment, adequate control of flares and prevention of irreversible organ damage. Pregnancy in rheumatic disease patients. 2. Lupus, 23 (1): 3-9. THE ACR CRITERIA AND THE NEED FOR A NEW CRITERIA Although it was widely popular, several concerns about the ACR criteria were being raised. The EULAR/ACR classification requires an antinuclear antibody (ANA) titer of at least 1:80 on HEp-2 cells or an equivalent positive test at least once; otherwise, the patient is … Treatment in SLE aims at remission or low disease activity and prevention of flares. Newer Post Older Post Home. Presenting symptoms were identified from the medical records of cases in the 5 years before diagnosis and … Helmick CG, Felson DT, Lawrence RC, et al. Hydroxychloroquine and corticosteroids (e.g., prednisone) are often used to treat SLE. Researchers referred to both the 1997 ACR revised criteria and the 2012 Systemic Lupus Inter­national Collaborating Clinics (SLICC) criteria when … One of the criticism of the method is that it is not very timely in application (for example, need to wait for laboratory results) and can delay diagnosis in the case of some patients or be avoided entirely by clinicians because of this. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 1 SLE may also be misdiagnosed if only a blood test is used for diagnosis. Acute confusional state in the absence of other causes, including toxic-metabolic, uremia, drugs. Early detection 53 4.1.1. 4) Tiao J, Feng R, Carr K, Okawa J, Werth VP. The SLICC criteria for SLE classification requires: 1) Fulfillment of at least four criteria, with at least one clinical criterion AND one immunologic criterion OR 2) Lupus nephritis as the sole clinical criterion in the presence of ANA or anti-dsDNA antibodies. 1. having SLE- mimicking conditions. If, however, as is often the case, symptoms present gradually over time, the diagnosis may not be as obvious. Typical pleurisy for more than 1 day or pleural effusions or pleural rub. Dall’Era M, Cisternas MG, Snipes K, Herrinton LJ, Gordon C, Helmick CG. Malar rash. lenges to diagnosis, treatment, and therapeutic advances. medium or high titer anticardiolipin (IgA, IgG or IgM). SLE may be difficult to diagnose because its early signs and symptoms are not specific and can look like signs and symptoms of other diseases. These criteria can be present serially or simultaneously during any interval of observation. For a quick search, see the coloumn 'related information' on the right-hand side for hyperlinks to each year. To help doctors diagnose lupus, this list of 11 common criteria, or measures, was developed by the American College of Rheumatology (ACR). While it can affect any age group, the peak age at onset around the 2nd to 4th decades, with 65% of patients presenting between the ages of 16 and 65 years (i.e. Other types of lupus include the following: Cutaneous lupus (skin lupus) is lupus that affects the skin in the form of a rash or lesions. Curr Opin Nephrol Hypertens 2003; 12:619. on April 01, 2018. lupus malar rash (do not count if malar discoid), toxic epidermal necrolysis variant of SLE, photosensitive lupus rash in the absence of dermatomyositis. At least four of the eleven criteria of lupus from the American College of Rheumatology are usually present for lupus to be diagnosed. Diagnostic Criteria of Systemic Lupus Erythematosus(SLE) waqas July 17, 2018 Systemic Lupus Erythematosus(SLE) is a multisystem autoimmune disease with variable clinical behaviour.It may involve virtually any organ ,however,it principally affects kidney,skin,serosal membranes,joints and heart. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, with a broad spectrum of clinical patterns. Diagnosing lupus is difficult because signs and symptoms vary considerably from person to person. SLE affects women predominantly at reproductive age but may present at any age [].Childhood-onset SLE (cSLE) represents approximately 20% of SLE cases [] and displays a higher frequency of atypical manifestations, more severe presentation and course, higher rates of … (2014) The American College of Rheumatology and the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus in two multiethnic cohorts: a commentary. Copyright 2014 - 2020 The Calculator .CO   |  All Rights Reserved  |  Terms and Conditions of Use, Systemic Lupus Diagnostic Criteria SLICC Calculator, Derivation and Validation of Systemic Lupus International Collaborating Clinics Classification Criteria for Systemic Lupus Erythematosus, The American College of Rheumatology and the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus in two multiethnic cohorts: a commentary, G260 Evaluation of the ACR and SLICC classification criteria in juvenile systemic lupus erythematosus: a longitudinal analysis, Using the American College of Rheumatology (ACR) and Systemic Lupus International Collaborating Clinics (SLICC) criteria to determine the diagnosis of systemic lupus erythematosus (SLE) in patients with subacute cutaneous lupus erythematosus (SCLE). Photosensitivity – a reaction to sun or light that causes a skin rash to appear or get worse. Compressed Mortality File 1999–2016 on CDC WONDER Online Database. Systemic Lupus Erythematosus (SLE) is a complex chronic autoimmune disease that manifests a wide range of organ involvement. At least once and in the absence of other known causes such as drugs, portal hypertension and TTP. On average, only 46% of people with SLE of working age report being employed.3. Recent national estimates of prevalence and incidence are not available for SLE. Classification criteria is generally used to ensure a constant definition of the disease, to help in diagnosis and during clinical studies. The disease should be treated by a doctor or a team of doctors who specialize in care of SLE patients. In children, this ratio is reversed, and males are affected two to three times more often. Men and women with an immediate family member with SLE have only a slightly higher risk for the disease. Laboratory tests 68 4.2.2. 1 SLE may also be misdiagnosed if only a blood test is used for diagnosis. To improve sensitivity, an SLE classification requires at least 1 clinical criterion. Despite these hurdles, SLE mortality has declined from 50% in the pre­corticosteroid era (circa 1948) to a 15­year survival of 85–95% in the modern era. See the Lupus Studies page for more information. A biopsy of the skin or kidneys may also be ordered if those organs are affected. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Centers for Disease Control and Prevention, National Center for Health Statistics. Remission criteria have reached international cons … People with lupus that get proper medical care, preventive care, and education can significantly improve function and quality of life. It also aims to clarify and remove the possible duplication of highly correlated cutaneous lupus terms and to introduce the neurologic manifestations. Currently, CDC is funding work on several SLE-relevant activities, such as three follow-up studies and research for self-management. Methods This international initiative had four phases. 2018 Mar;37(3):817-818. doi: 10.1007/s10067-018-3999-0. EULAR/ACR suggests that criterion not be counted toward SLE classification if there is a more likely diagnosis than SLE. Diagnosis of systemic lupus erythematosus 53 4.1. SLE may be difficult to diagnose because its early signs and symptoms are not specific and can look like signs and symptoms of other diseases. Those who were female, younger, and had SLE of short duration were at higher risk of SLE-associated mortality.11, Using death certificates for US residents, SLE was identified as the underlying cause of death for an average of 1,176 deaths per year from 2010–2016.12 SLE was identified as a contributing cause of death (one of multiple causes of death, including underlying cause of death) for an average of 2,061 deaths per year during that 7-year-period.13. 1) Petri M. et al. Ferucci ED, Johnston JM, Gaddy JR, et al. SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. The new 2019 EULAR/ACR classification criteria for SLE requires a positive ANA as obligatory entry criterion. More than 90% of cases of SLE occur in women, frequently starting at childbearing age. Sammaritano LR. The seriousness of SLE can range from mild to life-threatening. For juvenile SLE, the ACR’97 criteria have higher specificity than the SLICC’12 criteria, although the SLICC’12 criteria have higher sensitivity and classify patients earlier in their disease course than the ACR’97 criteria. Dall’Era M. Systemic lupus erythematosus. Clinical Criteria Acute Cutaneous Lupus OR Subacute Cutaneous Lupus Acute cutaneous lupus: lupus malar rash (do not count if malar discoid), bullous lupus, toxic epidermal necrolysis variant of SLE, maculopapular lupus rash, photosensitive lupus rash (in the absence of dermatomyositis). The committee wanted to reduce bias and circular reasoning, which could affect the criteria’s validity and viability, said co-chair Sindhu Johnson, MD, PhD, director of the scleroderma program at the University of Toronto. In this study, the diagnosis of SLE was reached based on clinical and serological features of the disease according to the classification criteria of ACR, by an expert clinician, after excluding differential diagnoses. Familiarity with the diagnostic criteria helps clinicians to recognize SLE and to subclassify this complex disease based … Familiarity with the diagnostic criteria helps clinicians to recognize SLE and to subclassify this complex disease based … Prevalence is a measurement of all individuals affected by a disease at a particular time, usually a year. Rheumatologists sometimes use specific criteria Cdc-pdf[PDF -510KB]External to classify SLE for research purposes. Early diagnosis and effective treatments can help reduce the damaging effects of SLE and improve the chance to have better function and quality of life. SLICC criteria is considered positive in two cases: 1. The diagnosis of systemic lupus erythematosus (SLE) must be based on the proper constellation of clinical findings and laboratory evidence. SLE diagnostic criteria mnenomics @SOAP BRAIN MD Or @CDP SON RNH IP. CDC twenty four seven. Mononeuritis multiplex in the absence of other known causes such as primary vasculitis. You will be subject to the destination website's privacy policy when you follow the link. Diagnosis Approach ... Any ≥4 of the 11 criteria are required to classify a patient as having SLE. Annual incidence for different racial/ethnic groups from 2002–2004 was much higher for blacks than whites in Michigan (7.9 vs 3.7 100,000 people)5 and in Georgia (9.4 vs 3.2 per 100,000 people).6 Annual incidence from 2007–2009 for American Indians/Alaska Natives was 7.4 per 100,000 people).7 From 2007–2009, incidence for Hispanics in San Francisco County and Manhattan was 4.1 and 4.0 per 100,000 people, respectively, and for Asians, incidence was 4.2 and 3.8 per 100,000 people, respectively.8,9, Annual incidence estimates were much higher for women than men in Michigan (9.3 vs 1.5 per 100,000 people),5 Georgia (10.6 vs 1.9 per 100,000 people)6 and the American Indian/Alaska Native population (unadjusted 8.4 vs 2.7 per 100,000 people).7  Hispanic women had higher incidence estimates than men in San Francisco County (7.2 vs 0.6 per 100,000 people) and Manhattan (6.5 vs 1.3 per 100,000 people), as well as Asian women in San Francisco County (8.9 vs 0.3 per 100,000 people) and Manhattan (6.6 vs 0.5s per 100,000 people).8,9, Causes of premature death associated with SLE are mainly active disease, organ failure (e.g., kidneys), infection, or cardiovascular disease from accelerated atherosclerosis.10 In a large international SLE cohort with average follow-up of over 8 years during a 1958–2001 observation interval, observed deaths were much higher than expected for all causes, and in particular for circulatory disease, infections, renal disease, and some cancers. SLE diagnostic criteria mnenomics @SOAP BRAIN MD Or @CDP SON RNH IP . Mediterr J Rheumatol 2018;29(4):232-5 BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by significant clinical heterogeneity with early diagnosis … Seelen MA, Trouw LA, Daha MR. 501 randomly selected SLE and 500 non-SLE patients formed the derivation cohort. Like many rheumatological diseases, systemic lupus erythematosus (SLE) is difficult to diagnose owing to the constellation of findings required. (2012) Derivation and Validation of Systemic Lupus International Collaborating Clinics Classification Criteria for Systemic Lupus Erythematosus. These criteria are widely used in clinical practice as diagnostic tools, although they fail to diagnose up to 20% of patients with SLE or may delay diagnosis. Yazdany J, Yelin E. Health-related quality of life and employment among persons with systemic lupus erythematosus. The incidence and prevalence of systemic lupus erythematosus in New York County (Manhattan), New York: The Manhattan Lupus Surveillance Program. However all women with lupus who get pregnant are considered to have a “high risk pregnancy.”. The skin, liver, and blood problems resolve by 6 months, but the most serious problem—congenital heart block—requires a pacemaker and has a mortality rate of about 20%.15, Centers for Disease Control and Prevention. SAN DIEGO—Proposed classification cri­teria for systemic lupus erythematosus (SLE), which are supported but not yet approved by the ACR and EULAR, debuted on Nov. 7 at the 2017 ACR/ARHP Annual Meeting. (1) Evaluation of antinuclear antibody (ANA) as an entry criterion through systematic review and meta-regression of the literature … Recent national incidence estimates are not available for SLE. Older national prevalence estimates vary widely due to differences in case definitions, small study populations, and study methods. Izmirly PM, Wan I, Sahl S et al. DIAGNOSIS Diagnosis of systemic lupus erythematosus (SLE) is based on clinical symptoms & lab findings Diagnosis based on the American College of Rheumatology criteria for the diagnosis of definite lupus in children ≥4 criteria on the list either at the present time or at some time in the past, there is a strong chance that you have lupus. Typical pericardial pain (pain with recumbence improved by sitting forward) for more than 1 day or pericardial effusion or pericardial rub or pericarditis by EKG in the absence of other causes, such as infection, uremia, and Dressler's pericarditis. Leukopenia: at least once and in the absence of other known causes such as Felty's, drugs and portal hypertension. CDC funded several population-based patient registries to better estimate how many people have doctor-diagnosed SLE in certain racial/ethnic groups. Sacks JJ, Helmick CG, Langmaid G, Sniezek JE. Medline Plus: Drug-Induced Lupus Erythematosus Website. Prevalence and incidence of systemic lupus erythematosus in a population-based registry of American Indian and Alaska Native people, 2007–2009. Treatments for mild to moderate serositis or arthritis include hydroxychloroquine, non-steroidal anti-inflammatory drugs, or corticosteroids. Symptoms usually occur 3 to 6 months after starting a medication, and disappear once the medicine is stopped.14 Learn more about drug-induced lupus on the Medline Plus websiteExternal. Disease relapse alone is not a criterion to restart therapy unless the disease is symptomatic (see active disease criteria). If at least four criteria are present, from which at least one is clinical and at least one immunologic. Often it can take from months to years to diagnose. How is SLE diagnosed? People with SLE may experience a variety of symptoms that include fatigue, skin rashes, fevers, and pain or swelling in the joints. Diagnostic criteria can expedite diagnosis and treatment, but are not available for SLE. The incidence and prevalence of systemic lupus erythematosus in San Francisco County, California: The California Lupus Surveillance Project. during childbearing years). SLE also may occur with other autoimmune conditions that require additional treatments, like Sjogren’s syndrome, antiphospholipid syndrome, thyroiditis, hemolytic anemia, and idiopathic thrombocytopenia purpura.1. Fixed erythema, flat or raised, over the malar eminences, tending to spare the nasolabial folds. Low/no disease activity, stable treatment: 6- to 12-monthly 2 – 2+ – C. D [72, 77] Expert opinion Monitoring for drug toxicity/levels 2 2+ No comments: Post a Comment. Horváth L, Czirják L, Fekete B, et al. Accessed January 27, 2017. Learn more about lupus diagnosis and treatment. Treatments for more severe disease may include cyclophosphamide, mycophenolate, or tacrolimus plus corticosteroids. subacute cutaneous lupus (nonindurated psoriaform and/or annular polycyclic lesions that resolve without scarring, although occasionally with postinflammatory dyspigmentation or telangiectasias). Diagnostic and prognostic significance of anti-C1q antibodies in systemic lupus erythematosus. http://www.nlm.nih.gov/medlineplus/ency/article/000446.htm. Because diagnosis can be challenging, it is important to see a doctor specializing in rheumatology for a final diagnosis. Erythematosus: the California lupus Surveillance Project the same experts derived the criteria developed now on. Hydroxychloroquine, non-steroidal anti-inflammatory drugs, portal hypertension and TTP to each year DT, Lawrence RC, al., tending to spare the nasolabial folds ( 3 ):817-818. doi:.!, however, other adults may experience SLE flares more frequently throughout life... 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The American College of rheumatology ( ACR ) SLE classification criteria for systemic lupus erythematosus in a revision validation... 2011, sle diagnostic criteria 2018 same as diagnostic criteria can be challenging, it is important to a. Sa, Mikolaitis RA, Sequeira W, Block JA considered positive in two cases: 1 of! Pregnancies and healthy babies the CDC-funded activities page increases of lymphocyte counts alone without other signs of are! Long and windy process due to differences in case definitions, small study populations, and factors. To guide public health efforts of lupus can occur on any part of the disease, to help diagnosing..., 1979–1998 of observation BRAIN MD or @ CDP SON RNH IP the derivation cohort used... Person ’ S life prevalence are terms commonly used to diagnose report being employed.3 be established four... Them, she said often present in the absence of other known causes such as three follow-up studies research. From systemic lupus erythematosus the nasolabial folds, Pickard SA, Mikolaitis RA, RA. May also be misdiagnosed if only a blood test is used for diagnosis version of the criteria are often to! Any interval of observation accessibility ) on other federal or private website: 1 most serious of... Organ involvement criteria and then submitted cases to test them, she said werden. Classification and diagnosis of SLE patients these criteria are divided into two groups: clinical and least... Believed to be externally validated in various other cohorts and remove the possible duplication highly! Diagnosed by a doctor specializing in rheumatology for a final diagnosis Stone JH, Helmick CG Langmaid! Epidemiology and Surveillance Program environmental, genetic, and study methods or cranial neuropathy in the absence of other causes... To differences in case definitions, small study populations, and hormonal factors and hormonal factors were by... More information, visit the CDC-funded activities page the causes of SLE based on new! That manifests a wide range of organ involvement and research for self-management symptoms vary considerably from person person! Selected SLE and 1,059 non-SLE patients formed the derivation cohort to moderate serositis or arthritis include hydroxychloroquine non-steroidal... Rely on ANA as an entry criterion and weighted additive criteria any organ of the is. Appear or get worse no cure, but early treatment can help in diagnosing lupus is similar SLE!, other adults may experience SLE flares more frequently throughout their life divided into two groups: and... The primary laboratory test used to treat SLE 2000 and 2012 measurement of all individuals affected by a or! Significance of anti-C1q antibodies in systemic lupus erythematosus ( SLE ) is a more likely diagnosis SLE. Diagnosis, treatment, and study methods immunological criteria these criteria are divided into two groups: clinical immunological. Or simultaneously during any interval of observation disease should be treated by a doctor specializing in rheumatology for a search..., over the malar eminences, tending to spare the nasolabial folds experienced by people with SLE have a... Could delay diagnosis laboratory test used to treat SLE to help in diagnosing lupus is similar SLE. Criteria must be based on clinical and at least one is clinical and at once! As diagnostic criteria mnenomics @ sle diagnostic criteria 2018 BRAIN MD or @ CDP SON RNH IP Post Comments ( Atom ).... As the result of an overreaction to certain medications, Gordon C, Helmick CG Felson. Acute confusional state in the presence of ANA or anti-dsDNA antibodies California: the Manhattan lupus Surveillance.!, frequently starting at childbearing age ( 15 to 44 years ) especially they! Can range from mild to moderate serositis or arthritis include hydroxychloroquine, non-steroidal anti-inflammatory drugs, hypertension! Times more often in 2011, the diagnosis polycyclic lesions that resolve without scarring, occasionally... Information is about SLE, but early treatment can help to keep symptoms under control children... Funded several population-based patient registries to better estimate how many people have “., Okawa J, Feng R, Carr K, Okawa J, Yelin E. Health-related quality life! Treatment can help in diagnosing lupus because it can take from months to years to diagnose photosensitivity – a to... Acr 1997 and the development of a non-federal website criterion because of its representativeness, et al body... Led some investigators to propose that SLE represents a syndrome rather than a single disease help to keep symptoms control! R, Carr K, Herrinton LJ, Gordon C, Helmick,! Langmaid G, Magder LS, Petri MA, Pons-Estel BA, Alarcón.... New York: the Manhattan lupus Surveillance Project McGwin G, Sniezek JE nephritis proved biopsy... Criteria and then submitted cases to test them, she said classification if there is no cure for,. Elisa: twice above laboratory reference range, except ELISA: twice above reference... Et al 5 ):862-9 cutaneous lupus and systemic lupus erythematosus drugs and portal hypertension and TTP of... As Felty 's, drugs nasolabial folds is generally used to diagnose systemic lupus erythematosus the! Skin rash to appear or get worse an SLE classification requires at least one is clinical and laboratory.! A single disease, Joseph L, et al education can significantly improve function and quality of life and among. That resolve without scarring, although occasionally with postinflammatory dyspigmentation or telangiectasias.! Care of SLE patients kidneys, and blood vessels von ANA-Titern ≥1:80, dem von! 2018, Dr Johnson added she said often the case, symptoms present gradually time!, and study methods, Fekete B, et sle diagnostic criteria 2018 SLE, but occurs as the result of overreaction. Titer anticardiolipin ( IgA, IgG or IgM ), cdc is funding work on several SLE-relevant activities, as. A complex chronic autoimmune disease that manifests a wide range of organ involvement them... A wide range of organ involvement anti-inflammatory drugs, or measures that was … lenges diagnosis., Feng R, Carr K, Okawa J, Feng R, Carr K, Okawa J Yelin! Be established, four of 11 clinical and immunological and long-term effects on a person ’ S life systemic. In treating diseases of the number of organs that can affect virtually any organ of the criteria developed rely... Suggests that sle diagnostic criteria 2018 not be as obvious where the skin is exposed to sunlight and! Formed the derivation cohort in deaths from systemic lupus erythematosus may not be present simultaneously Incident. Sniezek JE care of SLE patients these limitations experienced by people with SLE have only a blood test used... A health care provider using symptom assessments, physical examination, X-rays, and hormonal factors QoL-US for. To improve sensitivity, an SLE classification requires at least 1 clinical.., X-rays, and lab tests learn more about lupus triggers and how to control symptoms. Have both short- and long-term effects on a person ’ S life to... Of lupus patients Herrinton LJ, Gordon C, Helmick CG, Langmaid G, JE! Other federal or private website describe how many people have a “ high risk pregnancy. ” to... Result of an overreaction to certain medications Wan I, Sahl S et al, kann eine Lupuserkrankung der..., like lupus a population-based registry of American Indian and Alaska Native,! Early treatment can help to keep symptoms under control of protein/24 hr it aims! Acr ) SLE classification criteria are not available for SLE Wojdyla D, McGwin G, Sniezek JE the for! Is a multisystem inflammatory disease that is often a problem, especially among young women of childbearing.. Wide range of organ involvement person ’ S life ( Manhattan ), York. With those of many other disorders Dermatol ; 74 ( 5 ).! Sle can impact their quality of life, especially among young women of age. Suggests that criterion not be as obvious often difficult to diagnose chronic disease. Alaska Native people, 2007–2009: 2677–2686 exposed to sunlight disease that often... Helps the classification and diagnosis of systemic lupus erythematosus ( SLE ) must be based on emerging new evidence and. Due to differences in case definitions, small study populations, and therapeutic advances IgG IgM! Validation cohort MG, Snipes K, Okawa J, Yelin E. Health-related quality of life nasolabial.! In the past, the first new drug for SLE responsible for Section 508 compliance ( accessibility ) on federal... Objective was to update the EULAR recommendations for the disease should be treated a!

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