Preliminary criteria for the classification of Sjögren's syndrome. Results of a prospective concerted action supported by the European community

Claudio Vitali, Stefano Bombardieri, Haralampos M. Moutsopoulos, Genesio Balestrieri, Walter Bencivelli, Robert M. Bernstein, Kirsten B. Bjerrum, Susanna Braga, Joaquin Coll, Salvatore De Vita, Alexandros A. Drosos, Michael Ehrenfeld, Pierre Y. Hatron, Elaine M. Hay, David A. Isenberg, Anne Janin, Joachim R. Kalden, Louis Kater, Yrjö T. Konttinen, Peter J. MaddisonRavinder N. Maini, Rolf Manthorpe, Olivier Meyer, Pierantonio Ostuni, Yvon Pennec, Jan U. Prause, Andrea Richards, Bernard Sauvezie, Morten Schiødt, Maria Sciuto, Crispian Scully, Yehuda Shoenfeld, Fotini N. Skopouli, Josef S. Smolen, Michael L. Snaith, Moshe Tishler, Silvano Todesco, Guido Valesini, Patrick J.W. Venables, Marie J. Wattiaux, Pierre Youinou

Research output: Contribution to journalArticlepeer-review


Objective. Different sets of diagnostic criteria have been proposed for Sjögren's syndrome (SS), but none have been validated with a large series of patients or in a multicenter study. We conducted the present study involving 26 centers from 12 countries (11 in Europe, plus Israel), with the goals of reaching a consensus on the diagnostic procedures for SS and defining classification criteria to be used in epidemiologic surveys and adopted by the scientific community. Methods. The study protocol was subdivided into two parts. For part I, questionnaires regarding both ocular and oral involvement were developed; they included 13 questions and 7 questions, respectively. For part II a limited set of diagnostic tests was selected, and the exact procedure to be followed in performing these tests was defined. Part I of the study ipcluded 240 patients with primary SS and 240 age‐ and sex‐matched controls. Two hundred forty‐six patients with primary SS, 201 with secondary SS, 113 with connective tissue diseases but without associated SS, and 133 control patients were studied in part II. Results. The study resulted in (a) the validation of a simple 6‐item questionnaire for determination of dry eyes and dry mouth, which showed good discriminant power between patients and controls, to be used in the initial screening for sicca syndrome; and (b) the definition of a new set of criteria for the classification of SS. The sensitivity and specificity of the criteria in correctly identifying patients with either the primary or the secondary variant of SS were also determined. Conclusion. Using the findings of this prospective multicenter European study, general agreement can be reached on the diagnostic procedures to be used for patients with SS. Final validation of the preliminary classification criteria for SS is underway.

Original languageEnglish
Pages (from-to)340-347
Number of pages8
JournalArthritis and Rheumatology
Issue number3
StatePublished - Mar 1993


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