Challenges and Advances in SLE Autoantibody Detection and Interpretation

This review is an overview of key autoantibodies used in the diagnosis and management of SLE. Questions addressed are the advantages to but limitations of ANA testing and what are the key considerations in ordering ANA tests and then interpreting the ANA results. There is a progressive move towards • Solid-phase multi-analyte arrays with algorithmic analysis (SPMAAA) • Closing the seronegative gap in SLE • Harmonization of ANA testing As an approach to limiting morbidity and rising health care costs associated with SLE, the future of ANA testing should focus on making an accurate and actionable diagnosis of very early SLE. To achieve this goal, harmonization of autoantibody testing will be important.