International expert consensus recommendations on standardised nomenclature of SSA/Ro (TROVE2/Ro60 and TRIM21/Ro52) autoantibodies in autoimmune diseases

Objectives: Autoantibodies directed against Telomerase RNA Ro y-RNAs and Vault RNAs Domain Family Member 2 (TROVE2)/Ro60 and Tripartite Motif 21 (TRIM21)/Ro52 are historically related to distinct SSA/Ro autoantigens. However, despite advances facilitating separate testing, these autoantibodies remain frequently confused resulting in a lack of clarity and precision in the literature. We conducted a systematic literature review to inform a Delphi process to achieve consensus on a clearer, harmonised nomenclature. Methods: The systematic review included primary publications in systemic lupus erythematosus (SLE) and Sjögren disease (SjD) published between January 1, 2000 and May 26, 2025 that mentioned testing for anti-TROVE2/Ro60 and/or anti-TRIM21/Ro52 autoantibodies. This analysis contributed to a Delphi consensus exercise proposing preferred nomenclature by a group of 17 international expert physicians and laboratorians. Results: Eight hundred ninety-one publications were included (301 SLE, 493 SjD, and 97 mixed SLE/SjD). Only 20.9% of studies tested and reported the autoantibodies separately; 75.0% did neither; and 4.2% tested but did not report them separately. There was considerable nomenclatural heterogeneity with 16 different terms used for anti-TROVE2/Ro60 and 11 terms for anti-TRIM21/Ro52 autoantibodies. After 2 rounds of voting, the Delphi panel reached a unanimous consensus on the terms anti-TROVE2/Ro60 and anti-TRIM21/Ro52 autoantibodies. Conclusions: The distinction of anti-TROVE2/Ro60 and anti-TRIM21/Ro52 autoantibodies was frequently unclear and imprecise throughout the literature. Their clinical associations also lacked clarity and precision. To clarify and strengthen the understanding of the clinical associations of these 2 important autoantibodies, the terms anti-TROVE2/Ro60 and anti-TRIM21/Ro52 are recommended for future studies and publications.