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2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative.

Abstract

OBJECTIVE

The 1987 American College of Rheumatology (ACR; formerly the American Rheumatism Association) classification criteria for rheumatoid arthritis (RA) have been criticised for their lack of sensitivity in early disease. This work was undertaken to develop new classification criteria for RA.

METHODS

A joint working group from the ACR and the European League Against Rheumatism developed, in three phases, a new approach to classifying RA. The work focused on identifying, among patients newly presenting with undifferentiated inflammatory synovitis, factors that best discriminated between those who were and those who were not at high risk for persistent and/or erosive disease--this being the appropriate current paradigm underlying the disease construct 'RA'.

RESULTS

In the new criteria set, classification as 'definite RA' is based on the confirmed presence of synovitis in at least one joint, absence of an alternative diagnosis better explaining the synovitis, and achievement of a total score of 6 or greater (of a possible 10) from the individual scores in four domains: number and site of involved joints (range 0-5), serological abnormality (range 0-3), elevated acute-phase response (range 0-1) and symptom duration (two levels; range 0-1).

CONCLUSION

This new classification system redefines the current paradigm of RA by focusing on features at earlier stages of disease that are associated with persistent and/or erosive disease, rather than defining the disease by its late-stage features. This will refocus attention on the important need for earlier diagnosis and institution of effective disease-suppressing therapy to prevent or minimise the occurrence of the undesirable sequelae that currently comprise the paradigm underlying the disease construct 'RA'.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Arthritis Research UK, Copeman House, Chesterfield, UK. a.silman@arthritisresearchuk.org

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    Source

    Annals of the rheumatic diseases 69:9 2010 Sep pg 1580-8

    MeSH

    Acute-Phase Reaction
    Algorithms
    Arthritis, Rheumatoid
    Early Diagnosis
    Europe
    Humans
    International Cooperation
    North America
    Severity of Illness Index
    Societies, Medical
    Synovitis
    Terminology as Topic
    Time Factors

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    20699241

    Citation

    Aletaha, Daniel, et al. "2010 Rheumatoid Arthritis Classification Criteria: an American College of Rheumatology/European League Against Rheumatism Collaborative Initiative." Annals of the Rheumatic Diseases, vol. 69, no. 9, 2010, pp. 1580-8.
    Aletaha D, Neogi T, Silman AJ, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010;69(9):1580-8.
    Aletaha, D., Neogi, T., Silman, A. J., Funovits, J., Felson, D. T., Bingham, C. O., ... Hawker, G. (2010). 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Annals of the Rheumatic Diseases, 69(9), pp. 1580-8. doi:10.1136/ard.2010.138461.
    Aletaha D, et al. 2010 Rheumatoid Arthritis Classification Criteria: an American College of Rheumatology/European League Against Rheumatism Collaborative Initiative. Ann Rheum Dis. 2010;69(9):1580-8. PubMed PMID: 20699241.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. AU - Aletaha,Daniel, AU - Neogi,Tuhina, AU - Silman,Alan J, AU - Funovits,Julia, AU - Felson,David T, AU - Bingham,Clifton O,3rd AU - Birnbaum,Neal S, AU - Burmester,Gerd R, AU - Bykerk,Vivian P, AU - Cohen,Marc D, AU - Combe,Bernard, AU - Costenbader,Karen H, AU - Dougados,Maxime, AU - Emery,Paul, AU - Ferraccioli,Gianfranco, AU - Hazes,Johanna M W, AU - Hobbs,Kathryn, AU - Huizinga,Tom W J, AU - Kavanaugh,Arthur, AU - Kay,Jonathan, AU - Kvien,Tore K, AU - Laing,Timothy, AU - Mease,Philip, AU - Ménard,Henri A, AU - Moreland,Larry W, AU - Naden,Raymond L, AU - Pincus,Theodore, AU - Smolen,Josef S, AU - Stanislawska-Biernat,Ewa, AU - Symmons,Deborah, AU - Tak,Paul P, AU - Upchurch,Katherine S, AU - Vencovsky,Jirí, AU - Wolfe,Frederick, AU - Hawker,Gillian, PY - 2010/8/12/entrez PY - 2010/8/12/pubmed PY - 2010/9/9/medline SP - 1580 EP - 8 JF - Annals of the rheumatic diseases JO - Ann. Rheum. Dis. VL - 69 IS - 9 N2 - OBJECTIVE: The 1987 American College of Rheumatology (ACR; formerly the American Rheumatism Association) classification criteria for rheumatoid arthritis (RA) have been criticised for their lack of sensitivity in early disease. This work was undertaken to develop new classification criteria for RA. METHODS: A joint working group from the ACR and the European League Against Rheumatism developed, in three phases, a new approach to classifying RA. The work focused on identifying, among patients newly presenting with undifferentiated inflammatory synovitis, factors that best discriminated between those who were and those who were not at high risk for persistent and/or erosive disease--this being the appropriate current paradigm underlying the disease construct 'RA'. RESULTS: In the new criteria set, classification as 'definite RA' is based on the confirmed presence of synovitis in at least one joint, absence of an alternative diagnosis better explaining the synovitis, and achievement of a total score of 6 or greater (of a possible 10) from the individual scores in four domains: number and site of involved joints (range 0-5), serological abnormality (range 0-3), elevated acute-phase response (range 0-1) and symptom duration (two levels; range 0-1). CONCLUSION: This new classification system redefines the current paradigm of RA by focusing on features at earlier stages of disease that are associated with persistent and/or erosive disease, rather than defining the disease by its late-stage features. This will refocus attention on the important need for earlier diagnosis and institution of effective disease-suppressing therapy to prevent or minimise the occurrence of the undesirable sequelae that currently comprise the paradigm underlying the disease construct 'RA'. SN - 1468-2060 UR - https://www.unboundmedicine.com/medline/citation/20699241/full_citation L2 - http://ard.bmj.com/cgi/pmidlookup?view=long&pmid=20699241 DB - PRIME DP - Unbound Medicine ER -