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The need to better classify and diagnose early and very early rheumatoid arthritis.
J Rheumatol. 2012 Feb; 39(2):212-7.JR

Abstract

Early rheumatoid arthritis (RA) and very early RA are major targets of research and clinical practice. Remission has become a realistic goal in the management of RA, particularly in early disease. The 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RA classification criteria, the EULAR treatment recommendations for RA, and the EULAR recommendations for the management of early arthritis focus on early disease and translate the knowledge related to early RA into classification and management. Nevertheless, there is a need for further improvement and progress. Results from 6 recent studies are summarized, evaluating the performance of the 2010 ACR/EULAR RA classification criteria. The data show a significant risk of misclassification, and highlight that overdiagnosis and underdiagnosis may become important issues if the criteria recommend synthetic and biological disease-modifying antirheumatic drugs. Therefore, some considerations are presented on how the current problems and limitations could be overcome in clinical practice and future research. A consensus is needed to better define the early phase of RA and differentiate from other early arthritis. The possible effect of misclassification on spontaneous and drug-induced remission of early and very early RA awaits further elucidation. Such research will eventually lead to more reliable diagnostic and classification criteria for new-onset RA.

Authors+Show Affiliations

Hannover Medical School, Hannover, Germany. henningzeidler@aol.com

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

22174195

Citation

Zeidler, Henning. "The Need to Better Classify and Diagnose Early and Very Early Rheumatoid Arthritis." The Journal of Rheumatology, vol. 39, no. 2, 2012, pp. 212-7.
Zeidler H. The need to better classify and diagnose early and very early rheumatoid arthritis. J Rheumatol. 2012;39(2):212-7.
Zeidler, H. (2012). The need to better classify and diagnose early and very early rheumatoid arthritis. The Journal of Rheumatology, 39(2), 212-7. https://doi.org/10.3899/jrheum.110967
Zeidler H. The Need to Better Classify and Diagnose Early and Very Early Rheumatoid Arthritis. J Rheumatol. 2012;39(2):212-7. PubMed PMID: 22174195.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The need to better classify and diagnose early and very early rheumatoid arthritis. A1 - Zeidler,Henning, Y1 - 2011/12/15/ PY - 2011/12/17/entrez PY - 2011/12/17/pubmed PY - 2012/6/6/medline SP - 212 EP - 7 JF - The Journal of rheumatology JO - J Rheumatol VL - 39 IS - 2 N2 - Early rheumatoid arthritis (RA) and very early RA are major targets of research and clinical practice. Remission has become a realistic goal in the management of RA, particularly in early disease. The 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RA classification criteria, the EULAR treatment recommendations for RA, and the EULAR recommendations for the management of early arthritis focus on early disease and translate the knowledge related to early RA into classification and management. Nevertheless, there is a need for further improvement and progress. Results from 6 recent studies are summarized, evaluating the performance of the 2010 ACR/EULAR RA classification criteria. The data show a significant risk of misclassification, and highlight that overdiagnosis and underdiagnosis may become important issues if the criteria recommend synthetic and biological disease-modifying antirheumatic drugs. Therefore, some considerations are presented on how the current problems and limitations could be overcome in clinical practice and future research. A consensus is needed to better define the early phase of RA and differentiate from other early arthritis. The possible effect of misclassification on spontaneous and drug-induced remission of early and very early RA awaits further elucidation. Such research will eventually lead to more reliable diagnostic and classification criteria for new-onset RA. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/22174195/The_need_to_better_classify_and_diagnose_early_and_very_early_rheumatoid_arthritis_ DB - PRIME DP - Unbound Medicine ER -