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Do the 2010 ACR/EULAR or ACR 1987 classification criteria predict erosive disease in early arthritis?
Ann Rheum Dis. 2013 May; 72(5):745-7.AR

Abstract

BACKGROUND

The new 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for rheumatoid arthritis (RA) aim at earlier diagnosis of RA compared to the 1987 ACR criteria.

OBJECTIVE

To evaluate the ability of the 2010 ACR/EULAR and the 1987 ACR classification criteria to predict radiographic progression after 10 years of follow-up.

METHODS

All early arthritis patients referred to Central Hospital in Jyväskylä from 1997 to 1999 (cases with peripheral joint synovitis, other specific diseases excluded) were included in this 10-year follow-up study. Radiographs of hands and feet were analysed according to Larsen on a scale of 0-100.

RESULTS

At 10 years, 58% of the patients had an erosive disease (defined as Larsen ≥2 in at least one joint). The discriminative power of the 2010 ACR/EULAR and the 1987 ACR criteria (erosive disease at 10 years) were comparable, with area under the curve 0.72 (95% CI 0.65 to 0.79) (2010 ACR/EULAR criteria) and 0.65 (95% CI 0.58 to 0.72) (1987 ACR criteria). The respective sensitivities and specificities were 0.87 and 0.70, and 0.44 and 0.47. At 10 years, median (IQR) Larsen score was 6 (0, 15) among patients who had fulfilled both sets of criteria, 2 (0, 8) in those who met the 2010 ACR/EULAR and did not meet the ACR 1987 criteria, 0 (0, 5) in those who met ACR 1987 criteria but did not meet 2010 ACR/EULAR criteria, and 0 (0, 2) among patients who did not fulfil either of the criteria. The percentage of patients with erosions was 69%, 64%, 32% and 26%, respectively.

CONCLUSIONS

The ability of the 2010 ACR/EULAR and 1987 ACR classification criteria to identify erosive disease in early arthritis is low. The discriminative power of the 2010 ACR/EULAR criteria of erosiveness in 10 years is slightly better than that of the 1987 ACR criteria.

Authors+Show Affiliations

Department of Rheumatology, Tampere University Hospital, PL 2000, 33521 Tampere, Finland. heidi.m.makinen@pshp.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

23172747

Citation

Mäkinen, Heidi, et al. "Do the 2010 ACR/EULAR or ACR 1987 Classification Criteria Predict Erosive Disease in Early Arthritis?" Annals of the Rheumatic Diseases, vol. 72, no. 5, 2013, pp. 745-7.
Mäkinen H, Kaarela K, Huhtala H, et al. Do the 2010 ACR/EULAR or ACR 1987 classification criteria predict erosive disease in early arthritis? Ann Rheum Dis. 2013;72(5):745-7.
Mäkinen, H., Kaarela, K., Huhtala, H., Hannonen, P. J., Korpela, M., & Sokka, T. (2013). Do the 2010 ACR/EULAR or ACR 1987 classification criteria predict erosive disease in early arthritis? Annals of the Rheumatic Diseases, 72(5), 745-7. https://doi.org/10.1136/annrheumdis-2012-201943
Mäkinen H, et al. Do the 2010 ACR/EULAR or ACR 1987 Classification Criteria Predict Erosive Disease in Early Arthritis. Ann Rheum Dis. 2013;72(5):745-7. PubMed PMID: 23172747.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Do the 2010 ACR/EULAR or ACR 1987 classification criteria predict erosive disease in early arthritis? AU - Mäkinen,Heidi, AU - Kaarela,Kalevi, AU - Huhtala,Heini, AU - Hannonen,Pekka J, AU - Korpela,Markku, AU - Sokka,Tuulikki, Y1 - 2012/11/21/ PY - 2012/11/23/entrez PY - 2012/11/23/pubmed PY - 2013/7/3/medline SP - 745 EP - 7 JF - Annals of the rheumatic diseases JO - Ann Rheum Dis VL - 72 IS - 5 N2 - BACKGROUND: The new 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for rheumatoid arthritis (RA) aim at earlier diagnosis of RA compared to the 1987 ACR criteria. OBJECTIVE: To evaluate the ability of the 2010 ACR/EULAR and the 1987 ACR classification criteria to predict radiographic progression after 10 years of follow-up. METHODS: All early arthritis patients referred to Central Hospital in Jyväskylä from 1997 to 1999 (cases with peripheral joint synovitis, other specific diseases excluded) were included in this 10-year follow-up study. Radiographs of hands and feet were analysed according to Larsen on a scale of 0-100. RESULTS: At 10 years, 58% of the patients had an erosive disease (defined as Larsen ≥2 in at least one joint). The discriminative power of the 2010 ACR/EULAR and the 1987 ACR criteria (erosive disease at 10 years) were comparable, with area under the curve 0.72 (95% CI 0.65 to 0.79) (2010 ACR/EULAR criteria) and 0.65 (95% CI 0.58 to 0.72) (1987 ACR criteria). The respective sensitivities and specificities were 0.87 and 0.70, and 0.44 and 0.47. At 10 years, median (IQR) Larsen score was 6 (0, 15) among patients who had fulfilled both sets of criteria, 2 (0, 8) in those who met the 2010 ACR/EULAR and did not meet the ACR 1987 criteria, 0 (0, 5) in those who met ACR 1987 criteria but did not meet 2010 ACR/EULAR criteria, and 0 (0, 2) among patients who did not fulfil either of the criteria. The percentage of patients with erosions was 69%, 64%, 32% and 26%, respectively. CONCLUSIONS: The ability of the 2010 ACR/EULAR and 1987 ACR classification criteria to identify erosive disease in early arthritis is low. The discriminative power of the 2010 ACR/EULAR criteria of erosiveness in 10 years is slightly better than that of the 1987 ACR criteria. SN - 1468-2060 UR - https://www.unboundmedicine.com/medline/citation/23172747/Do_the_2010_ACR/EULAR_or_ACR_1987_classification_criteria_predict_erosive_disease_in_early_arthritis DB - PRIME DP - Unbound Medicine ER -