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Defining erosive disease typical of RA in the light of the ACR/EULAR 2010 criteria for rheumatoid arthritis; results of the data driven phase.
Ann Rheum Dis. 2013 Apr; 72(4):590-5.AR

Abstract

BACKGROUND

According to the 2010 criteria, rheumatoid arthritis (RA) can be classified in the presence of ≥6 points on the criteria or 'typical' erosive disease. RA-specific erosiveness however has not been defined yet. This study reports the results of the data driven phase of a European League Against Rheumatism (EULAR) taskforce aiming to define RA-specific erosiveness.

METHODS

Baseline radiographs of hands and feet of 980 Dutch and 811 French early arthritis patients were studied on the number and site of erosive joints. Test characteristics were determined, with the outcome measures being initiation of methotrexate (MTX) therapy or any disease modifying antirheumatic drug (DMARD) therapy within the first year of disease and arthritis persistency over 5 years. Analyses were repeated in the patients with <6 points on the American College of Rheumatology/EULAR 2010 criteria.

RESULTS

In both cohorts comparable test characteristics were observed for the outcomes MTX therapy, any DMARD therapy and arthritis persistency. Test characteristics were not influenced by the site of erosiveness. The specificity observed was >50% for ≥1 erosive joint, >80% for ≥3 erosive joints and >90% for ≥5 erosive joints. When analysing the patients not fulfilling the 2010 criteria (n=308 and 149), specificity was >60% for ≥1 erosive joint, >90% for ≥3 erosive joints and >95% for ≥5 erosive joints. Few of these patients fulfilled the radiological criterion; 27-36 patients had ≥3 erosive joints and 13-14 patients had ≥5 erosive joints.

CONCLUSIONS

RA-specific erosiveness can be defined with high specificity at several cut-offs for the number of erosive joints in two independent cohorts with multiple different outcomes. The final radiological criterion will be established in the next phase.

Authors+Show Affiliations

Correspondence to Dr Annette H M van der Helm-van Mil, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, Leiden 2300RC, The Netherlands.No 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

23393145

Citation

Knevel, Rachel, et al. "Defining Erosive Disease Typical of RA in the Light of the ACR/EULAR 2010 Criteria for Rheumatoid Arthritis; Results of the Data Driven Phase." Annals of the Rheumatic Diseases, vol. 72, no. 4, 2013, pp. 590-5.
Knevel R, Lukas C, van der Heijde D, et al. Defining erosive disease typical of RA in the light of the ACR/EULAR 2010 criteria for rheumatoid arthritis; results of the data driven phase. Ann Rheum Dis. 2013;72(4):590-5.
Knevel, R., Lukas, C., van der Heijde, D., Rincheval, N., Combe, B., & van der Helm-van Mil, A. H. (2013). Defining erosive disease typical of RA in the light of the ACR/EULAR 2010 criteria for rheumatoid arthritis; results of the data driven phase. Annals of the Rheumatic Diseases, 72(4), 590-5. https://doi.org/10.1136/annrheumdis-2012-202778
Knevel R, et al. Defining Erosive Disease Typical of RA in the Light of the ACR/EULAR 2010 Criteria for Rheumatoid Arthritis; Results of the Data Driven Phase. Ann Rheum Dis. 2013;72(4):590-5. PubMed PMID: 23393145.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Defining erosive disease typical of RA in the light of the ACR/EULAR 2010 criteria for rheumatoid arthritis; results of the data driven phase. AU - Knevel,Rachel, AU - Lukas,Cédric, AU - van der Heijde,Désirée, AU - Rincheval,Nathalie, AU - Combe,Bernard, AU - van der Helm-van Mil,Annette H M, Y1 - 2013/02/07/ PY - 2013/2/9/entrez PY - 2013/2/9/pubmed PY - 2013/5/1/medline SP - 590 EP - 5 JF - Annals of the rheumatic diseases JO - Ann Rheum Dis VL - 72 IS - 4 N2 - BACKGROUND: According to the 2010 criteria, rheumatoid arthritis (RA) can be classified in the presence of ≥6 points on the criteria or 'typical' erosive disease. RA-specific erosiveness however has not been defined yet. This study reports the results of the data driven phase of a European League Against Rheumatism (EULAR) taskforce aiming to define RA-specific erosiveness. METHODS: Baseline radiographs of hands and feet of 980 Dutch and 811 French early arthritis patients were studied on the number and site of erosive joints. Test characteristics were determined, with the outcome measures being initiation of methotrexate (MTX) therapy or any disease modifying antirheumatic drug (DMARD) therapy within the first year of disease and arthritis persistency over 5 years. Analyses were repeated in the patients with <6 points on the American College of Rheumatology/EULAR 2010 criteria. RESULTS: In both cohorts comparable test characteristics were observed for the outcomes MTX therapy, any DMARD therapy and arthritis persistency. Test characteristics were not influenced by the site of erosiveness. The specificity observed was >50% for ≥1 erosive joint, >80% for ≥3 erosive joints and >90% for ≥5 erosive joints. When analysing the patients not fulfilling the 2010 criteria (n=308 and 149), specificity was >60% for ≥1 erosive joint, >90% for ≥3 erosive joints and >95% for ≥5 erosive joints. Few of these patients fulfilled the radiological criterion; 27-36 patients had ≥3 erosive joints and 13-14 patients had ≥5 erosive joints. CONCLUSIONS: RA-specific erosiveness can be defined with high specificity at several cut-offs for the number of erosive joints in two independent cohorts with multiple different outcomes. The final radiological criterion will be established in the next phase. SN - 1468-2060 UR - https://www.unboundmedicine.com/medline/citation/23393145/Defining_erosive_disease_typical_of_RA_in_the_light_of_the_ACR/EULAR_2010_criteria_for_rheumatoid_arthritis L2 - https://ard.bmj.com/lookup/pmidlookup?view=long&amp;pmid=23393145 DB - PRIME DP - Unbound Medicine ER -