Document Detail

Performance of the 2010 ACR/EULAR criteria for rheumatoid arthritis: comparison with 1987 ACR criteria in a very early synovitis cohort.
MedLine Citation:
PMID:  21285117     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Early identification of patients with rheumatoid arthritis (RA) is essential to allow the prompt institution of therapy. The 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria, which replace the 1987 classification criteria, have been developed to facilitate such identification in patients with newly presenting inflammatory arthritis. This study therefore assesses the performance of these new criteria in patients with early synovitis.
METHODS: Data were analysed from patients with synovitis seen within 3 months of the onset of inflammatory arthritis. Patients were followed for 18 months to determine outcomes, and data on the cumulative fulfilment of 2010 and 1987 criteria and therapy were recorded.
RESULTS: 265 patients were included in the study. 60 had alternative diagnoses at baseline. Of the remaining 205 patients, 20% fulfilled both 1987 and 2010 criteria, 3% fulfilled only 1987 criteria and 22% fulfilled only 2010 criteria at baseline. The 2010 criteria, when applied at baseline, detected more patients who eventually required disease-modifying antirheumatic drugs (DMARD) (65 (62%) vs 40 (38%); p<0.001), especially methotrexate (50 (68%) vs 31 (42%); p<0.01), within the first 18 months. However, more patients whose disease eventually resolved without ever requiring DMARD were classified at baseline as RA according to the 2010 criteria than with the 1987 criteria (16 (8%) vs 5 (2%); p=0.01).
CONCLUSION: The 2010 ACR/EULAR criteria allow more rapid identification of patients requiring methotrexate compared with the 1987 ACR criteria when applied at baseline. However, overdiagnosis is an important issue to consider if these criteria are to be used in very early disease.
Mohammed Z Cader; Andrew Filer; Jonathan Hazlehurst; Paola de Pablo; Christopher D Buckley; Karim Raza
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-02-01
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  70     ISSN:  1468-2060     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-04     Completed Date:  2011-07-13     Revised Date:  2014-03-14    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  949-55     Citation Subset:  IM    
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MeSH Terms
Antirheumatic Agents / therapeutic use
Arthritis, Rheumatoid / complications,  diagnosis*,  drug therapy
Early Diagnosis
Epidemiologic Methods
Methotrexate / therapeutic use
Middle Aged
Synovitis / diagnosis*,  drug therapy,  etiology
Time Factors
Treatment Outcome
Grant Support
18547//Arthritis Research UK; 20088//Arthritis Research UK; //Arthritis Research UK
Reg. No./Substance:
0/Antirheumatic Agents; YL5FZ2Y5U1/Methotrexate
Erratum In:
Ann Rheum Dis. 2011 Jul;70(7):1349
Ann Rheum Dis. 2012 Sep;71(9):1592

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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