| Performance of the 2010 ACR/EULAR criteria for rheumatoid arthritis: comparison with 1987 ACR criteria in a very early synovitis cohort. | |
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MedLine Citation:
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PMID: 21285117 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Mohammed Z Cader; Andrew Filer; Jonathan Hazlehurst; Paola de Pablo; Christopher D Buckley; Karim Raza |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2011-02-01 |
Journal Detail:
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Title: Annals of the rheumatic diseases Volume: 70 ISSN: 1468-2060 ISO Abbreviation: Ann. Rheum. Dis. Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-05-04 Completed Date: 2011-07-13 Revised Date: 2012-10-05 |
Medline Journal Info:
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Nlm Unique ID: 0372355 Medline TA: Ann Rheum Dis Country: England |
Other Details:
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Languages: eng Pagination: 949-55 Citation Subset: IM |
Affiliation:
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Department of Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antirheumatic Agents / therapeutic use Arthritis, Rheumatoid / complications, diagnosis*, drug therapy Early Diagnosis Epidemiologic Methods Female Humans Male Methotrexate / therapeutic use Middle Aged Synovitis / diagnosis*, drug therapy, etiology Time Factors Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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//Arthritis Research UK |
| Chemical | |
Reg. No./Substance:
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0/Antirheumatic Agents; 59-05-2/Methotrexate |
| Comments/Corrections | |
Erratum In:
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Ann Rheum Dis. 2012 Sep;71(9):1592 Ann Rheum Dis. 2011 Jul;70(7):1349 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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