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OP0134 Risk stratification in patients with undifferentiated arthritis according to the 2010 ACR/EULAR criteria
  1. A. Krabben1,
  2. A. Abhishek2,
  3. K. Britsemmer3,
  4. A. Filer2,
  5. T.W.J. Huizinga1,
  6. K. Raza2,
  7. D. van Schaardenburg3,
  8. A.H.M. van der Helm-van Mil1
  1. 1Rheumatology, Leiden University Medical Center, Leiden, Netherlands
  2. 2Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
  3. 3Rheumatology, Jan van Breemen Research Institute/Reade, Amsterdam, Netherlands

Abstract

Background Early recognition and treatment of Rheumatoid Arthritis (RA) is associated with an improved outcome. The 2010 ACR/EULAR criteria for RA identify RA patients earlier than the 1987 criteria. Nevertheless, we observed that 24% of the 2010-undifferentiated arthritis (UA) patients develop RA during follow-up.

Objectives Here we studied this frequency in other cohorts and evaluated the prognostic accuracy of anti-CCP antibodies and the Leiden prediction rule in 2010-UA patients.

Methods 2010-UA patients derived from three Early Arthritis Clinics were studied: 776 UA patients from Leiden, 121 from Birmingham and 322 from Amsterdam. Fulfilling the 1987 ACR criteria for RA during follow-up was studied as outcome. The presence of anti-CCP antibodies and the prediction score at baseline were evaluated in relation to the outcome.

Results In the three cohorts, 24%, 26% and 12% of the 2010-UA patients fulfilled the 1987 criteria after one year, respectively. Some of these patients fulfilled the 1987 criteria already at baseline. In “1987-and-2010-UA patients'', 15%, 21% and 9% respectively developed RA. In all cohorts, the large majority of 2010-UA patients were anti-CCP negative and had low prediction scores at baseline. Therefore these markers were not helpful for risk stratification.

Conclusions Some of the 2010-UA patients progress to RA. Anti-CCP antibodies and the Leiden prediction rule are not useful to identify these patients. Hence, other prognostic markers are needed with significantly different sensitivity and specificity characteristics to clinical examination; these may include imaging modalities such as ultrasound or extremity-MRI.

Disclosure of Interest None Declared

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