Background Recently, a new classification criteria for early rheumatoid arthritis (ERA) have been developed.
Objectives To evaluate the value of 2012 classification criteria for early rheumatoid arthritis (ERA), 2010 ACR/EULAR classification criteria, and 1987 ACR classification criteria in the diagnosis of early RA.
Methods Early arthritis patients with age more than 16 years, disease duration no more than 1 year, Cat least one joint swelling and tenderness were enrolled in a multicenter, open, cross-sectional study cohort. The patients were diagnosed as RA or other none RA disease by 2 trained experienced rheumatologists. Detailed recorded the clinical and laboratory parameters include disease duration, morning stiffness duration, RF, anti-CCP, ESR, CRP etc.The sensitivity and specificity of three RA classification criteria were compared by McNemar test, The areas under the ROC curve (AUC) of each RA classification criteria were analyzed using MedCalc software.
Results A total of 310 patients were randomly enrolled in this study, including 182 ERA and 128 non-RA. The sensitivity (88.5%) of ERA criteria were much higher than that of 1987 ACR criteria (45.6%, χ2=75.013, P<0.0125), and not significantly different with the 2010 ACR/EULAR criteria (91.8%, χ2=1.042, P>0.05). The specificity of ERA criteria (91.4%) were similar to those of 2010 ACR/EULAR criteria (87.5%, χ2=1.8, P>0.05) and 1987 ACR criteria (96.1%, χ2=3.1, P>0.05). The AUC of ERA criteria was 0.962 (95% CI: 0.934, 0.980), which was slightly better than that of the 2010 ACR/EULAR criteria [0.959 (95% CI: 0.931, 0.978), Z=0.380, P=0.7038], and much higher than that of the 1987 ACR criteria [0.885 (95% CI: 0.845, 0.919), Z=4.517, P<0.0001].
Conclusions Overall evaluation, the diagnostic value of ERA criteria is better than 1987 ACR and 2010 ACR/EULAR criteria in early rheumatoid arthritis. Compared to 2010 ACR/EULAR classification criteria, ERA criteria is obviously more simple and practical.
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Disclosure of Interest None declared