Article Text

other Versions

Validation of a prediction rule for development of rheumatoid arthritis in patients with early undifferentiated arthritis
  1. Bindee Kuriya (bindee.kuriya{at}
  1. University of Toronto, Canada
    1. Carly K Cheng (ccheng2{at}
    1. University of Toronto, Canada
      1. Hong M Chen (maggiehchen{at}
      1. University of Toronto, Canada
        1. Vivian P Bykerk (vbykerk{at}
        1. University of Toronto, Canada


          Objective: A model to predict progression from undifferentiated arthritis (UA) to RA was recently created. This study aimed to validate the model in a Canadian UA cohort.

          Methods: The prediction rule consists of variables, which are scored (range 0-13), with higher scores reflecting an increased risk of RA. The model was applied to baseline characteristics of all UA patients. Progression to RA was determined at 6 months.

          Results: Overall, 105 patients were identified. By 6 months, 80 (76%) developed RA while 25 (24%) developed another diagnosis. The number of tender and swollen joints, RF positivity, anti-CCP positivity, poor functional status and high disease activity were associated with development of RA (p < 0.01). Among progressors, the median prediction score was 8.0 while non-progressors had a median score of 5.0. Using these cutoffs, 18 (72%) patients with scores ≤ 5 did not develop RA while 35 (97%) of patients with scores ≥ 8 did develop RA.

          Conclusions: High scores in our cohort predicted those who progressed to RA by 6 months. Baseline scores ≥ 8 corresponded with higher rates of progression, validating the original prediction model. Future research should focus on how to predict disease outcome and response to therapy among patients with intermediary scores.

          Statistics from

          Review history and Supplementary material

          • Web only appendix 68:9;1482

            Request Permissions

            If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.