RT Journal Article
SR Electronic
T1 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 1580
OP 1588
DO 10.1136/ard.2010.138461
VO 69
IS 9
A1 Aletaha, Daniel
A1 Neogi, Tuhina
A1 Silman, Alan J
A1 Funovits, Julia
A1 Felson, David T
A1 Bingham, Clifton O
A1 Birnbaum, Neal S
A1 Burmester, Gerd R
A1 Bykerk, Vivian P
A1 Cohen, Marc D
A1 Combe, Bernard
A1 Costenbader, Karen H
A1 Dougados, Maxime
A1 Emery, Paul
A1 Ferraccioli, Gianfranco
A1 Hazes, Johanna MW
A1 Hobbs, Kathryn
A1 Huizinga, Tom WJ
A1 Kavanaugh, Arthur
A1 Kay, Jonathan
A1 Kvien, Tore K
A1 Laing, Timothy
A1 Mease, Philip
A1 Ménard, Henri A
A1 Moreland, Larry W
A1 Naden, Raymond L
A1 Pincus, Theodore
A1 Smolen, Josef S
A1 Stanislawska-Biernat, Ewa
A1 Symmons, Deborah
A1 Tak, Paul P
A1 Upchurch, Katherine S
A1 Vencovský, Jiří
A1 Wolfe, Frederick
A1 Hawker, Gillian
YR 2010
UL http://ard.bmj.com/content/69/9/1580.abstract
AB Objective The 1987 American College of Rheumatology (ACR; formerly the American Rheumatism Association) classification criteria for rheumatoid arthritis (RA) have been criticised for their lack of sensitivity in early disease. This work was undertaken to develop new classification criteria for RA. Methods A joint working group from the ACR and the European League Against Rheumatism developed, in three phases, a new approach to classifying RA. The work focused on identifying, among patients newly presenting with undifferentiated inflammatory synovitis, factors that best discriminated between those who were and those who were not at high risk for persistent and/or erosive disease—this being the appropriate current paradigm underlying the disease construct ‘RA’. Results In the new criteria set, classification as ‘definite RA’ is based on the confirmed presence of synovitis in at least one joint, absence of an alternative diagnosis better explaining the synovitis, and achievement of a total score of 6 or greater (of a possible 10) from the individual scores in four domains: number and site of involved joints (range 0–5), serological abnormality (range 0–3), elevated acute-phase response (range 0–1) and symptom duration (two levels; range 0–1). Conclusion This new classification system redefines the current paradigm of RA by focusing on features at earlier stages of disease that are associated with persistent and/or erosive disease, rather than defining the disease by its late-stage features. This will refocus attention on the important need for earlier diagnosis and institution of effective disease-suppressing therapy to prevent or minimise the occurrence of the undesirable sequelae that currently comprise the paradigm underlying the disease construct ‘RA’.