2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative.
2010
Aletaha, Daniel | Neogi, Tuhina | Silman, J. | Funovits, Julia | Felson, David T | Bingham, Clifton O | Birnbaum, Neal S | Burmester, Gerd R | Bykerk, P. | Combe, Bernard | Costenbader, Karen H | Dougados, Maxime | Emery, Paul P | Ferraccioli, Gianfranco | Hazes, Johanna M W | Hobbs, Kathryn | Huizinga, Tom W J | Kavanaugh, Arthur | Kay, Jonathan | Kvien, Tore K | Laing, Timothy | Mease, Philip | Menard, H. A. | Moreland, Larry W | Naden, Raymond L | Pincus, Theodore | Smolen, Josef S | Stanislawska-Biernat, Ewa | Symmons, Deborah | Tak, Paul P | Upchurch, Katherine S | Vencovsky, Jirí | Wolfe, Frederick | Hawker, Gillian | Silman, Alan J | Bykerk, Vivian P | Cohen, Marc D | Ménard, Henri A | Saraux, A. | Tufts University School of Medicine [Boston] | University of North Carolina [Chapel Hill] (UNC) ; University of North Carolina System (UNC) | Department of Rheumatology and Clinical Immunology ; Charité - UniversitätsMedizin = Berlin University Medicine | Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)) ; Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM) | Service de rhumatologie [CHU Cochin] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP) | University of Leeds | Erasmus University Medical Center [Rotterdam] (Erasmus MC) | Leiden University Medical Center (LUMC) ; Universiteit Leiden = Leiden University | Virginia Tech [Blacksburg] | University of Colorado [Boulder] | Department of Rheumatology ; Diakonhjemmet Hospital | Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou] | Division of Rheumatology (NYU Hospital - Rheumato) ; New York University Langone Medical Center (NYU Langone Medical Center) ; NYU System (NYU)-NYU System (NYU) | Medizinische Universität Wien = Medical University of Vienna | University of Amsterdam [Amsterdam] = Universiteit van Amsterdam (UvA) | Institute of Rheumatology ; Institute of Rheumatology | Institut de Neurosciences de la Timone (INT) ; Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS) | University of Manchester [Manchester] | Lymphocytes B, Autoimmunité et Immunothérapies (LBAI) ; Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-LabEX IGO Immunothérapie Grand Ouest ; Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Institut Brestois Santé Agro Matière (IBSAM) ; Université de Brest (UBO) | CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato) ; Centre Hospitalier Régional Universitaire de Brest (CHRU Brest) | Centre d'Investigation Clinique (CIC - Brest) ; Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)
International audience
Show more [+] Less [-]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'.
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