1. 2010 Rheumatoid Arthritis Classification Criteria An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative
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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., AII - Amsterdam institute for Infection and Immunity, Clinical Immunology and Rheumatology, 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 / Charite - University Medicine Berlin, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Service de rhumatologie [CHU Cochin], CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), University of Leeds, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Leiden University Medical Center (LUMC), Virginia Tech [Blacksburg], University of Colorado [Boulder], Department of Rheumatology, Diakonhjemmet Hospital, CHU Pontchaillou [Rennes], Division of Rheumatology (NYU Hospital - Rheumato), New York University Langone Medical Center (NYU Langone Medical Center), NYU System (NYU)-NYU System (NYU), Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, University of Amsterdam [Amsterdam] (UvA), Institute of Rheumatology, Institut de Neurosciences de la Timone (INT), Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), ARC Epidemiology Unit, The University of Manchester, Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-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 INSERM 1412 (CIC 1412 - BREST), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], 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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Rheumatology, Faculteit der Geneeskunde, The University of North Carolina at Chapel Hill, Charité - University Medicine, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Recherche Agronomique ( INRA ), Service de Rhumatologie [CHU Cochin], CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), Erasmus MC, University Medical Center Rotterdam, Hogeschool Rotterdam, University of Colorado Boulder [Boulder], Division of Rheumatology ( NYU Hospital - Rheumato ), New York University Hospital, University of Amsterdam [Amsterdam] ( UvA ), Institut de Neurosciences de la Timone ( INT ), Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Lymphocyte B et Auto-immunité ( LBAI ), Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), CHRU Brest - Service de Rhumatologie ( CHU - BREST - Rhumato ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Centre d'Investigation Clinique INSERM 1412 ( CIC 1412 - BREST ), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Universiteit Leiden, Medizinische Universität Wien = Medical University of Vienna, 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, and Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Institut Brestois Santé Agro Matière (IBSAM)
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Time Factors ,MESH : International Cooperation ,MESH: Synovitis ,International Cooperation ,[SDV]Life Sciences [q-bio] ,Arthritis ,Disease ,Severity of Illness Index ,MESH : Early Diagnosis ,Arthritis, Rheumatoid ,MESH : North America ,MESH: Early Diagnosis ,MESH: Acute-Phase Reaction ,Immunology and Allergy ,Pharmacology (medical) ,MESH : Algorithms ,Societies, Medical ,MESH : Synovitis ,MESH: Arthritis, Rheumatoid ,Synovitis ,biology ,undifferentiated arthritis citrullinated peptide controlled-trial methotrexate disease progression antibodies therapies erosions ,Anti–citrullinated protein antibody ,Early Inflammatory Arthritis ,Connective tissue disease ,Europe ,Rheumatoid arthritis ,MESH : Severity of Illness Index ,Algorithms ,MESH : Time Factors ,medicine.medical_specialty ,MESH: Terminology as Topic ,MESH : Europe ,Immunology ,MESH: Societies, Medical ,MESH: Algorithms ,MESH : Acute-Phase Reaction ,General Biochemistry, Genetics and Molecular Biology ,Rheumatology ,Terminology as Topic ,Internal medicine ,MESH: Severity of Illness Index ,Severity of illness ,medicine ,MESH : Societies, Medical ,Humans ,Acute-Phase Reaction ,MESH: Humans ,[ SDV ] Life Sciences [q-bio] ,business.industry ,MESH : Humans ,MESH: Time Factors ,medicine.disease ,MESH : Terminology as Topic ,MESH: North America ,MESH: International Cooperation ,Early Diagnosis ,MESH : Arthritis, Rheumatoid ,North America ,Physical therapy ,biology.protein ,MESH: Europe ,business ,Rheumatism - Abstract
Objective. The 1987 American College of Rheumatology (ACR; formerly, the American Rheumatism Association) classification criteria for rheumatoid arthritis (RA) have been criticized 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 3 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 "rheumatoid arthritis." Results. In the new criteria set, classification as "definite RA" is based on the confirmed presence of synovitis in at least 1 joint, absence of an alternative diagnosis that better explains the synovitis, and achievement of a total score of 6 or greater (of a possible 10) from the individual scores in 4 domains: number and site of involved joints (score range 0-5), serologic abnormality (score range 0-3), elevated acute-phase response (score range 0-1), and symptom duration (2 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 minimize the occurrence of the undesirable sequelae that currently comprise the paradigm underlying the disease construct "rheumatoid arthritis."
- Published
- 2010
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