TY - JOUR
T1 - 2010 Rheumatoid arthritis classification criteria
T2 - An American College of Rheumatology/European League Against Rheumatism collaborative initiative
AU - Aletaha, Daniel
AU - Neogi, Tuhina
AU - Silman, Alan J.
AU - Funovits, Julia
AU - Felson, David T.
AU - Bingham, Clifton O.
AU - Birnbaum, Neal S.
AU - Burmester, Gerd R.
AU - Bykerk, Vivian P.
AU - Cohen, Marc D.
AU - Combe, Bernard
AU - Costenbader, Karen H.
AU - Dougados, Maxime
AU - Emery, Paul
AU - Ferraccioli, Gianfranco
AU - Hazes, Johanna M.W.
AU - Hobbs, Kathryn
AU - Huizinga, Tom W.J.
AU - Kavanaugh, Arthur
AU - Kay, Jonathan
AU - Kvien, Tore K.
AU - Laing, Timothy
AU - Mease, Philip
AU - Ménard, Henri A.
AU - Moreland, Larry W.
AU - Naden, Raymond L.
AU - Pincus, Theodore
AU - Smolen, Josef S.
AU - Stanislawska-Biernat, Ewa
AU - Symmons, Deborah
AU - Tak, Paul P.
AU - Upchurch, Katherine S.
AU - Vencovský, Jiří
AU - Wolfe, Frederick
AU - Hawker, Gillian
PY - 2010/9
Y1 - 2010/9
N2 - 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."
AB - 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."
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U2 - 10.1002/art.27584
DO - 10.1002/art.27584
M3 - Review article
C2 - 20872595
AN - SCOPUS:77956055481
SN - 0004-3591
VL - 62
SP - 2569
EP - 2581
JO - Arthritis and rheumatism
JF - Arthritis and rheumatism
IS - 9
ER -