2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism collaborative initiative

Wiley - Tập 62 Số 9 - Trang 2569-2581 - 2010
Daniel Aletaha1, Tuhina Neogi2, A J Silman3, Julia Funovits1, David T. Felson2, Clifton O. Bingham4, Neal S. Birnbaum5, Gerd R Burmester6, Vivian P. Bykerk7, Marc D. Cohen8, Bernard Combe9, Karen H. Costenbader10, Maxime Dougados11, Paul Emery12, Gianfranco Ferraccioli13, Kathryn Hobbs14, T. Huizinga15, Arthur Kavanaugh16, Jonathan Kay17, Tore K. Kvien18, Timothy Laing19, Philip J. Mease20, H Ménard21, Larry W. Moreland22, Raymond L. Naden23, Theodore Pincus24, Sofía Ramiro1, Ewa Stanisławska-Biernat25, Deborah Symmons26, Paul P. Tak27, Katherine S. Upchurch17, Jiří Vencovský28, Frederick Wolfe29, Gillian Hawker30
1Medical University of Vienna, Vienna, Austria
2Boston University School of Medicine, Boston, Massachusetts
3Arthritis Research UK, Chesterfield, UK
4Johns Hopkins University, Baltimore, Maryland
5California Pacific Medical Center and University of California, San Francisco
6Charité Hospital–University Medicine Berlin, Free University and Humboldt University Berlin, Berlin, Germany
7Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
8National Jewish Medical and Research Center
9Lapeyronie Hospital and Montpellier I University, Montpellier, France
10Brigham and Women's Hospital and Harvard University, Boston, Massachusetts.
11Cochin Hospital, Assistance Publique Hôpitaux de Paris, and Paris‐Descartes University, Paris, France
12University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
13School of Medicine, Catholic University of the Sacred Heart, Rome, Italy
14University of Colorado School of Medicine, Denver
15Leiden University Medical Centre, Leiden, the Netherlands
16University of California, San Diego
17UMassMemorial Medical Center and University of Massachusetts Medical School, Worcester
18Diakonhjemmet Hospital, Oslo, Norway
19University of Michigan, Ann Arbor
20Swedish Medical Center, and University of Washington, Seattle
21McGill University Health Centre and McGill University, Montreal, Quebec, Canada.
22University of Pittsburgh, Pittsburgh, Pennsylvania
23Ministry of Health, Auckland, New Zealand
24#N# †New York University Hospital for Joint Diseases, New York, New York
25Institute of Rheumatology, Warsaw, Poland
26University of Manchester, Manchester, UK
27Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
28Institute of Rheumatology, Prague, Czech Republic
29National Data Bank for Rheumatic Diseases and University of Kansas, Wichita
30Women's College Hospital and University of Toronto, Toronto, Ontario, Canada.

Tóm tắt

AbstractObjectiveThe 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.MethodsA 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.”ResultsIn 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).ConclusionThis 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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Tài liệu tham khảo

10.1016/S0140-6736(87)91672-2

10.1002/art.1780290602

10.1002/art.1780270805

10.3109/03009749209101477

Wolfe F, 1996, The natural history of rheumatoid arthritis, J Rheumatol Suppl, 44, 13

Aho K, 1991, Rheumatoid factors antedating clinical rheumatoid arthritis, J Rheumatol, 18, 1282

Aho K, 1993, Antikeratin antibody and antiperinuclear factor as markers for subclinical rheumatoid disease process, J Rheumatol, 20, 1278

10.1002/art.20018

10.1002/art.11223

10.1038/nature01661

10.1016/S0140-6736(07)60784-3

10.1016/S0950-3579(96)80038-0

Van der Heijde DM, 1995, Joint erosions and patients with early rheumatoid arthritis, Br J Rheumatol, 34, 74, 10.1093/rheumatology/XXXIV.suppl_2.74

Plant MJ, 1998, Patterns of radiological progression in rheumatoid arthritis: results of an 8 year prospective study, J Rheumatol, 25, 417

10.1002/1529-0131(199809)41:9<1571::AID-ART7>3.0.CO;2-R

Machold KP, 2002, Very recent onset arthritis: clinical, laboratory, and radiological findings during the first year of disease, J Rheumatol, 29, 2278

10.1136/ard.2007.076463

Pincus T, 2003, Methotrexate as the “anchor drug” for the treatment of early rheumatoid arthritis, Clin Exp Rheumatol, 21, S179

10.1136/ard.2008.092668

10.1177/0091270005277938

10.7326/0003-4819-124-8-199604150-00001

10.1002/art.10727

10.1002/art.22525

10.1002/art.1780310302

10.1136/ard.2010.130310

10.1002/art.27580

10.1002/art.23681

Hyrich KL, 2005, Reconciling subject differences in recruitment to clinical trials and clinical practice, J Rheumatol, 32, 2475

10.1002/art.21385

10.1186/ar2832

10.1002/art.24827

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Wiley

Tập 62 Số 9

2569-2581

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