Performance of the 2010 Rheumatoid Arthritis Classification Criteria

Abstract

Objectives: Rheumatoid arthritis (RA) needs early treatment to improve clinical outcome by reducing joint damage, radiographic progression and disability. The aim of this study was to evaluate the 2010 Rheumatoid Arthritis Classification Criteria for its ability to classify RA patients, in their early stages, not exceeding 12 months of disease progression.

Methods: Rheumatoid arthritis (RA) patients were selected from August to December 2010, among those coming for their follow-up. The inclusion criteria were patients with not more than 12 months of disease progression at their first evaluation. Patients were selected from four rheumatology subspecialty clinics.

Results: Nine hundred and ninety-seven patients with a confirmed diagnosis of RA entered the study. The female-to-male ratio was 4.3/1.0. Mean age was 46.4 years. Mean disease progression at first visit was 6.3 months. The mean follow-up of their disease was 5.9 years. The 1987 American College of Rheumatology (ACR) criteria were fulfilled for 74% of patients. The ACR/EULAR (European League Against Rheumatism) criteria were fulfilled for 69% of patients. Ten percent had involvement of 2-10 large joints, 29% 1-3 small joints, 25% 4-10 small joints and 32% more than 10 joints. Low rheumatoid factor (RF)/anticytoplasmic antibodies (ACPA) were discovered in 30%, high RF/ACPA in 37%; high erythrocyte sedimentation rate/C-reactive protein in 77%, and duration of 6 weeks or more in 92% of patients. There was no significant difference between men and women.

Conclusions: The 2010 ACR/EULAR criteria have good performance: sensitivity of 69% in early disease (first year), with the same sensitivity in both genders.