Potential classification criteria for rheumatoid arthritis after two years: results from a French multicenter cohort.

Abstract : OBJECTIVE: To determine agreement among the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) criteria, a diagnosis of rheumatoid arthritis (RA) by a rheumatologist, and other criteria previously used to classify arthritis. METHODS: We used a nationwide longitudinal prospective cohort of patients with recent-onset arthritis. After 2 years, the patients were classified as receiving disease-modifying antirheumatic drugs (DMARDs), having synovitis, having joint erosions typical of RA, having a rheumatologist diagnosis of RA with >50.0% certainty, having a no better alternative diagnosis with >50.0% certainty, and having a diagnosis of RA using the 1987 ACR criteria and the 2010 ACR/EULAR criteria. Agreement among these criteria was assessed based on Cohen's kappa coefficient, where ≥0.80 = excellent, 0.60-0.79 = good, 0.40-0.59 = moderate, and <0.40 = poor. RESULTS: Of the 692 evaluated patients, 544 (78.6%) had persistent arthritis (defined as synovitis, ongoing DMARD treatment, or both) after 2 years. Among these 544 patients, 496 (91.2%) were receiving DMARDs. Agreement among all criteria was poor (estimated κ = 0.09-0.43), except when including a rheumatologist diagnosis of RA with >50.0% certainty or a no better alternative diagnosis with >50.0% certainty (estimated κ = 0.69-0.81). The strongest associations with a rheumatologist diagnosis of RA with >50.0% certainty were the 2010 ACR/EULAR criteria and the combination of no better alternative diagnosis, persistent arthritis, 1987 ACR criteria, and positive anti-citrullinated protein antibody. CONCLUSION: Rheumatologist diagnosis of RA with >50.0% certainty after 2 years agreed well with the 2010 ACR/EULAR criteria or a combination of items including no better alternative diagnosis, confirming high value as classification criteria after 2 years of followup.
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Arthritis Care and Research, Wiley-Blackwell, 2013, 65 (8), pp.1227-34. 〈10.1002/acr.21982〉
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Soumis le : vendredi 24 janvier 2014 - 10:26:52
Dernière modification le : vendredi 31 août 2018 - 09:13:21

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Alain Saraux, Gabriel J Tobón, Mathilde Benhamou, Valérie Devauchelle-Pensec, Maxime Dougados, et al.. Potential classification criteria for rheumatoid arthritis after two years: results from a French multicenter cohort.. Arthritis Care and Research, Wiley-Blackwell, 2013, 65 (8), pp.1227-34. 〈10.1002/acr.21982〉. 〈hal-00935790〉

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