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2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative.

Daniel Aletaha Tuhina Neogi J. Silman Julia Funovits David T Felson 1 Clifton O Bingham 2 Neal S Birnbaum Gerd R Burmester 3 P. Bykerk Bernard Combe Karen H Costenbader Maxime Dougados 4, 5 Paul P Emery 6 Gianfranco Ferraccioli Johanna M W Hazes 7 Kathryn Hobbs Tom W J Huizinga 8 Arthur Kavanaugh 9 Jonathan Kay 10 Tore K Kvien 11 Timothy Laing Philip Mease H. A. Menard 12 Larry W Moreland Raymond L Naden Theodore Pincus 13 Josef S Smolen 14 Ewa Stanislawska-Biernat Deborah Symmons Paul P Tak 15 Katherine S Upchurch Jirí Vencovsky 16 Frederick Wolfe 17 Gillian Hawker Alan J Silman 18 Vivian P Bykerk Marc D Cohen Henri A Ménard 12 A. Saraux 19, 20, 21 
Résumé : Objective The 1987 American College of Rheumatology (ACR; formerly the American Rheumatism Association) classification criteria for rheumatoid arthritis (RA) have been criticised 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 three 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 'RA'. Results In the new criteria set, classification as 'definite RA' is based on the confirmed presence of synovitis in at least one joint, absence of an alternative diagnosis better explaining the synovitis, and achievement of a total score of 6 or greater (of a possible 10) from the individual scores in four domains: number and site of involved joints (range 0-5), serological abnormality (range 0-3), elevated acute-phase response (range 0-1) and symptom duration (two 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 minimise the occurrence of the undesirable sequelae that currently comprise the paradigm underlying the disease construct 'RA'.
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Submitted on : Thursday, July 6, 2017 - 1:09:29 PM
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Daniel Aletaha, Tuhina Neogi, J. Silman, Julia Funovits, David T Felson, et al.. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative.. Annals of the Rheumatic Diseases, 2010, 69 (9), pp.1580-8. ⟨10.1136/ard.2010.138461⟩. ⟨hal-01557559⟩



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