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2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative
Rheumatology Publications and Presentations
  • Daniel Aletaha, Medical University of Vienna
  • Tuhina Neogi, Boston University
  • Alan J. Silman, Arthritis Research UK
  • Julia Funovits, Medical University of Vienna
  • David T. Felson, Boston University
  • Clifton O. Bingham, III, Johns Hopkins University
  • Neal S. Birnbaum, University of California - San Francisco
  • Gerd R. Burmester, Humboldt University Berlin
  • Vivian P. Bykerk, University of Toronto,
  • Marc D. Cohen, National Jewish Medical and Research Center
  • Bernard Combe, Montpellier I University
  • Karen H. Costenbader, Harvard University
  • Maxime Dougados, Paris-Descartes University
  • Paul Emery, University of Leeds
  • Gianfranco Ferraccioli, Catholic University of the Sacred Heart
  • Johanna M. W. Hazes, University of Rotterdam
  • Kathryn Hobbs, University of Colorado School of Medicine
  • Tom W. J. Huizinga, Leiden University Medical Centre
  • Arthur Kavanaugh, University of California - San Diego
  • Jonathan Kay, University of Massachusetts Medical School Worcester
  • Tore K. Kvien, Diakonhjemmet Hospital
  • Timothy Laing, University of Michigan - Ann Arbor
  • Philip Mease, University of Washington - Seattle Campus
  • Henri A. Menard, McGill University
  • Larry W. Moreland, University of Pittsburgh
  • Raymond L. Naden, Ministry of Health
  • Theodore Pincus, New York University Hospital for Joint Diseases
  • Josef S. Smolen, Medical University of Vienna
  • Ewa Stanislawska-Biernat, Institute of Rheumatology
  • Deborah Symmons, University of Manchester
  • Paul P. Tak, University of Amsterdam
  • Katherine S. Upchurch, University of Massachusetts Medical School
  • Jiri Vencovsky, Institute of Rheumatology
  • Frederick Wolfe, University of Kansas Main Campus
  • Gillian Hawker, University of Toronto
UMMS Affiliation
Department of Medicine, Division of Rheumatology
Publication Date
2010-9-1
Document Type
Article
Subjects
Acute-Phase Reaction; Algorithms; Arthritis, Rheumatoid; Early Diagnosis; Europe; Humans; International Cooperation; North America; Severity of Illness Index; Societies, Medical; Synovitis; Terminology as Topic; Time Factors
Abstract

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."

DOI of Published Version
10.1002/art.27584
Source
Arthritis Rheum. 2010 Sep;62(9):2569-81. doi: 10.1002/art.27584. Link to article on publisher's site
Comments

This article was published simultaneously in the September 2010 issue of Annals of the Rheumatic Diseases. PubMed id: 20699241

Related Resources
Link to Article in PubMed
PubMed ID
20872595
Citation Information
Daniel Aletaha, Tuhina Neogi, Alan J. Silman, Julia Funovits, et al.. "2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative" Vol. 62 Iss. 9 (2010) ISSN: 0004-3591 (Linking)
Available at: http://works.bepress.com/philip-mease/383/