Rheumatoid Arthritis (ra) New Standards for Clinical Research

Abstract

Objective The aim of this study was to evaluate differences in classification between the 1987 ACR criteria and the 2010 ACR/European League Against Rheumatism(EULAR) criteria in an early arthritis patients.Methods A total of 410 patients with recent-onset arthritis of6 mouths duration were studied prospectively between 2009 and 2011 and followed-up for 1 year.Fulfillment of the 1987 and 2010 criteria for the classification of RA was determined at baseline.The diagnosis of each patient at 1year was assessed.The sensitivity and specificity of the 2010 criteria were determined using the following outcome measures: using fulfillment of 1987 ACR criteria after 1 year.Results 175 patients fulfilled the 2010 criteria,and 93 patients fulfilled the 1987 criteria for RA.The 2010 criteria when applied at baseline detected more patients [175(42.7%)/93(22.7%),P0.05].However,more patients whose disease eventually resolved without ever requiring DMARD were classified at baseline as RA according to the 2010 criteria than with the 1987 criteria [31(8%)/9(2%),P0.05].At baseline,the sensitivity and specificity of the 2010 criteria with using fulfillment of 1987 ACR criteria were 0.75 and 0.73,the positive and negative predictive values were 0.76 and 0.91.Conclusion Compared with the 1987 criteria,the 2010 criteria classify more patients with RA at an earlier phase of the disease although overdiagnosis is an important issue to consider.