• DOI:10.1136/ard.2010.138461
• Corpus ID: 1191830

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

@article{Aletaha20102010RA,
  title={2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative},
  author={Daniel Aletaha and Tuhina Neogi and Alan J Silman and Julia Funovits and David T. Felson and Clifton O. Bingham and Neal S. Birnbaum and Gerd R{\"u}diger Burmester and Vivian P. Bykerk and Marc-David Cohen and Bernard Combe and Karen H. Costenbader and Maxime Dougados and Paul Emery and Gianfranco Ferraccioli and Johanna M. W. Hazes and Kathryn F Hobbs and Thomas W J Huizinga and Arthur Kavanaugh and Jonathan Kay and Tore K. Kvien and Timothy J. Laing and Philip J. Mease and Henri Andr{\'e} M{\'e}nard and Larry W. Moreland and Raymond L. Naden and Theodore Pincus and Josef S. Smolen and Ewa Stanisławska-Biernat and Deborah P M Symmons and Paul P. Tak and Katherine S. Upchurch and Jiř{\'i} Vencovsk{\'y} and Frederick Wolfe and Gillian A. Hawker},
  journal={Annals of the Rheumatic Diseases},
  year={2010},
  volume={69},
  pages={1580 - 1588}
}

• D. Aletaha, T. Neogi, +32 authors G. Hawker
• Published 10 August 2010
• Medicine
• Annals of the Rheumatic Diseases

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’.