Dr. Schaeverbeke has received consultancies, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Bristol-Myers Squibb, Merck Sharp & Dohme, Pfizer, Roche, and UCB and has received research grants from Pfizer and Roche.
Potential Classification Criteria for Rheumatoid Arthritis After Two Years: Results From a French Multicenter Cohort
Article first published online: 26 JUL 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 8, pages 1227–1234, August 2013
How to Cite
Saraux, A., Tobón, G. J., Benhamou, M., Devauchelle-Pensec, V., Dougados, M., Mariette, X., Berenbaum, F., Chiocchia, G., Rat, A.-C., Schaeverbeke, T., Rincheval, N., Meyer, O., Fautrel, B. and Combe, B. (2013), Potential Classification Criteria for Rheumatoid Arthritis After Two Years: Results From a French Multicenter Cohort. Arthritis Care Res, 65: 1227–1234. doi: 10.1002/acr.21982
- Issue published online: 26 JUL 2013
- Article first published online: 26 JUL 2013
- Accepted manuscript online: 11 FEB 2013 03:16PM EST
- Manuscript Accepted: 30 JAN 2013
- Manuscript Received: 18 JUL 2012
- Merck Sharp & Dohme
- French Society of Rheumatology
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.
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.
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.
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.