Skip to main content

The 2010 ACR/EULAR classification criteria for rheumatoid arthritis in the Heinola inception cohort—diagnoses confirmed by long-term follow-up

Abstract

The aim of this study was to evaluate the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for rheumatoid arthritis (RA) in a cohort with early arthritis and true diagnosis confirmed by long-term follow-up. The criteria were tested in the Heinola community-based inception cohort of 121 true RA patients, while the control group consisted of 95 patients with definite spondyloarthritis and swollen joint(s), recruited in the same time. The diagnoses were confirmed by long-term follow-up. The fulfillment of the four 2010 criteria was determined at baseline (arthritis duration less than 6 months). Ninety-five in one hundred twenty-one (79%) of all RA patients, 54/68 (79%) of nonerosive (at baseline) RA patients, and 4/95 (4%) of controls fulfilled the 2010 criteria of RA, with better specificity (96%) than the 1987 ACR criteria (86%) in the same material. At baseline erosions were found in 44% of all RA patients and in 15% of the controls; rheumatoid factor was positive in 87% of the RA patients, but in 1% of the controls. One hundred seven in one hundred twenty-one (88%) of all RA patients and 16/95 (17%) of the controls fulfilled the 2010 total score criteria or were erosive at onset. The 2010 ACR/EULAR criteria should be documented in all patients with arthritis. If the criteria are not fulfilled at baseline in a nonerosive patient, the true diagnose may still be RA due to seroconversion or diagnostic manifestations during the follow-up. Indications for early disease modifying antirheumatic drug treatment may be present in active arthritis also in cases not fulfilling the new criteria at baseline.

This is a preview of subscription content, access via your institution.

References

  1. Scott DL, Pugner K, Kaarela K, Doyle DV, Woolf A, Holmes J et al (2000) The links between joint damage and disability in rheumatoid arthritis. Rheumatology 39:122–132

    PubMed  Article  CAS  Google Scholar 

  2. Kaarela K (1985) Prognostic factors and diagnostic criteria in early rheumatoid arthritis. Scand J Rheumatol 14(Suppl 57):1–54

    Article  Google Scholar 

  3. Kaarela K, Kauppi MJ, Lehtinen KES (1995) The value of the ACR 1987 criteria in very early rheumatoid arthritis. Scand J Rheumatol 24:279–281

    PubMed  Article  CAS  Google Scholar 

  4. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO III et al (2010) 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 69:1580–1588

    PubMed  Article  Google Scholar 

  5. Jäntti JK, Kaarela K, Belt EA, Kautiainen HJ (2002) Incidence of severe outcome in rheumatoid arthritis during 20 years. J Rheumatol 29:688–692

    PubMed  Google Scholar 

  6. Kaarela K, Luukkainen R, Koskimies S (1993) How often is seropositive rheumatoid arthritis an erosive disease? A 17-year follow-up study. J Rheumatol 20:1670–1673

    PubMed  CAS  Google Scholar 

  7. Kaarela K, Jäntti JK, Kotaniemi KM (2009) Similarity between chronic reactive arthritis and ankylosing spondylitis. A 32–35-year follow-up study. Clin Exp Rheumatol 27:325–328

    PubMed  CAS  Google Scholar 

  8. Kaarela K, Kautiainen H (1997) Continuous progression of radiological destruction in seropositive rheumatoid arthritis. J Rheumatol 24:1285–1287

    PubMed  CAS  Google Scholar 

  9. Klaukka T, Kaarela K (2003) Methotrexate is the leading DMARD in Finland. Ann Rheum Dis 62:494

    PubMed  Article  CAS  Google Scholar 

  10. Jäntti JK, Kaarela K, Lehtinen KES (2002) Seronegative oligoarthritis: a 23-year follow-up study. Clin Rheumatol 21:353–356

    PubMed  Article  Google Scholar 

  11. Le Loët X, Strotz V, Lequerré T, Boumier P, Pouplin S, Meijjad O et al (2011) Combining anti-cyclic citrullinated peptide with the American College of Rheumatology 1987 criteria failed to improve early rheumatoid arthritis diagnosis in the community-based very early arthritis cohort. Rheumatology (Oxford). doi:10.1093/rheumatology/ker217

  12. van der Linden MP, Knevel R, Huizinga TW, van der Helm-van Mil AH (2011) Classification of rheumatoid arthritis: comparison of the 1987 American College of Rheumatology criteria and the 2010 American College of Rheumatology/European League Against Rheumatism criteria. Arthritis Rheum 63:37–42

    PubMed  Article  Google Scholar 

  13. Alves C, Luime JJ, van Zeben D, Huisman AM, Weel AE, Barendregt PJ et al (2011) Diagnostic performance of the ACR/EULAR 2010 criteria for rheumatoid arthritis and two diagnostic algorithms in an early arthritis clinic (REACH). Ann Rheum Dis 70(9):1645–1647

    PubMed  Article  Google Scholar 

  14. Varache S, Cornec D, Morvan J, Devauchelle-Pensec V, Berthelot JM, LE Henaff-Bourhis C et al (2011) Diagnostic accuracy of ACR/EULAR 2010 criteria for rheumatoid arthritis in a 2-year cohort. J Rheumatol 38:1250–1257

    PubMed  Article  Google Scholar 

  15. Cader MZ, Filer A, Hazlehurst J, de Pablo P, Buckley CD, Raza K (2011) Performance of the 2010 ACR/EULAR criteria for rheumatoid arthritis: comparison with 1987 ACR criteria in a very early synovitis cohort. Ann Rheum Dis 70:949–955

    PubMed  Article  Google Scholar 

Download references

Disclosures

Markku J Kauppi has participated and given lectures in scientific meetings sponsored by pharmaceutical companies (Abbott, BMS, MSD, Pfizer, Roche, and UCB).

Author information

Affiliations

Authors

Corresponding author

Correspondence to Markku J. Kauppi.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kaarela, K., Kauppi, J.E. & Kauppi, M.J. The 2010 ACR/EULAR classification criteria for rheumatoid arthritis in the Heinola inception cohort—diagnoses confirmed by long-term follow-up. Clin Rheumatol 31, 547–551 (2012). https://doi.org/10.1007/s10067-011-1859-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-011-1859-2

Keywords

  • Criterion
  • Diagnosis
  • Early rheumatoid arthritis