RESEARCH - The 2010 ACR/EULAR classification criteria for RA: methodological report phase I

[Guest guest]

Ann Rheum Dis. 2010 Sep;69(9):1589-95.

The 2010 American College of Rheumatology/European League Against

Rheumatism classification criteria for rheumatoid arthritis:

methodological report phase I

Funovits J, Aletaha D, Bykerk V, Combe B, Dougados M, Emery P, Felson

D, Hawker G, Hazes JM, Huizinga T, Kay J, Kvien TK, Smolen JS, Symmons

D, Tak PP, Silman A.

Division of Rheumatology, Medical University Vienna, Waehringer

Guertel 18-20, Vienna, Austria.

Abstract

OBJECTIVE: To apply a data-driven approach to investigate, in patients

newly presenting with undifferentiated inflammatory synovitis, key

variables that discriminate the subset of patients at sufficiently

high risk of persistent or erosive disease for the purpose of

developing new criteria for rheumatoid arthritis (RA).

METHODS: In this first phase of the collaborative effort of the

American College of Rheumatology and European League Against

Rheumatism to develop new criteria for RA, a pooled analysis of early

arthritis cohorts made available by the respective investigators is

presented. All the variables associated with the gold standard of

treatment with methotrexate during the first year after enrolment were

first identified. Principal component analysis was then used to

identify among the significant variables those sets that represent

similar domains. In a final step, from each domain one representative

variable was extracted, all of which were then tested for their

independent effects in a multivariate regression model. From the OR in

that final model, the relative weight of each variable was estimated.

RESULTS: The final domains and variables identified by this process

(and their relative weights) were: swelling of a metacarpophalangeal

joint (MCP; 1.5), swelling of a proximal interphalangeal joint (PIP;

1.5), swelling of the wrist (1.5), tenderness of the hand (ie, MCP,

PIP or wrist (2)), acute phase reaction (ie, C reactive protein or

erythrocyte sedimentation rate and weights for moderate or high

elevations of either one (1 for moderate, 2 for high elevation)) and

serological abnormalities (ie, rheumatoid factors or

anti-citrullinated protein antibodies, again with separate weights for

moderate or high elevations (2 and 4, respectively)).

CONCLUSION: The results of this first phase were subsequently used in

the second phase of the project, which is reported in a separate

methodological paper, and for derivation of the final set of criteria.

PMID: 20699242

http://www.ncbi.nlm.nih.gov/pubmed/20699242

Not an MD