Revised RA classification criteria allow for earlier study of treatments

Newly revised classification criteria for rheumatoid arthritis (RA) will allow for the study of treatments at much earlier disease stages and lead to better patient outcomes, according to the American College of Rheumatology (ACR), which created the new criteria in collaboration with the European League Against Rheumatism (EULAR). Classification criteria are intended to help researchers define a disease rather than be used for diagnosis in clinical practice, but with additional research, the new criteria may be modified for use in practice, it was noted.

With the emergence of new RA therapies since creation of the previous criteria in 1987, the goal has shifted to providing earlier treatment to prevent long-term joint damage. The 1987 criteria actually posed a barrier to the study of treatments designed to prevent joint damage in RA, researchers noted, explaining that many patients did not fulfill the criteria until their disease was well-advanced and joint damage already had occurred.

The ACR and the EULAR began to collaborate in creating the revised RA classification criteria in 2008. To establish the new criteria, researchers completed the following 3 phases of work:

•A review of existing data collected from patients with early arthritis, led by EULAR, was designed to determine which factors best identify patients at high risk for the more persistent and erosive arthritis currently considered to be RA.

•An effort to reach consensus among practicing rheumatologists on which factors are most important in determining the probability that a person will experience chronic joint damage, known for many years as the hallmark of RA, was led by the ACR. Ensuring that the new criteria reflect the opinions of front-line rheumatologists seeing patients in clinical practice is key to their ultimate acceptance, it was noted.

•The findings from the first 2 phases were integrated, a scoring system was refined, and the optimal cutoff point to define the disease was determined.

Creation of the new RA classification criteria is expected to accelerate the research currently being conducted, according to the ACR. The development of diagnostic criteria for RA for use by practicing rheumatologists is anticipated.

Findings from the study “2010 Rheumatoid Arthritis Classification Criteria: An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative” will be published in the September issue of Arthritis & Rheumatism. For more information about the ACR, visit http://www.rheumatology.org. Or, contact the organization at ACR, 2200 Lake Boulevard NE, Atlanta, GA 30319-5312; telephone: (404) 633-3777; fax: (404) 633-1870. For discussions of the recently released international task force RA treatment recommendations, go to “Podcasts” in the “Rheumatoid Arthritis Resource Center” on www.musculoskeletalnetwork.com.