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Potential Classification Criteria for Rheumatoid Arthritis After Two Years: Results From a French Multicenter Cohort
Author(s) -
Saraux Alain,
Tobón Gabriel J.,
Benhamou Mathilde,
DevauchellePensec Valérie,
Dougados Maxime,
Mariette Xavier,
Berenbaum Francis,
Chiocchia Gilles,
Rat AnneChristine,
Schaeverbeke Thierry,
Rincheval Nathalie,
Meyer Olivier,
Fautrel Bruno,
Combe Bernard
Publication year - 2013
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.21982
Subject(s) - medicine , rheumatoid arthritis , rheumatism , synovitis , cohort , rheumatology , arthritis , physical therapy
Objective 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. Methods 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. Results 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. Conclusion 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.