Literature DB >> 21953339

Undifferentiated arthritis characteristics and outcomes when applying the 2010 and 1987 criteria for rheumatoid arthritis.

A Krabben1, T W J Huizinga, A H M van der Helm-van Mil.   

Abstract

OBJECTIVE: Undifferentiated arthritis (UA) is a diagnosis 'per exclusionem'. Therefore this patient population may change since the development of the ACR/EULAR 2010-criteria for RA. This study evaluated characteristics and outcomes of UA in its new shape. Second, it was evaluated whether the 2010-criteria and the Leiden prediction rule were congruent in categorizing UA-patients.
METHODS: 2,472 early arthritis patients were studied. RA was classified according to either the 1987 or the 2010-criteria. UA was defined as not fulfilling existing classification criteria. UA-patients were compared for baseline characteristics and outcomes. In 1987-UA-patients both the 2010-criteria and the Leiden prediction rule were applied and categorization compared.
RESULTS: 2010-UA-patients (n=776) had milder baseline characteristics than 1987-UA-patients (n=1,166). During follow-up, still 24% of the 2010-UA-patients fulfilled the 1987 RA-criteria compared to 32% of the 1987-UA-patients. The 2010-UA-patients started less frequent DMARD-therapy and reached more frequent sustained DMARD-free remission. 30% of 2010-criteria-positive patients were predicted to have a low risk on RA; these patients achieved more frequent DMARD-free sustained remission than other 2010-criteria-positive patients.
CONCLUSION: UA in the era of the 2010-criteria is less prevalent and milder at presentation and in outcome. This implies that UA-patients with unfavorable characteristics are now more often classified as RA.

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Year:  2011        PMID: 21953339     DOI: 10.1136/annrheumdis-2011-200205

Source DB:  PubMed          Journal:  Ann Rheum Dis        ISSN: 0003-4967            Impact factor:   19.103


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