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Validation of new classification criteria of rheumatoid arthritis in an international multicentre study


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26

 

  1. Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135) and Peking-Tsinghua Center for Life Sciences, Beijing, China.
  2. Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135) and Peking-Tsinghua Center for Life Sciences, Beijing, China. 18810650837@163.com
  3. Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135) and Peking-Tsinghua Center for Life Sciences, Beijing, China.
  4. Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135) and Peking-Tsinghua Center for Life Sciences, Beijing, China.
  5. Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China.
  6. Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China.
  7. Department of Rheumatology and Immunology of the First Af liated Hospital of Harbin Medical University, Harbin, China.
  8. Department of Rheumatology and Immunology of the First Af liated Hospital of Harbin Medical University, Harbin, China.
  9. Department of Rheumatology and Immunology, China-Japan Union Hospital of Jilin University, Changchun, China.
  10. Department of Rheumatology and Immunology, China-Japan Union Hospital of Jilin University, Changchun, China.
  11. Department of Rheumatology and Immunology, China-Japan Friendship Hospital, Beijing, China.
  12. Department of Rheumatology & Immunology, China-Japan Friendship Hospital, Beijing, China.
  13. Department of Rheumatology and Immunology, Peking Union Medical College Hospital, Beijing, China.
  14. Department of Rheumatology and Immunology, Peking Union Medical College Hospital, Beijing, China.
  15. Department of Rheumatology and Immunology of the Affiliated Drum Tower Hospital, Nanjing University, Nanjing, China.
  16. Department of Rheumatology and Immunology of the Affiliated Drum Tower Hospital, Nanjing University, Nanjing, China.
  17. Department of Rheumatology and Immunology, Southwest Hospital of Third Military Medical University, Chongqing, China.
  18. Department of Rheumatology and Immunology, Southwest Hospital of Third Military Medical University, Chongqing, China.
  19. Guang An Men Hospital of Academy of Traditional Chinese Medicine, Beijing, China.
  20. Rheumatology Unit, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
  21. Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India.
  22. Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India.
  23. Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India.
  24. Rheumatology Unit, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden. anca.catrina@ki.se
  25. Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India. debashisdandacmc@hotmail.com
  26. Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135) and Peking-Tsinghua Center for Life Sciences, Beijing, China. li99@bjmu.edu.cn

CER12286
2020 Vol.38, N°5
PI 0841, PF 0847
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PMID: 31820726 [PubMed]

Received: 30/03/2019
Accepted : 16/09/2019
In Press: 09/12/2019
Published: 02/10/2020

Abstract

OBJECTIVES:
Early identification of patients with rheumatoid arthritis (RA) is essential to allow prompt therapy. In this study, we aimed to evaluate the performance of the newly proposed ERA criteria, compared to the 1987 ACR and 2010 ACR/EULAR criteria in an international multicentre study.
METHODS:
A total of 606 patients with disease duration ≤2 years and age ≥16 years who were diagnosed as RA or non-RA were enrolled from China, Sweden and India. The clinical and laboratory parameters were recorded. We compared the sensitivity, specificity, predictive value, likelihood ratio (LR), and the area under the ROC curve (AUC) of three criteria in these cohorts. Concordance between the three criteria was calculated with the Kappa coefficient.
RESULTS:
Three hundred and twelve RA and 294 non-RA patients were included. The Early Rheumatoid Arthritis (ERA) criteria had significantly higher specificity compared to the 2010 ACR/ EULAR criteria (83.7% vs. 78.2%, p=0.02) and sensitivity were similar (79.2% vs. 78.5%, p=0.883). In comparison with the 1987 ACR criteria, the ERA criteria had higher sensitivity (79.2% vs. 54.5%, p<0.001) but lower specificity (83.7% vs. 89.1%, p<0.001), and the AUC of the ERA criteria (0.878) was comparable to the 2010 ACR/EULAR criteria (0.849) and higher than the 1987 ACR criteria (0.791, p<0.0001). Patients from the three countries, seronegative and very early arthritis cohorts yielded consistent results.
CONCLUSIONS:
The ERA criteria demonstrate a better performance across ethnics in early RA diagnosis, and is more feasible in daily practice.

Rheumatology Article