Rheumatology Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran.
Int J Rheum Dis. 2012 Oct;15(5):455-61. doi: 10.1111/j.1756-185X.2012.01766.x. Epub 2012 Jun 12.
Rheumatoid arthritis (RA) needs early treatment to improve clinical outcome by reducing joint damage, radiographic progression and disability. The aim of this study was to evaluate the 2010 Rheumatoid Arthritis Classification Criteria for its ability to classify RA patients, in their early stages, not exceeding 12 months of disease progression.
Rheumatoid arthritis (RA) patients were selected from August to December 2010, among those coming for their follow-up. The inclusion criteria were patients with not more than 12 months of disease progression at their first evaluation. Patients were selected from four rheumatology subspecialty clinics.
Nine hundred and ninety-seven patients with a confirmed diagnosis of RA entered the study. The female-to-male ratio was 4.3/1.0. Mean age was 46.4 years. Mean disease progression at first visit was 6.3 months. The mean follow-up of their disease was 5.9 years. The 1987 American College of Rheumatology (ACR) criteria were fulfilled for 74% of patients. The ACR/EULAR (European League Against Rheumatism) criteria were fulfilled for 69% of patients. Ten percent had involvement of 2-10 large joints, 29% 1-3 small joints, 25% 4-10 small joints and 32% more than 10 joints. Low rheumatoid factor (RF)/anticytoplasmic antibodies (ACPA) were discovered in 30%, high RF/ACPA in 37%; high erythrocyte sedimentation rate/C-reactive protein in 77%, and duration of 6 weeks or more in 92% of patients. There was no significant difference between men and women.
The 2010 ACR/EULAR criteria have good performance: sensitivity of 69% in early disease (first year), with the same sensitivity in both genders.
类风湿关节炎(RA)需要早期治疗,通过减少关节损伤、放射学进展和残疾来改善临床结局。本研究旨在评估 2010 年类风湿关节炎分类标准在疾病进展不超过 12 个月的早期阶段对 RA 患者进行分类的能力。
2010 年 8 月至 12 月,从前来复诊的患者中选择类风湿关节炎(RA)患者。纳入标准为首次评估时疾病进展不超过 12 个月的患者。患者选自四个风湿病亚专科诊所。
997 例确诊为 RA 的患者进入研究。男女比例为 4.3/1.0。平均年龄为 46.4 岁。首次就诊时的平均疾病进展时间为 6.3 个月。疾病的平均随访时间为 5.9 年。74%的患者符合 1987 年美国风湿病学会(ACR)标准。69%的患者符合 ACR/EULAR(欧洲抗风湿病联盟)标准。10%的患者累及 2-10 个大关节,29%的患者累及 1-3 个小关节,25%的患者累及 4-10 个小关节,32%的患者累及 10 个以上关节。30%的患者类风湿因子(RF)/抗细胞质抗体(ACPA)低,37%的患者 RF/ACPA 高;77%的患者红细胞沉降率/C 反应蛋白高,92%的患者持续 6 周或以上。男女之间无显著差异。
2010 年 ACR/EULAR 标准具有良好的性能:在疾病早期(第一年)的敏感性为 69%,在两性中具有相同的敏感性。