Navigation Links
New way of classifying rheumatoid arthritis aimed at identifying the disease earlier

The American College of Rheumatology today announced the release of revised classification criteria (created in collaboration with the European League Against Rheumatism) for rheumatoid arthritis, which will allow the study of treatments for RA at much earlier stages of the diseasebefore joint damage occursultimately leading to better patient outcomes.

Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in the organs as well. An estimated 1.3 million Americans have RA, and the disease typically affects women twice as often as men.

Classification criteria are the standard and accepted means by which researchers define a disease. They allow researchers to define individuals as having or not having a given disease, helping to standardize recruitment into clinical trials and other research studies. Although not intended as criteria for diagnosis in clinical practice, with some additional research, classification criteria may be modified and adopted for such use.

Classification criteria are typically updated as knowledge changes, which is the case with the new RA criteria published in the College's journal, Arthritis & Rheumatism. The previous criteria were created in 1987. Since that time, new therapies have emerged that can prevent joint damage in people with RA. With these modern therapies, the goal of treatment is to prevent people from reaching the point where their RA is causing chronic damage to their joints.

"The 1987 criteria actually posed a major barrier to the study of treatments designed to prevent joint damage in RA," explains Gillian Hawker, MD; senior author of the new criteria. "Many patients did not fulfill the previous RA classification criteria until their disease was well-advanced, andin many casesjoint damage had already occurred. This truly limited RA researchers from studying the disease at its earlier phases, which is critical to the development of new treatments to prevent damage."

In 2008, the ACR began a collaborative project with the EULAR to create the first new set of RA classification criteria in over 20 years. To establish the new criteria, researchers completed three phases of work. The first phase (led by EULAR) involved reviewing existing data collected from patients with early arthritis to determine which factors best identified patients who were, according to Daniel Aletaha, MD, MS; lead author of this phase of research, "at a high risk of developing the more persistent and erosive arthritis that we currently consider to be RA." Dr. Aletaha also explains that this phase of research is an important component to the overall project as "all classification criteria need to be built on scientific evidence, either from the literature oras with these criteriafrom extensive analysis of real patient data."

The second phase of work (led by the ACR) was aimed at reaching consensus among practicing rheumatologists on which factors were most important in determining a person's likelihood of developing the chronic joint damage that has been known for many years as the hallmark of RA. "Both scientific evidence and the experience of RA experts needed to be considered in the development of the new criteria to ensure all important factors were identified," explains criteria author Tuhina Neogi, MD, PhD. "Additionally, ensuring the new criteria reflects the opinions of front-line rheumatologists diagnosing and treating patients in clinical practice is key to their ultimate acceptance."

In phase three, researchers integrated the findings from the first two phases of work, refined a scoring system, and determined the optimal cut off point to define the disease. Patients to whom these criteria should be applied must have confirmed presence of joint swelling, indicating synovitisthe inflammation of the synovial membrane, which lines a jointin at least one joint, and no other possible diagnosis that might better explain the symptoms (such as lupus or gout).

"To be classified as having 'definite RA,' patients must receive a score of six or greater (out of a possible 10)," explains Alan Silman, MD who initiated the project. "The scoring system takes into consideration the number and site/size of involved joints, laboratory tests of inflammation and auto-immunity, and symptom duration."

Researchers continue to make great strides in RA research. The creation of this new set of classification criteria is expected to further accelerate the research being done in this field. The next logical step, according to Dr. Hawker, is to use these classification criteria as the basis for the development of diagnostic criteria for RA, for use by practicing rheumatologists.

"Under the correct circumstances, new knowledge resulting from rheumatology research can quickly move into applicable treatments for patients," explains ACR President Stanley B. Cohen, MD. "We believe these new classification criteria will open the door to more meaningful studies of RA and will eventually lead to changes in the diagnosis and treatment of the disease. This is an important step for RA researchers, practicing rheumatologists and patients."


Contact: Dawn Peters

Related medicine news :

1. Almost three quarters of women with rheumatoid arthritis worldwide suffer pain daily
2. Stomach Bacteria Might Trigger Rheumatoid Arthritis
3. Partners grieve rheumatoid arthritis diagnosis as much as patients
4. Women who consume large amounts of tea have increased risk of rheumatoid arthritis
5. Sex lives of patients are negatively affected by rheumatoid arthritis and SLE
6. New Approach to Rheumatoid Arthritis
7. Majority of Ontarians suffering from rheumatoid arthritis not receiving needed speciality care
8. Could Drinking Help Thwart Rheumatoid Arthritis?
9. Instaflex Announces Proceeds Agreement with Arthritis Foundation
10. Contrast-enhanced MRI could play a key role in differentiating between common types of arthritis
11. Stopain Labels Featuring Arthritis Foundation Sponsorship Now Appearing on Retail Shelves
Post Your Comments:
(Date:12/1/2015)... ME (PRWEB) , ... December 01, 2015 , ... Royal ... reports a new study that found post-menopausal women who took the nutritional supplement creatine, ... than women who trained but did not take creatine. , The report is part ...
(Date:12/1/2015)... ... ... is the first health care provider in the region to offer the vBloc® Therapy ... vagal blocking therapy, delivered via the Maestro® System, for the treatment of adult patients over ... to 45 kg, or a BMI of at least 35 to 39.9 kg with a ...
(Date:12/1/2015)... , ... December 01, 2015 , ... ... oncology and hematology continuing medical education (CME), today announced that the first annual ... Hyatt New York. , “The prevention, detection and treatment of gastrointestinal cancers are ...
(Date:12/1/2015)... ... December 01, 2015 , ... Califia Farms , ... that its iconic bottle has won top honors in Beverage World Magazine’s Global Packaging ... also announced that it has been selected as a 2015 U.S.A. Taste Champion in ...
(Date:12/1/2015)... , ... December 01, 2015 , ... ... there are professionals who believe that with innovative technologies and under the right ... patient to get the benefit of a dual-approach to his or her therapeutic ...
Breaking Medicine News(10 mins):
(Date:12/1/2015)... 2015  Athletic apparel company Tommie Copper ... pay $1.35 million to settle Federal Trade Commission ... compression clothing would relieve severe and chronic pain ... Tommie Copper,s proposed settlement ... its founder and chairman Thomas Kallish ...
(Date:12/1/2015)... and PITTSBURGH , Dec. ... announced that it expects to be the first to ... funded by international donors, TLE400 (Tenofovir Disoproxyl Fumarate 300 ... for $99 per patient, per year. Mylan partnered with ... The significantly reduced price could generate savings of tens ...
(Date:12/1/2015)... Virginia , 1 de diciembre de ... en tecnología para cuchillas de precisión, develó ... programa de identidad de marca. El nuevo ... el diseño y la ingeniería de productos ... la diferencia". ...
Breaking Medicine Technology: