2010 Rheumatoid Arthritis Classification Criteria An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative
2010 Rheumatoid Arthritis Classification Criteria An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative
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DOI：
10.1002/art.27584
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发表时间：
2010-09-01
影响因子：
--
通讯作者：
Hawker, Gillian
中科院分区：
文献类型：
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作者：
Aletaha, Daniel;Neogi, Tuhina;Hawker, Gillian
目标。1987年美国风湿病学会(ACR；前身为美国风湿病协会)对类风湿性关节炎(RA)的分类标准因对早期疾病缺乏敏感性而受到批评。这项工作是为了制定新的RA分类标准。由ACR和欧洲风湿病联盟组成的联合工作组分3个阶段制定了一种新的类风湿性关节炎分类方法。这项工作的重点是在新出现未分化炎性滑膜炎的患者中识别最能区分那些有持续性和/或侵袭性疾病的高风险患者和那些没有高风险的患者的因素--这是当前构建疾病结构的适当的当前范式。在新的标准集中，明确的类风湿性关节炎的分类是基于至少1个关节存在滑膜炎，缺乏更好地解释滑膜炎的替代诊断，以及从受累关节的数量和位置(评分范围0-5)、血清学异常(评分范围0-3)、急性时相反应升高(评分范围0-1)和症状持续时间(2级；0-1)的4个领域的总分达到6分或更高(可能的10分)。这一新的分类系统通过关注与持续性和/或侵袭性疾病相关的疾病早期阶段的特征，而不是通过其晚期特征来定义疾病，从而重新定义了当前的RA范式。这将使人们重新关注对早期诊断和建立有效的疾病抑制治疗的重要需要，以防止或最大限度地减少不良后遗症的发生，这些后遗症目前构成了构成疾病的范例“类风湿性关节炎”。
Objective. The 1987 American College of Rheumatology (ACR; formerly, the American Rheumatism Association) classification criteria for rheumatoid arthritis (RA) have been criticized for their lack of sensitivity in early disease. This work was undertaken to develop new classification criteria for RA.Methods. A joint working group from the ACR and the European League Against Rheumatism developed, in 3 phases, a new approach to classifying RA. The work focused on identifying, among patients newly presenting with undifferentiated inflammatory synovitis, factors that best discriminated between those who were and those who were not at high risk for persistent and/or erosive disease-this being the appropriate current paradigm underlying the disease construct "rheumatoid arthritis."Results. In the new criteria set, classification as "definite RA" is based on the confirmed presence of synovitis in at least 1 joint, absence of an alternative diagnosis that better explains the synovitis, and achievement of a total score of 6 or greater (of a possible 10) from the individual scores in 4 domains: number and site of involved joints (score range 0-5), serologic abnormality (score range 0-3), elevated acute-phase response (score range 0-1), and symptom duration (2 levels; range 0-1).Conclusion. This new classification system redefines the current paradigm of RA by focusing on features at earlier stages of disease that are associated with persistent and/or erosive disease, rather than defining the disease by its late-stage features. This will refocus attention on the important need for earlier diagnosis and institution of effective disease-suppressing therapy to prevent or minimize the occurrence of the undesirable sequelae that currently comprise the paradigm underlying the disease construct "rheumatoid arthritis."