TY - JOUR
T1 - EULAR/ACR risk stratification criteria for development of rheumatoid arthritis in the risk stage of arthralgia
AU - van Steenbergen, Hanna W.
AU - Doornkamp, Frank
AU - Alivernini, Stefano
AU - Backlund, John
AU - Codreanu, Catalin
AU - Cohen, Stanley B.
AU - Combe, Bernard
AU - Cope, Andrew P.
AU - Deane, Kevin D.
AU - England, Bryant R.
AU - Falahee, Marie
AU - de Jong, Pascal H.P.
AU - Kleyer, Arnd
AU - Lacaille, Diane
AU - Maat, Bertha
AU - Mankia, Kulveer
AU - van Mulligen, Elise
AU - Nagy, György
AU - O'Neill, Liam J.
AU - Rodamaker, Linda
AU - Sahbudin, Ilfita
AU - van Schaardenburg, Dirkjan
AU - Sepriano, Alexandre
AU - da Silva, Jose A.P.
AU - De Smet, Lukas
AU - Sparks, Jeffrey A.
AU - Steyerberg, Ewout W.
AU - Studenic, Paul
AU - Wethingtone, Elisabeth
AU - Landewe, Robert L.
AU - Raza, Karim
AU - van der Helm-van Mil, Annette H.M.
N1 - Copyright © 2025. Published by Elsevier B.V.
PY - 2025/5/8
Y1 - 2025/5/8
N2 - Objectives: The field of rheumatoid arthritis (RA) is moving towardsidentification of and intervention in people at risk of RA, but a validatedrisk stratification method is lacking. This work was undertaken to develop arisk stratification method for persons presenting with arthralgia considered tobe at risk of RA.Methods: A joint European Alliance of Associations for Rheumatology(EULAR)/American College of Rheumatology (ACR) expert committee wasestablished. Risk factor and outcome data from 10 arthralgia cohorts (includingclinically suspect arthralgia and autoantibody-positive arthralgia) werestudied. The work focused on differentiating the risk of progression toclinically apparent inflammatory arthritis (IA) within 1 year, using clinicaland serologic variables, without and with subclinical joint inflammation detectedby ultrasound (US) or magnetic resonance imaging (MRI). Developing RA accordingto the 2010 EULAR/ACR criteria within 1 year was a secondary outcome. A set ofvalidated risk stratification criteria was developed.Results: Using data from 2293 symptomatic at-risk individuals, astratification method was derived consisting of 6 clinical and serologicvariables (morning stiffness, patient-reported joint swelling, difficultymaking a fist, C-reactive protein, rheumatoid factor, and anti-citrullinatedpeptide antibody) yielding an area under the curve (AUC) of 0.80 (95% CI,0.77-0.83) for IA development. The inclusion of US variables did not increasethe discriminative ability. When MRI-detected subclinical inflammation variableswere included, the AUC was 0.87 (95% CI, 0.82-0.90). In the presence ofclinical, serologic, and MRI variables, a sensitivity and specificity of>75% was achieved. For RA development, the AUC of the criteria with MRI was0.93 (95% CI, 0.90-0.97).Conclusions: EULAR/ACR risk stratification criteria have been developedfor people with arthralgia in secondary care who are considered at risk for RA.They can be applied in the absence or presence of imaging data and have beendeveloped to define homogeneous risk groups for future prevention trials.
AB - Objectives: The field of rheumatoid arthritis (RA) is moving towardsidentification of and intervention in people at risk of RA, but a validatedrisk stratification method is lacking. This work was undertaken to develop arisk stratification method for persons presenting with arthralgia considered tobe at risk of RA.Methods: A joint European Alliance of Associations for Rheumatology(EULAR)/American College of Rheumatology (ACR) expert committee wasestablished. Risk factor and outcome data from 10 arthralgia cohorts (includingclinically suspect arthralgia and autoantibody-positive arthralgia) werestudied. The work focused on differentiating the risk of progression toclinically apparent inflammatory arthritis (IA) within 1 year, using clinicaland serologic variables, without and with subclinical joint inflammation detectedby ultrasound (US) or magnetic resonance imaging (MRI). Developing RA accordingto the 2010 EULAR/ACR criteria within 1 year was a secondary outcome. A set ofvalidated risk stratification criteria was developed.Results: Using data from 2293 symptomatic at-risk individuals, astratification method was derived consisting of 6 clinical and serologicvariables (morning stiffness, patient-reported joint swelling, difficultymaking a fist, C-reactive protein, rheumatoid factor, and anti-citrullinatedpeptide antibody) yielding an area under the curve (AUC) of 0.80 (95% CI,0.77-0.83) for IA development. The inclusion of US variables did not increasethe discriminative ability. When MRI-detected subclinical inflammation variableswere included, the AUC was 0.87 (95% CI, 0.82-0.90). In the presence ofclinical, serologic, and MRI variables, a sensitivity and specificity of>75% was achieved. For RA development, the AUC of the criteria with MRI was0.93 (95% CI, 0.90-0.97).Conclusions: EULAR/ACR risk stratification criteria have been developedfor people with arthralgia in secondary care who are considered at risk for RA.They can be applied in the absence or presence of imaging data and have beendeveloped to define homogeneous risk groups for future prevention trials.
U2 - 10.1016/j.ard.2025.01.021
DO - 10.1016/j.ard.2025.01.021
M3 - Article
C2 - 40447498
SN - 0003-4967
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
ER -