UMass Chan Affiliations
Department of Medicine, Division of RheumatologyDocument Type
Journal ArticlePublication Date
2012-12-01Keywords
Acute-Phase ProteinsAntirheumatic Agents
Arthritis, Rheumatoid
Biological Markers
Disease Progression
Europe
Humans
Joints
Methotrexate
Societies, Medical
United States
Musculoskeletal Diseases
Rheumatology
Skin and Connective Tissue Diseases
Metadata
Show full item recordAbstract
Advances in our understanding of the pathogenesis of RA over the past two decades, particularly the identification of cytokines that promote synovial inflammation (e.g. TNF-alpha, IL-1 and IL-6), have led to treatment courses that affect the disease process itself, beyond alleviation of symptoms. In turn, emphasis has shifted to intervention early enough in the disease course to prevent the joint destruction that follows inflammation. Accordingly, in 2010 the ACR and the European League Against Rheumatism (EULAR) put forward revised classification criteria emphasizing RA characteristics that emerge early in the disease course, including ACPAs, a biomarker that predicts aggressive disease. These were in contrast with the 1987 ARA criteria, which distinguished established RA patients from those with other forms of arthritis, and identified patients with later disease. The categories of the 2010 ACR/EULAR criteria are grouped into four classifications, with point scores for each: joint symptoms; serology (including RF and/or ACPA); symptom duration, whether < 6 weeks or > 6 weeks; and acute-phase reactants (CRP and/or ESR). The criteria were developed in a three-phase process, beginning with an analysis of patient cohorts to determine what disease characteristics had persuaded clinicians to initiate MTX therapy, followed by consensus-based decisions and the creation of a scoring system that would predict which patients would go on to develop persistent and/or erosive disease.Source
Rheumatology (Oxford). 2012 Dec;51 Suppl 6:vi5-9. doi: 10.1093/rheumatology/kes279. Link to article on publisher's siteDOI
10.1093/rheumatology/kes279Permanent Link to this Item
http://hdl.handle.net/20.500.14038/48723PubMed ID
23221588Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1093/rheumatology/kes279