Implications of the 2010 rheumatoid arthritis classification criteria

Abstract

Since their last revision in 1987, nurses and other health professionals have looked to the American College of Rheumatology Classification Criteria for Rheumatoid Arthritis in working with arthritis patients. At the time of their development, these criteria reflected our current understanding and definition of established disease and allowed us to stratify patients into those with and without rheumatoid arthritis (RA) (Arnett et al, 1987). Unfortunately, the 1987 criteria have been limited in their ability to recognize those with early RA among patients who present with undifferentiated inflammatory arthritis. This limitation has been more fully appreciated over the past several years since the discovery of new disease modifying anti-rheumatic drugs (DMARDs), such as biologics, and more sensitive laboratory testing, such as anti-cyclic citrullinated peptide, which can precede the development of clinical disease by years. (Rantapaa-Dahlqvis et al, 2003). Early implementation of modern DMARD treatment regimens have also shown us that RA patients can often be prevented from reaching a chronic, erosive disease state as defined by the 1987 criteria. With this in mind, the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) collaborated to publish the 2010 RA Classification Criteria in September (Aletaha et a, 2010).