期刊
ANNALS OF THE RHEUMATIC DISEASES
卷 71, 期 2, 页码 238-241出版社
B M J PUBLISHING GROUP
DOI: 10.1136/annrheumdis-2011-200205
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资金
- Dutch Arthritis Foundation
- Dutch organisation of Health Research and Development
- European Community [Health-F2-2008-223404]
Objective Undifferentiated arthritis (UA) is a diagnosis 'per exclusionem'. Therefore this patient population may change since the development of the ACR/EULAR 2010-criteria for RA. This study evaluated characteristics and outcomes of UA in its new shape. Second, it was evaluated whether the 2010-criteria and the Leiden prediction rule were congruent in categorizing UA-patients. Methods 2,472 early arthritis patients were studied. RA was classified according to either the 1987 or the 2010-criteria. UA was defined as not fulfilling existing classification criteria. UA-patients were compared for baseline characteristics and outcomes. In 1987-UA-patients both the 2010-criteria and the Leiden prediction rule were applied and categorization compared. Results 2010-UA-patients (n=776) had milder baseline characteristics than 1987-UA-patients (n=1,166). During follow-up, still 24% of the 2010-UA-patients fulfilled the 1987 RA-criteria compared to 32% of the 1987-UA-patients. The 2010-UA-patients started less frequent DMARD-therapy and reached more frequent sustained DMARD-free remission. 30% of 2010-criteria-positive patients were predicted to have a low risk on RA; these patients achieved more frequent DMARD-free sustained remission than other 2010-criteria-positive patients. Conclusion UA in the era of the 2010-criteria is less prevalent and milder at presentation and in outcome. This implies that UA-patients with unfavorable characteristics are now more often classified as RA.
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