Background/Purpose:

To evaluate the specificity of the new ACR/EULAR classification criteria for PMR in a consecutive series of outpatients attending an early arthritis clinic (EAC).

Methods:

All patients attending our outpatients EAC are followed according to a standardized protocol which include clinical examination, determination of laboratory parameters, quality of life questionnaires and ultrasound (US) examination of shoulders, hips, hands and feet. In this 3-year prospective study we included consecutive patients aged > 50 years followed for at least 12 months. Patients entered the study if they had a definite diagnosis of non-PMR inflammatory joint condition confirmed at 12 month follow-up period according to rheumatologist opinion (PM). The PMR group consisted of 136 recent onset, consecutive patients seen in our rheumatological centre during a 5 year period. C statistic were utilized to compare the new ACR/EULAR classification criteria with some of the former diagnostic/classification criteria (Hunder’s, Jones’s, Bird’s, Healey’s criteria). 

Results:

One hundred and twenty-eight non PMR patients entered the study (mean age 64.2+9.9y, female 70.3%, mean disease duration at first visit 12.47+9.0 w, mean ESR 35.13+25.3 mm/1sth, mean CRP 2.04+2.48 mg/dl). After one year of follow up their diagnosis was : rheumatoid arthritis (RA) 96 pts, spondyloarthropaty 32 pts.

Table 1 shows the specificity and area under the curve (AUC) of the receiver operating characteristic curves when conditions were met in the total group and in the RA patients group(*).

Specificity and AUC in the total group and in the rheumatoid arthritis patients group(*)

PMR diagnostic /classification criteria Specificity (128 total cases) AUC (SE) Specificity* (96 RA patients) AUC* (SE) ACR/EULAR 81.5 0.872(.029) 79.7 0.863(.031) US-ACR /EULAR 91.4 0.917(.023) 89.9 0.910(.025) HEALEY 80.2 0.799(.033) 78.3 0.773(.035) HUNDER 79.0 0.777(.034) 78.3 0.789(.036) BIRD 72.8 0.742(.036) 72.5 0.740(.038) JONES 96.7 0.810(.030) 98.6 0.816(.030)

Conclusion:

In a series of outpatients attending our EAC the new ACR/EULAR PMR classification criteria have a better specificity as compared to the previous criteria (except for Jones’s one). US shoulders and hips examination increases the specificity of the new ACR/EULAR criteria.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/specificity-of-the-new-american-college-of-rheumatologyeuropean-league-against-rheumatism-classification-criteria-for-polymyalgia-rheumatica-in-comparison-with-the-former-ones-a-single-centre-study/