Background/Purpose:  The 2010-ACR/EULAR criteria were derived to classify RA earlier in time. Previous studies indeed observed that the 2010-criteria were fulfilled earlier than the 1987-criteria. This study determined whether the 2010-criteria perform equally in early detection of autoantibody-positive and autoantibody-negative RA.

Methods:  From the total Leiden-EAC (n=3448) and ESPOIR (n=813) RA-patients who fulfilled the 1987-RA criteria at 1-year but not at presentation were selected (n=515 and n=53, respectively). These RA-patients were studied on the presence of ACPA and RF, and on fulfilling the 2010-criteria at baseline, as 2010-positivity indicated that these RA-patients were earlier identified.

Results:  In the EAC, 67% of the selected RA-patients did already fulfil the 2010-criteria at baseline. In ESPOIR this was 57%, indeed demonstrating early classification with the 2010-criteria. Among the selected autoantibody-positive RA-patients of the EAC, 85% was identified at baseline already with the 2010-criteria. Within autoantibody-negative RA this was 45% (p<0.001). Similarly within autoantibody-positive RA-patients in ESPOIR 92% was 2010-positive at baseline, whereas this was only 25% within autoantibody-negative RA (p<0.001).

Conclusion:  The 2010-criteria perform well in the early identification of autoantibody-positive RA, but autoantibody-negative RA-patients are still frequently missed with these criteria. This implies that other diagnostics are required for ACPA-negative patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-2010-acreular-criteria-are-not-sufficiently-accurate-in-the-early-identification-of-autoantibody-negative-rheumatoid-arthritis/