title: Validation of the 2010-ACR/EULAR -classification criteria using newly EULAR-defined erosion for rheumatoid arthritis on the very early arthritis community-based (VErA) cohort.
abstract: OBJECTIVE
  To validate the 2010-ACR/EULAR criteria for rheumatoid arthritis (RA), taking into account the recent EULAR definition of "erosive disease", on the 310 patients comprising the very early arthritis cohort (VErA).
  
  
  METHODS
  2010-criteria performances were tested by first strictly applying its three items successively: ≥ 1 clinical synovitis/another disease(s)/score ≥ 6/10), then the typical erosion grid without obtaining a score of ≥ 6 to diagnose RA. We tested successively: no erosion (S1), ≥ 1 erosion(s) (S2), EULAR-defined erosive disease (S3). Two gold standards were used: expert diagnosis at six years and EULAR erosive disease at two years.
  
  
  RESULTS
  At inclusion, median age was 52 years; median RA duration 4.2 months. 2010-ACR/EULAR criteria, including EULAR-defined erosive disease applied at baseline, classified comparable numbers of patients as the 1987 criteria (P=0.27). Using expert diagnosis at six years, more patients were classified as RA with S2 than 1987-ACR criteria (P<0.04). In contrast, sensitivity and specificity indicated that 2010-ACR/EULAR-S3 criteria performed slightly but not significantly better than 1987-ACR criteria. On ROC curves, a score ≥ 6 correctly classified RA. When EULAR-defined erosion at two years was the gold standard, the 1987-ACR, the 2010-S1, -S2 and -S3 criteria performed comparably.
  
  
  CONCLUSIONS
  Using the very early community-based, conservatively treated VErA cohort, the strict application of 2010-ACR/EULAR criteria using the new EULAR definition of erosive disease or not performed slightly but not significantly better than the 1987-ACR criteria.
authors.affiliation: Department of Rheumatology, Rouen University Hospital, Inserm U 905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, CHU-hôpitaux de Rouen, 76031 Rouen cedex, France. Electronic address: xavier.le-loet@chu-rouen.fr.
authors.forename: Xavier
authors.initials: X
authors.lastname: Le Loët
authors.affiliation: Department of Rheumatology, Rouen University Hospital, Inserm U 905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, CHU-hôpitaux de Rouen, 76031 Rouen cedex, France.
authors.forename: Julia
authors.initials: J
authors.lastname: Nicolau
authors.affiliation: Department of Rheumatology, Amiens University Hospital, Inserm U 1088, Amiens, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Boumier
authors.affiliation: Department of Rheumatology, Rouen University Hospital, Inserm U 905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, CHU-hôpitaux de Rouen, 76031 Rouen cedex, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Daragon
authors.affiliation: Department of Rheumatology, Rouen University Hospital, Inserm U 905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, CHU-hôpitaux de Rouen, 76031 Rouen cedex, France.
authors.forename: Othmane
authors.initials: O
authors.lastname: Mejjad
authors.affiliation: Department of Rheumatology, Rouen University Hospital, Inserm U 905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, CHU-hôpitaux de Rouen, 76031 Rouen cedex, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Pouplin
authors.affiliation: Le Havre Hospital, Le Havre, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Zarnitsky
authors.affiliation: Department of Rheumatology, Rouen University Hospital, Inserm U 905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, CHU-hôpitaux de Rouen, 76031 Rouen cedex, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Vittecoq
authors.affiliation: Department of Rheumatology, Amiens University Hospital, Inserm U 1088, Amiens, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Fardellone
authors.affiliation: Department of Biostatistics, Rouen University Hospital, Rouen, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Ménard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000145:classification* / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D013585:Synovitis / Q000145:classification / Q000175:diagnosis; D055815:Young Adult
keywords: Classification criteria; Early rheumatoid arthritis; Erosion; Undifferentiated arthritis