SAT0675 The role of erosions typical of rheumatoid arthritis in the 2010 acr/eular rheumatoid classification criteria: results from a very early arthritis cohort. (15th June 2017)

• Record Type: Journal Article
• Authors: Brinkmann, GH; Norli, ES; Bøyesen, P; Heijde, D van der; Grøvle, L; Haugen, AJ; Nygaard, H; Bjørneboe, O; Thunem, C; Kvien, TK; Mjaavatten, MD; Lie, E
• Is Part Of: Annals of the rheumatic diseases. Volume 76(2017)Supplement 2
• Page Start: 1030
• Page End: 1030
• Publication Date: 2017-06-15
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2017-eular.1484
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: A EULAR task force has proposed that in addition to the 2010 ACR/EULAR rheumatoid arthritis (RA) classification criteria (2010 RA criteria), patients can still be classified as having RA with less than 6 criteria points on the presence of ≥3 joints with typical erosions on conventional radiographs of hands and feet (erosion criterion) (1). Objectives: To determine how the EULAR definition of erosive disease contributes to the number of patients classified as RA according to the 2010 RA criteria in an early arthritis cohort. Methods: Patients with arthritis of ≤16 weeks duration and a clinical diagnosis of RA or undifferentiated arthritis (UA) with available hand and feet radiographs were included from the Norwegian Very Early Arthritis Clinic (NOR-VEAC) study. Erosive disease was defined according to the EULAR definition accompanying the 2010 RA criteria, i.e. ≥3 erosive joints (1). We calculated the additional number of patients being classified as RA based on the erosion criteria at baseline and during follow-up. Other cut-offs and the distribution of erosive joints was also examined. Results: The current study included 289 patients (mean (SD) age 48 (14.7) years, 54.3% females, median (25, 75 perc) duration of joint swelling 46 (19.5, 79.0) days). At baseline, 120 patients (41.5%) fulfilled the 2010 RA criteria. Of the remaining 169 not fulfilling the 2010 RA criteria, 55 patients had ≥1 erosive joint (40 with hand erosions, 28 with feet erosions and 13 with hand and feet erosions) and 15 (5.2%) patients fulfilled the erosion criterion (Figure 1 ). The distribution of erosive joints in the 169 patients not fulfilling the 2010 RA criteria at baseline is shown in the table. 118 patients had radiographic follow-up at 2 years, of whom only 1 additional patient solely fulfilled the erosion criterion during follow-up (7 additional patients fulfilled both the 2010 criteria and the erosion criterion). Among patients with no erosions at baseline (N=74), 13 (17.6%) developed erosions during follow-up (PIP joints n=3, MCP n=4, wrist n=3, CMC joint n=1, MTP joints n=9 and IP1 joint in the foot n=3). Conclusions: Among this cohort of patients with very early arthritis, 5.2% were classified as RA at baseline based solely on the erosion criterion. Of the 118 patients with 2-year follow-up data, only 1 additional patient was classified based on the erosion criterion alone during follow-up, thus, follow-up radiographs in patients with early UA do not seem to provide additional information in classifying patients with RA. References: van der Heijde D, van der Helm-van Mil AH, Aletaha D, Bingham CO, Burmester GR, Dougados M, et al. EULAR definition of erosive disease in light of the 2010 ACR/EULAR rheumatoid arthritis classification criteria. Ann Rheum Dis2013 Apr;72(4):479–81. Disclosure of Interest: G. Brinkmann: None declared, E. Norli: None declared, P. Bøyesen: None declared, D. van der Heijde: None declared, L. Grøvle: None declared, A. Haugen: None declared, H. Nygaard: None declared, O. Bjørneboe: None declared, C. Thunem: None declared, T. Kvien Consultant for: Has received fees for speaking and/ or consulting from AbbVie, Biogen, BMS, Boehringer Ingelheim, Celltrion, Eli Lilly, Epirus, Janssen, Merck-Serono, MSD, Mundipharma, Novartis, Oktal, Orion Pharma, Hospira/Pfizer, Roche, Sandoz and UCB, M. Mjaavatten: None declared, E. Lie: None declared