Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: EULAR definition of arthralgia suspicious for progression to rheumatoid arthritis
Authors : van Steenbergen, Hanna W.
Aletaha, Daniel
Beaart-van de Voorde, Liesbeth J. J.
Brouwer, Elisabeth
Codreanu, Catalin
Combe, Bernard
Fonseca, João E.
Hetland, Merete L.
Humby, Frances
Kvien, Tore K.
Niedermann Schneider, Karin
Nuño, Laura
Oliver, Sue
Rantapää-Dahlqvist, Solbritt
Raza, Karim
van Schaardenburg, Dirkjan
Schett, Georg
De Smet, Liesbeth
Szücs, Gabriella
Vencovský, Jirí
Wiland, Piotr
de Wit, Maarten
Landewé, Robert L.
van der Helm-van Mil, Annette H. M.
DOI : 10.1136/annrheumdis-2016-209846
Published in : Annals of the Rheumatic Diseases
Volume(Issue) : 76
Issue : 3
Pages : 491
Pages to: 496
Issue Date: 6-Oct-2016
Publisher / Ed. Institution : BMJ Publishing Group
ISSN: 0003-4967
Language : English
Subjects : Early Rheumatoid Arthritis; Outcomes research; Rheumatoid Arthritis; Arthralgia; Arthritis; Circadian Rhythm; Consensus; Delphi Technique; Humans; Metacarpophalangeal Joint; Range of Motion, Articular; Risk Assessment; Risk Factors; Sensitivity and Specificity; Time Factors; Rheumatoid
Subject (DDC) : 616.7: Diseases of musculoskeletal system and orthopaedics
Abstract: Background: During the transition to rheumatoid arthritis (RA) many patients pass through a phase characterised by the presence of symptoms without clinically apparent synovitis. These symptoms are not well-characterised. This taskforce aimed to define the clinical characteristics of patients with arthralgia who are considered at risk for RA by experts based on their clinical experience. Methods: The taskforce consisted of 18 rheumatologists, 1 methodologist, 2 patients, 3 health professionals and 1 research fellow. The process had three phases. In phase I, a list of parameters considered characteristic for clinically suspect arthralgia (CSA) was derived; the most important parameters were selected by a three-phased Delphi approach. In phase II, the experts evaluated 50 existing patients on paper, classified them as CSA/no-CSA and indicated their level of confidence. A provisional set of parameters was derived. This was studied for validation in phase III, where all rheumatologists collected patients with and without CSA from their outpatient clinics. Results: The comprehensive list consisted of 55 parameters, of which 16 were considered most important. A multivariable model based on the data from phase II identified seven relevant parameters: symptom duration <1 year, symptoms of metacarpophalangeal (MCP) joints, morning stiffness duration ≥60 min, most severe symptoms in early morning, first-degree relative with RA, difficulty with making a fist and positive squeeze test of MCP joints. In phase III, the combination of these parameters was accurate in identifying patients with arthralgia who were considered at risk of developing RA (area under the receiver operating characteristic curve 0.92, 95% CI 0.87 to 0.96). Test characteristics for different cut-off points were determined. Conclusions: A set of clinical characteristics for patients with arthralgia who are at risk of progression to RA was established.
Fulltext version : Published version
License (according to publishing contract) : Licence according to publishing contract
Departement: Health Professions
Organisational Unit: Institute of Physiotherapy (IPT)
Appears in Collections:Publikationen Gesundheit

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