Arthritis Ireland Arthritis Ireland

Revised classification criteria for rheumatoid arthritis have been published by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR), which will allow the study of treatments for the disease at a much earlier stage.

Researchers use classification criteria to define a disease in a standardised and accepted way, helping to standardise recruitment into clinical trials and other research studies. The last criteria for rheumatoid arthritis were created in 1987, but there have been significant advances in therapies since that time.

Dr Gillian Hawker, senior author of the new criteria, revealed: "The 1987 criteria actually posed a major barrier to the study of treatments designed to prevent joint damage in rheumatoid arthritis. "Many patients did not fulfil the previous rheumatoid arthritis classification criteria until their disease was well-advanced and - in many cases - joint damage had already occurred. This truly limited rheumatoid arthritis researchers from studying the disease at its earlier phases, which is critical to the development of new treatments to prevent damage."

The new criteria are published in both Arthritis & Rheumatism journal and the Annals of the Rheumatic Diseases and are based on three phases of work, which were started in 2008. In the first phase, which was led by EULAR, scientists reviewed existing data on patients with early arthritis to determine the factors that indicate a high risk of disease progression. The second phase, led by the ACR, sought to reach a consensus on which factors were most important in determining an individual's chances of developing chronic joint damage. Finally, the third phase brought together the findings from the previous two phases, enabling researchers to determine the optimal cut-off point to define rheumatoid arthritis.

Professor Alan Silman, Arthritis Research UK's medical director who initiated the project, explained that in order to be classified with 'definite' rheumatoid arthritis, a patient must have a score of at least six out of ten on the agreed scoring system. He revealed: "The scoring system takes into consideration the number and site/size of involved joints, laboratory tests of inflammation and auto-immunity, and symptom duration."

Dr Hawker added that the revised classification criteria will now be used to develop up-to-date diagnostic criteria for use by practicing rheumatologists.

A spokesperson for Arthritis Ireland said: 'This is hugely encouraging news. Early diagnosis and treatment is essential for good patient outcomes in the long-term. The revised classification for RA should help not only earlier diagnosis, but will also allow and encourage reasearch at earlier stages of the condition.'