In an editorial accompanying the guidelines in the Annals of the Rheumatic Diseases, ACR President Stanley Cohen and EULAR President Paul Emery said that the 1987 criteria, although useful for differentiating “established” RA from other rheumatologic diseases, are “widely regarded as unsatisfactory for the diagnosis of RA (for which they were not designed)” (Ann. Rheum. Dis. 2010;69:1575-6).
However, in 2010, “the need for the new classification criteria has been made more urgent by the understanding that, at presentation, RA may be an evolving disease, the final phenotype of which can be altered by interventions.”
And despite the fact that “change can be difficult for a generation of rheumatologists used to classifying RA with the old criteria,” the authors were hopeful that “these new classification criteria will be rapidly adopted in daily practice, and we look forward to their implementation in clinical trials.”
Indeed, they added, “How these criteria might impact patient selection for clinical trials will be of great interest.”
Dr. Cohen is affiliated with the clinical research center at the University of Texas Southwestern Medical School in Dallas. Dr. Emery is from the University of Leeds (England). Both stated that they had no competing interests to disclose in relation to this editorial.
"When they do [occur], they can be very useful in identifying the disease, and they are important markers and predictors of disease severity and need for therapy," he said.
The guidelines also lack biomarkers for treatment response, he added.
Several of the guideline authors disclosed financial and other relationships with multiple pharmaceutical companies. Dr. Matteson stated that he had no financial disclosures relative to his comments.
