Validation of the EULAR definition of arthralgia suspicious for progression to rheumatoid arthritis

Burgers, L.E.; Siljehult, Filip; Brinck, Robin M. ten; Steenbergen, H.W. van; Landewé, Robert; Rantapää‐Dahlqvist, Solbritt; Mil, Annette H M van der Helm-van

doi:10.1093/rheumatology/kex324

Cited by 51 publications

(37 citation statements)

References 10 publications

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“…74% of patients with CSA had a positive EULAR definition. 19 CSA, clinically suspect arthralgia; GP, general practitioner; EULAR, European League Against Rheumatism; RA, rheumatoid arthritis; MSK, musculoskeletal symptoms.…”

Section: Differentiating Arthralgia Suspicious For Progression To Ra mentioning

confidence: 99%

“…The first longitudinal study of patients with CSA showed that the definition had a high sensitivity and served to further harmonise patients, as patients with arthralgia who were identified as CSA by their rheumatologist but had <3 clinical items indeed had a lower risk of progression to RA. 19 …”

Section: Differentiating Arthralgia Suspicious For Progression To Ra mentioning

confidence: 99%

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Which patients presenting with arthralgia eventually develop rheumatoid arthritis? The current state of the art

2017

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Early initiation of treatment in patients with inflammatory arthritis at risk of persistence and/or erosive progression is important because it is associated with a reduced rate of progression of joint damage and functional disability. It has been proposed that a window of opportunity exists, during which disease processes are less matured and disease modification can be more effective. The phase of arthralgia preceding clinical arthritis is likely to be an important part of this window of opportunity, during which treatment might prevent progression to clinical arthritis. Several proof-of-concept trials in individuals with arthralgia are now evaluating this hypothesis. Central to such trials is the ability to identify groups at high risk of rheumatoid arthritis (RA) in whom preventive treatment can be tested. This review describes the relevance of adequate prediction making, as well as the accuracy of different types of predictors (including imaging and serological markers) with their value in predicting the progression of arthralgia to arthritis. Despite promising results, studies have been performed in heterogeneous patient populations and most findings have not been validated in independent studies. Future observational or preventive studies should be conducted with homogeneous patient groups (eg, patients fulfilling the European League Against Rheumatism criteria for arthralgia at risk of RA) in order to increase interstudy comparability and to allow result validation.

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Section: Differentiating Arthralgia Suspicious For Progression To Ra mentioning

confidence: 99%

Section: Differentiating Arthralgia Suspicious For Progression To Ra mentioning

confidence: 99%

Which patients presenting with arthralgia eventually develop rheumatoid arthritis? The current state of the art

2017

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“…A combination of clinical symptoms and signs suggestive of future RA has been developed, resulting in the EULAR definition of arthralgia suspicious for progression to RA 23. The clinical definition has shown to be highly sensitive when tested against the external standard ‘expert diagnosis of RA’ in cross-sectional studies and actual RA development in longitudinal studies 23 24. In order to obtain a sufficiently high specificity, the clinical definition should be combined with the results of biomarkers.…”

Section: Identifying Persons With Arthralgia At Risk For Ramentioning

confidence: 99%

The earlier, the better or the worse? Towards accurate management of patients with arthralgia at risk for RA

Mil

Landewé

2020

Ann Rheum Dis

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The favourable long-term results of early treatment in patients with classified rheumatoid arthritis have resulted in an increasing interest in the diseases phases preceding clinical arthritis. The hypothesis to test is that an intervention in these early phases may better prevent or reduce disease persistence than an intervention when arthritis has become clinically manifest. While several placebo-controlled trials are still ongoing, to date there is no firm evidence that this hypothesis truly holds. Therefore, it is important to reflect on the current status of arthralgia preceding clinical arthritis. Inherent to every new field of research, attitudes are conflicting, with opinions propagating innovation (based on the fear of undertreatment) on the one hand, and critical sounds pleading for more restraint (fear of overtreatment) on the other hand. In this Viewpoint, we will examine these divergent opinions, relate them to a preferred ultimate scenario and provide considerations for future studies and daily practice.

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“…2). 8,9 In a healthy person, the genetic risk factors, the environmental risk factor of smoking, and the presence of autoantibodies are insufficient to detect early disease. The genetic risk factors are very common, and actually everyone carries one or several of the risk alleles.…”

Section: Clinical Background: Early Disease Detectionmentioning

confidence: 99%

Magnetic Resonance Imaging of Rheumatoid Arthritis: Peripheral Joints and Spine

Reijnierse

Helm-Mil

Eshed

et al. 2018

Semin Musculoskelet Radiol

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Both the fields of rheumatology and radiology are changing rapidly. Effective medication has become available for rheumatoid arthritis (RA) and transformed it from a progressive disabling disease into a chronic disease. Indications for magnetic resonance imaging (MRI) have changed accordingly, shifting toward early detection. There is also an overall increased clinical demand for high-end imaging. Together with improvement of MRI units and sequences, MRI protocols are adapted based on clinical indications. This article addresses (1) the clinical background and present role of MRI in early disease detection, (2) RA involvement of peripheral joints, (3) RA involvement of the spine, and (4) state-of-the-art RA MRI protocols. The key toward cost-effective MRI examination in RA is communication between radiologist and rheumatologist as well as awareness and knowledge of the basics and advancements in both fields.

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Validation of the EULAR definition of arthralgia suspicious for progression to rheumatoid arthritis

Cited by 51 publications

References 10 publications

Which patients presenting with arthralgia eventually develop rheumatoid arthritis? The current state of the art

Which patients presenting with arthralgia eventually develop rheumatoid arthritis? The current state of the art

The earlier, the better or the worse? Towards accurate management of patients with arthralgia at risk for RA

Magnetic Resonance Imaging of Rheumatoid Arthritis: Peripheral Joints and Spine

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