The new European League Against Rheumatism/American College of Rheumatology diagnostic criteria for rheumatoid arthritis: how are they performing?

PURPOSE OF REVIEW: This era of early aggressive treatment of rheumatoid arthritis (RA) calls for criteria that allow timely classification of patients at risk of persistent erosive disease. We review how the new American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria meet up to this challenge.

RECENT FINDINGS: The new 2010 ACR/EULAR classification criteria for RA were developed using initiation of methotrexate as anchor in a population with undifferentiated arthritis. Many studies from different countries have now been published that have addressed the performances of these new criteria.

SUMMARY: The goal of earlier classification of RA seems to be met with the new criteria, but exclusion of other diagnoses is essential. Increased sensitivity comes at the price of loss of specificity and indiscriminate use of these classification criteria as a diagnostic tool carries the risk of overtreatment.