New criteria, proposed by researchers writing in the Annals of Rheumatic Diseases, focus on early diagnosis and treatment of initial symptoms to prevent more serious late stage disease.
The authors said: ‘The new criteria redefine RA, reflecting our collective hope that in the future, RA will no longer be characterised by erosive joint disease and persistence of symptoms, although these characteristics will continue to define established or longstanding untreated disease.'
If identified early, synthetic and biological disease modifying antirheumatic drugs (DMARDs) can be used to prevent the destructive and disabling joint damage, a hallmark of late stage RA.
The new criteria classify ‘definite RA’ as:
- The confirmed presence of synovitis - inflammation of the synovial membrane that lines the joint - in at least one joint
- The absence of an alternative diagnosis to explain the synovitis, for example gout or arthritis triggered by infection (reactive arthritis)
- A combined score of six or more from each of the following four domains:
- number and sites of affected joints
- blood tests results (for autoantibodies indicative of RA)
- evidence of an increase in inflammatory proteins (known as the acute phase response)
- how long symptoms have lasted
Around 350,000 people in the UK live with RA, which affects around three times as many women as men.