eular 2011 updates

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Eular 2011

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  • 1. EULAR 2011-RA updatesBy A.Arputha Selvaraj APMP IIM Calcutta BMS India

2. Agenda We will discuss updates from EULAR 2011 about: 1. Diagnosis of RA 2. RA remission 3. Early RA 4. Safety of medications in RA 5. Imaging in RA 6. Other updates in RA 3. DiagnosisBMS India 4. 2010 ACR/EULAR RA criteria in clinical practice: Prediction of clinical RA & distribution of patients with early UA New ACR/EULAR criteria predicts risk of RA (early) - Tree format or scoring system 6 points = RA NOR-VEAC: (SJC 1 with 16 weeks duration, 18-75 ys) 128/343 definite RA by both versions new criteria82/83 (98.8%) >10 joints = RA vs 3/111 (2.7%) 2-10 joints57/60 (95%) ACPA and/or RF = RA Sensitivity 85.9%; specificity 80.5%; LR+ 4.4, LR- 0.18;area under the ROC curve (95% CI) was 0.92 (0.89-0.95) Criteria performed well in predicting clinical RA, particularly in seropositive patients Mjaavatten MD, et al. EULAR 2011, London, #SAT0373BMS India 5. Comparison of 1987 & 2010 classification criteria for RA in patients with early arthritis 253 pts with 1 swollen joint for 4 wks; symptoms < 1 y RF+ 34.4% pts CCP+ 28.6% pts Gold std: pts Dx after 2 ys f/u Estimate sensitivity, specificity, PPV, NPV, LR+ & LR- RA diagnosis 108 pts (42.7%) with 2010 criteria 114 pts (45.1%) with 1987 criteria20101987Sens. (%)8086Spec. (%)81.781.7PPV (%)74.175.4NPV (%)86.289.9LR+4.374.7LR-0.2450.171LR = likelihood ratioNo relevant differences in RA diagnosis using 1987 or 2010 criteria Fernandez-Ortiz AM, et al. EULAR 2011, London, #SAT0396BMS India 6. RemissionBMS India 7. CATCH: Remission prevalence in early RA new criteria vs other criteria RF+/ CCP+ (n)Bio %Mean CRP (mg/dL)100 80DAS28