Performance of the new 2012 EULAR/ACR classification criteria for polymyalgia rheumatica: Comparison with the previous criteria in a single-centre study

Pierluigi Macchioni, Luigi Boiardi, Mariagrazia Catanoso, Giulia Pazzola, Carlo Salvarani

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Abstract

Objective To compare the performance of published classification/diagnostic criteria for polymyalgia rheumatica (PMR), including the new 2012 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) criteria, in a single-centre study. Methods: We studied all consecutive patients with new-onset PMR seen in our centre over 6 years, whose diagnosis was confirmed during a prospective 12-month follow-up period. Subjects were classified by each of the seven different criteria. Sensitivity and specificity were compared. Control population consisted of all consecutive patients aged ≥50 years seen in a 4-year period in our early arthritis clinic who had a 12-month confirmation of a diagnosis of rheumatoid arthritis (RA) or other inflammatory articular diseases. Results: Data were collected from 136 cases and 149 controls, including 94 patients with RA. The most sensitive criteria were the new 2012 EULAR/ACR classification criteria (92.6%). Adding ultrasound (US) specificity increased from 81.5% to 91.3% in total cases and from 79.7% to 89.9% in RA. Bird criteria had a sensitivity of 89.2% but the lowest specificity (40.2% in total cases and 72.5% in RA). Jones and Nobunaga criteria were the most specific criteria (96.7% and 97.8% in total cases and 98.6% and 99.5% in RA) but the less sensitive (63.1% and 58.2%) ones. Overall, discriminatory ability, as reflected by the area under the receiver operating characteristic curve, was better for the 2012 US EULAR/ACR criteria (0.920 in total cases and 0.910 in RA). Conclusions: The new EULAR/ACR criteria in newonset PMR patients perform best in discriminating PMR from RA and other inflammatory articular diseases. Ultrasound further increases the specificity of the criteria.

Original languageEnglish
Pages (from-to)1190-1193
Number of pages4
JournalAnnals of the Rheumatic Diseases
Volume73
Issue number6
DOIs
Publication statusPublished - 2014

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Polymyalgia Rheumatica
Rheumatology
Rheumatic Diseases
Rheumatoid Arthritis
Ultrasonics
Birds
Joints
ROC Curve
Arthritis
Sensitivity and Specificity

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Allergy

Cite this

Performance of the new 2012 EULAR/ACR classification criteria for polymyalgia rheumatica : Comparison with the previous criteria in a single-centre study. / Macchioni, Pierluigi; Boiardi, Luigi; Catanoso, Mariagrazia; Pazzola, Giulia; Salvarani, Carlo.

In: Annals of the Rheumatic Diseases, Vol. 73, No. 6, 2014, p. 1190-1193.

Research output: Contribution to journalArticle

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abstract = "Objective To compare the performance of published classification/diagnostic criteria for polymyalgia rheumatica (PMR), including the new 2012 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) criteria, in a single-centre study. Methods: We studied all consecutive patients with new-onset PMR seen in our centre over 6 years, whose diagnosis was confirmed during a prospective 12-month follow-up period. Subjects were classified by each of the seven different criteria. Sensitivity and specificity were compared. Control population consisted of all consecutive patients aged ≥50 years seen in a 4-year period in our early arthritis clinic who had a 12-month confirmation of a diagnosis of rheumatoid arthritis (RA) or other inflammatory articular diseases. Results: Data were collected from 136 cases and 149 controls, including 94 patients with RA. The most sensitive criteria were the new 2012 EULAR/ACR classification criteria (92.6{\%}). Adding ultrasound (US) specificity increased from 81.5{\%} to 91.3{\%} in total cases and from 79.7{\%} to 89.9{\%} in RA. Bird criteria had a sensitivity of 89.2{\%} but the lowest specificity (40.2{\%} in total cases and 72.5{\%} in RA). Jones and Nobunaga criteria were the most specific criteria (96.7{\%} and 97.8{\%} in total cases and 98.6{\%} and 99.5{\%} in RA) but the less sensitive (63.1{\%} and 58.2{\%}) ones. Overall, discriminatory ability, as reflected by the area under the receiver operating characteristic curve, was better for the 2012 US EULAR/ACR criteria (0.920 in total cases and 0.910 in RA). Conclusions: The new EULAR/ACR criteria in newonset PMR patients perform best in discriminating PMR from RA and other inflammatory articular diseases. Ultrasound further increases the specificity of the criteria.",
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