The Predictive Value of the EULAR-Defined Clinically Suspected Arthralgia for the Development of Rheumatoid Arthritis: A Prospective Longitudinal Study

• Published in: Journal of clinical rheumatology and immunology (Online) Vol. 24; no. 1; pp. 34 - 40
• Main Authors: Tam, Cheuk Yin, Chan, Pak Ho, Cheng, Minerva Yuk Yee, Lau, Adrian Ka Chun, Tam, Kwan Kin, Cheng, Tsz Ho, So, Ho
• Format: Journal Article
• Language: English
• Published: World Scientific Publishing 01.07.2024
• Subjects: Clinically Suspected Arthralgia; Rheumatoid Arthritis
• ISSN: 2661-3417; 2661-3425
• DOI: 10.1142/S2661341724500032

Objective: To assess the predictive accuracy of the EULAR definition of clinically suspected arthralgia (CSA) for progression to rheumatoid arthritis (RA) in patients presenting with arthralgia without arthritis. Methods: This prospective study recruited 100 patients with arthralgia but no clinical arthritis. Patients were evaluated at baseline and followed up every 6 months for 2 years. The association of the presence of [Formula: see text] and [Formula: see text] out of seven CSA parameters at baseline with RA development was investigated. The association of individual CSA parameters with RA development was also evaluated. Results: Twenty-one of 100 patients (21%) developed RA. The proportion of patients meeting [Formula: see text] CSA criteria was higher in those who developed RA (66.7%) compared to those who did not (39.2%, [Formula: see text]). Similarly, a higher proportion of patients who developed RA met [Formula: see text] CSA criteria (47.6%) compared to those who did not (20.3%, [Formula: see text]). The sensitivity and specificity of [Formula: see text] CSA parameters were 71.4% and 69.6%, and for [Formula: see text] CSA parameters were 42.9% and 87.3%, respectively. “Symptom duration [Formula: see text] year” and “difficulty holding a fist” were significantly associated with RA development. A simplified criteria using these two items provided a similar area under receiver operating characteristic (ROC) curve (0.747 vs. 0.676) compared to the original criteria. Conclusion: Meeting EULAR CSA criteria was significantly associated with progression to RA in patients with arthralgia. Symptom duration [Formula: see text] year and difficulty holding a fist were the most predictive individual parameters. Continuous monitoring using the CSA criteria, and probably a simplified version, could help identify high-risk individuals for RA development.