{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T22:53:47Z","timestamp":1788821627179,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100008741","name":"European League Against Rheumatism","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008741","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000960","name":"American College of Rheumatology Research and Education Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000960","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The field of rheumatoid arthritis (RA) is moving towards identification of and intervention in people at risk of RA, but a validated risk stratification method is lacking. This work was undertaken to develop a risk stratification method for persons presenting with arthralgia considered to be at risk of RA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A joint EULAR\/American College of Rheumatology (ACR) expert committee was established. Risk factor and outcome data from 10 arthralgia cohorts (including clinically suspect arthralgia and autoantibody\u2010positive arthralgia) were studied. The work focused on differentiating the risk of progression to clinically apparent inflammatory arthritis (IA) within 1 year, using clinical and serologic variables, without and with subclinical joint inflammation detected by ultrasound (US) or magnetic resonance imaging (MRI). Developing RA according to the 2010 EULAR\/ACR criteria within 1 year was a secondary outcome. A set of validated risk stratification criteria was developed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Using data from 2,293 symptomatic at\u2010risk individuals, a stratification method was derived consisting of 6 clinical and serologic variables (morning stiffness, patient\u2010reported joint swelling, difficulty making a fist, C\u2010reactive protein, rheumatoid factor, and anti\u2010citrullinated peptide antibody) yielding an area under the curve (AUC) of 0.80 (95% confidence interval [CI] 0.77\u20130.83) for IA development. The inclusion of US variables did not increase the discriminative ability. When MRI\u2010detected subclinical inflammation variables were included, the AUC was 0.87 (95% CI 0.82\u20130.90). In the presence of clinical, serologic, and MRI variables, a sensitivity and specificity of &gt;75% was achieved. For RA development, the AUC of the criteria with MRI was 0.93 (95% CI 0.90\u20130.97).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EULAR\/ACR risk stratification criteria have been developed for people with arthralgia in secondary care who are considered at risk for RA. The criteria can be applied in the absence or presence of imaging data and have been developed to define homogeneous risk groups for future prevention trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.43218","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T08:00:12Z","timestamp":1746691212000},"page":"523-536","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["<scp>EULAR<\/scp>\n                    \/American College of Rheumatology Risk Stratification Criteria for Development of Rheumatoid Arthritis in the Risk Stage of Arthralgia"],"prefix":"10.1002","volume":"78","author":[{"given":"Hanna W.","family":"van Steenbergen","sequence":"first","affiliation":[{"name":"Department of Rheumatology Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Doornkamp","sequence":"additional","affiliation":[{"name":"Department of Biomedical Data Sciences Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Alivernini","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Fondazione Policlinico Universita'rio A. Gemelli Istituto di Ricovero e Cura a Carattere"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Backlund","sequence":"additional","affiliation":[{"name":"At\u2010risk participant"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catalin","family":"Codreanu","sequence":"additional","affiliation":[{"name":"Center for Rheumatic Diseases University of Medicine and Pharmacy  Bucharest Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley B.","family":"Cohen","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical School  Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Combe","sequence":"additional","affiliation":[{"name":"Montpellier University  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P.","family":"Cope","sequence":"additional","affiliation":[{"name":"Centre for Rheumatic Diseases, School of Immunology and Microbial Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2211-4861","authenticated-orcid":false,"given":"Kevin D.","family":"Deane","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus  Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9649-3588","authenticated-orcid":false,"given":"Bryant R.","family":"England","sequence":"additional","affiliation":[{"name":"Veterans Affairs Nebraska\u2010Western Iowa Health Care System &amp; University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5928-486X","authenticated-orcid":false,"given":"Marie","family":"Falahee","sequence":"additional","affiliation":[{"name":"Department of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medicine and Health University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal H. P.","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Erasmus Medical Centre  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2026-7728","authenticated-orcid":false,"given":"Arnd","family":"Kleyer","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Charite'\u2010Universitatsmedizin Berlin, Berlin, Germany, and Department of Internal Medicine 3 Rheumatology and Immunology University Hospital Erlangen and Friedrich Alexander University (FAU)  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4065-4151","authenticated-orcid":false,"given":"Diane","family":"Lacaille","sequence":"additional","affiliation":[{"name":"Arthritis Research Canada, Division of Rheumatology, Department of Medicine University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertha","family":"Maat","sequence":"additional","affiliation":[{"name":"Patient Research Partner European Alliance of Associations for Rheumatology People with Arthritis and Rheumatism in Europe and National Association ReumaZorg Nederland  The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kulveer","family":"Mankia","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and National Institute for Health and Care Research Leeds Biomedical Research Centre Leeds Teaching Hospitals National Health Services Trust  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1900-790X","authenticated-orcid":false,"given":"Elise","family":"van Mulligen","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Centre, Leiden, and Department of Rheumatology Erasmus Medical Centre  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1198-3228","authenticated-orcid":false,"given":"Gy\u00f6rgy","family":"Nagy","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Department of Internal Medicine and Oncology, Heart and Vascular Center, Department of Genetics, Cell\u2010 and Immunobiology Semmelweis University, and National Institute of Locomotor Diseases and Disabilities  Budapest Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5580-6472","authenticated-orcid":false,"given":"Liam J.","family":"O'Neil","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Rodamaker","sequence":"additional","affiliation":[{"name":"Department of Rheumatology University of Colorado School of Medicine  Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilfita","family":"Sahbudin","sequence":"additional","affiliation":[{"name":"Department of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, and National Institute for Health and Care Research Birmingham Biomedical Research Center and Clinical Research Facility University of Birmingham, Queen Elizabeth Hospital  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirkjan","family":"van Schaardenburg","sequence":"additional","affiliation":[{"name":"Amsterdam Rheumatology Center  Reade Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1954-0229","authenticated-orcid":false,"given":"Alexandre","family":"Sepriano","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands, and Nova Medical School Universidade Nova de Lisboa  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A. P.","family":"da Silva","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Centro Hospitalar e Universita'rio de Coimbra, Institute for Clinical and Biomedical Research, Faculty of Medicine University of Coimbra  Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"De Smet","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5556-4618","authenticated-orcid":false,"given":"Jeffrey A.","family":"Sparks","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewout W.","family":"Steyerberg","sequence":"additional","affiliation":[{"name":"Department of Biomedical Data Sciences Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Studenic","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 3, Division of Rheumatology, Medical University of Vienna, Vienna, Austria, and Department of Medicine (Solna), Division of Rheumatology Karolinska Institute  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Wethington","sequence":"additional","affiliation":[{"name":"Patient research partner, Department of Information Services and Technology National Jewish Health  Denver Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L.","family":"Landew\u00e9","sequence":"additional","affiliation":[{"name":"Rheumatology &amp; Clinical Immunology, Amsterdam University Medical Center, Amsterdam, and Department of Rheumatology Zuyderland Medical Center  Heerlen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Raza","sequence":"additional","affiliation":[{"name":"Department of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, and Department of Rheumatology, Bronglais Hospital Hywel Dda University Health Board  Aberystwyth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette H. 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