The patients with RA benefit from early identification soon after the first clinical symptoms appear. The 2010 ACR/EULAR classification criteria were developed to fulfill this need and their application has been demonstrated to be effective. However, there is still room for improvement. Therefore, we aimed to evaluate the potential of the concordant presence of RF, anti-CCP and anti-carbamylated protein antibodies to improve current RA classification among early arthritis (EA) patients. Data from the first visit of 1057 patients in two EA prospective cohorts were used. The serological scores from the 2010 ACR/EULAR criteria and the concordant presence of the three RA autoantibodies were assessed relative to a gold standard consisting of the RA classification with the 1987 ACR criteria at the 2 years of follow-up. The concordant presence of three antibodies showed predictive characteristics allowing for direct classification as RA (positive predictive value = 96.1% and OR = 80.9). They were significantly better than the corresponding to the high antibody titers defined as in the 2010 classification criteria (PPV = 88.8%, OR = 26.1). In addition, the concordant presence of two antibodies was also very informative (PPV = 82.3%, OR = 15.1). These results allowed devising a scoring system based only on antibody concordance that displayed similar overall performance as the serological scoring system of the 2010 criteria. However, the best classification was obtained combining the concordance and 2010 serological systems, a combination with a significant contribution from each of the two systems. The concordant presence of RA autoantibodies showed an independent contribution to the classification of EA patients that permitted increased discrimination and precision.

中文翻译：

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同时存在三种RA自身抗体的早期关节炎患者中改善的RA分类：在两家早期关节炎诊所进行的分析。

首次出现临床症状后不久，RA患者就可从早期识别中受益。为满足这一需求，制定了2010 ACR / EULAR分类标准，并证明了其应用是有效的。但是，仍有改进的空间。因此，我们旨在评估RF，抗CCP和抗氨甲酰化蛋白抗体的同时存在对改善早期关节炎（EA）患者当前RA分类的潜力。使用来自两个EA前瞻性队列中1057例患者的首次就诊数据。在随访的2年中，相对于包括RA分类和1987 ACR标准的金标准，评估了2010 ACR / EULAR标准的血清学评分和三种RA自身抗体的一致存在。三种抗体的一致存在显示出预测特征，可直接分类为RA（阳性预测值= 96.1％，OR = 80.9）。它们显着优于2010年分类标准中定义的高抗体滴度（PPV = 88.8％，OR = 26.1）。此外，两种抗体的一致存在也非常有用（PPV = 82.3％，OR = 15.1）。这些结果允许设计仅基于抗体一致性的评分系统，该评分系统显示出与2010年标准的血清学评分系统相似的总体性能。但是，结合了一致性和2010年血清学系统获得了最佳分类，这是两个系统中每个系统的重要贡献。