EULAR develops new classification criteria for hand osteoarthritis

Jun 7 2024European Alliance of Associations for Rheumatology , EULAR At present, classifying hand osteoarthritis is based on clinical findings, and available tools are not able to distinguish between certain phenotypes. With new disease-modifying treatments in development, trials will require reliable classification criteria to ensure accurate comparisons between groups.

Hand osteoarthritis mainly affects the distal interphalangeal, proximal interphalangeal, and thumb base joints, leading to joint pain, aching, and stiffness. Criteria developed by the American College of Rheumatology in 1990 are useful, but they cannot distinguish between interphalangeal or thumb base disease, and this is important since these two phenotypes may require different treatment strategies.

To address this, EULAR and a team of leading experts in the field set out to develop new classification criteria sets that include radiographic features. Early phases of the project used observational data to identify self-reported, clinical, radiographic, and laboratory features associated with OA in the hand. This information was then subjected to a consensus-driven decision-making approach to refine the criteria and determine their relative importance.

The new work, published in the May 2024 issue of the Annals of the Rheumatic Diseases, suggests that - in people with symptoms and no other relevant disease or acute injury - hand osteoarthritis can be classified based on age, duration of morning stiffness, number of joints with osteophytes and joint space narrowing, and agreement between symptoms and X-ray findings.

Osteoarthritis Pain Research Rheumatology

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