2010 ACR/EULAR Classification Criteria for RA
2010 ACR/EULAR criteria for classifying definite rheumatoid arthritis. Score ≥ 6/10 = definite RA. Applicable to patients with ≥ 1 joint with clinical synovitis not better explained by another diagnosis.
Score interpretation
Score < 6: Does not meet 2010 criteria for definite RA at this time.
→ Consider undifferentiated inflammatory arthritis. Monitor — early RA may not initially meet criteria. Repeat serology in 6–12 weeks. DMARD therapy may still be appropriate if clinical diagnosis made. Rheumatology referral (NICE QS33: within 3 working days if more than one joint or the small joints of the hands or feet are affected).
Score ≥ 6: Meets 2010 ACR/EULAR criteria for definite RA.
→ Initiate csDMARD. Adults: methotrexate (first-line, 15–25 mg/week with folic acid 5 mg once weekly). Hydroxychloroquine ± sulfasalazine as combination or if MTX not tolerated. Short-course prednisolone bridge 7.5–10 mg/day tapering over 6 weeks. Treat-to-target: DAS28 < 2.6 (remission) or < 3.2 (low disease activity) within 6 months. Anti-TNF / biologic if inadequate response to ≥ 2 csDMARDs. NICE NG100. Children: use a children's formulary.
Interpretation bands for the ACR/EULAR RA. Apply clinical judgement and local guidance.
References
- Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62(9):2569–2581.
- NICE NG100. Rheumatoid arthritis in adults: management. 2018 (updated 2020).
- NICE QS33. Rheumatoid arthritis in over 16s. 2013 (updated 2020).
Related
Curated clinical cross-links plus same-class fallbacks.
- Hydroxychloroquine · Aminoquinoline — Malaria Prophylaxis / SLE / Rheumatoid Arthritis
- Methotrexate (Low-dose) · DMARD (Disease-Modifying Antirheumatic Drug) / Immunosuppressant
- Sulfasalazine · DMARD / Anti-inflammatory
- Rituximab (Rheumatology) · Biologic DMARD — Anti-CD20
- Guselkumab · Biologic DMARD — IL-23 Inhibitor (Anti-p19)
- Risankizumab (Rheumatology) · Biologic DMARD — IL-23 Inhibitor (Anti-p19)
- Cutaneous Lupus Erythematosus · BAD; EULAR
- Osteoporosis / Fragility Fracture · NOGG 2021; NICE NG147; NG224
- Arteritic AION (Giant Cell Arteritis) · RCOphth; BSR
- Osteoarthritis Hip / Knee Management · NICE NG226 (2022)
- Lupus Nephritis · EULAR/ERA-EDTA 2019; KDIGO 2024
- Rheumatoid Arthritis Management · NICE CG79 2018 / EULAR 2022
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.