EXTENDED REPORTS

QUEST-RA: quantitative clinical assessment of patients with rheumatoid arthritis seen in standard rheumatology care in 15 countries

Tuulikki Sokka¹, Hannu Kautiainen², Sergio Toloza³, Heidi Mäkinen⁴, Suzan M M Verstappen⁵, Merete Lund Hetland⁶, Antonio Naranjo⁷, Eva Baecklund⁸, Gertraud Herborn⁹, Rolf Rau¹⁰, Massimiliano Cazzato¹¹, Laure Gossec¹², Vlado Skakic¹³, Feride Gogus¹⁴, Stanislaw Sierakowski¹⁵, Barry Bresnihan¹⁶, Peter Taylor¹⁷, Catherine McClinton¹⁸, Theodore Pincus¹⁹ and for the QUEST-RA Group

¹ Jyväskylä Central Hospital, Jyväskylä, and Medcare Oy, Äänekoski, Finland
² Medcare Oy, Äänekoski, Finland
³ Hospital San Juan Bautista, Catamarca, Argentina
⁴ Jyväskylä Central Hospital, Jyväskylä, Finland
⁵ University Medical Center Utrecht, Utrecht, The Netherlands
⁶ Copenhagen Univeraity Hospital at Hvidovre, Hvidovre, Denmark
⁷ Hospital de Gran Canaria Dr Negrin, Las Palmas, Spain
⁸ Uppsala University Hospital, Uppsala, Sweden
⁹ Evangelisches Fachkrankenhaus, Ratingen, Germany
¹⁰ Evangelisches Fachkrankenhaus, Ratingen, Germany
¹¹ Ospedale Santa Chiara, Pisa, Italy
¹² Université René Descartes, Hôpital Cochin, Paris, France
¹³ Rheumatology Institut, Niska Banja, Serbia
¹⁴ Gazi Medical School, Ankara, Turkey
¹⁵ Medical University in Bialystok, Bialystok, Poland
¹⁶ St. Vincent University Hospital, Dublin, Ireland
¹⁷ Charing Cross Hospital, London, UK
¹⁸ Charing Cross Hospital, London, UK
¹⁹ NYU Hospital for Joint Diseases, New York, NY, USA

Correspondence to:
Tuulikki Sokka, Arkisto/Tutkijat, Jyvaskyla Central Hospital, 40620 Jyvaskyla, Finland; tuulikki.sokka{at}ksshp.fi

Objective: To conduct a cross-sectional review of non-selected consecutive outpatients with rheumatoid arthritis (RA) as part of standard clinical care in 15 countries for an overview of the characteristics of patients with RA.

Methods: The review included current disease activity using data from clinical assessment and a patient self-report questionnaire, which was translated into each language. Data on demographic, disease and treatment-related variables were collected and analysed using descriptive statistics. Variation in disease activity on DAS28 (disease activity score on 28-joint count) within and between countries was graphically analysed. A median regression model was applied to analyse differences in disease activity between countries.

Results: Between January 2005 and October 2006, the QUEST-RA (Quantitative Patient Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis) project included 4363 patients from 48 sites in 15 countries; 78% were female, >90% Caucasian, mean age was 57 years and mean disease duration was 11.5 years. More than 80% of patients had been treated with methotrexate in all but three countries. Overall, patients had an active disease with a median DAS28 of 4.0, with a significant variation between countries (p<0.001). Among 42 sites with >50 patients included, low disease activity of DAS28 3.2 was found in the majority of patients in seven sites in five countries; in eight sites in five other countries, >50% of patients had high disease activity of DAS28 >5.1.

Conclusions: This international multicentre cross-sectional database provides an overview of clinical status and treatments of patients with RA in standard clinical care in 2005–6 including countries that are infrequently involved in clinical research projects.

Abbreviations: BMI, body mass index; DAS28, disease activity score on 28-joint count; DMARD, disease-modifying antirheumatic drug; ESR, erythrocyte sedimentation rate; HAQ, Health Assessment Questionnaire; QUEST-RA, Quantitative Patient Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis; RA, rheumatoid arthritis; RF, rheumatoid factor

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