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Evaluation of a modified ACR20 scoring system in patients with rheumatoid arthritis receiving treatment with etanercept
  1. J A Goldman1,
  2. H A Xia2,
  3. B White2,
  4. H Paulus3
  1. 1Emory University School of Medicine, Atlanta, Georgia, USA
  2. 2Amgen Inc, Thousand Oaks, California, USA
  3. 3UCLA School of Medicine, Los Angeles, California, USA
  1. Correspondence to:
    J A Goldman
    Division of Rheumatology, Emory University School of Medicine, Medical Quarters 5555 Peachtree-Dunwoody Road, Atlanta, GA 30342-1711, USA; jointdoc{at}mindspring.com

Abstract

Objective: To evaluate a modified American College of Rheumatology 20 (mACR20) scoring system for patients with rheumatoid arthritis.

Methods: The data were evaluated from one study on patients with methotrexate (MTX)-naive early rheumatoid arthritis (ERA) and another study on patients with DMARD-refractory late rheumatoid arthritis (LRA). For mACR20 scoring, acute-phase reactant measurements were excluded, and 20% improvement from baseline was determined by 2 or 3 of the 4 remaining ACR components.

Results: For full joint counts with data from patients with ERA, marked differences favoured 25 mg etanercept (ETN) over 10 mg ETN by using the unmodified ACR20 (69% v 55%), the mACR203 of 4 (63% v 49%) and the mACR202 of 4 (72% v 58%). An assessment of 28 joints showed similar findings. In the trial on patients with LRA, considerably more patients in both ETN groups achieved a clinical response compared with placebo by using the ACR20, the mACR203 of 4 and the mACR202 of 4, whether using full or 28 joint counts. The mACR203 of 4 and full joint counts with data on patients with ERA showed a marked difference between the MTX and 10 mg ETN groups (63% v 49%), which was not observed with the ACR20.

Conclusion: Patterns of improvement indicated by mACR20 scores were consistent with standard ACR20 scores.

  • ACR, American College of Rheumatology
  • CRP, C reactive protein
  • DAS, Disease Activity Score
  • DMARD, disease-modifying antirheumatic drug
  • ERA, early rheumatoid arthritis
  • ESR, erythrocyte sedimentation rate
  • ETN, etanercept
  • LRA, late rheumatoid arthritis
  • mACR20, modified American College of Rheumatology 20
  • MTX, methotrexate

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Footnotes

  • Competing interests: These studies were funded by Amgen Inc, Thousand Oaks, California, USA. JAG is a member of Amgen’s Speakers Bureau and HP has received research grants and consulting fees from Amgen. JAG and HP are members of the RADIUS steering committee. BW and AX are employees of Amgen.

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