Background treat-to-target and tight control strategies are actually the two main paradigms in the treatment of rheumatoid arthritis (RA), aiming to improve patients outcome by achieving either remission or minimal disease activity status. There is actually no consensus regarding the right assessment tools for monitoring the magnitude of improvement and the absolute reached level in routine clinical practice.
Objectives to compare EULAR-DAS28 with RAPID3 (a patient-reported outcome based on pain, patient global assessment of disease activity, and multidimensional HAQ)response criteria in patients with moderate to severe active RA treated with rituximab (RTX).
Methods prospective observational study on 72 moderate to severe active RA (DAS28>3.2) receiving one cycle of RTX (two infusions of 1000 mg at two weeks interval). Response to treatment was appreciated at six months by: (i) EULAR-DAS28 response criteria, classified as EULAR good (decrease with 1.2 units), moderate (decrease of 0.6–1.2 units) or non-responder (decrease ≤0.6 units); and (ii) RAPID3 response categories defined as good (decrease with 3.6 units), moderate (decrease of 1.8–3.6 units) and poor (decrease ≤1.8 units).
Statistical analysis was done in SPSS.16 (weighted kappa statistics, p<0.05.
Results up to 85% of RA has been classified as good and moderate responders based on RAPID3, while about 75% have been responders according to EULAR-DAS28; moreover, nearly 45% of the RAPID3 good responders have also been categorized as moderate EULAR-DAS28 responders. Statistical significant moderate agreement between the EULAR-DAS28 response criteria and RAPID3 has been demonstrated (p<0.05).
Conclusions Patient-centered tools such as RAPID3 allow more easily and quickly to quantify disease activity levels and patient responses to therapy, providing a more complex insight into the patient’s perception of disease status.
Disclosure of Interest None Declared
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