Background The Rheumatoid Arthritis (RA) Impact of Disease (RAID) score includes questions regarding pain, functional capacity, fatigue, physical and emotional wellbeing, quality of sleep and coping, and by use of an equation the answers are converted to a score 0-10, with 10 being the worst score.
Objectives The present objectives were to follow the changes in RAID scores in RA patients during their first months of treatment with anti-TNF alpha therapy, and to explore the associations between RAID and established measures of disease activity.
Methods A total of 30 RA patients (mean (SD) age 50 (13) years, disease duration 8 (7) years, 26 women, 72% anti-CCP positive) were consecutively included as they started treatment with anti-TNF alpha therapy (Remicade (n=11), Enbrel (n=10), Humira (n=6), Simponi (n=3)) and they were followed monthly for three months. All patients answered the RAID questionnaire, and they were assessed for number of tender and swollen joints (of 28), the assessors global VAS and ESR/CRP with DAS28 (ESR) being calculated. Correlations were analyzed by use of Spearman’s rank, Wilcoxon test was used to explore significant changes from baseline, one way ANOVA was used to explore differences between groups and sensitivity to change was calculated by use of Standardized Response Mean (SRM).
Results RAID scores fell significantly (p<0.001) after start of treatment with median (range) scores 4.4 (0.5-8.7) at baseline, 2.2 (0.1-8.4) after 1 month, 2.6 (0.0-9.1) after 2 months and 2.4 (0.2-9.1) after 3 months, and significant improvement was also found for DAS28 (4.5 (2.1-7.1), 3.7 (0.6-6.3), 2.9 (1.7-7.2) and 3.7 (1.0-6.8), at baseline and after 1, 2 and 3 months, respectively (p≤0.005)). There were significant correlations between RAID and DAS28 at all examinations (r=0.52-0.66, p<0.01). At three of the four examinations, RAID had significant correlations with assessors global VAS (r=0.39-0.49, p<0.05), number of tender joints (r=0.49-0.64, p<0.01), ESR (r=0.54-0.60, p<0.01) and CRP (r=0.50-0.52, p<0.01), while there were no significant correlation between RAID and number of swollen joints. The RAID scores differentiated significantly between different levels of DAS28 (with cut-offs at 2.6, 3.2 and 5.1) at all examinations (p=0.038 - <0.001). The SRMs for RAID was 0.84, 1.06 and 0.77 after 1, 2 or 3 months compared to 1.06, 0.97 and 0.60 for DAS28.
Conclusions The present study found the RAID scores to fall extensively already 1 month after starting biologic medication and that the scores were highly associated to DAS28. Being rapid to answer, the RAID questionnaire may give the clinicians immediate information about important aspects of the patients life, and thus contribute to treatment decisions.
Disclosure of Interest None Declared
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