Objectives Recently an ACR/EULAR expert comity published new proposals of remission for rheumatoid arthritis (RA) . Two propositions have been made: The Boolean based definition with ≤1 tender joint (TJ), ≤1 swollen joint (SJ), the patient global assessment on a 10cm visual analogue scale (PATGA) ≤1.0 and the C-reactive protein (CRP) in mg/dl ≤1.0 or the index based definition with a SDAI ≤3.3. The purpose of this investigation was to characterize patients according to both approaches.
Methods 1844 assessments out of 720 long standing RA out-patients collected between 2007 and 2011 were enrolled (mean age 61.9 yrs. (95%CI 60.9-62.9), 76.7% female, 53.5% RF pos, mean disease duration 87.0 months (80.1-94.1), mean assessments per patient 2.5 (2.4-2.7), mean interval of assessments 6.7 months (6.39-7.03), mean DAS28 3.45 (3.39-3.51)). The assessments included a 28-joint count for TJ and SJ, evaluation of PATGA, CRP in mg/dl and physician’s global assessment (MDGA) to calculate the SDAI as described  but also to identify patients in remission according to the 2011 proposed ACR/EULAR remission definition. Moreover erythrocyte sedimentation rate first hour (ESR), patient’s pain perception on a 10cm VAS (VASpain) and the HAQ was recorded. The mean of each core set parameter and the 95% Confidence interval was calculated in the respective group of remission and student’s t-test was calculated for their relation. P<0.05 was defined to be significant.
Results 184 assessments were identified to be in remission according to the Boolean based definition, whereas 379 according to the index based definition. 181 assessments fulfilled both criteria. PGA, VASpain and the HAQ-score (all patient related parameters) were statistically different in both groups.
Conclusions 198 more patients are identified to fulfil the index based definition than the Boolean based definition of remission. Patient’s related parameters as PGA, VASpain and the HAQ-score are statistically significantly different in both groups. The Boolean based definition is more stringent than the index based one. Both definitions are not interchangeable.
Felson DT et al. Arthritis Rheum. 2011 Mar;63(3):573-86.
Smolen JS et al. Rheumatology (Oxford) 2003:42:244-57.
Disclosure of Interest None Declared