Background The public database JointMan® was launched January 2012 with a mission to provide a practical outcome tool to manage patients with RA in a clinical setting. This was not constructed as a research registry. The rheumatology community has been educated on the importance of measurement in patients with RA.
Objectives In this observational study, the stated hypothesis is that rheumatologists in a clinical real world setting in the United States who are consistently measuring disease activity using a web based electronic practical outcome tool are achieving appropriate targets in patients with RA.
Methods JointMan® captures RA diagnostic criteria and selected disease features, formal joint counts, MDHAQ, DAS 28, CDAI, SDAI, RAPID3, CRP and ESR, VECTRA DA, medication use, toxicities and reason for discontinuation. This was a descriptive observational study.
Results To date 51 United States providers have entered patients. A total of 2465 unique RA patients and 6860 encounters were recorded between January 1, 2012 and December 31, 2012. Of the 2465 unique RA patients, 1862 patients had greater than one encounter reported. Only patients with greater than one encounter were evaluated. Demographic characteristics of this group revealed that 72% were female, mean age was 62, 55% were RF positive, 41% were CCP positive, 34% had documented erosions noted on radiographic studies.
CDAI and RAPID3 scores were available for 83.4% and 91.73% respectively. The mean number of encounters per patient where CDAI and RAPID3 were recorded was 4.71 and 4.38 respectively. The mean initial CDAI score was 14.63 at the time of first encounter and a mean CDAI score of 12.18 was noted at the time of the last encounter for a 2.45 improvement (16.73% improvement p=0.0001). The mean initial RAPID3 score was 11.33 at the time of first and 10.88 was noted at the time of the last encounter for a 0.45 improvement (3.97% improvement p=0.0005).
More importantly, LDA and R were achieved in a substantial number of patients. 17.75% of patients in High Disease Activity (HDA) at first visit were in LDA at last visit and 3.62% of patients were in R. Of those in Moderate Disease Activity (MDA) at baseline 38.97% were in LDA and 4.31% R respectively at last visit.
Conclusions Utilizing a new database, JointMan®, constructed to easily enter patient data in a clinical setting, it was demonstrated that physicians in a real world setting consistently determine outcome measurements. Patients followed using defined metrics demonstrate an overall improvement in CDAI and RAPID3 scores and importantly over time have improvement in the percentages of patients in remission and low disease activity.
Disclosure of Interest S. Schwartzman Consultant for: Abbvie, Janssen, Genentech, Pfizer, UCB, Hospira, Speakers bureau: Abbvie, Janssen, Genentech, Pfizer, UCB, G. Craig Consultant for: genentech, Speakers bureau: Genentech, Abbvie, H. Kenney Grant/research support: BMS, K. Knapp Grant/research support: BMS, W.-T. Huang: None declared
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