Background Routine Assessment of Patient Index Data 3 (RAPID3) comprises the three patient-reported ACR RA Core Data Set measures: function (HAQ-DI), pain and patient global estimate of status (10-cm visual analogue scale). These can be scored in <10 seconds, making it suitable for use in routine clinical practice where it provides quantitative data to supplement qualitative assessments. Significant correlations between RAPID3 scores and DAS28 (CRP) and CDAI have been previously reported.1,2
Objectives To examine whether RAPID3-defined remission performs similarly to definitions of remission by DAS28 (CRP), CDAI, SDAI or Boolean criteria in patients with early RA.
Methods We performed post hoc analyses on data from the AVERT study, described previously.3 RAPID3 scores were calculated at baseline and 3-monthly intervals thereafter, up to 12 months. Definitions of remission were RAPID3 ≤1 (scale of 1–10); DAS28 (CRP) <2.6; CDAI ≤2.8; SDAI ≤3.3; and Boolean: TJC28 ≤1, SJC28 ≤1, patient global assessment of disease activity (0–10 cm) ≤1 and high-sensitivity CRP ≤1 mg/dL. Proportions of patients in RAPID3, DAS28 (CRP), CDAI, SDAI and ACR/EULAR Boolean remission at each time point were calculated. Proportions at 3, 6, 9 and 12 months were compared using cross-tabulation analysis. Agreement between RAPID3 disease activity states and those of other measures were assessed using kappa and weighted kappa statistics.
Results Among the total AVERT population, the respective percentages of patients in remission according to each measure at Months 3, 6 and 9 were: RAPID3, 12.3%, 17.4%, 21.9%; Boolean, 8.5%, 12.5%, 21.1%; SDAI, 10.8%, 21.4%, 27.4%; CDAI, 10.0%, 20.8%, 27.1%; and DAS28 (CRP), 25.1%, 35.0%, 42.7%. Similar trends held at Month 12: 29.3%, 28.8%, 32.2%, 33.6%, 50.1%, respectively. When weighted kappa correlations were calculated for RAPID3 versus other remission criteria, RAPID3 remission showed good correlation with Boolean remission, and kappa correlations with SDAI and CDAI remission were higher than those with DAS28 (CRP) (Table). These trends were similar for each treatment arm.
Conclusions RAPID3-defined remission may be as stringent as ACR/EULAR Boolean-defined remission and agrees well with SDAI and CDAI remission criteria. RAPID3 may be used in clinical trials in addition to routine clinical care in early RA, and its ease of use may be an advantage over other indices.
Disclosure of Interest Y. Yazici Shareholder of: Samumed, Grant/research support from: Bristol-Myers Squibb, Genentech, Consultant for: AbbVie, Bristol-Myers Squibb, Genentech, UCB, Employee of: Samumed, K. K. Gandhi Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, E. Alemao Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, D. E. Furst Grant/research support from: AbbVie, Actelion, Amgen, Bristol-Myers Squibb, Gilead, GlaxoSmithKline, National Institutes of Health, Novartis, Pfizer, Roche/Genentech, UCB, Consultant for: AbbVie, Actelion, Amgen, Bristol-Myers Squibb, Cytori, Janssen, Gilead, GlaxoSmithKline, National Institutes of Health, Novartis, Pfizer, Roche/Genentech, UCB, Speakers bureau: (CME only) AbbVie, Actelion, UCB