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THU0597 Comparaison of Self Assessment of Disease Activity To Das28 in Rheumatoid Arthritis: Data from The Randomized “Roc” Trial
  1. C. Sordet1,
  2. E. Chatelus1,
  3. P. Ravaud2,
  4. J. Sibilia1,
  5. J.-E. Gottenberg1,
  6. on behalf of the ROC Trial Investigators
  1. 1University Hospital, Strasbourg
  2. 2Hotel Dieu, Paris, France

Abstract

Background In rheumatoid arthritis (RA), self assessment of disease activity by patients could be useful in clinical practice. Data in literature regarding the relevance of self-assessment remain limited. We therefore addressed this issue in the Rotation Or Change of biologics (ROC) trial.

Objectives To compare self-assessment of disease activity by patients to assessment of disease activity by physicians in RA.

Methods The ROC trial randomized patients with an insufficient response to a 1st anti-TNF to receive either a second anti-TNF or a non-TNF targeted biologic. At enrollment in the trial, a very brief oral information on self assessment of disease activity, along with a short written reminder, was provided to patients. Within 2 weeks of enrollment and at 6 months, patients received a phone call by a clinical research technician to collect the self-DAS28 (patient-derived DAS28). The clinical research technician was unaware of the arm of randomization and of the result of the DAS28. The concordance between self-DAS28 and DAS-28-ESR assessed by the physician was analyzed using the Bland and Altmann method.

Results At enrollment, self-DAS28 was collected in 97 patients treated with a non TNF-targeted biologic and in 94 patients treated with a second anti-TNF. Mean (SD) self-DAS28 was 4.97 (1.46) and mean DAS28-ESR assessed by the physician was 5.06 (1.10). The systematic difference between self DAS-28 and DAS28 (statistically significant if the confidence interval does not include 0) was -0.11 [-0.29; 0.07]. Thus, self-DAS28 at enrollment sligthly but not significantly underestimated DAS28 assessed by the physician.

At 6 months, self-DAS28 was collected in 91 patients treated with a non TNF-targeted biologic and in 84 patients treated with a second anti-TNF. Mean (SD) self-DAS28 was 3.82 (1.56) and mean DAS28-ESR assessed by the physician was 3.53 (1.40). The systematic difference between self DAS-28 and DAS28 was 0.29 [0.09; 0.46]. Thus, self-DAS28 sligthly but not significantly overestimated DAS28 at 6 months.

Conclusions Self-assessment of disease activity by patients, even without a long period of training, provides a correct appreciation of genuine disease activity in RA. Self-assessment of disease activity could be helpful for patients to have a better perception of disease activity between times of referrals to their rheumatologist, and might therefore contribute to optimize disease control in RA.

Disclosure of Interest None declared

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