Article Text

other Versions

PDF
Comparison of composite measures of disease activity in an early sero-positive rheumatoid arthritis cohort
  1. Veena Kittane Ranganath (vranganath{at}mednet.ucla.edu)
  1. University of California, Los Angeles, CA, United States
    1. Jeonglim Yoon
    1. University of California, Los Angeles, CA, United States
      1. David Alexander Elashoff (dae{at}ucla.edu)
      1. University of California, Los Angeles, CA, United States
        1. Grace S. Park
        1. University of California, Los Angeles, CA, United States
          1. Dinesh Khanna
          1. University of Cincinnati, Cincinnati, Ohio, and Veterans Affairs Medical Center, Cincinnati, Ohio, United States
            1. Daniel E Furst (defurst{at}mednet.ucla.edu)
            1. University of California, Los Angeles, CA, United States
              1. Damini Jawaheer (damini{at}mednet.ucla.edu)
              1. University of California, Los Angeles, CA, United States
                1. John T. Sharp
                1. University of Washington, Seattle, United States
                  1. Richard H. Gold
                  1. University of California, Los Angeles, CA, United States
                    1. Edward C. Keystone
                    1. University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada, Canada
                      1. Harold E Paulus (hpaulus{at}mednet.ucla.edu)
                      1. University of California, Los Angeles, CA, United States

                        Abstract

                        Objective: To evaluate concordance and agreement of the original DAS44/ESR-4 item composite disease activity status measure with 9 simpler derivatives when classifying patient responses by European League of Associations for Rheumatology(EULAR) response, using an early rheumatoid factor positive(RF+) rheumatoid arthritis(RA) patient cohort.

                        Methods: DMARD-naïve RF+ RA patients(n=223,mean duration of symptoms,6 months) were categorized as ACR none/20/50/70 responders. One-way analysis of variance and two sample t-tests were used to investigate the relationship between the ACR response groups and each composite measure. EULAR reached/change cut-point scores were calculated for each composite measure. EULAR(good/moderate/none) responses for each composite measure and the degree of agreement with DAS44/ESR-4 item were calculated for 203 patients.

                        Results: Patients’ were mostly female(78%) with moderate to high disease activity. A percentile-based nomogram compares equivalent composite measure scores. Changes from baseline in the composite measures in patients with ACR none were significantly less than those of ACR20/50/70 responders, and those for ACR50 were significantly different than for ACR70. EULAR reached/change cut-point scores for our cohort were similar to published cut-points. When compared to DAS44/ESR-4 item, EULAR(good/moderate/none) percent agreements included 92% with DAS44/ESR-3 item, 74% with CDAI, and 80% each with DAS28/ESR-4 item, DAS28/CRP-4 item, and SDAI.

                        Conclusion: We describe the relationships of 9 different RA composite measures against DAS44/ESR-4 item when applied to a cohort of early sero-positive RA patients. Each of these simplified status and response measures could be useful in assessing RA patients, but the specific measure selected should be pre-specified and described for each study.

                        • disease activity score
                        • outcome measures
                        • rheumatoid arthritis

                        Statistics from Altmetric.com

                        Request permissions

                        If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.