scholarly journals Relationship of patient-reported outcomes with MRI measures in rheumatoid arthritis

2016 ◽  
Vol 76 (3) ◽  
pp. 486-490 ◽  
Author(s):  
Joshua F Baker ◽  
Philip G Conaghan ◽  
Paul Emery ◽  
Daniel G Baker ◽  
Mikkel Ostergaard
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Physical Function ◽  
Patient Reported Outcomes ◽  
Bone Erosion ◽  
Clinical Disease ◽  
Time Points ◽  
Patient Reported ◽  
Activity Measures ◽  
Disease Activity Measures

PurposeWe assessed whether MRI measures of synovitis, osteitis and bone erosion were associated with patient-reported outcomes (PROs) in a longitudinal clinical trial setting among patients with rheumatoid arthritis (RA).MethodsThis longitudinal cohort of 291 patients with RA was derived from the MRI substudy of the GO-BEFORE randomised controlled trial of golimumab among methotrexate-naïve patients. Correlations between RAMRIS scores (synovitis, osteitis, bone erosion) and physical function (Health Assessment Questionnaire (HAQ)), pain and global patient scores were determined at 0, 12, 24 and 52 weeks. Correlations between interval changes were also assessed. Multivariable regression models using robust generalised estimating equations evaluated associations over all time-points and their relationship to other clinical disease activity measures.ResultsGreater synovitis, osteitis and bone erosion scores were positively associated with HAQ at all time-points (all p<0.05) and with pain and patient global scores at 24 and 52 weeks. Over all visits, synovitis was associated with HAQ, pain and patient global scores (p≤0.03) independent of clinical disease activity measures. Improvements in synovitis and bone erosion were also associated with improvements in PROs. Less improvement in synovitis and progression in MRI erosion at 52 weeks were both independently associated with worsening in all PROs at 52 weeks while progression on X-ray was not associated. Similar associations were observed across treatment groups.ConclusionsMRI measures of inflammation and structural damage correlate independently with physical function, pain and patient global assessments. These observations support the validity of MRI biomarkers.Trial registration numberNCT00264537; Post-results.

scholarly journals Comparative analyses of responsiveness between the Rheumatoid Arthritis Impact of Disease score, other patient-reported outcomes and disease activity measures: secondary analyses from the ARCTIC study

RMD Open ◽  
2018 ◽  
Vol 4 (2) ◽  
pp. e000754 ◽  
Author(s):  
Karen Holten ◽  
Joseph Sexton ◽  
Tore K Kvien ◽  
Anna-Birgitte Aga ◽  
Espen A Haavardsholm
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Inflammatory Markers ◽  
Disease Duration ◽  
Treat To Target ◽  
Patient Reported ◽  
Short Disease Duration ◽  
Activity Measures ◽  
The Mean ◽  
Disease Activity Measures

ObjectiveTo evaluate the responsiveness of the Rheumatoid Arthritis Impact of Disease (RAID) score compared with other patient-reported outcome measures (PROMs), inflammatory markers and clinical disease activity measures in patients with early rheumatoid arthritis (RA).MethodsDisease-modifying antirheumatic drug–naïve patients with RA with short disease duration were included in the treat-to-target ARCTIC trial and followed for 24 months. The responsiveness of the RAID score was evaluated using standardised response mean (SRM) and relative efficiency (RE) with respect to tender joints by Ritchie Articular Index (RAI). SRMs and REs were also calculated for other PROMs, inflammatory markers and clinical outcome measures. An SRM with value above 0.80 was considered high.Results230 patients with RA were included. The mean±SD symptom duration was 7.1±5.4 months and the baseline mean±SD  RAID score was 4.49±2.14. At 3 months of follow-up, the mean±SD change score for RAID was −2.25±1.98  and the SRM (95%  CI) −1.13 (−1.33 to −0.96). The RAID score showed high responsiveness both at 3 and 6 months (SRM≥0.80) and was more sensitive in detecting change than the reference, tender joints assessed by RAI.ConclusionsThe RAID score proved to be highly responsive to change in patients with RA with short disease duration who followed a treat-to-target strategy. The RAID score was more efficient in detecting change than the reference (RAI) as well as most other PROMs.

scholarly journals Interaction between rheumatoid arthritis and pregnancy: correlation of molecular data with clinical disease activity measures

Rheumatology ◽  
2008 ◽  
Vol 47 (Supplement 3) ◽  
pp. iii19-iii22 ◽  
Author(s):  
T. Haupl ◽  
M. Ostensen ◽  
A. Grutzkau ◽  
G.-R. Burmester ◽  
P. M. Villiger
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Molecular Data ◽  
Clinical Disease ◽  
Clinical Disease Activity ◽  
Activity Measures ◽  
Disease Activity Measures

scholarly journals Does autoimmune thyroid disease affects rheumatoid arthritis disease activity or response to methotrexate?

RMD Open ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e001282
Author(s):  
Kristin Waldenlind ◽  
Bénédicte Delcoigne ◽  
Saedis Saevarsdottir ◽  
Johan Askling
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Eular Response ◽  
Autoimmune Thyroid ◽  
Patient Reported ◽  
Activity Measures ◽  
Disease Activity Measures ◽  
Moderate Response

ObjectiveTo investigate if autoimmune thyroid disease (AITD) impacts rheumatoid arthritis (RA) disease activity or response to methotrexate.MethodsA nationwide register-based cohort study of 9 004 patients with new-onset RA from the Swedish Rheumatology Quality Register year 2006–2016, with linkage to other nationwide registers to identify comorbidity with AITD defined as thyroxine prescription before RA diagnosis, excluding non-autoimmune causes. We compared RA disease activity using 28-joint Disease Activity Score (DAS28) and its components, and EULAR response, between patients with and without AITD, using logistic regression.ResultsAt diagnosis, patient reported outcome measures (PROMs; patient global, Health Assessment Questionnaire Disability Index and pain) but not objective disease activity measures (erythrocyte sedimentation rate and swollen joint count) were significantly higher (p<0.05 for all PROMs) among RA patients with AITD compared with those without. The level of DAS28 was 5.2 vs 5.1. By contrast, AITD had little influence on EULAR response to methotrexate at 3 months (OR of non/moderate response=0.95, 95% CI 0.8 to 1.1), nor at 6 months. When stratified by age, however, AITD was more common among EULAR non/moderate responders at 3 and 6 months in patients below 45 years resulting in ORs of non/moderate response of 1.44 (0.76–2.76) and 2.75 (1.04–7.28).ConclusionAt diagnosis, RA patients with concomitant AITD score worse on patient reported but not on objective RA disease activity measures, while DAS28 was only marginally elevated. The overall chance of achieving a EULAR good response at 3 or 6 months remains unaffected, although among a limited subgroup of younger patients, AITD may be a predictor for an inferior primary response.

scholarly journals Very early MRI responses to therapy as a predictor of later radiographic progression in early rheumatoid arthritis

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Philip G. Conaghan ◽  
Mikkel Østergaard ◽  
Orrin Troum ◽  
Michael A. Bowes ◽  
Gwenael Guillard ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Early Rheumatoid Arthritis ◽  
Radiographic Progression ◽  
Multivariate Analyses ◽  
Clinical Disease ◽  
Clinical Disease Activity ◽  
Activity Measures ◽  
Univariate Analyses ◽  
Disease Activity Measures

Abstract Background The objective of this study was to evaluate early changes in magnetic resonance imaging (MRI) and clinical disease activity measures as predictors of later structural progression in early rheumatoid arthritis (RA). Methods This was a post hoc analysis of data pooled across treatments from a three-arm (tofacitinib monotherapy, tofacitinib with methotrexate [MTX], or MTX monotherapy) trial of MTX-naïve patients with early, active RA. Synovitis, osteitis and erosions were assessed with the Outcome Measures in Rheumatology (OMERACT) RA MRI scoring system (RAMRIS) and RAMRIQ (automated quantitative RA MRI assessment system; automated RAMRIS) at months 0, 1, 3, 6 and 12. Radiographs were assessed at months 0, 6 and 12, and clinical endpoints were assessed at all timepoints. Univariate and multivariate analyses explored the predictive value of early changes in RAMRIS/RAMRIQ parameters and disease activity measures, with respect to subsequent radiographic progression. Results Data from 109 patients with a mean RA duration of 0.7 years were included. In univariate analyses, changes in RAMRIS erosions at months 1 and 3 significantly predicted radiographic progression at month 12 (both p <  0.01); changes in RAMRIQ synovitis and osteitis at months 1 and 3 were significant predictors of RAMRIS erosions and radiographic progression at month 12 (all p <  0.01). In subsequent multivariate analyses, RAMRIS erosion change at month 1 (p <  0.05) and RAMRIQ osteitis changes at months 1 and 3 (both p <  0.01) were significant independent predictors of radiographic progression at month 12. Univariate analyses demonstrated that changes in Clinical Disease Activity Index (CDAI) and Disease Activity Score in 28 joints, erythrocyte sedimentation rate (DAS28-4[ESR]) at months 1 and 3 were not predictive of month 12 radiographic progression. Conclusions MRI changes seen as early as 1 month after RA treatment initiation have the potential to better predict long-term radiographic progression than changes in disease activity measures. Trial registration ClinicalTrials.gov, NCT01164579.

scholarly journals Effectiveness of an Outreach Model of Care for Rheumatology Specialty Clinics to an On-Reserve First Nations Community

2018 ◽  
Vol 13 (1) ◽  
pp. 157-167 ◽  
Author(s):  
Sujay Nagaraj ◽  
Margaret Kargard ◽  
Brenda Hemmelgarn ◽  
Marvin J. Fritzler ◽  
Tyler White ◽  
...  
Keyword(s):  
Disease Activity ◽  
First Nations ◽  
Patient Reported Outcomes ◽  
Model Of Care ◽  
Tender Joint ◽  
Patient Reported ◽  
Activity Measures ◽  
Tender Joint Counts ◽  
Disease Activity Measures

A model of care consisting of rheumatology specialty services embedded in the primary care system on a First Nations reserve was instituted to reduce barriers to care and improve inflammatory arthritis outcomes for patients. We assessed the effectiveness of this model of care on disease activity measures and patient-reported outcomes over 7 years. Patients were enrolled in a longitudinal cohort at the Siksika Nation in Alberta. Clinical characteristics, treatment recommendations and disease activity measures were systematically recorded over follow-up. Mixed-model regression was performed to determine rates of change for continuous measures. 59 participants (78% female; M = 47 years, SD = 13), predominantly with rheumatoid arthritis (RA; n = 36), were followed for an average of 29 months (SD = 23). Swollen and tender joint counts decreased significantly (change per month: -0.20, 95% CI -0.29 to -0.10, and -0.20, 95%CI -0.34 to -0.06, respectively) but pain, physician global and function scores did not significantly improve (all p > 0.05). Patient global evaluation scores worsened over time (change per month 0.08, 95%CI 0.029 to 0.131, p = 0.002). Inflammatory markers improved at a slower rate in patients with incident compared to incident disease. Disease-modifying agents were escalated for moderate or high disease activity at 64% of RA visits, with justifications for not escalating or application of local treatment approaches in all but one instance. Despite improvement in swollen and tender joint counts and adherence to current treatment paradigms, patient-reported outcomes did not significantly improve during follow-up. Further innovation is required to meet relevant outcomes.

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