scholarly journals FRI0481 Interplay between patient global assessment, pain and fatigue and influence of other clinical disease activity measures in patients with active spondyloarthritis

2017 ◽  
Author(s):  
OR Madsen ◽  
EL Egsmose
Keyword(s):  
Disease Activity ◽  
Global Assessment ◽  
Patient Global Assessment ◽  
Clinical Disease ◽  
Clinical Disease Activity ◽  
Activity Measures ◽  
Disease Activity Measures

scholarly journals Synovitis in rheumatoid arthritis detected by grey scale ultrasound predicts the development of erosions over the next three years

Rheumatology ◽  
2019 ◽  
Vol 59 (7) ◽  
pp. 1556-1565 ◽  
Author(s):  
Burkhard Möller ◽  
Daniel Aletaha ◽  
Michael Andor ◽  
Andrew Atkinson ◽  
Bérengère Aubry-Rozier ◽  
...  
Keyword(s):  
Disease Activity ◽  
Joint Damage ◽  
Clinical Disease ◽  
Biological Dmards ◽  
Clinical Disease Activity ◽  
Upper Limit ◽  
Grey Scale ◽  
Damage Progression ◽  
Activity Measures ◽  
Disease Activity Measures

Abstract Objectives To evaluate grey scale US (GSUS) and power Doppler US synovitis (PDUS), separately or in combination (CombUS), to predict joint damage progression in RA. Methods In this cohort study nested in the Swiss RA register, all patients with sequential hand radiographs at their first US assessment were included. We analysed the summations of semi-quantitative GSUS, PDUS and CombUS assessments of both wrists and 16 finger joints (maximum 54 points) at their upper limit of normal, their 50th, 75th or 87.5th percentiles for the progression of joint damage (ΔXray). We adjusted for clinical disease activity measures at baseline, the use of biological DMARDs and other confounders. Results After a median of 35 months, 69 of 250 patients with CombUS (28%), 73 of 259 patients with PDUS (28%) and 75 of 287 patients with available GSUS data (26%) demonstrated joint damage progression. PDUS beyond upper limit of normal (1/54), GSUS and CombUS each at their 50th (9/54 and 10/54) and their 75th percentiles (14/54 and 15/54) were significantly associated with ΔXray in crude and adjusted models. In subgroup analyses, GSUS beyond 14/54 and CombUS higher than 15/54 remained significantly associated with ΔXray in patients on biological DMARDs, while clinical disease activity measures had no significant prognostic power in this subgroup. Conclusion Higher levels of GSUS and CombUS are associated with the development of erosions. GSUS appears to be an essential component of synovitis assessment and an independent predictor of joint damage progression in patients on biological DMARDs.

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 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.

P042 FATIGUE AND DISEASE ACTIVITY: A SECONDARY REVIEW OF PATIENT MEDICAL RECORDS

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S63-S63
Author(s):  
Kendra Kamp ◽  
Kindra Clark-Snustad ◽  
Scott D Lee
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Clinic Visit ◽  
Clinical Disease ◽  
Clinical Disease Activity ◽  
Endoscopic Remission ◽  
Activity Measures ◽  
Inflammatory Bowel ◽  
Disease Activity Measures

Abstract Introduction Fatigue is often the most prevalent symptom in inflammatory bowel disease (IBD). Previous research has highlighted that patients with active clinical disease activity have greater levels of fatigue compared to those with inactive clinical disease activity. Endoscopic assessment of inflammation is considered the best measure of disease activity; yet, clinical disease activity does not necessarily correlate with endoscopic inflammation. Therefore, there is a need to examine the relationship between endoscopic inflammation and fatigue. Methods A retrospective chart review was conducted of adult patients at an academic medical center. Participants were included in the review if they had a diagnosis of ulcerative colitis or Crohn’s disease, a clinic visit between 2018–2019 with completed Short Inflammatory Bowel Disease Questionnaire and clinical disease activity measures (Harvey Bradshaw Index [HBI] or Simple Clinical Colitis Activity Index [SCCAI]), and had a scored endoscopic disease activity score (Mayo Score of Ulcerative Colitis or the Simple Endoscopic Score for Crohn’s Disease) within 6 months of the clinic visit. Fatigue (range 1–7) was reversed scored; a higher number indicated increased fatigue. Descriptive statistics were calculated using STATA 14. Results Individuals (N=43) had a mean age of 37.4 (SD=12.3) and 54% were female. Disease location was 9% ileal, 53% ileocolonic, and 37% colonic; 54% were in endoscopic remission. The mean fatigue score was 4.2 (SD=1.7). There was no difference in fatigue between individuals in endoscopic remission (M=4.2, SD=1.6) compared to individuals with active endoscopic disease (M=4.2, SD=1.9; p=0.97). Fatigue was correlated with clinical disease activity measures including the HBI (r=0.61) and the SCCAI (r=0.58). Increased levels of fatigue were associated with abnormal c-reactive protein (p&lt;0.01), erythrocyte sedimentation rate (p&lt;0.01), and albumin (p=0.04) but not hematocrit (p=0.71) or hemoglobin (p=0.60). Conclusions The majority of the sample reported fatigue; however, fatigue did not correlate with endoscopic disease activity despite previous research suggesting that clinical disease activity correlates with fatigue. Further confounding our understanding of disease activity’s association with fatigue is the fact that clinical disease activity and biochemical abnormalities (CRP, ESR, albumin) did correlate with fatigue. Additional research is clearly needed to characterize the cause of fatigue among individuals with IBD.

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.

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