A decrease in disease activity score (DAS) level is associated with a decrease in health assessment questionnaire (HAQ) score, independent of follow-up duration, during 5 years of tightly controlled treatment: results from the BeSt study

2010 ◽  
Vol 70 (1) ◽  
pp. 168-171 ◽  
Author(s):  
E. van der Kooi ◽  
N. B. Klarenbeek ◽  
M. Guler-Yuksel ◽  
P. J. S. M. Kerstens ◽  
P. A. H. M. van der Lubbe ◽  
...  
Keyword(s):  
Disease Activity ◽  
Health Assessment Questionnaire ◽  
Disease Activity Score ◽  
Health Assessment ◽  
Activity Score ◽  
Treatment Results ◽  
Controlled Treatment ◽  
Assessment Questionnaire

Versorgung von Kindern, Jugendlichen und jungen Erwachsenen mit juveniler idiopathischer Arthritis

2018 ◽  
Vol 43 (05) ◽  
pp. 375-382 ◽  
Author(s):  
Kirsten Minden ◽  
Martina Niewerth ◽  
Jens Klotsche ◽  
Angela Zink
Keyword(s):  
Disease Activity ◽  
Medikamentöse Therapie ◽  
Health Assessment Questionnaire ◽  
Disease Activity Score ◽  
Health Assessment ◽  
Juvenile Arthritis ◽  
Activity Score ◽  
Childhood Health Assessment Questionnaire ◽  
Childhood Health ◽  
Assessment Questionnaire

Zusammenfassung Hintergrund Multizentrische Beobachtungsstudien, wie die Kerndokumentation rheumakranker Kinder und Jugendlicher, und bundesweite Abrechnungsdaten vermitteln Informationen zur Versorgung von Kindern, Jugendlichen und jungen Erwachsenen mit juveniler idiopathischer Arthritis (JIA). Sie gestatten die Art der Versorgung, deren Veränderungen über die Zeit und assoziierte Outcomes sowie Defizite aufzuzeigen. Methoden Basierend auf Daten der Kerndokumentation, der Umfrage der kinderrheumatologischen Fachgesellschaft zu Versorgungsangeboten in 2017 und Publikationen der letzten Jahre wird die Versorgungssituation bei der JIA zusammenfassend dargestellt. Zur Beurteilung der Krankheitslast wurden neben der in der Kerndokumentation erfassten Krankheitsaktivität (beurteilt anhand des klinischen JADAS-10 [juvenile arthritis disease activity score]) die patienten-berichteten Outcomes Funktionsfähigkeit (bestimmt mittels Childhood Health Assessment Questionnaire) und Schmerzen (erfasst mittels numerischer Ratingskala) herangezogen. Ergebnisse Für die Behandlung rheumakranker Kinder und Jugendlicher stehen inzwischen bundesweit über 160 Kinder- und Jugendrheumatologen zur Verfügung. Die Versorgung der jungen Patienten erfolgt überwiegend an Krankenhausambulanzen, die Häufigkeit stationärer Behandlungen ist jedoch zurückgegangen. Die medikamentöse Therapie unterlag erheblichen Änderungen, in 2016 wurden 22% aller JIA-Patienten mit Biologika behandelt, von den Patienten mit systemischer JIA sogar fast 40%. Glukokortikoide und NSAR haben mit zunehmendem Biologikaeinsatz an Bedeutung verloren. Die Krankheitslast war bei den Kindern und Jugendlichen mit JIA in den letzten Jahren rückläufig. Sowohl die durchschnittliche Krankheitsaktivität als auch die Funktionseinschränkungen im Alltag sind zurückgegangen, die mittlere Schmerzstärke der Betroffenen änderte sich über die Zeit jedoch nicht relevant. Schätzungsweise mindestens zwei Drittel der JIA-Patienten werden im Kindes- und Jugendalter fachspezifisch versorgt. Im jungen Erwachsenenalter sind es weniger, was Konsequenzen für die medikamentöse Versorgung der Betroffenen hat. Fazit Mit den heute vorhandenen Versorgungsangeboten und Therapiestrategien lässt sich die Krankheitslast bei den JIA-Patienten erfolgreich reduzieren. Damit Patienten von den neuen Optionen profitieren können, braucht es eine rechtzeitige Erkennung der JIA mit Überweisung und langfristigem Verbleiben in fachspezifischer Betreuung.

scholarly journals Prevalencia de Artrtitis Reumatoide en dos poblaciones originarias de Argentina. Estudio de base comunitaria: ¿“Dos caras de una misma moneda”?

2021 ◽  
Vol 1 ◽  
pp. 113-121
Author(s):  
Rosana Quintana ◽  
Vicente Juárez ◽  
Adriana Silvestre ◽  
Mariana Aciar ◽  
Romina Nieto ◽  
...  
Keyword(s):  
Disease Activity ◽  
Rheumatic Diseases ◽  
Health Assessment Questionnaire ◽  
Disease Activity Score ◽  
Health Assessment ◽  
Activity Score ◽  
Calidad De Vida ◽  
Das 28 ◽  
Assessment Questionnaire ◽  
Questionnaire Disability

La artritis reumatoide (AR) es una patología crónica que genera limitación funcional, impactando en la calidad de vida de los pacientes y de su entorno familiar. El objetivo de este estudio fue estimar la prevalencia de AR en las comunidades de pueblos originarios qom y wichi de la ciudad de Rosario y Misión Chaqueña (Salta); además de comparar las características entre ambas. Se realizó un estudio transversal, epidemiológico, de base comunitaria, utilizando la metodología Community Oriented Program for the Control of Rheumatic Diseases (COPCORD). Los individuos con dolor músculo—esquelético (casos positivos) fueron evaluados en forma consecutiva por médicos generales y referenciados dentro de la semana al reumatólogo para diagnóstico y eventual tratamiento. La prevalencia de AR fue de 3% (qom) y 3.2% (wichi). Las características de la AR fueron similares en ambas comunidades en relación a la actividad medida por Disease Activity Score—28 (DAS 28) (p 0,341) pero no en la limitación funcional medida por Health Assessment Questionnaire Disability Index (HAQ) (p 0,031). Existió un retraso promedio en el diagnóstico de 2 años. El 45% y 66% (p 0,100) de los pacientes qom y wichi tuvieron cambios radiográficos propios de una enfermedad avanzada. Más del 90% fueron seropositivos para factor reumatoideo y anticuerpos antipéptido citrulinado cíclico. El 42% y 29% (p 0,246) de los pacientes qom y wichi tenían antecedentes familiares de AR. Las prevalencias de AR en ambas comunidades fueron altas, con marcada agresividad de la enfermedad, así como impactante limitación funcional. El retraso en el diagnóstico es un factor fundamental para mejorar el pronóstico de esta patología.

The Influence of Sex on Patients with Rheumatoid Arthritis in a Large Observational Cohort

2009 ◽  
Vol 36 (3) ◽  
pp. 508-511 ◽  
Author(s):  
NORIKO IIKUNI ◽  
ERI SATO ◽  
MASAYA HOSHI ◽  
EISUKE INOUE ◽  
ATSUO TANIGUCHI ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Health Assessment Questionnaire ◽  
Disease Activity Score ◽  
Health Assessment ◽  
Observational Cohort Study ◽  
Observational Cohort ◽  
Male Patients ◽  
Assessment Questionnaire ◽  
Over Time

Objective.To compare the sex differences of various components of rheumatoid arthritis (RA).Methods.Data of 4823 patients from a large observational cohort study were analyzed. Remarkable differences were noted between the sexes, and overall, women had significantly higher disease activity.Results.When variables were adjusted using sex, age, and duration, Health Assessment Questionnaire, rather than Disease Activity Score, contributed most to sex difference. Further analysis showed evidence that progression of disability was approximately 3 times more rapid in female patients compared to male patients.Conclusion.Women overall have higher RA disease activity and are prone to greater and faster progression of disability over time.

scholarly journals AB0140 A HIGH-CONFIDENCE DEFINITION OF THERAPEUTIC RESPONSE IN RHEUMATOID ARTHRITIS USING A MONTE CARLO SIMULATION APPROACH

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1097.2-1098
Author(s):  
V. Strand ◽  
S. Cohen ◽  
L. Zhang ◽  
T. Mellors ◽  
A. Jones ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Monte Carlo ◽  
Disease Activity ◽  
Health Assessment Questionnaire ◽  
Health Assessment ◽  
High Confidence ◽  
Response Status ◽  
Definition Of ◽  
Fidelity Score ◽  
Assessment Questionnaire

Background:Therapy choice and therapy change depend on the ability to accurately assess patients’ disease activity. The clinical assessments used to evaluate treatment response in rheumatoid arthritis have inherent variability, normally considered as measurement error, intra-observer variability or within subject variability. Each contribute to variability in deriving response status as defined by composite measures such as the ACR or EULAR criteria, particularly when a one-time observed measurement lies near the boundary defining response or non-response. To select an optimal therapeutic strategy in the burgeoning age of precision medicine in rheumatology, achieve the lowest disease activity and maximize long-term health outcomes for each patient, improved treatment response definitions are needed.Objectives:Develop a high-confidence definition of treatment response and non-response in rheumatoid arthritis that exceeds the expected variability of subcomponents in the composite response criteria.Methods:A Monte Carlo simulation approach was used to assess ACR50 and EULAR response outcomes in 100 rheumatoid arthritis patients who had been treated for 6 months with a TNF inhibitor therapy. Monte Carlo simulations were run with 2000 iterations implemented with measurement variability derived for each clinical assessment: tender joint count, swollen joint count, Health Assessment Questionnaire disability index (HAQ-DI), patient pain assessment, patient global assessment, physician global assessment, serum C-reactive protein level (CRP) and disease activity score 28-joint count with CRP.1-3 Each iteration of the Monte Carlo simulation generated one outcome with a value of 0 or 1 indicating non-responder or responder, respectively.Results:A fidelity score, calculated separately for ACR50 and EULAR response, was defined as an aggregated score from 2000 iterations reported as a fraction that ranges from 0 to 1. The fidelity score depicted a spectrum of response covering strong non-responders, inconclusive statuses and strong responders. A fidelity score around 0.5 typified a response status with extreme variability and inconclusive clinical response to treatment. High-fidelity scores were defined as >0.7 or <0.3 for responders and non-responders, respectively, meaning that the simulated clinical response status label among all simulations agreed at least 70% of the time. High-confidence true responders were considered as those patients with high-fidelity outcomes in both ACR50 and EULAR outcomes.Conclusion:A definition of response to treatment should exceed the expected variability of the clinical assessments used in the composite measure of therapeutic response. By defining high-confidence responders and non-responders, the true impact of therapeutic efficacy can be determined, thus forging a path to development of better treatment options and advanced precision medicine tools in rheumatoid arthritis.References:[1]Cheung, P. P., Gossec, L., Mak, A. & March, L. Reliability of joint count assessment in rheumatoid arthritis: a systematic literature review. Semin Arthritis Rheum43, 721-729, doi:10.1016/j.semarthrit.2013.11.003 (2014).[2]Uhlig, T., Kvien, T. K. & Pincus, T. Test-retest reliability of disease activity core set measures and indices in rheumatoid arthritis. Ann Rheum Dis68, 972-975, doi:10.1136/ard.2008.097345 (2009).[3]Maska, L., Anderson, J. & Michaud, K. Measures of functional status and quality of life in rheumatoid arthritis: Health Assessment Questionnaire Disability Index (HAQ), Modified Health Assessment Questionnaire (MHAQ), Multidimensional Health Assessment Questionnaire (MDHAQ), Health Assessment Questionnaire II (HAQ-II), Improved Health Assessment Questionnaire (Improved HAQ), and Rheumatoid Arthritis Quality of Life (RAQoL). Arthritis Care Res (Hoboken) 63 Suppl 11, S4-13, doi:10.1002/acr.20620 (2011).Disclosure of Interests:Vibeke Strand Consultant of: Abbvie, Amgen, Arena, BMS, Boehringer Ingelheim, Celltrion, Galapagos, Genentech/Roche, Gilead, GSK, Ichnos, Inmedix, Janssen, Kiniksa, Lilly, Merck, Novartis, Pfizer, Regeneron, Samsung, Sandoz, Sanofi, Setpoint, UCB, Stanley Cohen: None declared, Lixia Zhang Shareholder of: Scipher Medicine Corporation, Employee of: Scipher Medicine Corporation, Ted Mellors Shareholder of: Scipher Medicine Corporation, Employee of: Scipher Medicine Corporation, Alex Jones Shareholder of: Scipher Medicine Corporation, Employee of: Scipher Medicine Corporation, Johanna Withers Shareholder of: Scipher Medicine Corporation, Employee of: Scipher Medicine Corporation, Viatcheslav Akmaev Shareholder of: Scipher Medicine Corporation, Employee of: Scipher Medicine Corporation

scholarly journals THU0106 PREDICTORS OF FLARE IN RHEUMATOID ARTHRITIS PATIENTS WITH LOW DISEASE ACTIVITY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 267.1-267
Author(s):  
K. W. Moon
Keyword(s):  
Rheumatoid Arthritis ◽  
Multivariate Analysis ◽  
Observational Study ◽  
Disease Activity ◽  
Health Assessment Questionnaire ◽  
Health Assessment ◽  
Low Disease Activity ◽  
Erythrocyte Sedimentation ◽  
Euroqol 5D ◽  
Assessment Questionnaire

Background:Low disease activity (LDA) in patients with rheumatoid arthritis (RA) are usually recognized as stable state. In according to most guidelines for RA, monotherapy of disease modifying anti-rheumatic drug (DAMRD) was recommended for RA patents with LDA. But some of patients with LDA suffer from flare in their disease course. Until now, we don’t have enough data on factors that can predict flare in RA patients with LDA.Objectives:The aim of this study is to evaluate predictor of flare in RA patient with LDA from long-term (3 year) cohort data.Methods:Korean observational study network for arthritis (KORONA) registry is a nationwide Korean RA specific cohort registry that collecting data annually from 5,376 RA patients in 23 centers across South Korea. We include the data from 1, 801 RA patients with LDA (28 –joint disease activity score (DAS 28) < 3.2 at enrollment) who had consecutive data of DAS28 for 3 years. Flare was defined as an increase in DAS28 compared with baseline of >1.2 or >0.6 if concurrent DAS28 ≥3.2. Cox regression analysis was used to identify baseline predictors of flare.Results:Among 1,801 RA patients, 673 patients (37.4%) experienced flare in 3 years. When we compare the baseline characteristics of both flare and non-flare group, more women and more non-adherent patients for medication were observed in flare group. Flare group had longer disease duration, lower EuroQol 5D score, higher health assessment questionnaire (HAQ) score, and higher erythrocyte sedimentation rate (ESR) than non-flare group at baseline. In multivariate analysis, physician’s VAS, HAQ score, ESR, and poor adherence for medication were significant predictors of flare (Table 1).Table 1.Multivariate analysis of prediction of flare with baseline variablesMeasureHazard ratio95% Confidence IntervalP-valueFemale1.1300.906-1.4090.280Age0.9960.988-1.0050.414Physician’s VAS1.0081.002-1.013<0.01Pain VAS1.0020.998-1.0060.34EQ5D0.9520.534-1.6960.87HAQ1.4071.109-1.786<0.01ESR1.0081.002-1.014<0.01Poor adherence1.2721.047-1.545<0.05VAS: Visual Analogue Scale; EQ5D: EuroQol 5D; HAQ: Health Assessment Questionnaire; ESR: Erythrocyte Sedimentation RateConclusion:RA patient who have risk factors for flare, even though their disease activity was low, require more proactive treatment.References:[1]Bechman K, Tweehuysen L, Garrood T, Scott DL, Cope AP, Galloway JB, et al. Flares in Rheumatoid Arthritis Patients with Low Disease Activity: Predictability and Association with Worse Clinical Outcomes. J Rheumatol. 2018;45(11):1515-21.[2]Singh JA, Saag KG, Bridges SL, Jr., Akl EA, Bannuru RR, Sullivan MC, et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheumatol. 2016;68(1):1-26.[3]Sung YK, Cho SK, Choi CB, Park SY, Shim J, Ahn JK, et al. Korean Observational Study Network for Arthritis (KORONA): establishment of a prospective multicenter cohort for rheumatoid arthritis in South Korea. Semin Arthritis Rheum. 2012;41(6):745-51.Disclosure of Interests:None declared

scholarly journals Efficacy and safety of a single switch from etanercept originator to etanercept biosimilar in a cohort of inflammatory arthritis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Maria Chiara Ditto ◽  
Simone Parisi ◽  
Marta Priora ◽  
Silvia Sanna ◽  
Clara Lisa Peroni ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Inflammatory Arthritis ◽  
Health Assessment Questionnaire ◽  
Activity Index ◽  
Health Assessment ◽  
Disease Activity Index ◽  
Clinical State ◽  
Assessment Questionnaire

Abstract AntiTNF-α biosimilars are broadly available for the treatment of inflammatory arthritis. There are a lot of data concerning the maintenance of clinical efficacy after switching from originators to biosimilars; therefore, such a transition is increasingly encouraged both in the US and Europe. However, there are reports about flares and adverse events (AE) as a non-medical switch remains controversial due to ethical and clinical implications (efficacy, safety, tolerability). The aim of our work was to evaluate the disease activity trend after switching from etanercept originator (oETA-Enbrel) to its biosimilar (bETA-SP4/Benepali) in a cohort of patients in Turin, Piedmont, Italy. In this area, the switch to biosimilars is stalwartly encouraged. We switched 87 patients who were in a clinical state of stability from oETA to bETA: 48 patients were affected by Rheumatoid Arthritis (RA),26 by Psoriatic Arthritis (PsA) and 13 by Ankylosing Spondylitis (AS).We evaluated VAS-pain, Global-Health, CRP, number of swollen and tender joints, Disease Activity Score on 28 joints (DAS28) for RA, Disease Activity in Psoriatic Arthritis (DAPSA) for PsA, Health Assessment Questionnaire (HAQ) and Health Assessment Questionnaire for the spondyloarthropathies (HAQ-S),Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for AS patients. 11/85 patients (12.6%) stopped treatment after switching to biosimilar etanercept. No difference was found between oETA and bETA in terms of efficacy. However, some arthritis flare and AE were reported. Our data regarding maintenance of efficacy and percentage of discontinuation were in line with the existing literature.

scholarly journals P158 Severity of hand vascular involvement as assessed by MRI Digital Artery Volume Index (DAVIX©) predicts worsening of clinical parameters and patient reported outcomes in scleroderma

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Fiammetta Danzo ◽  
Klodian Gjeloshi ◽  
Giovanni Lettieri ◽  
Giuseppina Abignano ◽  
Mark Hinton ◽  
...  
Keyword(s):  
Disease Activity ◽  
Health Assessment Questionnaire ◽  
Patient Reported Outcomes ◽  
Health Assessment ◽  
Volume Index ◽  
Vascular Involvement ◽  
Clinical Parameters ◽  
Digital Artery ◽  
Patient Reported ◽  
Assessment Questionnaire

Abstract Background Neointima proliferation is a key pathologic feature of systemic sclerosis (SSc), causing arterial vessel narrowing and being the recognised culprit pathological lesion in digital ulcers (DUs), pulmonary artery hypertension and renal crisis. Nevertheless, there are no validated imaging techniques to assess the severity of vascular involvement in SSc. We have previously shown digital artery volume index (DAVIX©) assessed with time of right MRI angiography, is a reliable measure of neointima proliferation in the hands. The purpose of our study was to identify the value of DAVIX© in predicting worsening of patient reported outcomes (PROs) and clinical parameters in SSc. Methods Cross-sectional data were available for 91 patients and complete 12 months follow-up data for 68 patients. Data collected included: modfied Rodnan skin score (mRSS), pulmonary function tests (PFTs), echocardiography, nailfold capillaroscopy, Health Assessment Questionnaire Disability Index (HAQ-DI), and Scleroderma Health Assessment Questionnaire (sHAQ). DAVIX© of the dominant hand was calculated as the % mean of the 4 fingers, employing MeVisLab software. Following analysis of distribution, Spearman or Pearson test were used to determine correlation coefficients, as appropriate (Prism 7). Results 56/68 were female and median of disease duration was 4 years (IQR 1.91-9). As previously reported DAVIX© correlated with the presence of DUs (p = 0.0093). Considering all patients, DAVIX© correlated with mRSS (r=-0.258, p = 0.017), DLCO% (r = 0.338, p = 0.008) and the pattern of capillaroscopy (r=-0.388, p = 0.001). In patients with DUs, DAVIX© showed a stronger correlation with DLCO% (r = 0.786, p = 0.048). Most importantly, DAVIX© predicted the worsening of HAQ-DI (r=-0.295, p = 0.029), sHAQ (r =-0.333, p = 0.029) and VAS pain (r=-0.269, p = 0.038) independently of the presence of DUs. Conclusion The quantitative assessment of neointima proliferation in the hand by DAVIX© is a useful imaging biomarker of vascular disease activity. The value of DAVIX© in predicting the worsening of PROs and clinical parameters in overall patients, may offer insights on the role of vascular disease activity in the global progression of SSc. The validation of our data in an independent cohort and the sensitivity to change over time of DAVIX© may aid to the implementation of hand MRI as imaging outcome measure of vascular severity in SSc. Disclosures F. Danzo None. K. Gjeloshi None. G. Lettieri None. G. Abignano None. M. Hinton None. A. Dean None. G. Cuomo None. O. Kubassova None. F. del Galdo None.

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