Evaluation of Selected Rheumatoid Arthritis Activity Scores for Office-based Assessment

2010 ◽  
Vol 37 (12) ◽  
pp. 2466-2468 ◽  
Author(s):  
MARY BETH SULLIVAN ◽  
CHRISTINE IANNACCONE ◽  
JING CUI ◽  
BING LU ◽  
KERRI BATRA ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Duration ◽  
Office Setting ◽  
Reactive Protein ◽  
Patient Reported ◽  
Pairwise Correlations ◽  
Patient Reported Measures ◽  
Rheumatoid Arthritis Activity ◽  
Citrullinated Peptide

Objective.Patient-reported measures can quickly provide assessments of rheumatoid arthritis (RA) disease activity in the office setting and do not require a laboratory test or physician examination. The goal of our study was to establish the validity of patient-reported indices compared to the C-reactive protein-based Disease Activity Score (DAS28-CRP4).Methods.Baseline and 1-year followup DAS28-CRP4 data were obtained from 740 RA subjects and were compared to indices (MDHAQ, CDAI, RAPID, RADAI, GAS) according to cyclic citrullinated peptide (CCP) status and change at 1 year. Pairwise correlations were calculated for each index.Results.Among 740 subjects, mean age 57 years, disease duration 14 years, the CDAI (r = 0.84, Δ r = 0.80) and RAPID (r = 0.71, Δ r = 0.70) had the highest correlation with the DAS28-CRP4 scores at baseline and 1 year. These correlations were not influenced by CCP status, disease-modifying antirheumatic drug use, biologic use, or by disease duration.Conclusion.In RA, the CDAI and RAPID correlated well with the DAS28-CRP4. They may both be practical and informative in the care of patients in the office setting.

scholarly journals Is there an association between Anti-Citrullinated Peptide Antibodies and the Severity of Rheumatoid Arthritis Parameters in Algerian Patients?

2020 ◽  
Vol 10 (4) ◽  
pp. 17-24
Author(s):  
Siheme OUALI ◽  
Khalida ZEMRI ◽  
Ferial SELLAM ◽  
Noria HARIR ◽  
Zahira BENIASSA ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Severity ◽  
Disease Duration ◽  
University Hospital ◽  
Laboratory Assessment ◽  
Functional Rehabilitation ◽  
Strong Relation ◽  
The University ◽  
Citrullinated Peptide

Objectives: The aim of this study was to demonstrate the relationships between anti-citrullinated peptide/protein antibodies status and clinical characteristics, disease severity, radiological damages and laboratory assessment in Algerian patients with Rheumatoid arthritis, as well as their importance like a predictive factor for the diagnosis of Rheumatoid arthritis (RA). Methods: 281 patients diagnosed with RA according to ACR 1987 criteria in the  internal medicine and Functional Rehabilitation departments (the University Hospital of Sidi Bel Abbes) were enrolled in the study based on medical records including age, gender, disease duration, disease activity score (DAS28), joint damages, laboratory tests and treatment. All data were processed and analyzed via SPSS 22.0. Results: 86.5% of patients were females with a mean age and disease duration of respectively 52.665±12.3477, 4.19±4.050.  Patients with Anti-CCP positive (79.7%) presented a high disease activity (p<0.0001), a long disease duration (p=0.016) and a erosion damages (p<0.0001). we did not found any significant relation between gender, hands damages and CRP..A logistic regression showed that the presence of Anti-CCP was associated with Erosion, disease activity, age and RF presence. Conclusion: There was a strong relation between Anti-CCP antibodies status and the development of RA in Algerian patients. It could be considered as a useful predictor of disease severity.  

scholarly journals Anti-Cyclic Citrullinated Peptide and Rheumatoid Factor (Prevalence and Association) in Saudi Rheumatoid Arthritis Patients

2018 ◽  
Vol 25 (2) ◽  
pp. 1-10
Author(s):  
Mohammad-Ayman A. Safi ◽  
Dhiya T. Houssien
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Rheumatoid Factor ◽  
Disease Duration ◽  
Direct Impact ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Disease Modifying Drugs ◽  
Disease Modifying ◽  
Citrullinated Peptide

To assess the prevalence and association of anti-cyclic citrullinated peptides and rheumatoid factor in Saudi rheumatoid arthritis patients.Over three years (February 2011 - February 2014). Demographic and clinical features, drugs, rheumatoid factor-positivity, and anti-cyclic citrullinated peptides-positivity were recorded for 205 Saudi rheumatoid arthritis patients (185 females; mean age was 45 years and mean disease duration was 5 years). Anti-cyclic citrullinated peptides and rheumatoid factor were assessed in serum. Disease activity scores for 28 joints was used. There were 36% rheumatoid factor+ve and 45% anti-cyclic citrullinated peptides+ve. 21.5% of the rheumatoid factor-ve subjects were anti-cyclic citrullinated peptides+ve. 13.3% of the rheumatoid factor positive patients were anti-cyclic citrullinated peptides-ve and 86.7% were anti-cyclic citrullinated peptides+ve. Significant association (P < 0.05) of anti-cyclic citrullinated peptides-positivity and rheumatoid factor-positivity with each other, and with gender, use of disease–modifying antirheumatic drugs, hydroxychloroquine and methotrexate. No direct impact of anti-cyclic citrullinated peptides status on the disease activity scores for 28 joints or its constituents (P > 0.5); nevertheless, anti-cyclic citrullinated peptides positive patients appear to represent a greater need for combination disease modifying drugs. 

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 Personalized Prediction of Disease Activity in Patients with Rheumatoid Arthritis Using an Adaptive Deep Neural Network

2020 ◽  
Author(s):  
Maria Hügle ◽  
Ulrich A Walker ◽  
Axel Finckh ◽  
Ruediger Mueller ◽  
Gabriel Kalweit ◽  
...  
Keyword(s):  
Neural Network ◽  
Rheumatoid Arthritis ◽  
Neural Networks ◽  
Disease Activity ◽  
Deep Neural Networks ◽  
Disease Duration ◽  
Disease Characteristics ◽  
Patient Reported ◽  
Individual Disease ◽  
Active Disease

Background: Rheumatoid arthritis (RA) lacks reliable biomarkers that predict disease evolution on an individual basis, potentially leading to over- and undertreatment. Deep neural networks learn from former experiences on a large scale and can be used to predict future events as a potential tool for personalized clinical assistance. Objective: To investigate deep learning for the prediction of individual disease activity in RA. Methods: Demographic and disease characteristics from over 9500 patients and 65.000 visits from the Swiss Quality Management (SCQM) database were used to train and evaluate an adaptive recurrent neural network (AdaptiveNet). Patient and disease characteristics along with clinical and patient reported outcomes, laboratory values and medication were used as input features. DAS28-BSR was used to predict active disease and future numeric individual disease activity by classification and regression, respectively. Results: AdaptiveNet predicted active disease defined as DAS28-BSR>2.6 at the next visit with an overall accuracy of 75.6% and a sensitivity and specificity of 84.2% and 61.5%, respectively. Regression allowed forecasting individual DAS28-BSR values with a mean squared error of 0.9, corresponding to a variation between predicted and true values at next visit of 8%. Apart from DAS28-BSR, the most influential characteristics to predict disease activity were joint pain, disease duration, age and duration of treatment. Longer disease duration, age >50 years or antibody positivity marginally improved prediction performance. Conclusion: Deep neural networks have the capacity to predict individual numeric disease activity in RA. Low specificity remains challenging and might benefit from alternative input data or outcome targets.

scholarly journals Serum Adenosine Deaminase Level is High But Not Related with Disease Activity Parameters in Patients with Rheumatoid Arthritis

2014 ◽  
Vol 8 (1) ◽  
pp. 24-28 ◽  
Author(s):  
Gülseren Demir ◽  
Pınar Borman ◽  
Figen Ayhan ◽  
Tuba Özgün ◽  
Ferda Kaygısız ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Adenosine Deaminase ◽  
Disease Duration ◽  
Control Group ◽  
Mean Values ◽  
Reactive Protein ◽  
Control Subjects ◽  
Rheumatology Unit ◽  
The Mean

Serum adenosine deaminase (ADA) has been previously proposed to predict disease activity in patients with rheumatoid arthritis (RA). The aim of this study was to investigate the level of serum ADA, and the relationship between ADA and disease activity markers, in a group of patients with RA.A hundred and 10 patients with a diagnosis of RA were recruited from outpatient clinic of Rheumatology Unit. Demographic properties comprising age, gender, disease duration and drugs were recorded. Disease activity based on disease activity score (DAS)28-erythrocyte sedimentation rate (ESR) and DAS28- C reactive protein (CRP,) ESR, CRP levels, as well as pain by visual analog scale and rheumatoid factor (RF) were recorded. Serum ADA levels (IU/L) were determined in all RA patients and in 55 age and sex similar healthy control subjects.Ninety-six female and 14 male RA patients with a mean age of 54.32±11.51, and with a mean disease duration of 11.5±9.13 years were included to the study. The control group comprised of 48 female and 7 male healthy subjects. 35.5% of the patients were on methotrexate (MTX) and 64.5% of patients were on combined DMARDs or combined MTX and anti-TNF therapies. The mean serum ADA level was statistically higher in RA patients than in control subjects (27.01±10.6 IU/Lvs21.8 ±9.9 IU/L). The mean values of ESR (23.2±14.8 mm/h), CRP (1.71±1.11mg/dL), pain by VAS (37.2±27.1), DAS28-ESR (2.72±0.77), DAS28 CRP (1.37±0.5) were not correlated with ADA levels (p>0.05).Our results have shown that serum ADA levels are higher in RA patients than in controls but were not related with any of the disease activity markers. We conclude that ADA in the serum may not be a reliable biochemical marker to predict disease activity in patients with RA.

scholarly journals Neuropathic pain in a sample of Egyptian patients with rheumatoid arthritis

2020 ◽  
Vol 47 (1) ◽  
Author(s):  
Abdullah Radwan ◽  
Ahmed Borai
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Neuropathic Pain ◽  
Disease Activity ◽  
Functional Disability ◽  
Disease Duration ◽  
Univariate Analysis ◽  
Health Assessment ◽  
Reactive Protein ◽  
Important Symptom

Abstract Background Rheumatoid arthritis (RA) is an autoimmune disease characterized by polyarthritis that may cause irreversible joint disability. Pain is the most important symptom in RA patients that requires more attention and careful evaluation. Despite the improvement in medications used to control inflammation in RA patients, a relevant number of them still experience neuropathic pain even with disease remission. This study was conducted to estimate the frequency of neuropathic pain (NP) in RA patients and to assess its relationship with disease activity, functional status, and overweight. Results NP was detected in 12.5% (14 patients) of RA patients. Highly significant differences were found between RA patients with NP and those without NP as regards disease duration, visual analog scale (VAS) of pain, disease activity score 28 (DAS28-ESR), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), body mass index (BMI), health assessment questionnaire (HAQ) score, and Douleur Neuropathique in 4 (DN4) questionnaire for NP assessment (p < 0.001). The correlation between the DN4 questionnaire and the parameters of disease activity in RA patients with NP was not significant. By univariate analysis, the possible risk factors for NP in RA patients were disease duration, VAS, DAS28-ESR, HAQ, and BMI; however, by multivariate analysis, no possible risk factors for NP in RA patients were detected. Conclusion Although pain in patients with RA was classified as nociceptive in nature, a relevant proportion of patients might also have NP. NP in RA patients was related to functional disability, high disease activity, and overweight.

Correlates of Successful Rheumatoid Arthritis Flare Management: Clinician-driven Treatment, Home-based Strategies, and Medication Change

2019 ◽  
Vol 47 (3) ◽  
pp. 333-340 ◽  
Author(s):  
Taysir G. Mahmoud ◽  
Jie Huang ◽  
Michelle Frits ◽  
Christine Iannaccone ◽  
Vivian Bykerk ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Adverse Outcomes ◽  
Reactive Protein ◽  
The Past ◽  
Medication Change ◽  
Clinical Consultation ◽  
Home Based ◽  
Patient Reported ◽  
Patients Experience

Objective.Describe strategies used to manage rheumatoid arthritis (RA) flares that contribute to a successful postflare outcome.Methods.Data were collected from the BRASS registry, including clinical and patient-reported outcomes, and a survey with a Likert scale assessing postflare symptoms (better, unchanged, or worse). A logistic regression analysis adjusting for age, sex, flare number in the past 6 months, flare pain severity, home management, clinical consultation, and medication change was performed to evaluate factors influencing flare outcome.Results.Of 503 participants, 185 reported at least 1 flare that had resolved in the past 6 months, with median (interquartile range) 28-joint count Disease Activity Score based on C-reactive protein 3 score 2.1 (1.7–2.8). Compared with RA symptoms before the flare, 22 (12%) patients felt worse, 125 (68%) were unchanged, and 38 (20%) felt better. To manage flares, 72% of patients used home-based remedies, 23% sought clinical consultation, and 56% made medication change. Of 103 patients who changed medication, 70% did so without seeking clinical advice. Making a medication change (OR 3.48, 95% CI 1.68–7.21) and having lower flare pain (OR 0.83, 95% CI 0.71–0.97) were associated with better flare outcome.Conclusion.Flares occur frequently even in patients with low disease activity. Independent of home-based or clinically guided care, making a medication change and having less severe pain during a flare were associated with better flare outcomes. Of interest, the decision to change medications was frequently made without clinical advice. Future studies might address how best to intervene when patients experience flares and whether patient-initiated medication changes have adverse outcomes.

Baseline predictors of different types of treatment success in rheumatoid arthritis

2021 ◽  
pp. annrheumdis-2021-220853
Author(s):  
Dafne Capelusnik ◽  
Daniel Aletaha
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Duration ◽  
Activity Index ◽  
Treatment Success ◽  
Disease Activity Index ◽  
Acute Phase Reactants ◽  
Reactive Protein ◽  
Composite Indices ◽  
Lower Disease Activity

ObjectiveTo perform a comprehensive analysis on predictors of achieving disease activity outcomes by change, response and state measures.MethodsWe used data from three rheumatoid arthritis (RA) trials (one for main analysis, two for validation) to analyse the effect of patient and disease characteristics, core set measure and composite indices on the achievement of different outcomes: response outcomes (% of patients achieving a relative response margin); state outcomes (remission or low disease activity, LDA) and change outcomes (numerical change on metric scales).ResultsWe included patients from the ASPIRE trial (for analysis) and from the ATTRACT and GO-BEFORE trials (for validation). While lower disease activity components at baseline—except acute phase reactants—were associated with achievement of state outcomes (such as LDA by the Simplified Disease Activity Index, SDAI), higher baseline values were associated with change outcomes (such as SDAI absolute change). A multivariate analysis of the identified predictors of state outcomes identified best prediction by a combination of shorter disease duration, male gender and lower disease activity. For prediction of response, no consistently significant predictors were found, again, with exception of C reactive protein, for which higher levels at baseline were associated with better responses.ConclusionPrediction of treatment success is limited in RA. Particularly in early RA, prediction of state targets can be achieved by lower baseline levels of diseases activity. Gender and disease duration may improve the predictability of state targets. In clinical trials, included populations and choice of outcomes can be coordinated to maximise efficiency from these studies.

scholarly journals RA disease impact in patients not treated with advanced therapies; survey findings from the National Rheumatoid Arthritis Society

2021 ◽  
Author(s):  
Elena Nikiphorou ◽  
Hannah Jacklin ◽  
Ailsa Bosworth ◽  
Clare Jacklin ◽  
Patrick Kiely
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Duration ◽  
Sleep Problems ◽  
Current Treatment ◽  
Advanced Therapies ◽  
Patient Reported ◽  
On Line ◽  
Patient Reported Measures ◽  
Daily Physical Activities ◽  
High Range

Abstract Objectives To reveal the everyday impact of living with RA in people not treated with advanced therapies; biologic or targeted synthetic disease modifying anti-rheumatic drugs. Methods People with RA, disease duration more than 2 years, not currently treated with advanced therapies, completed an on-line survey promoted by the National Rheumatoid Arthritis Society. Items covered demographics, current treatment, RA flare frequency, the Rheumatoid Arthritis Impact of Disease (RAID) tool and questions reflecting work status and ability. Descriptive and multivariable regression analyses were performed. Results There were 612 responses, mean age 59 years, 88% female, disease duration 2– 5 years 37.7%, 5–10 years 27.9%. In the last year 90% reported an RA flare, &gt;6 flares in 23%. A RAID ‘patient acceptable state’ was recorded in 12.4%. Each of the seven domains were scored in the high range by &gt; 50% respondents. 74.3% scored sleep problems and 72% fatigue in the high range. A need to change working h was reported by 70%. Multivariable analyses revealed increasing difficulties with daily physical activities, reduced emotional and physical wellbeing in the past week were all significantly associated with pain, number of flares and ability to cope (p &lt; 0.005). The RAID score was significantly predictive of the number of flares. Conclusions Patients not currently treated with advanced therapies experience profound difficulties in everyday living with RA, across a broad range of measures. We advocate that patient reported measures be used to facilitate holistic care, addressing inflammation and other consequences of RA on everyday life.

scholarly journals Comparison of the Disease Activity Score Using Erythrocyte Sedimentation Rate and C-reactive Protein in African Americans with Rheumatoid Arthritis

2013 ◽  
Vol 40 (11) ◽  
pp. 1812-1822 ◽  
Author(s):  
Ashutosh Tamhane ◽  
David T. Redden ◽  
Gerald McGwin ◽  
Elizabeth E. Brown ◽  
Andrew O. Westfall ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
African Americans ◽  
Disease Activity ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Disease Activity Score ◽  
Disease Duration ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation

Objective.The Disease Activity Score based on 28 joints (DAS28) has been increasingly used in clinical practice and research studies of rheumatoid arthritis (RA). Studies have reported discordance between DAS28 based on erythrocyte sedimentation rate (ESR) versus C-reactive protein (CRP) in patients with RA. However, such comparison is lacking in African Americans with RA.Methods.This analysis included participants from the Consortium for the Longitudinal Evaluation of African Americans with Early Rheumatoid Arthritis (CLEAR) registry, which enrolls self-declared African Americans with RA. Using tender and swollen joint counts, separate ESR-based and CRP-based DAS28 scores (DAS28-ESR3 and DAS28-CRP3) were calculated, as were DAS28-ESR4 and DAS28-CRP4, which included the patient’s assessment of disease activity. The scores were compared using paired t-test, simple agreement and κ, correlation coefficient, and Bland-Altman plots.Results.Of the 233 included participants, 85% were women, mean age at enrollment was 52.6 years, and median disease duration at enrollment was 21 months. Mean DAS28-ESR3 was significantly higher than DAS28-CRP3 (4.8 vs 3.9; p < 0.001). Similarly, mean DAS28-ESR4 was significantly higher than DAS28-CRP4 (4.7 vs 3.9; p < 0.001). ESR-based DAS28 remained higher than CRP-based DAS28 even when stratified by age, sex, and disease duration. Overall agreement was not high between DAS28-ESR3 and DAS28-CRP3 (50%) or between DAS28-ESR4 and DAS28-CRP4 (59%). DAS28-CRP3 underestimated disease activity in 47% of the participants relative to DAS28-ESR3 and DAS28-CRP4 in 40% of the participants relative to DAS28-ESR4.Conclusion.There was significant discordance between the ESR-based and CRP-based DAS28, a situation that could affect clinical treatment decisions for African Americans with RA.

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