Predicting Disease Activity for Biologic Selection in Rheumatoid Arthritis

In this article, we implemented a regression model and conducted experiments for predicting disease activity using data from 1929 rheumatoid arthritis patients to assist in the selection of biologics for rheumatoid arthritis. On modelling, the missing variables in the data were completed by three different methods, mean value, self-organizing map and random value. Experimental results showed that the prediction error of the regression model was large regardless of the missing completion method, making it difficult to predict the prognosis of rheumatoid arthritis patients.

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AB0110 DETERMINING THE AMOUNT OF COPPER–CONTAINING PROTEIN, ITS BIOCHEMICAL AND IMMUNOLOGIC ACTIVITY IN RHEUMATOID ARTHRITIS PATIENTS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.948 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1083.2-1084

Author(s):

O. Rusanova ◽

A. Trofimenko ◽

N. Emelyanov ◽

O. Emelyanova

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Enzyme Immunoassay ◽

Oxidase Activity ◽

Mean Value ◽

Hospital Treatment ◽

Diagnostic Agent ◽

Immunologic Activity ◽

Rheumatoid Arthritis Activity

Background:Production of antibodies to ceruloplasmin (CP) in rheumatoid arthritis is an issue that has not been studied well enough. It was not by chance that this copper–containing alpha 2-glycorpoteid of blood plasma showing multienzymatic properties was chosen as an object of investigation. Data on the content and activity of CP in the blood of rheumatoid arthritis patients are contradictory, which has to do with different approaches to selection of patients and different measuring methods.Objectives:Improving diagnosis of rheumatoid arthritis by determination of antibodies to CP as well as its amount and enzymatic activity.Methods:We studied the serum from 30 apparently healthy individuals, and 108 rheumatoid arthritis patients. Antibodies to CP were determined by enzyme immunoassay using immobilized granulated antigen preparations (modification by Gontar et al, 2002). The amount of CP was determined by enzyme immunoassay according to the method of I.S. Kuzmina et al (1991) using commercial diagnostic agent manufactured by Mechnikov Research Institute for Vaccines and Sera.Results:Enzyme immunoassay showed a mean level of CP antibodies in donor sera of 0,020±0,006 optical density units. The level of normal values of specific antibodies determined as M±2σ included an extinction value in the range 0 – 0,086. The mean value of oxidase activity and the amount of CP in healthy people was 716±26,3 and 921±32 ng/ml, correspondingly. In the process of study we revealed a reliable increase in CP antibody count, the activity and amount of CP in patients with rheumatoid arthritis while in all cases the parameters under study correlated with the degree of disease activity (p<0,05): at activity degree I CP antibodies were 0,098±0,011; CP activity was 954±48,1; CP amount was 1292±73,4. At activity degree II CP antibodies were 0,138±0,007; CP activity was 1163±39,6; CP amount was 1763±69,3. At activity degree III, CP antibodies were 0,182±0,015; CP activity was 1368±89,5; CP amount was 1794±102,8. After a course of hospital treatment was completed, we noted a reliable decrease in the activity and amount of CP (at degree I of rheumatoid arthritis activity p<0,001, at degree II of rheumatoid arthritis activity p<0,01for both parameters; at degree III, p<0,05) compared with baseline findings. A decrease in CP antibodies shows decelerated dynamics, especially in patients with pronounced disease activity, which indicates severe disorders in the immunity that cannot be cured completely within 30 – 40 days of hospital treatment course.Conclusion:Determination of CP antibodies, as well as quantitative content of CP and its oxidase activity can serve as indicators of the activity of rheumatoid arthritis, as well as an accessory criterion of the effectiveness of administered therapy.Disclosure of Interests:None declared

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AB0101 THE IMPACT OF TIME SPAN TO ACHIEVE BOOLEAN REMISSION FOR MAINTAINING DISEASE ACTIVITY AFTER ACQUISITION IN RHEUMATOID ARTHRITIS PATIENT

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.297 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1079.1-1079

Author(s):

I. Yoshii

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Disease Duration ◽

Remission Rate ◽

Mean Value ◽

Time Span ◽

Mean Values ◽

The Mean ◽

The Relationship

Background:Boolean remission criteria is one most popular and stringent criteria in treating patient with rheumatoid arthritis (RA), because it may guarantees a stable clinical course after attaining remission.Objectives:Impact of time span from initiation to achieving Boolean remission on maintaining disease activity, daily activities, and quality of life after attaining Boolean remission was investigated from daily clinical practice data.Methods:685 patients with RA since August 2010 under the T2T strategy were treated. They were monitored for their TJC, SJC, PGA, EGA, CRP, and disease activity indices such as CDAI, SDAI, DAS28, and Boolean criteria at every visit. HAQ-DI score, pain score using visual analog scale (PS-VAS), and EQ-5D were also monitored, and the quality of life score (QOLS) calculated from EQ-5D was determined at every visit from the time of diagnosis (baseline).Of 685 patients, 465 patients had achieved Boolean remission >1 times, and were consecutively followed up for >3 years. These patients were enrolled in the study. Time span from the first visit to first Boolean remission was calculated. The relationship between the time span and each of background parameters, and the relationship between the time span and each of the mean values of the SDAI score, HAQ score, PS-VAS, SHS, and QOLS at the first Boolean remission and thereafter was evaluated statistically.Patients were subsequently divided into the G ≤ 6 and G > 6 groups based on the achievement of first Boolean remission within two groups: time span G ≤ 6 months and G > 6 months. The two groups were compared with regard to the SDAI score, HAQ score, PS-VAS, SHS, and QOLS at first visit and at the time of first Boolean remission, and the mean values of these parameters after remission were evaluated statistically. Moreover, changes of these parameters and the mean Boolean remission rate after the first remission, and SDAI remission rate at the first Boolean remission to thereafter were compared between the two groups statistically.Results:Out of 465 patients, females comprised 343 (73.7%), and the mean age was 67.8 years (range, from 21–95 years). The mean disease duration at first visit was 6.1 years (range, from 1 months–45 years). The mean follow up length was 88.1 months (range: 36–122 months; median: 85 months) and mean time span from the first visit to the first Boolean remission was 8.1 months. The mean SDAI score, HAQ score, PS-VAS, and the QOLS at first visit were 13.3, 0.467, 33.2, and 0.834, respectively. Among the study parameters, PS-VAS and QOLS were significantly correlated with the time span. For parameters at the first Boolean remission, HAQ-DI score, PS-VAS, and QOLS demonstrated significant correlation with the time span, whereas SDAI, HAQ-DI score, PS-VAS, SHS, and QOLS after the Boolean remission demonstrated significant correlation with the time span.The comparison between the G ≤ 6 and the G > 6 groups revealed that the disease duration, HAQ score, and PS-VAS at baseline in the G > 6 were significantly higher than that in the G ≤ 6 group, and QOLS in the G ≤ 6 group was significantly higher than that in the G > 6 group at baseline. Similarly, the HAQ score and PS-VAS at the first Boolean remission in the G > 6 group were significantly higher than that in the G ≤ 6 group, whereas QOLS in the G ≤ 6 group demonstrated no significant difference compared with that in the G > 6 group.The mean value of the SDAI score after the first Boolean remission in the G > 6 group was significantly higher than that in the G ≤ 6 group. Similarly, the SDAI score, HAQ score, and PS-VAS after the first Boolean remission in the G > 6 group were also significantly higher than those in the G ≤ 6 group, and the mean value of the QOLS in the G ≤ 6 group were significantly higher than that in the G > 6 group. The Boolean remission rate and SDAI remission rate after the first Boolean remission were significantly higher in the G ≤ 6 group than those in the G > 6 group.Conclusion:Attaining Boolean remission ≤ 6 months for RA has significant benefit for more stable disease control, that leads good maintenance of ADL.Disclosure of Interests:None declared

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Regular use of non-steroidal anti-inflammatory drugs can effectively control pain and global health in patients with moderate activity of rheumatoid arthritis

Modern Rheumatology Journal ◽

10.14412/1996-7012-2021-2-57-63 ◽

2021 ◽

Vol 15 (2) ◽

pp. 57-63

Author(s):

A. E. Karateev ◽

E. Yu. Pogozheva ◽

V. N. Amirdzhanova ◽

E. S. Filatova ◽

V. A. Nesterenko

Keyword(s):

Rheumatoid Arthritis ◽

Global Health ◽

Disease Activity ◽

Baseline Level ◽

Mean Value ◽

Moderate Activity ◽

Low Disease Activity ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

Control Pain

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used to control pain in rheumatoid arthritis (RA). However, many aspects of the therapeutic effect of NSAIDs in RA have not been sufficiently studied. In particular, this concerns the effect of NSAIDs on the inflammatory activity of the disease.Objective: to study the comparative efficacy and safety of NSAIDs in RA patients with moderate and low disease activity.Patients and methods. The study group consisted of 404 patients with RA, 69% women and 31% men, mean age 58.6±10.0 years, with moderate and low disease activity – DAS28<5.1 (mean value 3.7±1.5), who initially had moderate or severe pain: >4 cm on the visual analog scale (VAS) 0–10 cm. All patients received DMARDs, mostly methotrexate 15 to 25 mg weekly, 8.2% biological agents, 18.6% glucocorticoids. All patients were prescribed NSAIDs at the full therapeutic dose. The results of treatment were evaluated after 2 weeks, 1, 3 and 6 months. Criteria of efficacy were the dynamics of pain (10 cm VAS), Patient Global Health (PGH on a 10-cm VAS), the change in the tender joints count (TJC) and swollen joints count(SJC), and dynamics of RA activity (DAS28).Results and discussion. 54.2% of patients received aceclofenac, 19.8% nimesulide, 14.3% meloxicam, 9.1% diclofenac, 2.6% – other NSAIDs. After 2 weeks, the pain decreased from 6.3±1.2 cm to 4.5±1.5 cm on VAS (p<0.001). The severity of pain continued to decrease further, and after 6 months of observation was 4.0±1.2 (p< 001, compared with the baseline level). A similar result was observed for the TJC, SJC, and PGH: the dynamics of these indicators, in comparison with the baseline level, was statistically significant after 2 weeks and after 1, 3, and 6 months of observation (p< 0.05). There was a decrease in the disease activity by DAS28: from 3.7±1.5 to 3.4±1.1 after 3 months (p=0.041) and 3.1±0.9 after 6 months (p=0.02). The effectiveness of aceclofenac and other NSAIDs for pain reduction, TJC, SJC, PGH and DAS28 did not differ. The tolerability of aceclofenac was better than of other NSAIDs: the frequency of dyspepsia after 2 weeks was 23.3% and 36.2% (p=0.004). The frequency of arterial hypertension and edema in patients who used aceclofenac, after 2 weeks and 6 months was slightly lower than in patients treated with other NSAIDs, but the difference was not statistically significant.Conclusion. The use of NSAIDs can effectively control the pain and other symptoms of RA, as well as the disease activity by DAS28 in patients with moderate or low disease activity. Aceclofenac is not inferior to other NSAIDs in analgesic potential and exceeds them in tolerability.

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Automatic selection of reliability estimates for individual regression predictions

The Knowledge Engineering Review ◽

10.1017/s0269888909990154 ◽

2010 ◽

Vol 25 (1) ◽

pp. 27-47 ◽

Cited By ~ 8

Author(s):

Zoran Bosnić ◽

Igor Kononenko

Keyword(s):

Regression Model ◽

Prediction Error ◽

Cross Validation ◽

Mean Squared Error ◽

True Label ◽

Automatic Selection ◽

Reliability Estimates ◽

The Difference ◽

The Individual ◽

Selection Of

AbstractIn machine learning and its risk-sensitive applications (e.g. medicine, engineering, business), the reliability estimates for individual predictions provide more information about the individual prediction error (the difference between the true label and regression prediction) than the average accuracy of predictive model (e.g. relative mean squared error). Furthermore, they enable the users to distinguish between more and less reliable predictions. The empirical evaluations of the existing individual reliability estimates revealed that the successful estimates’ performance depends on the used regression model and on the particular problem domain. In the current paper, we focus on that problem as such and propose and empirically evaluate two approaches for automatic selection of the most appropriate estimate for a given domain and regression model: the internal cross-validation approach and the meta-learning approach. The testing results of both approaches demonstrated an advantage in the performance of dynamically chosen reliability estimates to the performance of the individual reliability estimates. The best results were achieved using the internal cross-validation procedure, where reliability estimates significantly positively correlated with the prediction error in 73% of experiments. In addition, the preliminary testing of the proposed methodology on a medical domain demonstrated the potential for its usage in practice.

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AB0217 IMPACT OF THE BODY-MASS-INDEX ON DISEASE ACTIVITY, FUNCTIONAL ABILITY AND QUALITY OF LIFE IN PATIENTS WITH RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4832 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1409.2-1409

Author(s):

L. Medjedovic ◽

J. Mrdja ◽

P. Ostojic

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Disease Activity ◽

Functional Ability ◽

Mean Value ◽

Normal Weight ◽

Obese Patients ◽

Mean Values ◽

Index Measure

Objectives:This study aims to assess differences in disease activity, functional ability and quality of life among underweight, normal weight, overweigth and obese patients with rheumatoid arthritis (RA).Methods:715 patients with RA (609 women and 106 men) were included in this study. According to their Body-Mass-Index, all patients were divided into four subgroups: underweight (BMI <18,5), normal weight (BMI between 18,5 and 24,9), overweight (BMI between 25,0 and 29,9) and obesitas (BMI ≥ 30,0). Mean values of DAS28, CDAI and SDAI (measures of disease activity), HAQ-disability index (measure of functional ability) and RAQoL index (measure of qualitiy of life) were compared among four subgroups of patients.Results:28 (3,9%) RA patients were underweight, 310 (43,4%) had normal weight, 268 (37,5%) were overweight, whilst 109 (15,2%) patients were obese. Among these subgroups, no difference in mean age, disease duration, percentage of seropositive patients, and patients treated with glucocorticoids, csDMARDs or biologics, was noticed. There were no statistically significant differences in mean values of DAS28, CDAI und SDAI in four subgroups of patients. However, mean value of the HAQ disability index was significantly higher (p<0.05) in underweight (1.32) and obese patients (1.27), compared to normal (0.87) and overweigth patients (1.08). The mean value of the RAQoL-Index was also somewhat higher in underweight and obese patients (8.8 and 8.1, respectively) than patients who are overweight or have normal weigth (7.0 and 6.5, respectively), but the difference was not statistically significant.Conclusion:Underweight and obese RA patients have worse physical function than normal and overweight patients. However, worse disability can not be explained by higher disease activity.Disclosure of Interests:None declared

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Predictors of response to etanercept-methotrexate treatment: a post hoc logistic regression analysis of a randomized, open-label study in Latin American patients with rheumatoid arthritis

Advances in Rheumatology ◽

10.1186/s42358-021-00213-4 ◽

2021 ◽

Vol 61 (1) ◽

Author(s):

Maria de la Vega ◽

Generoso Guerra Bautista ◽

Ricardo Machado Xavier ◽

César Pacheco-Tena ◽

Gastón Solano ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Mental Health ◽

Logistic Regression ◽

Regression Model ◽

Disease Activity ◽

Latin American ◽

Disease Duration ◽

Open Label ◽

Sf 36 ◽

Post Hoc

Abstract Background Determining potential predictors of clinical response would allow a more personalized rheumatoid arthritis (RA) treatment approach in heterogeneous populations such as Latin American (LA) patients. Methods Post hoc analysis to identify baseline characteristics predictive of clinical remission in response to treatment with etanercept (ETN) plus methotrexate (MTX) in LA patients with moderate to severe MTX-resistant RA. We report data from the group of patients who received ETN 50 mg/week plus MTX (ETN + MTX, n = 281) in a clinical trial consisting of an initial 24-week open-label phase, followed by a 104-week extension. Remission was defined as 28-joint Disease Activity Score with erythrocyte sedimentation rate (DAS28-ESR) score < 2.6. Cutoff values to dichotomize baseline variables maximizing the detection of remission were obtained from Receiver Operator Curve analyses. Baseline dichotomized and categorical variables were analyzed altogether in a stepwise logistic regression model. Odds of attaining response at Weeks 24 and 128 were estimated for each significant predictor. Results At Week 24 and Week 128, 27% (66/241) and 42% (91/219) of patients in the ETN + MTX group achieved remission. On average, patients achieving remission were younger and had lower baseline ESR, lower Physician Global Assessment (PGA) scores, lower total Health Assessment Questionnaire (HAQ) scores, and lower visual analog scale (VAS) Pain scores compared with patients who did not achieve remission. The best subset of baseline variables predicting Week 24 remission in the stepwise regression model were age ≤ 49 years (odds ratio [OR] 2.93), body mass index (BMI) > 28.5 kg/m2 (OR 3.24), disease duration > 3.7 years (OR 2.22), ESR ≤ 42 mm/h (OR 2.72), PGA ≤ 6 (OR 3.21), tender joint count ≤ 14 (OR 2.25), and total HAQ score ≤ 1.6 (OR 2.86). At Week 128, age ≤ 42 years (OR 2.21), SF-36 Mental Health Scale score > 39.6 (OR 2.16), White race (OR 4.07), > 18 swollen joints (OR 2.11), and VAS Pain ≤ 41 (OR 6.05) at baseline were the best subset of significant predictors of remission. Conclusions In LA patients with RA, younger age, higher BMI, longer disease duration, higher SF-36 Mental Health Scale score, higher swollen joint count, and overall lower disease activity predicted clinical response to ETN + MTX therapy. Trial registration: ClinicalTrials.gov Identifier: NCT00848354.

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Influence of balneophysical therapy on activity, functional capacity, and quality of life in patients with rheumatoid arthritis

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0904171s ◽

2009 ◽

Vol 137 (3-4) ◽

pp. 171-174 ◽

Cited By ~ 5

Author(s):

Sonja Stojanovic ◽

Aleksandar Dimic ◽

Bojana Stamenkovic ◽

Aleksandra Stankovic ◽

Jovan Nedovic

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Disease Activity ◽

Functional Capacity ◽

Mean Value ◽

Disease Modifying Antirheumatic Drugs ◽

Das 28 ◽

Before And After ◽

The Mean

Introduction It has been well known that balneophysical therapy has a therapeutic effect on clinical and biological parameters of disease activity in the patients with rheumatoid arthritis (RA). Objective. To determine the influence of balneophysical therapy on functional capacity, activity and quality of life of the patients with RA primarily treated with some of disease modifying antirheumatic drugs. Methods. The study enrolled 73 patients with RA treated with some of disease modifying antirheumatic drugs (Methotrexate in 85% of patients). During hospitalization at the Clinical Rheumatologic Department of the Institute 'Niska Banja', the patients were treated, beside the medicamentous therapy, by hydrotherapy (oligomineral, homeothermic, low radioactive water), mineral peloid therapy, electrotherapy and kinesiotherapy. Before and after balneotherapy, the patients filled in the Health Assessment Questionnaire (HAQ) and the Quality of Life Rheumatoid Arthritis (QOL-RA) scale. The Disease Activity Score (DAS) 28 was used to measure the disease activity before and after balneotherapy. A possible value of HAQ was from 0 to 3, and QOL-RA from 0 to 10. Results. The mean value of the duration of balneophysical therapy was 14.7?4.8 days. We found significant improvement of functional capacity in the patients with RA. The average HAQ score before balneotherapy was 1.07?0.61, and 0.86?0.55 after balneotherapy, which was statistically significantly lower (p<0.05). DAS 28 after balneotherapy was also statistically significantly lower than DAS 28 before balneotherapy: the mean value of DAS 28 before therapy was 6.30?0.81 and after therapy 5.48?0.75 (p<0.001). The quality of life significantly improved after balneophysical therapy: the mean value of QOL-RA scale before therapy was 5.38?1.62 and after therapy 7.35?1.81 (p<0.05). Conclusion. Balneophysical therapy, when properly dosed, is an effective, adjuvant therapy in the patients with RA of mild disease activity. Balneophysical therapy has a positive influence on disease activity, functional capacity and quality of life in the patients with rheumatoid arthritis.

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Metabolic Syndrome as a Factor Affecting on Intima-Media Thickness in Patients with Rheumatoid Arthritis

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.5943 ◽

2021 ◽

Vol 9 (B) ◽

pp. 411-416

Author(s):

Lyudmila Gennadievna Turgunova ◽

Anna Andreevna Shalygina ◽

Lyazat Kataevna Ibrayeva ◽

Anar Akylbecovna Turmuhambetova

Keyword(s):

Rheumatoid Arthritis ◽

Metabolic Syndrome ◽

Regression Model ◽

Disease Activity ◽

Statistical Processing ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Media Thickness ◽

Biochemical Examination

AIM: The aim of the study was to assess the association of the thickness of the intima-media complex with metabolic syndrome (MetS) and the degree of disease activity in patients with rheumatoid arthritis (RA). MATERIALS AND METHODS: The study included 101 patients with RA. All patients underwent a biochemical examination, the presence of MetS was determined, and the carotid thickness of the intima-media was determined. Statistical processing was performed using SPSS for Windows, version 18.0. RESULTS: Among 101 patients with RA, 41 (40.5%) had MetS. The frequency of detecting an increased value of the intima-media complex thickness was significantly higher in the group with MetS (n = 31 [75.6%]) than in the group without MetS (n = 21 [35.0%] p ≤ 0.0001). In the group of patients with MetS, the median carotid intima-media thickness (CIMT) was 1.2 mm, while this indicator in the group without MetS was 0.78 mm (U = 727, p = 0.001). In the regression model, MetS (B = 1.05; p = 0.027) and DAS28-ESR (B = 0.506; p = 0.021) were influenced by CIMT. CONCLUSIONS: The results of our study show the effect of MetS and RA activity on the increase of intima-media thickness.

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POS0439 THE INFLUENCE OF ESCALATED PGA SCORE ON DISEASE ACTIVITY, DAILY ACTIVITY, AND QUALITY OF LIFE, AND SOLUTION FOR OPTIMAL PGA LEVEL THAT DESERVES CLINICAL REMISSION IN PATIENT WITH RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.285 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 448.2-448

Author(s):

I. Yoshii

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Disease Activity ◽

Sensitivity And Specificity ◽

Daily Activity ◽

Remission Rate ◽

Mean Value ◽

Daily Activities ◽

Mean Values

Background:Patient’s global assessment (PGA) is one most difficult component as a part of disease activity index for treatment of rheumatoid arthritis (RA), that often causes an obstacle to attaining clinical remission. Moreover, PGA level affects activities in daily living.Objectives:The influence of escalated PGA score on disease activity, daily activity, and quality of life for patient with RA was investigated., and the optimal PGA level for both disease activity and daily activities was investigated from real world data.Methods:A total of 24,075 times of monitoring for RA was performed in the institute. Monitored items included TJC, SJC, PGA, EGA, CRP, and calculated values of DAS28, CDAI, SDAI, composite index of Boolean evaluation (Boolean), pain score with visual analog scale (PS-VAS), Health Assessment Questionnaire Disability Index (HAQ-DI), and quality of life score (QOLS) calculated from Euro-QOL questionnaire with 5th dimensions. Each measured item was calculated as mean value according to the PGA score, which was measured at the same time. The PGA score was classified by one increment from zero to ten. The mean values of DAS28, CDAI, SDAI, remission rate of these indices and Boolean remission rate, and mean values of PS-VAS, HAQ-DI, and QOLS were statistically evaluated.HAQ-DI below 0.5 was determined as remission (HAQ remission). Sensitivity and specificity regarding attaining HAQ remission according to each level of PGA score were calculated, and cutoff index (COI) was determined with receiver operating characteristic (ROC) curve. For PS-VAS, sensitivity and specificity of Boolean remission regarding each level of PS-VAS after classification divided by one increment was calculated, and comparable level (PS-VAS remission) was determined with reference of the curve. ROC was performed according to PGA level, and COI was determined with a same manner.Results:Number of measures counted 10428, 3099, 3110, 2346, 998, 1773, 751, 703, 655, 139, and 73 for each PGA level. PGA level from 3 to 5, and 5 to 10 were put together for number adjusting.Mean DAS28, CDAI, and SDAI demonstrated significant increase as PGA level increased, and remission rate of the all indices including Boolean demonstrated significant decrease as PGA level increases (p<0.01%). Boolean remission rate demonstrated zero percent from two, and CDAI and SDAI remission rate demonstrated zero from five, whereas DAS remission rate showed gradual decrease then zero percent was not shown in any level. Mean value of PS-VAS and HAQ-DI score demonstrated also significant decrease as PGA level increases, and QOLS demonstrated significant decrease as PGA level increases (p<0.01%). Increase of HAQ-DI score and decline of QOLS demonstrated more steep from PGA level 3, whereas no significant difference demonstrated from zero to one.HAQ remission counted 15,703, whereas no HAQ remission counted 8,335. Using ROC, COI of the PGA level was 2.0, whereas sensitivity and specificity were 63.4% and 66.3%, respectively. The estimated PS-VAS remission level was 10mm. Optimal PGA level for PS-VAS remission was set as 1.0, and sensitivity and specificity regarding PS-VAS remission were 87.1% and 71.3%, respectively.Conclusion:Increase of PGA affects daily activities and quality of life. The evident level that increases deterioration risk significantly was supposed to be from 3. Optimal level of PGA score for attaining the PS-VAS remission was 1.0, whereas the optimal PGA level for HAQ-DI remission is 1.0, despite sensitivity and specificity for the HAQ remission were lower than these for the PS-VAS remission.Disclosure of Interests:None declared

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