Rheumatoid Arthritis

Study Compares Utility of Outcome Measures For Rheumatoid Arthritis

Composite disease activity indices, patient-reported pain and disease activity, and physician-reported disease activity are the most effective outcome measures for assessing patients with rheumatoid arthritis (RA), according to the results of a recent study.

The researchers used data from 462 participants from the Dutch Potential Optimalisation of (Expediency) and Effectiveness of Tumor necrosis factor-α blockers (POET) study. Using effect size statistics, they compared the ability of various measures to discriminate between individuals with and without physician-reported flare or medication escalation at a 3-month follow-up visit.
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Overall, the standardizing change scores were greater for disease activity indices than for any other individual measure. The 28-joint Disease Activity Score, Clinical Disease Activity Index, and Simplified Disease Activity Index all performed similarly. Pain and physician’s and patient’s global assessment of disease activity were the most responsive measures. Pain was the only measure that demonstrated incremental validity beyond Simple Disease Activity Index in predicting flares.

“These results support the use of composite disease activity indices, patient-reported pain and disease activity, and physician-reported disease activity for measuring disease exacerbation or identifying flares of RA. Physical function, acute-phase response, and the auxiliary measures fatigue, participation, and emotional well-being performed poorly.”

—Michael Potts

Reference:

Voshaar MAHO, Moghadam MG, Vonkeman HE, et al. Measuring disease exacerbation and flares in rheumatoid arthritis: comparison of commonly used disease activity indices and individual measures [published online May 15, 2017]. Rheumatology. doi:https://doi.org/10.3899/jrheum.160915.