PAM1: JOINT COUNTS IN PATIENTS WITH NEW ONSET RHEUMATOID ARTHRITIS: PATIENT VS. PHYSICIAN ASSESSMENT

Abstract

BACKGROUND: Both physician-assessed and patient self-reported joint counts have been used in the assessment of disease activity in rheumatoid arthritis. The objective of this study was to compare patient vs. physician reported joint counts in patients with new onset RA. METHODS: Baseline data was analyzed from the Study of New Onset Rheumatoid Arthritis (S.O.N.O.R.A.SM), a five-year prospective, longitudinal, inception cohort study to document long-term functional, clinical, and humanistic outcomes and patterns of treatment in patients with new onset RA. Baseline data collection consisted of physician and patient surveys. Physicians assessed swollen (SJ) and tender/painful joints (TJ) while patients reported painful joint (PJ). Physician's SJ and TJ consisted of examination in 64 and 66 joints, respectively. Patient's PJ was assessed in 16 joint areas with use of a mannequin. The Pearson product moment correlation coefficient was calculated for SJ, TJ, and PJ counts. RESULTS: One hundred and seven patients completed the baseline survey. Mean age of the sample was 55 ± 15 years; 79% were female; 80% were Caucasian. Mean joint counts were 12.6 (SE = 0.9) SJ, 14.0 (SE = 1.3) TJ, and 6.6 (SE = 0.4) PJ. Patient-reported PJ correlated with physician-reported SJ (r = 0.22, p = 0.023) and TJ (r = 0.55, p < 0.001). CONCLUSION: Higher correlation was observed between PJ and TJ compared to SJ. Patient, self-reported joint counts may be a useful surrogate of joint activity in the absence of physician assessment. However, caution should be taken given that the accuracy of patient, self-reported joint counts still needs further evaluation. Five-year follow-up of this population will provide further insight on the sensitivity to change for both patient and physician reported joint counts as it relates to disease activity.