POS1005 ASSESSMENT OF DAREA AND MODIFIED DAREA IN AN ARGENTINIAN-GUATEMALAN REACTIVE ARTHRITIS COHORT

Abstract

Background:Reactive Arthritis (ReA) is an inflammatory joint disease and, as in rheumatoid or psoriatic arthritis, composite indices are the most useful tools to measure disease activity. The Disease Activity Index for Reactive Arthritis (DAREA) is the only developed index for ReA, which requires a 66/68 joint count and CRP for its assessment, the latter being difficult to acquire in our setting. Therefore, we developed a simplified index, the modified DAREA (DAREAm), with a lower joint count and ESR for its evaluation.Objectives:1) To evaluate the DAREA and the DAREAm in a cohort of patients with diagnosis of ReA and post-infectious arthritis 2) To assess the correlation of the DAREA and DAREAm with several clinical variables, functional capacity and quality of life in a cohort of patients with ReA.Methods:Patients with diagnosis of ReA (Calin’79) and post-infectious arthritis were included. Demographic data were collected, patient´s pain and global assessment were evaluated through a visual analog scale (VAS) and a 3-point scale (no pain = 0, mild = 1, moderate = 2, severe = 3), physician´s global assessment, morning stiffness (MS) and VAS fatigue. Functional capacity was assessed by HAQ and quality of life according to EuroQol-5 dimensions (EQ-5D), and the activity indices DAS28, DAREA and DAREAm were calculated. Statistical analysis: a descriptive analysis of the variables and correlation between numerical variables with Spearman rank correlation were performed.Results:57 patients were included, 53 with diagnosis of ReA, the majority post urogenital (63%) and gastrointestinal (17%), and 4 with diagnosis of post-infectious arthritis. Fifty six percent were male, mean age: 40 years old (SD ± 14) and median ReA duration: 15 months (IQR 2-45). The number of painful and swollen joints in a 66/68 joint count showed a median of 2 (IQR 0-3) and 1 (IQR 1-2) respectively. Median VAS pain 43 (IQR 15-70), patient´s disease activity 40 (IQR 20-60) and physician´s 40 (IQR 20-60), MS 10 (IQR 0-50) and fatigue 30 (IQR 0-80). Median DAS28 3.6 (IQR 2.3-4.3), DAREA 7.4 (IQR 2.5-10.6), DAREAm 8.6 (IQR 4.6-12.7), HAQ 0.625 (IQR 0.125-1). The dimensions with the greatest compromise in the EQ-5D were pain/discomfort (63%) and anxiety/depression (51%), and the median VAS EQ-5D was 60 (IQR 32-80). DAREA correlated with DAREAm (rs= 0.89; p <0.001), DAS28 (rs= 0.84; p <0.001), medical VAS (rs= 0.60; p <0.001), MS (rs= 0, 50; p <0.001), HAQ (rs= 0.53; p <0.001), VAS fatigue (rs= 0.57; p <0.001) and mobility subscales of the EQ5D (rs= 0.56; p <0.001), pain/discomfort (rs= 0.49; p <0.001) and anxiety/depression (rs= 0.61; p <0.001). The DAREAm correlated with DAS28 (rs= 0.93; p <0.001), physician VAS (rs= 0.58; p <0.001), fatigue VAS (rs= 0.53; p <0.001), HAQ (rs= 0 .51; p <0.001) and the EQ5D subscales: mobility (rs= 0.64; p <0.001), pain/discomfort (rs= 0.56; p <0.001) and anxiety/depression (rs= 0.66; p <0.001)Conclusion:This is the first study that assess activity indices in a cohort of patients with ReA. The DAREAm demonstrated a very good correlation with both DAREA and DAS28. We encourage the use of this simplified index in daily practice to evaluate patients with ReA.Disclosure of Interests:None declared.