Patient Global Assessment Of Disease Activity Research Articles

THE VALUE OF THE ANKYLOSING SPONDYLITIS DISEASE ACTIVITY SCORE (ASDAS) IN EVALUATING DISEASE ACTIVITY IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS

Aim. To evaluate the clinical value of the Ankylosing Spondylitis Disease Activity Score (ASDAS) in assessing disease activity in axial SpA patients in comparison with conventional clinical measures of disease activity in daily clinical practice. Patients and methods. Eighty-five patients with axial SpA were included in a cross-sectional study. Disease activity was assessed by Bath Ankylosing Spondylitis Disease Activity (BASDAI) score, ASDAS score with C-reactive protein (ASDAS-CRP), ASDAS score with erythrocyte sedimentation rate (ASDAS-ESR), patient’s global assessment of disease activity (PtGA), CRP and ESR, while physical function was evaluated by the Bath Ankylosing Spondylitis Functional Index (BASFI). The correlation between different markers of disease activity and functional capacity and ASDAS scores were determined. Patients were grouped into high and low disease activity states according to PtGA scores, CRP levels and BASDAI scores. We compared the discriminating ability of the two ASDAS versions and the conventional clinical measures of disease activity in differentiating between patients with high and low disease activity by using standardized mean differences and receiver operating characteristic (ROC) curve analysis. Results. ASDAS-CRP and ASDAS-ESR showed good correlation with BASDAI (r = 0.84 and 0.72, respectively), PtGA (r = 0.82 and 0.74, respectively), and BASFI (r = 0.74 and 0.70, espectively). Moderate correlations were seen between the two ASDAS versions and ESR and CRP (r ranged from 0.43 to 0.70). The ASDAS versions had higher discriminating capacities as compared to conventional patient-reported measures (BASDAI and PtGA) and objective markers of disease activity (CRP and ESR). The ASDAS-CRP performed better than ASDAS-ESR. Both ASDAS versions and BASDAI had high areas under the curve (AUC) according to PtGA and CRP levels (AUC ranged from 0.66 to 0.92, all p < 0.01). The calculated cut-offs for discriminating between disease activity states in our axSpA patients were relatively similar to the Assessment of Spondyloarthritis International Society (ASAS) endorsed cut-offs. Conclusions. ASDAS versions had higher discriminating ability in patients with axSpA in terms of high and low disease activity states than conventional measures. These findings suggest that ASDAS is a valid and reliable assessment tool for axial SpA patients in daily clinical practice.

SAT0083 Does Specific Joint Involvement in Rheumatoid Arthritis Patients PREDICT Patient Reported Outcomes? Implications for Clinical Practice

BackgroundAssessment of functional (dis)ability in rheumatoid arthritis (RA) is subject to patient judgment when appraising their ability to do daily activities.ObjectivesThe aim of this analysis was to describe the impact...

FRI0142 Patient-Reported Disease Activity and Outcome in Male versus Female Patients of the Groningen Leeuwarden Axial Spondyloarthritis (GLAS) Cohort

BackgroundThere are differences in clinical presentation of ankylosing spondylitis (AS). Women tend to have milder disease and may therefore be underdiagnosed. Male AS patients are more likely to develop spinal...

SAT0551 What is the Real World Relationship between Patient-Reported Pain or Patient Global Assessment and Disease Activity Indices in Rheumatoid Arthritis? An Analysis from the Prospective, Observational Registry, Biotrac

BackgroundPatient-reported outcomes such as pain and patient global assessment of disease activity (PtGA) have been critiqued for not accurately assessing RA disease activity as they may reflect aspects not directly...

AB0178 Elevated serum igg4 correlates with disease activity in patients with rheumatoid arthritis

BackgroundElevated serum IgG4 is one of the characteristics of IgG4-related diseases and it has also been reported in some patients with rheumatoid arthritis (RA). However, the significance of elevated serum...

Improved Health-related Quality of Life and Physical Function in Patients with Refractory Chronic Gout Following Treatment with Pegloticase: Evidence from Phase III Randomized Controlled Trials

To assess the efficacy of pegloticase on pain, physical function, and health-related quality of life (HRQOL) in patients with refractory chronic gout. Subjects in 2 replicate, 6-month, randomized controlled phase III trials received intravenous infusions of pegloticase 8 mg twice monthly (biweekly group), pegloticase alternating with placebo (8-mg monthly group), or placebo. Medical Outcomes Study Short Form-36 (SF-36), Health Assessment Questionnaire-Disability Index (HAQ-DI), patient global assessment of disease activity (PtGA), and pain by visual analog scale were completed at weeks 1 (baseline), 13, 19, and 25. Prespecified pooled analyses of patient-reported outcomes were performed by combining values for each treatment group (biweekly treatment, monthly treatment, and placebo) at Week 25. Of 212 patients enrolled, 157 (74.1%) completed treatment. At entry, mean age was 55.4 years (range 23-89 yrs) and mean plasma uric acid was 9.7 mg/dl; most were male (81.6%) and white (67.5%). Subjects reported an average of 9.8 flares in the previous 18 months. Baseline SF-36 physical component summary (PCS) scores were > 1.5 SD below US normative values. At Week 25, mean changes from baseline in PtGA, pain, HAQ-DI, and PCS scores were statistically significant and exceeded minimum clinically important differences (MCID) in the biweekly treatment group, compared with little to no improvement in placebo group. Statistically significant improvements greater than or equal to MCID were reported in 6 of 8 SF-36 domains. Monthly pegloticase resulted in significantly improved PtGA, HAQ-DI, PCS, and 3 SF-36 domains. Pegloticase therapy resulted in statistically significant and clinically meaningful improvements in PtGA, pain, physical function, and HRQOL.

Certolizumab pegol plus methotrexate provides broad relief from the burden of rheumatoid arthritis: analysis of patient-reported outcomes from the RAPID 2 trial

ObjectiveTo assess the impact of certolizumab pegol (CZP) on patient-reported outcomes (PROs) in rheumatoid arthritis (RA), and to interpret these results using number needed to treat (NNT), and associations between...

Health Literacy Predicts the Discrepancy Between Patient and Provider Global Assessments of Rheumatoid Arthritis Activity at a Public Urban Rheumatology Clinic

Numerous studies report that significant discordance exists between patient and provider [physician] measures of rheumatoid arthritis (RA). We examined whether health literacy explains this discordance. We recruited English-speaking adult patients with RA for this cross-sectional study. Subjects completed 2 versions of patient global assessments of disease activity (PTGA), using standard terminology from the Multi-Dimensional Health Assessment Questionnaire (MDHAQ) and the 28-joint count Disease Activity Score 28 (DAS28). The provider global assessment (MDGA) was also obtained. The discrepancy between PTGA and MDGA was calculated as the absolute difference between these assessments. We used validated instruments [Short Test of Functional Health Literacy in Adults (S-TOFHLA) and Rapid Estimate of Adult Literacy in Medicine (REALM)] and linear regression to determine whether health literacy predicts disease measure discrepancy. The study included 110 subjects. Limited health literacy was a common finding by both the REALM and S-TOFHLA. PTGA and MDGA showed fair to good correlation (r = 0.66-0.68), although both versions of the PTGA were significantly higher than MDGA by the t-test (p < 0.001). The S-TOFHLA and REALM both were associated with the absolute difference between the MDGA and PTGA by linear regression, and results remained statistically significant in multivariate analysis. Health literacy was independently associated with the extent of discrepancy between PTGA and MDGA in English-speaking patients with RA at an urban clinic. This finding should influence our interpretation of disease measures.