Session Information
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: RAPID3 (routine assessment of patient index data) is a patient self-report index which is feasible in busy clinical settings to assess severity and change in clinical status in many rheumatic diseases, including RA, OA, gout, AxSpA. RAPID3 (0-30) includes 3 0-10 measures: a health assessment questionnaire (HAQ) or its multidimensional version (MDHAQ) measuring physical function and two 0-10 visual analogue scales (VAS) for pain and patient global estimate. A score of ≤3 (of 30) identifies near remission (NR) in rheumatoid arthritis. RAPID3 is correlated significantly with other PsA measures; a RAPID3Ps has also been investigated with the addition of a skin VAS for PsA. The Minimal Disease Activity (MDA) criteria for PsA require achievement of 5 of 7 cutpoints in 7 measures: the three RAPID measures; tender joint count (TJC); swollen joint count (SJC); enthesitis count and skin measure. Our aim was to compare patients achieving RAPID3 and RAPID3Ps near remission and MDA criteria in PsA in individual patients in the Tight Control of Psoriatic Arthritis (TICOPA) trial.
Methods: Data from TICOPA were analysed to identify patients achieving RAPID3 and RAPID3Ps NR, and the patients were compared to those achieving the MDA criteria. MDA was achieved if patients achieved 5 of the 7 following cut points: TJC ≤1; SJC ≤1; enthesitis ≤1; PASI ≤1; HAQ function ≤0.5; global VAS ≤20 and pain VAS ≤15. Frequency of residual active disease in the RAPID3 NR states was investigated. A measure of acute phase response is not included in either measure, but CRP levels were assessed to recognize whether an active acute phase response was missed.
Results: The percentage exact agreement (PEA) between RAPID3 NR and MDA was 83.8, 89.8, 87.1, 85.2 at 12, 24, 36, 48 weeks respectively. Adding the skin component to create RAPID3Ps and using the equivalent NR cutpoint (4/40) led to PEA of 85.1, 88.0, 88.5 and 85.1 respectively. Very few patients (2.2-3.8%) were in RAPID3NR but not MDA due to high physician assessed outcomes. For patients in RAPID3NR at the end of the study, residual disease activity is shown in the table. Levels of skin disease in this population were very low with PASI of 0 in 94% of these patients.
Conclusion: RAPID3NR and RAPID3PsNR shows good agreement with the MDA criteria in PsA. The addition of a psoriasis measure did not change the results meaningfully in this population, but may be more infortative in patients with more severe skin disease. The RAPID3 NR definition does allow significant residual disease in a few patients but may be useful as an adjunct to physician examination when monitoring disease activity.
| RAPID3 NR n (%) (n=67) | RAPID3Ps NR n (%)(n=67) | ||
| PASDAS | Mean (SD) | 1.82 (0.70) | 1.79 (0.71) |
| Tender joint count | 0 | 38 (56.7) | 38 (56.7) |
| 1 | 11 (16.4) | 10 (14.9) | |
| 2 | 5 (7.5) | 6 (9.0) | |
| 3 | 2 (3.0) | 2 (3.0) | |
| 4 | 5 (7.5) | 5 (7.5) | |
| 5 | 1 (1.5) | 1 (1.5) | |
| 7 | 3 (4.5) | 3 (4.5) | |
| 8 | 2 (3.0) | 2 (3.0) | |
| Swollen joint count | 0 | 49 (73.1) | 50 (74.6) |
| 1 | 9 (13.4) | 7 (10.4) | |
| 2 | 5 (7.5) | 5 (7.5) | |
| 3 | 1 (1.5) | 1 (1.5) | |
| 4 | 2 (3.0) | 3 (4.5) | |
| 5 | 1 (1.5) | 1 (1.5) | |
| Enthesitis count | 0 | 48 (71.6) | 49 (73.1) |
| 1 | 8 (11.9) | 7 (10.4) | |
| 2 | 7 (10.4) | 7 (10.4) | |
| 3 | 3 (4.5) | 3 (4.5) | |
| 7 | 1 (1.5) | 1 (1.5) | |
| Dactylitis count | 0 | 62 (92.5) | 63 (94) |
| 1 | 1 (1.5) | 1 (1.5) | |
| 2 | 3 (4.5) | 3 (4.5) | |
| 3 | 1 (1.5) | 0 (0) | |
| PASI | 0 | 63 (94.0) | 63 (94.0) |
| 0.3 | 1 (1.5) | 1 (1.5) | |
| 0.6 | 1 (1.5) | 1 (1.5) | |
| 0.8 | 0 (0) | 1 (1.5) | |
| 3 | 2 (3.0) | 1 (1.5) | |
| CRP | Normal (<5mg/dl) | 51 (76.1) | 50 (74.6) |
| Raised | 15 (22.4) | 15 (22.4) | |
| Missing | 1 (1.5) | 2 (3.0) |
To cite this abstract in AMA style:
Coates LC, Tillett W, Pincus T, Kavanaugh A, Helliwell PS. RAPID3 Near Remission Shows Good Agreement with Minimal Disease Activity Criteria in Psoriatic Arthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/rapid3-near-remission-shows-good-agreement-with-minimal-disease-activity-criteria-in-psoriatic-arthritis/. Accessed .« Back to 2016 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/rapid3-near-remission-shows-good-agreement-with-minimal-disease-activity-criteria-in-psoriatic-arthritis/