ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 518

Contribution of Patient Global Assessment on Loss and Gain of Disease Remission in Patients with Established Rheumatoid Arthritis in Clinical Practice

George A. Karpouzas1, Elizabeth Hernandez2, Chelsie Cost2 and Sarah Ormseth2, 1Harbor UCLA Medical Center, Torrance, CA, 2Rheumatology, Harbor-UCLA Medical Center, Torrance, CA

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: remission and rheumatoid arthritis (RA)

  • Tweet
  • Email
  • Print
Session Information

Date: Sunday, November 13, 2016

Title: Rheumatoid Arthritis – Clinical Aspects - Poster I: Clinical Characteristics/Presentation/Prognosis

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:  Patient global assessment (PGA) is part of the remission definitions in Rheumatoid arthritis (RA). We explored the proportion of patients who fail to achieve various remission definitions due to PGA ratings, and further assessed change in remission status attributed to PGA change at follow-up 12 months later. 

Methods:  We evaluated 271 patients with established RA in a single academic center. Remission definitions included DAS28 (disease activity score-28 joints)<2.6, CDAI (clinical disease activity index)=<2.8, SDAI (simplified disease activity index) =<3.3, and Boolean [tender joints=<1, swollen joints=<1, CRP (c-reactive protein) =<1, and PGA=<1]. Tentative remissions were computed for each scale by omitting the PGA component while retaining the same numeric threshold for definition. Subtracting observed remissions (R) from tentative ones yielded numbers of remissions lost (RL) due to PGA. Non-remissions (NR), observed remissions (R) and lost remissions (RL) at baseline and follow-up were cross-tabulated for each composite index. Differences in proportions of RL among various scales were compared with chi-squared tests, and PGA differences between R and RL for each scale were assessed with Mann-Whitney U tests.

Results: At baseline, tentative remissions were seen in 121 (44.6%), 105 (38.8%), 108 (39.9%), and 90 (33.2%) subjects respectively for DAS28, CDAI, SDAI and Boolean scales. RL comprised 17%, 52%, 57%, and 72% of the tentative ones for the respective scales (figure 1A). PGA was significantly lower for observed R vs. RL for all scales (figure 1B, p<0.0001). Baseline remission was maintained for the majority of patients at follow-up (table 1); of the remainder, roughly half were lost due to PGA change. Of patients with NR at baseline, 5-27% depending on scale remitted at follow-up, while 5-20% failed to do so because of PGA.

Conclusion: A significant proportion of patients with clinical measurements suggesting otherwise good disease control fail to be classified as or retain remission because of PGA ratings. Exploring and therapeutically addressing determinants of PGA will likely improve patient satisfaction and outcomes and lead to a more comprehensive disease remission.

Table 1: Cross-tabulation of disease severity at baseline and follow-up

Follow-up status, n (%)

Baseline status Scale Remission (R) Remission Lost (RL) Non-Remission

Remission (R)

DAS28 71 (71) 11 (11) 18 (18)
CDAI 33 (66) 9 (18) 8 (16)
SDAI 32 (69.6) 7 (15.2) 7 (15.2)
Boolean 15 (60) 5 (20) 5 (20)

Remission Lost (RL)

DAS28 8 (38) 2 (9.5) 11 (52.4)
CDAI 8 (14.5) 23 (41.8) 24 (43.6)
SDAI 10 (16.1) 27 (43.5) 25 (40.3)
Boolean 8 (12.3) 36 (55.4) 21 (32.3)

Non-Remission (NR)

DAS28 41 (27.3) 8 (5.3) 101 (67.3)
CDAI 21 (12.7) 26 (15.7) 119 (71.7)
SDAI 18 (11) 31 (19) 114 (69.9)
Boolean 9 (5) 37 (20.4) 135 (74.6)

Disclosure: G. A. Karpouzas, None; E. Hernandez, None; C. Cost, None; S. Ormseth, None.

To cite this abstract in AMA style:

Karpouzas GA, Hernandez E, Cost C, Ormseth S. Contribution of Patient Global Assessment on Loss and Gain of Disease Remission in Patients with Established Rheumatoid Arthritis in Clinical Practice [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/contribution-of-patient-global-assessment-on-loss-and-gain-of-disease-remission-in-patients-with-established-rheumatoid-arthritis-in-clinical-practice/. Accessed .
  • Tweet
  • Email
  • Print

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/contribution-of-patient-global-assessment-on-loss-and-gain-of-disease-remission-in-patients-with-established-rheumatoid-arthritis-in-clinical-practice/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology