Background/Purpose: Osteoarthritis commonly is regarded as less severe and less debilitating than RA. However, limited data are available for direct comparison of OA versus RA, in large part because different measures traditionally have been used to assess patients, primarily a HAQ (Health Assessment Questionnaire) in RA and WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) in OA. RAPID3 (Routine Assessment of Patient Index Data) on an MDHAQ (Multi-Dimensional HAQ) is a composite of 3 patient self-report measures that was developed for RA, but is informative in many other rheumatic diseases, including OA¹. Recent observations from 4 settings indicate that RAPID3 and other MDHAQ scores were similar or higher in OA versus RA patients². Those findings were from a cross-sectional convenience sample, and likely were affected by treatment in most patients. We analyzed MDHAQ/RAPID3 scores in patients with a primary diagnosis of either OA or RA at their first visit to a rheumatology center and at 6 month follow-up.

Methods: At one academic center, all patients complete an MDHAQ/RAPID3 prior to seeing the rheumatologist. The 2-page MDHAQ/RAPID3 includes scores for physical function (FN) (0-3 converted to 0-10) and 0-10 visual analog scale (VAS) scores for pain (PN) and patient global assessment (PATGL), compiled into a 0-30 composite RAPID3. Patients with physician-diagnosed primary OA or RA were included in the study. Mean FN, PN, PATGL and RAPID3 scores in RA and OA at baseline and 6-month follow-up (range 3-9 months) were compared for differences between first and second visits using t-tests, as well as between OA and RA adjusted using MANOVA.

Results: At first visit, RAPID3 was 15.9 in OA vs 15.3 in RA – no meaningful differences in individual measures or index (Table). At 6-month follow-up, in OA, RAPID3 fell from 15.9 to 14.9 (-1.0, p=0.06) vs 15.3 to 11.1 (-4.2, p<0.001) in RA, indicating greater improvement in RA, resulting in significantly higher disease burden in OA vs RA. These differences remained significant after adjusting for age, sex, body mass index, and education level.

Mean and standard deviation (SD) at first visit and 6-month follow up visit MDHAQ/RAPID3 of patients with OA and RA seen in routine care

*adjusted for age, sex, BMI and education

Conclusion: Patients with OA or RA have similar disease burdens at first visit, but OA patients have a considerably higher burden 6 months later, reflecting more effective treatments for RA than for OA. Nonetheless, OA is a severe disease at first visit, suggesting a need for further research in OA toward improved treatment and outcomes. MDHAQ/RAPID3 is feasible and useful to assess and monitor clinical status in routine care of patients with different rheumatic diseases.

References: 1. J Clin Rheumatol. 2013;19(4):169-74. 2. RMD Open, 2017, in press.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/disease-burden-at-one-academic-rheumatology-routine-care-setting-is-similar-in-osteoarthritis-oa-and-rheumatoid-arthritis-ra-at-first-visit-but-significantly-greater-in-oa-at-a-6-month-follow-up-v/