Background/Purpose: Patient global assessment (PtGA) is a component of the new ACR/EULAR remission criteria for rheumatoid arthritis (RA). It has been reported that >50% of patients who satisfied the other 3 components failed to achieve remission due to their higher PtGA score. Certain problems related to the higher PtGA among such patients may have been hidden. However, it remains to be clarified whether RA patients with a PtGA score ≤1 would essentially differ from those with a score >1, and whether significant differences would be found when comparing patients with a PtGA score ≤1 to those with a slightly higher score.

Methods: The Institute of Rheumatology, Rheumatoid Arthritis (IORRA), is a hospital-based large observational cohort of RA patients. Clinical information and laboratory data have been collected biannually. PtGA scores were rated using a Visual Analogue Scale (0-10 cm). Swollen and tender joint counts were recorded by examination of 45 joints. Components of DAS28 were documented as TJC28 and SJC28, and the other joint involvements in this study were described as “TJC45-28” and “SJC45-28.” The validated Japanese versions of Health Assessment Questionnaire (J-HAQ) scores and European Quality of life 5 Dimensions (EQ-5D) ratings were used to evaluate physical function and quality of life (QOL), respectively. The subjects were 2,973 RA patients who participated in the IORRA survey in April 2011, and “fulfilled 3 other components” defined as TJC, SJC, and CRP being ≤1. Multivariate logistic regression analyses were performed to evaluate factors associated with PtGA in 2 models; model 1, patients with a PtGA >1 compared to those with a PtGA ≤1, and model 2, patients with a 1Results: Among patients fulfilling the other 3 components, only 42.8% achieved Boolean trials remission. Multivariate analysis showed that, whether Boolean trials remission was achieved or not was independently associated with age (OR = 0.99; 95% CI, 0.98-0.99; p<0.001), SJC28 (OR = 1.10; 95% CI, 1.04-1.16; p<0.001), TJC28 (OR = 1.26; 95% CI, 1.17-1.37; p<0.001), J-HAQ (OR = 1.97; 95% CI, 1.62-2.41; p<0.001), EQ-5D (OR 0.001; 95% CI, 0.000-0.001; p<0.001), and NSAID use (OR = 1.41; 95% CI, 1.20-1.65; p<0.001). Notably, “SJC45-28” was also strongly associated (OR = 1.18; 95% CI, 1.02-1.38; p<0.001) with achieving Boolean trials remission. When factors were analyzed in patients with a 1

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/high-patient-global-assessment-scores-associate-with-the-residual-disease-activity-unidentified-by-a-28-joint-examination-in-rheumatoid-arthritis-patients-approaching-clinical-remission/