Background/Purpose: Remission rates in patients with rheumatoid arthritis (RA) according to RAPID3 (routine assessment of patient index data) are reported at 25% in France¹ and 21% in Norway². Remission according to RAPID3 or DAS28 (disease activity score) criteria are similar and less stringent compared to the American College of Rheumatology (ACR)/European League against Rheumatism (EULAR) criteria. Addition of whether only one or no joint is swollen renders RAPID 3-based remission criteria similar to ACR/EULAR Criteria¹. However, RAPID3 is more feasible for routine care. We examined the prevalence of remission according to RAPID3 in RA patients at three USA sites.

Methods: All patients with all diagnoses seen at 3 academic rheumatology centers complete a multidimensional health assessment questionnaire (MDHAQ), which includes RAPID3, at all visits in the waiting area, before seeing the rheumatologist in routine care. The MDHAQ includes 0-10 scores for physical function (FN), a pain (PN) visual analog scale (VAS), patient global estimate (PATGL) VAS, compiled into a 0-30 RAPID3, as well as a 0-10 fatigue VAS, RADAI self-report of painful joints of 16 joint groups bilaterally scored 0-3, and demographic data. RAPID3 categories for severity are high =≥12, moderate=6.1-12, low=3.1-6, and near-remission=≤3. Physicians complete a Rheumetric checklist, which includes 4 physician 0-10 VAS estimates for overall global status and 3 subscales for inflammation, damage and distress. A random visit for each RA patient from each site with complete data to calculate RAPID3 was analyzed for the percentage of patients in each category, compared using a chi-square test.

Results: 420 patients with RA from three different sites were analyzed. Demographic characteristics were similar at the 3 sites. RAPID3 remission rates ranged from 23% to 26%, comparable to reported rates from France¹ and Norway². Other categories were virtually identical at sites 1 and 2, but patients at site 3, a private practice, appeared to have better status; low severity ranged from 7-24%, moderate from 23-29% and high disease severity from 21-46%. Patients in remission had lower scores for fatigue and RADAI self-report painful joint than patients in other categories at all 3 sites, as well as lower physician global estimates for overall status, inflammation, damage and distress (data not shown).

Conclusion: RAPID3 remission rates at 3 US sites were 23%-26%, similar to 25% in France and 21% in Norway. RAPID3 provides a feasible approach to identify remission in busy clinical settings, as the patients do almost all the work, although addition of whether only one or no joint is swollen adds to stringency so that RAPID 3-based criteria are comparable to ACR/EULAR remission criteria. References: 1) Castrejon I, Dougados M, et al. J Rheumatol 2013, 40(4):386 -393. 2) Uhlig T, Lie E, et al. J Rheumatol 2016, 43(4):716-723.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/remission-according-to-rapid3-routine-assessment-of-patient-index-data-3-in-patients-with-rheumatoid-arthritis-a-cross-sectional-3-center-study-from-routine-care/