ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1606

The 66/68 Joint Count for the Measurement of MSK Disease Activity/Peripheral Joint Activity in Psa: A Grappa-Omeract Working Group Initiative

Ali Duarte-Garcia1, Lihi Eder2, Niti Goel3, Robin Christensen4, Maarten de Wit5, Oliver FitzGerald6, Dafna D Gladman7, Richard Holland8, Ying Ying Leung9, Christine Lindsay10, Neil McHugh11, Philip J. Mease12, Ana-Maria Orbai13, Beverly Shea14, Vibeke Strand15, William Tillett16, Laura C. Coates17 and Alexis Ogdie18, 1Mayo Clinic College of Medicine and Science, Rochester, MN, 2Women's College Research Institute, University of Toronto, Women's College Hospital, Toronto, ON, Canada, 3Kezar Life Sciences; Duke University School of Medicine, Durham, NC, 4Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg, Denmark, 5EULAR standing committee of PARE, Zurich, Switzerland, 6Department of Rheumatology, St Vincent's University Hospital and Conway Institute, University College Dublin, Ireland, Dublin, Ireland, 7University of Toronto, Toronto Western Hospital, Toronto, ON, Canada, 8Royal Prince Alfred Hospital Medical Centre, Sydney, Australia, 9North District Hospital, Hong Kong, China, 10Medical Affairs, Amgen Inc, Thousand Oaks, CA, 11Rheumatology, Royal National Hospital, Bath, Great Britain, 12Swedish Medical Center and University of Washington School of Medicine, Seattle, WA, 13Johns Hopkins University School of Medicine, Baltimore, MD, 14University of Ottawa, Ottawa, ON, Canada, 15Stanford University School of Medicine, Palo Alto, CA, 16Royal National Hospital for Rheumatic Diseases and University of Bath, Bath, United Kingdom, 17University of Oxford, Oxford, United Kingdom, 18Medicine/Rheumatology and Epidemiology, University of Pennsylvania, Philadelphia, PA

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Date: Monday, October 22, 2018

Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster II: Clinical/Epidemiology Studies

Session Type: ACR Poster Session B

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

Background/Purpose: A psoriatic arthritis (PsA) core domain set to be measured in randomized controlled trials (RCT) and longitudinal observational studies (LOS) was developed by Group for Research and Assessment of Psoriasis and PsA (GRAPPA) and endorsed by Outcome Measures in Rheumatology (OMERACT) in 2016. Joint counts are central to the measurement of musculoskeletal (MSK) disease activity, one of the key domains. Having reviewed the 28 as well as 76/78 joint counts, the 66/68-swollen and tender joint count (SJC66/TJC68) was identified as the target instrument for peripheral joint assessment. We assessed the domain match, feasibility, construct validity, reliability, responsiveness, discrimination and thresholds of meaning of SJC66/TJC68 in PsA to secure endorsement of this instrument for inclusion in the PsA Core Outcome Measurement Set at OMERACT.

Methods: A multi-prong protocol was designed to assess the properties of the joint counts. A provider and methodologist focus group at GRAPPA, an international web-based working group survey, and patient research partner survey and web-based focus groups were conducted to assess domain match and feasibility.  To address reliability, construct validity, responsiveness and discrimination, we conducted a systematic literature review and analyzed data from one LOS and 8 PsA RCTs using a standardized protocol.  These results were summarized in a “Summary of Measurement Properties Table,” (developed by OMERACT), and presented and discussed at OMERACT2018.  OMERACT participants voted on endorsement of the SJC66/TJC68 as an instrument for the PsA Core Outcome Measurement Set.

Results: Participants in the preconference work and within our working group agreed that the SJC66/TJC68 joint count matched the domain “MSK disease activity: peripheral arthritis” and is feasible for use in RCT and LOS.  Construct validity was demonstrated in four published studies and within our primary data analyses.  Test-retest reliability was only examined in one cohort of 14 patients with PsA but was found to be excellent (0.8-0.9). Inter-rater reliability has been previously shown to be low for the SJC66 (intraclass correlation [ICC], 0.24) but good for the TJC68 (ICC, 0.78).  The SJC66/TJC68 was responsive and able to discriminate between patients receiving placebo and active treatment.  Finally, the minimally important difference was found to be 2.5 joints for both SJC66 and TJC68 in a new analysis of an LOS. Overall, 17 (100%) of patient research partners and 96/113 (85%) of other stakeholders (eg, clinicians, methodologists) voted for full endorsement of the SJC66/TJC68.

Conclusion: SJC66/TJC68 is a feasible, valid and reliable instrument for the measurement of peripheral joint activity in RCT/LOS and is recommended over the 76/78 and 28 joint counts. The SJC66/TJC68 is the first fully endorsed instrument within the PsA Core Outcome Measurement Set.

 

Disclosure: A. Duarte-Garcia, None; L. Eder, None; N. Goel, None; R. Christensen, None; M. de Wit, None; O. FitzGerald, None; D. D. Gladman, None; R. Holland, None; Y. Y. Leung, None; C. Lindsay, None; N. McHugh, None; P. J. Mease, None; A. M. Orbai, Abbvie, Celgene, Eli Lilly and Company, Horizon, Janssen, Novartis, Pfizer, 2,Eli Lilly and Company, Janssen, Novartis, Pfizer, UCB, 5; B. Shea, None; V. Strand, None; W. Tillett, None; L. C. Coates, None; A. Ogdie, Pfizer, Inc.; Novartis, 2,Abbvie, Amgen, BMS, Corrona, Lilly, Novartis, Pfizer, Takeda, 5.

To cite this abstract in AMA style:

Duarte-Garcia A, Eder L, Goel N, Christensen R, de Wit M, FitzGerald O, Gladman DD, Holland R, Leung YY, Lindsay C, McHugh N, Mease PJ, Orbai AM, Shea B, Strand V, Tillett W, Coates LC, Ogdie A. The 66/68 Joint Count for the Measurement of MSK Disease Activity/Peripheral Joint Activity in Psa: A Grappa-Omeract Working Group Initiative [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/the-66-68-joint-count-for-the-measurement-of-msk-disease-activity-peripheral-joint-activity-in-psa-a-grappa-omeract-working-group-initiative/. Accessed .

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