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Abstract Number: 356

The Rheumatoid Arthritis Impact of Disease Score Is Associated with Disease Activity By Clinical, Laboratory and Ultrasonographic Measures: Validation in an inception Cohort of DMARD naïve Patients with Rheumatoid Arthritis

Lena Bugge Nordberg1, Elisabeth Lie2, Anna-Birgitte Aga1, Marthe Thoresen Maehlen3, Inge Olsen C4, Till Uhlig4, Tore K. Kvien4, Espen A. Haavardsholm5 and the Arctic study Group5, 1Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 2Dept. of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 3Department of rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 4Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 5Diakonhjemmet Hospital, Oslo, Norway

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Disease Activity, outcome measures and rheumatoid arthritis (RA), PRO

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Session Information

Session Title: Rheumatoid Arthritis - Clinical Aspects: Novel Biomarkers and Other Measurements of Disease Activity

Session Type: Abstract Submissions (ACR)

 

Background/Purpose:

The Rheumatoid arthritis impact of disease (RAID) score is a relatively new patient-derived composite score assessing the seven most important domains of the impact of rheumatoid arthritis (RA). It is unknown how the RAID score correlates with other disease measures in patients with early RA. We aimed to examine associations between the RAID score and different clinical, laboratory and ultrasonographic disease measures as well as other patient reported outcome measures (PROMs) in an inception cohort of DMARD naïve patients with early RA.

 

Methods:

Consecutive patients from 11 rheumatology centers in Norway who fulfilled the 2010 ACR/EULAR classification criteria for RA were included from October 2010 to April 2013. All patients had symptom duration (from first swollen joint) <2 years and were DMARD naïve with indication for DMARD treatment. Patients were stratified according to level of RAID score at baseline, and a RAID score of ≤3 was considered low, >3-6 moderate and >6 high. Disease measures were compared across RAID levels using either Kruskal-Wallis or ANOVA, and we assessed the correlation between the RAID score and other measures using Pearson or Spearman correlation coefficients, as appropriate.

 

Results:

A total of 229 patients were included, 61.1% female, 81.2% ACPA-positive and with mean (SD) age 51.0 (13.6) years. At baseline, mean (SD) RAID score was 4.5 (0.7), and 28.4%/47.6%/24.0% of the patients had low/moderate/high RAID score according to the above specified cut-offs. Differences in disease measures were all statistically significant across the low, moderate and high RAID groups, with the exception of the power Doppler ultrasonography score (table). Correlation analysis revealed statistically significant correlations between RAID score and all other measures, again with the exception of the power Doppler ultrasonography score. Correlations between RAID and Patient global, EQ-5D and Pain (VAS), respectively, were strong (r≥0.70), and the correlations between RAID and Ritchie, DAS44, Physician global, fatigue and SF-36 Physical and Mental Components Summary measures were moderate (r ≥0.4-0.7). The remaining correlations were weak (r<0.4).

 

 

Low RAID≤3,

n=65

Moderate RAID>3-6,

n=109

High RAID>6,

n=55

P

Disease duration, months*†

6.3 [3.6-12.0]

5.4 [2.7-9.8]

4.3 [2.2-9.3]

0.057

Age**

52.2 (14.4)

49.7 (13.7)

52.0 (12.5)

0.41

Female, n (%)

37 (56.9)

67 (61.5)

36 (65.5)

0.63

DAS-44**

2.71 (0.96)

3.53 (0.89)

4.27 (1.08)

<0.001

44-Swollen joint count*

7 [3-13]

9 [5-13]

12 [7-18]

0.003

ESR (mm/h)*

14 [9-26]

21 [12-30]

29 [15-45]

<0.001

CRP (mg/L)*

4 [2-7]

8  [4-18]

12 [6-28]

<0.001

Ritchie tender joint score*

4 [2-7]

8 [4-13]

12 [6-17]

<0.001

Patient global VAS (mm)**

27.9 (16.4)

48.4 (17.3)

77.2 (15.1)

<0.001

Physician global VAS (mm)**

29.6 (16.5)

41.6 (20.0)

51.4 (20.3)

<0.001

GSUS score ††

14 [9-23]

17 [10-28]

23 [16-30]

0.008

PDUS score*††

6 [2-13]

6 [3-13]

9 [4-14]

0.11

Total US score*††

20 [12-36]

24.5 [15-38]

33 [21-45]

0.015

EQ-5D (UK)*

0.76 [0.69-0.80]

0.66 [0.52-0.69]

0.06 [-0.2-0.18]

<0.001

Pain VAS (mm)**

26.5 (15.8)

45.8 (18.0)

75.6 (11.3)

<0.001

Fatigue VAS (mm)**

19.1 (20.8)

40.8 (24.9)

63.1 (24.7)

<0.001

SF-36 PCS**

43.3 (8.5)

33.9 (7.9)

23.8 (7.9)

<0.001

SF-36 MCS**

52.9 (9.3)

48.2 (10.9)

42.1 (10.3)

<0.001

*Median [25-75 percentiles]. **Mean(SD). †Time from patient reported first swollen joint. ††Ultrasonography (US) examinations were performed by experienced sonographers using a validated gray-scale (GS) and power-Doppler (PD) semi-quantitative scoring system with ranges 0-3 for GS and PD in each of the following 32 joints: MCP I-V, radio-carpal (RCJ), distal radio-ulnar (DRUJ), inter-carpal (ICJ), elbow, knee, talo-crural and MTP I-V bilaterally.

PCS = Physical Components Summary, MCS = Mental Component Summary.

Conclusion:

The RAID score was associated with both patient-reported and objective disease measures in this inception cohort of DMARD naïve RA patients. These findings support the use of RAID as a valid PROM in patients with early RA, covering a wide variety of disease manifestations and reflecting the patient perspective.

 


Disclosure:

L. B. Nordberg,
None;

E. Lie,
None;

A. B. Aga,
None;

M. T. Maehlen,
None;

I. Olsen C,
None;

T. Uhlig,
None;

T. K. Kvien,
None;

E. A. Haavardsholm,

AbbVie, Pfizer, MSD, Roche, UCB,

2;

T. A. study Group,

AbbVie, Pfizer, MSD, Roche, UCB,

2.

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