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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