Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Takayasu’s arteritis (TAK) is a relapsing large vessel vasculitis. There are currently no reliable predictors of disease relapse. This study explored whether changes in patient-reported outcomes (PROs) during periods of remission are associated with future disease relapse in TAK.
Methods: Data from patients with TAK participating in a longitudinal cohort and/or a clinical trial in TAK were available for this analysis; quarterly assessments were made. Patients completed a patient global assessment (PtGA) on a 100-mm visual analog scale with higher scores indicating worse disease activity, and the 36-item Short Form Health Survey (SF-36) from which the physical component scores (PCS) and mental component scores (MCS) were calculated and normalized to the general population (mean ± SD=50 ± 10) with lower scores indicating worse outcomes. ESR and CRP were measured at each visit. Physicians determined disease state (remission or active) at each visit and whether a relapse had occurred since last visit. The 2 visits preceding relapse (remission visits) and the study visit following or concurrent with relapse (relapse visit) were used for analysis. Robust generalized estimating equations in logistic regression models evaluated associations between changes in PtGA, PCS, MCS, ESR, and CRP in the 2 remission visits preceding relapse and disease relapse, adjusting for intra-subject correlations, age, and sex.
Results: 207 patients with TAK were seen at a total of 1,077 study visits (881 remission and 196 relapse visits); 97% were female with a mean age at entry (± SD) of 38.7 ± 12.9 years. Table 1 shows the mean PtGA, PCS, MCS, ESR and CRP during remission and relapse visits. An increase of 10 mm in PtGA or a decrease in PCS scores by 1 point between the 2 visits preceding relapse were associated with disease relapse (OR [95% CI]= 1.23 [1.05-1.45], p=0.011 for PtGA and 1.07 [1.02-1.13], p=0.016 for PCS). Changes in MCS, ESR, or CRP were not associated with disease relapse (OR=1.10 [0.96-1.05, p=0.638, OR=1.01 [0.97-1.04], p=0.546, OR=1.00 [0.95-1.03], p=0.864 for MCS, ESR and CRP respectively).
Conclusion: Changes in patient global assessment and the SF-36 physical component scores, but not the SF-36 mental component scores, during periods of remission are associated with future disease relapse. Changes in ESR or CRP during periods of remission do not predict future disease relapse. These findings suggest that patients are good predictors of disease relapse and the current measures of disease activity and definitions of relapse in TAK are problematic and should incorporate patient-reported outcomes.
To cite this abstract in AMA style:Sreih AG, Kermani TA, Tomasson G, Baker JF, Cuthbertson D, Borchin R, Carette S, Forbess LJ, Hoffman GS, Khalidi NA, Koening CL, McAlear CA, Monach PA, Moreland LW, Pagnoux C, Seo P, Spiera RF, Warrington KJ, Ytterberg SR, Langford CA, Merkel PA. The Utility of Patient-Reported Outcomes in Predicting Disease Activity in Patients with Takayasu’s Arteritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/the-utility-of-patient-reported-outcomes-in-predicting-disease-activity-in-patients-with-takayasus-arteritis/. Accessed September 22, 2019.
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