OBJECTIVE: To compare the performance of different definitions of remission in a large multinational cross-sectional cohort of patients with rheumatoid arthritis (RA). METHODS: The Questionnaires in Standard Monitoring of Patients with RA (QUEST-RA) database, which (as of January 2008) included 5,848 patients receiving usual care at 67 sites in 24 countries, was used for this study. Patients were clinically assessed by rheumatologists and completed a 4-page self-report questionnaire. The database was analyzed according to the following definitions of remission: American College of Rheumatology (ACR) definition, Disease Activity Score in 28 joints (DAS28), Clinical Disease Activity Index (CDAI), clinical remission assessed using 42 and 28 joints (Clin42 and Clin28), patient self-report Routine Assessment of Patient Index Data 3 (RAPID3), and physician report of no disease activity (MD remission). RESULTS: The overall remission rate was lowest using the ACR definition of remission (8.6%), followed by the Clin42 (10.6%), Clin28 (12.6%), CDAI (13.8%), MD remission (14.2%), and RAPID3 (14.3%); the rate of remission was highest when remission was defined using the DAS28 (19.6%). The difference between the highest and lowest remission rates was >or=15% in 10 countries, 5-14% in 7 countries, and <5% in 7 countries (the latter of which had generally low remission rates [<5.5%]). Regardless of the definition of remission, male sex, higher education, shorter disease duration, smaller number of comorbidities, and regular exercise were statistically significantly associated with remission. CONCLUSION: The use of different definitions of RA remission leads to different results with regard to remission rates, with considerable variation among countries and between sexes. Reported remission rates in clinical trials and clinical studies have to be interpreted in light of the definition of remission that has been used.
OBJECTIVE: To compare the performance of different definitions of remission in a large multinational cross-sectional cohort of patients with rheumatoid arthritis (RA). METHODS: The Questionnaires in Standard Monitoring of Patients with RA (QUEST-RA) database, which (as of January 2008) included 5,848 patients receiving usual care at 67 sites in 24 countries, was used for this study. Patients were clinically assessed by rheumatologists and completed a 4-page self-report questionnaire. The database was analyzed according to the following definitions of remission: American College of Rheumatology (ACR) definition, Disease Activity Score in 28 joints (DAS28), Clinical Disease Activity Index (CDAI), clinical remission assessed using 42 and 28 joints (Clin42 and Clin28), patient self-report Routine Assessment of Patient Index Data 3 (RAPID3), and physician report of no disease activity (MD remission). RESULTS: The overall remission rate was lowest using the ACR definition of remission (8.6%), followed by the Clin42 (10.6%), Clin28 (12.6%), CDAI (13.8%), MD remission (14.2%), and RAPID3 (14.3%); the rate of remission was highest when remission was defined using the DAS28 (19.6%). The difference between the highest and lowest remission rates was >or=15% in 10 countries, 5-14% in 7 countries, and <5% in 7 countries (the latter of which had generally low remission rates [<5.5%]). Regardless of the definition of remission, male sex, higher education, shorter disease duration, smaller number of comorbidities, and regular exercise were statistically significantly associated with remission. CONCLUSION: The use of different definitions of RA remission leads to different results with regard to remission rates, with considerable variation among countries and between sexes. Reported remission rates in clinical trials and clinical studies have to be interpreted in light of the definition of remission that has been used.
Authors: Lilian H D van Tuyl; David T Felson; George Wells; Josef Smolen; Bin Zhang; Maarten Boers Journal: Arthritis Care Res (Hoboken) Date: 2010-01-15 Impact factor: 4.794
Authors: Tuulikki Sokka; Hannu Kautiainen; Theodore Pincus; Suzanne M M Verstappen; Amita Aggarwal; Rieke Alten; Daina Andersone; Humeira Badsha; Eva Baecklund; Miguel Belmonte; Jürgen Craig-Müller; Licia Maria Henrique da Mota; Alexander Dimic; Nihal A Fathi; Gianfranco Ferraccioli; Wataru Fukuda; Pál Géher; Feride Gogus; Najia Hajjaj-Hassouni; Hisham Hamoud; Glenn Haugeberg; Dan Henrohn; Kim Horslev-Petersen; Ruxandra Ionescu; Dmitry Karateew; Reet Kuuse; Ieda Maria Magalhaes Laurindo; Juris Lazovskis; Reijo Luukkainen; Ayman Mofti; Eithne Murphy; Ayako Nakajima; Omondi Oyoo; Sapan C Pandya; Christof Pohl; Denisa Predeteanu; Mjellma Rexhepi; Sylejman Rexhepi; Banwari Sharma; Eisuke Shono; Jean Sibilia; Stanislaw Sierakowski; Fotini N Skopouli; Sigita Stropuviene; Sergio Toloza; Ivo Valter; Anthony Woolf; Hisashi Yamanaka Journal: Arthritis Res Ther Date: 2010-03-12 Impact factor: 5.156
Authors: Michel de Bandt; Bruno Fautrel; Jean Francis Maillefert; Jean Marie Berthelot; Bernard Combe; René-Marc Flipo; Frédéric Lioté; Olivier Meyer; Alain Saraux; Daniel Wendling; Xavier Le Loët; Francis Guillemin Journal: Arthritis Res Ther Date: 2009-10-23 Impact factor: 5.156
Authors: T Sokka; H Kautiainen; T Pincus; S Toloza; G da Rocha Castelar Pinheiro; J Lazovskis; M L Hetland; T Peets; K Immonen; J F Maillefert; A A Drosos; R Alten; C Pohl; B Rojkovich; B Bresnihan; P Minnock; M Cazzato; S Bombardieri; S Rexhepi; M Rexhepi; D Andersone; S Stropuviene; M Huisman; S Sierakowski; D Karateev; V Skakic; A Naranjo; E Baecklund; D Henrohn; F Gogus; H Badsha; A Mofti; P Taylor; C McClinton; Y Yazici Journal: Ann Rheum Dis Date: 2009-07-30 Impact factor: 19.103