OBJECTIVES: To evaluate composite measures of response without acute-phase reactants in RA patients. Specifically, Clinical Disease Activity Index (CDAI)-derived response criteria were compared with the European League Against Rheumatism (EULAR) response criteria, and the modified ACR (mACR) response criteria were compared to the ACR response criteria. METHODS: Data from 10 108 RA patients enrolled in the Consortium of Rheumatology Researchers of North America registry were examined, including 649 patients initiating DMARD therapy. CDAI cut-off points for disease activity levels and responses were derived using receiver operating characteristic curves with the DAS28 and EULAR response criteria as gold standards. The kappa-statistics were applied to assess agreement between CDAI-derived and EULAR-defined responses, as well as ACR20 and ACR50 with mACR20- and mACR50-defined responses, respectively. RESULTS: For the components of the EULAR response, the derived CDAI cut-off points for DAS28 levels of 3.2 and 5.1 were 7.6 and 19.6, respectively. The derived CDAI cut-off points were 4.3 and 10.0 for DAS28 changes of 0.6 and 1.2, respectively. There were moderate to substantial agreements between CDAI-derived and EULAR responses (kappa = 0.57-0.71). Agreement of ACR20 and ACR50 with mACR20 and mACR50 responses, respectively, was excellent (kappa = 0.88-0.95). CONCLUSIONS: Agreement between composite measures of response without acute-phase reactants and standard measures ranged from moderate to excellent. The mACR20 and mACR50 criteria as well as CDAI-derived response criteria, can serve as composite measures of response in clinical practice and research settings without access to acute-phase reactants.
OBJECTIVES: To evaluate composite measures of response without acute-phase reactants in RApatients. Specifically, Clinical Disease Activity Index (CDAI)-derived response criteria were compared with the European League Against Rheumatism (EULAR) response criteria, and the modified ACR (mACR) response criteria were compared to the ACR response criteria. METHODS: Data from 10 108 RApatients enrolled in the Consortium of Rheumatology Researchers of North America registry were examined, including 649 patients initiating DMARD therapy. CDAI cut-off points for disease activity levels and responses were derived using receiver operating characteristic curves with the DAS28 and EULAR response criteria as gold standards. The kappa-statistics were applied to assess agreement between CDAI-derived and EULAR-defined responses, as well as ACR20 and ACR50 with mACR20- and mACR50-defined responses, respectively. RESULTS: For the components of the EULAR response, the derived CDAI cut-off points for DAS28 levels of 3.2 and 5.1 were 7.6 and 19.6, respectively. The derived CDAI cut-off points were 4.3 and 10.0 for DAS28 changes of 0.6 and 1.2, respectively. There were moderate to substantial agreements between CDAI-derived and EULAR responses (kappa = 0.57-0.71). Agreement of ACR20 and ACR50 with mACR20 and mACR50 responses, respectively, was excellent (kappa = 0.88-0.95). CONCLUSIONS: Agreement between composite measures of response without acute-phase reactants and standard measures ranged from moderate to excellent. The mACR20 and mACR50 criteria as well as CDAI-derived response criteria, can serve as composite measures of response in clinical practice and research settings without access to acute-phase reactants.
Authors: J M Bathon; R W Martin; R M Fleischmann; J R Tesser; M H Schiff; E C Keystone; M C Genovese; M C Wasko; L W Moreland; A L Weaver; J Markenson; B K Finck Journal: N Engl J Med Date: 2000-11-30 Impact factor: 91.245
Authors: A M van Gestel; J J Anderson; P L van Riel; M Boers; C J Haagsma; B Rich; G Wells; M L Lange; D T Felson Journal: J Rheumatol Date: 1999-03 Impact factor: 4.666
Authors: D T Felson; J J Anderson; M Boers; C Bombardier; D Furst; C Goldsmith; L M Katz; R Lightfoot; H Paulus; V Strand Journal: Arthritis Rheum Date: 1995-06
Authors: D T Felson; J J Anderson; M Boers; C Bombardier; M Chernoff; B Fried; D Furst; C Goldsmith; S Kieszak; R Lightfoot Journal: Arthritis Rheum Date: 1993-06
Authors: Leslie R Harrold; J Timothy Harrington; Jeffrey R Curtis; Daniel E Furst; Mary Jane Bentley; Ying Shan; George Reed; Joel Kremer; Jeffrey D Greenberg Journal: Arthritis Rheum Date: 2012-03
Authors: Jie Zhang; Ying Shan; George Reed; Joel Kremer; Jeffrey D Greenberg; Scott Baumgartner; Jeffrey R Curtis Journal: Arthritis Care Res (Hoboken) Date: 2011-12 Impact factor: 4.794
Authors: J R Curtis; S Yang; L Chen; J E Pope; E C Keystone; B Haraoui; G Boire; J C Thorne; D Tin; C A Hitchon; C O Bingham; V P Bykerk Journal: Arthritis Care Res (Hoboken) Date: 2015-10 Impact factor: 4.794
Authors: Jéssica Barreto Ribeiro Dos Santos; Alessandra Maciel Almeida; Francisco de Assis Acurcio; Haliton Alves de Oliveira Junior; Adriana Maria Kakehasi; Augusto Afonso Guerra Junior; Marion Bennie; Brian Godman; Juliana Alvares Journal: J Comp Eff Res Date: 2016-09-19 Impact factor: 1.744
Authors: Leslie R Harrold; George W Reed; Robert Magner; Ashwini Shewade; Ani John; Jeffrey D Greenberg; Joel M Kremer Journal: Arthritis Res Ther Date: 2015-09-18 Impact factor: 5.156
Authors: George W Reed; Katherine Leung; Ronald G Rossetti; Susan Vanbuskirk; John T Sharp; Robert B Zurier Journal: Evid Based Complement Alternat Med Date: 2014-03-19 Impact factor: 2.629
Authors: Dimitrios A Pappas; Joel M Kremer; George Reed; Jeffrey D Greenberg; Jeffrey R Curtis Journal: BMC Musculoskelet Disord Date: 2014-04-01 Impact factor: 2.362
Authors: Leslie R Harrold; George W Reed; Joel M Kremer; Jeffrey R Curtis; Daniel H Solomon; Marc C Hochberg; Jeffrey D Greenberg Journal: Ann Rheum Dis Date: 2013-12-02 Impact factor: 19.103