OBJECTIVE: To compare the reliability of 3 different simplified joint counts with the gold standard 66 swollen/68 tender joint count (JC66/68) for assessing clinical response in patients with polyarticular psoriatic arthritis (PsA). METHODS: The 28-joint count (JC28), in the same way that it is used in rheumatoid arthritis, and 2 measures including distal interphalangeal (DIP) joints (the 32-joint count [JC32], including all finger joints as well as wrists and knees, and 36-joint count [JC36], which additionally included elbows and ankles), were compared with the JC66/68 in 182 patients using data from the Infliximab Multinational Psoriatic Arthritis Controlled Trial 2 trial database. Pearson's correlation coefficients were calculated to compare the swollen and tender JC28, JC32, and JC36 with the corresponding results of the total JC66/68. American College of Rheumatology (ACR) responses based on the individual measures were compared, and their ability in predicting a clinical response of ACR 20% improvement (ACR20) based on the JC66/68 was assessed by calculating the area under the receiver operating characteristic curve via logistic regression and the maximum Youden indices at weeks 14 and 24. RESULTS: All simplified joint counts were highly correlated to the standard JC66/68 both for tenderness and swelling at each individual visit (Pearson's correlation coefficients consistently >0.8, n = 182-200; P < 0.0001). Logistic regression for ACR20 response showed that area under the curve was constantly >0.91, with comparable results for Youden indices of the simplified joint counts. CONCLUSION: All simplified joint counts considered seemed sufficiently sensitive and specific to measure clinical response in trial patients with polyarticular PsA when compared with the JC66/68, no matter whether DIP joints were included (the JC36 and JC32) or excluded (the JC28). Further research will be needed to clarify this issue.
RCT Entities:
OBJECTIVE: To compare the reliability of 3 different simplified joint counts with the gold standard 66 swollen/68 tender joint count (JC66/68) for assessing clinical response in patients with polyarticular psoriatic arthritis (PsA). METHODS: The 28-joint count (JC28), in the same way that it is used in rheumatoid arthritis, and 2 measures including distal interphalangeal (DIP) joints (the 32-joint count [JC32], including all finger joints as well as wrists and knees, and 36-joint count [JC36], which additionally included elbows and ankles), were compared with the JC66/68 in 182 patients using data from the Infliximab Multinational Psoriatic Arthritis Controlled Trial 2 trial database. Pearson's correlation coefficients were calculated to compare the swollen and tender JC28, JC32, and JC36 with the corresponding results of the total JC66/68. American College of Rheumatology (ACR) responses based on the individual measures were compared, and their ability in predicting a clinical response of ACR 20% improvement (ACR20) based on the JC66/68 was assessed by calculating the area under the receiver operating characteristic curve via logistic regression and the maximum Youden indices at weeks 14 and 24. RESULTS: All simplified joint counts were highly correlated to the standard JC66/68 both for tenderness and swelling at each individual visit (Pearson's correlation coefficients consistently >0.8, n = 182-200; P < 0.0001). Logistic regression for ACR20 response showed that area under the curve was constantly >0.91, with comparable results for Youden indices of the simplified joint counts. CONCLUSION: All simplified joint counts considered seemed sufficiently sensitive and specific to measure clinical response in trial patients with polyarticular PsA when compared with the JC66/68, no matter whether DIP joints were included (the JC36 and JC32) or excluded (the JC28). Further research will be needed to clarify this issue.
Authors: Alí Duarte-García; Ying Ying Leung; Laura C Coates; Dorcas Beaton; Robin Christensen; Ethan T Craig; Maarten de Wit; Lihi Eder; Lara Fallon; Oliver FitzGerald; Dafna D Gladman; Niti Goel; Richard Holland; Chris Lindsay; Lara Maxwell; Philip Mease; Ana Maria Orbai; Beverley Shea; Vibeke Strand; Douglas J Veale; William Tillett; Alexis Ogdie Journal: J Rheumatol Date: 2019-02-15 Impact factor: 4.666
Authors: Mihai G Netea; Frances Balkwill; Michel Chonchol; Fabio Cominelli; Marc Y Donath; Evangelos J Giamarellos-Bourboulis; Douglas Golenbock; Mark S Gresnigt; Michael T Heneka; Hal M Hoffman; Richard Hotchkiss; Leo A B Joosten; Daniel L Kastner; Martin Korte; Eicke Latz; Peter Libby; Thomas Mandrup-Poulsen; Alberto Mantovani; Kingston H G Mills; Kristen L Nowak; Luke A O'Neill; Peter Pickkers; Tom van der Poll; Paul M Ridker; Joost Schalkwijk; David A Schwartz; Britta Siegmund; Clifford J Steer; Herbert Tilg; Jos W M van der Meer; Frank L van de Veerdonk; Charles A Dinarello Journal: Nat Immunol Date: 2017-07-19 Impact factor: 25.606