BACKGROUND: The American College of Rheumatology/European League Against Rheumatism remission criteria for rheumatoid arthritis (RA) have been published recently. OBJECTIVE: To quantify the proportions of patients fulfilling only three of the four Boolean criteria and the relevance of patient global assessment (PGA) in context of remission. METHODS: From an observational prospective RA database the first visit of patients, fulfilling just three of the four Boolean criteria was identified. Logistic regression and descriptive analyses were processed, also defining remission by index-based (Simplified Disease Activity Index (SDAI)) definition and comparing outcomes with the evaluator global assessment (EGA). RESULTS: 52% had at least one visit, fulfilling just three criteria (not fulfilled were: PGA 61%; swollen joints 20%; tender joints 13%; C-reactive-protein 7%). 67% of patients not fulfilling the PGA criterion had an EGA≤1 cm, 25% of those fulfilled the SDAI definition. Increased pain (OR=1.28), EGA (OR=1.10) and discrepancy towards higher PGA than EGA (OR=1.28) could explain PGA failure to reach remission. CONCLUSIONS: PGA is often the limiting factor for reaching remission; index-based remission showed balancing effects by adjusting for elevated variables in the summative score.
BACKGROUND: The American College of Rheumatology/European League Against Rheumatism remission criteria for rheumatoid arthritis (RA) have been published recently. OBJECTIVE: To quantify the proportions of patients fulfilling only three of the four Boolean criteria and the relevance of patient global assessment (PGA) in context of remission. METHODS: From an observational prospective RA database the first visit of patients, fulfilling just three of the four Boolean criteria was identified. Logistic regression and descriptive analyses were processed, also defining remission by index-based (Simplified Disease Activity Index (SDAI)) definition and comparing outcomes with the evaluator global assessment (EGA). RESULTS: 52% had at least one visit, fulfilling just three criteria (not fulfilled were: PGA 61%; swollen joints 20%; tender joints 13%; C-reactive-protein 7%). 67% of patients not fulfilling the PGA criterion had an EGA≤1 cm, 25% of those fulfilled the SDAI definition. Increased pain (OR=1.28), EGA (OR=1.10) and discrepancy towards higher PGA than EGA (OR=1.28) could explain PGA failure to reach remission. CONCLUSIONS:PGA is often the limiting factor for reaching remission; index-based remission showed balancing effects by adjusting for elevated variables in the summative score.
Authors: Laure Gossec; John Richard Kirwan; Maarten de Wit; Andra Balanescu; Cecile Gaujoux-Viala; Francis Guillemin; Anne-Christine Rat; Alain Saraux; Bruno Fautrel; Tore K Kvien; Maxime Dougados Journal: Clin Rheumatol Date: 2018-02-21 Impact factor: 2.980
Authors: Yvonne C Lee; Clifton O Bingham; Robert R Edwards; Wendy Marder; Kristine Phillips; Marcy B Bolster; Daniel J Clauw; Larry W Moreland; Bing Lu; Alyssa Wohlfahrt; Zhi Zhang; Tuhina Neogi Journal: Arthritis Care Res (Hoboken) Date: 2018-02 Impact factor: 4.794
Authors: Ethan T Craig; Jamie Perin; Scott Zeger; Jeffrey R Curtis; Vivian P Bykerk; Clifton O Bingham; Susan J Bartlett Journal: Arthritis Care Res (Hoboken) Date: 2020-11 Impact factor: 4.794
Authors: Björn Svensson; Maria L E Andersson; Sidona-Valentina Bala; Kristina Forslind; Ingiäld Hafström Journal: BMJ Open Date: 2013-09-10 Impact factor: 2.692