Activity indices in rheumatoid arthritis.

Area of Science:

• Rheumatology
• Clinical Assessment
• Disease Activity Measurement

Background:

• Rheumatoid arthritis (RA) management requires accurate assessment of disease activity.
• Global assessments by patients (PGA) and assessors (AGA) are crucial but need validation against objective indices.
• Standardized criteria like ACR and EULAR are used to define treatment response.

Purpose of the Study:

• To evaluate the correlation between various RA activity indices and both PGA and AGA.
• To compare the efficacy of improvement criteria (ACR/EULAR) in reflecting overall patient and assessor-reported outcomes.
• To identify the most reliable indices for measuring disease activity in RA.

Main Methods:

• Seventy-five RA patients were assessed before and after 6 months of treatment.
• Data collected included joint counts, morning stiffness, grip strength, pain, PGA, AGA, HAQ score, ESR, CRP, and hemoglobin.
• Calculated indices included DAS, DAS 3, DAS 28, and a modified Stoke index.

Main Results:

• All tested indices showed significant correlation with PGA and AGA (r > 0.38, p < 0.01), with AGA demonstrating stronger correlations.
• DAS, DAS 3, DAS 28, and modified Stoke index exhibited the highest correlation with AGA (r >= 0.77, p < 0.01).
• ACR and EULAR improvement classifications showed comparable agreement and significant association with overall PGA and AGA improvement (p < 0.01).

Conclusions:

• All RA activity indices correlate with patient and assessor global assessments, with AGA yielding superior results.
• The DAS group and modified Stoke index appear most effective for measuring RA disease activity.
• ACR and EULAR criteria demonstrate comparable ability to discriminate improvement and associate with overall global assessments.