Patient-derived joint counts are a potential alternative for determining Disease Activity Score

Area of Science:

• Rheumatology
• Clinical Trials
• Biostatistics

Background:

• Rheumatoid arthritis (RA) management relies on accurate disease activity assessment.
• The Disease Activity Score using a 28-joint count (DAS28) is a standard measure.
• Patient-reported outcomes are increasingly recognized for their value in clinical practice.

Purpose of the Study:

• To evaluate the correlation between physician-derived DAS28 and patient-derived DAS28 (Pt-DAS28) in RA patients.
• To determine if patient joint counts can reliably assess RA disease activity.
• To assess the agreement in disease activity classification and treatment response between DAS28 and Pt-DAS28.

Main Methods:

• Analysis of data from a multicenter, open-label study of etanercept (ETN) in RA patients.
• Independent joint counts (tender and swollen) performed by physicians and patients at baseline, Week 12, and Week 24.
• Patients received training for performing joint assessments.

Main Results:

• A significant correlation (r >= 0.57) was observed between DAS28 and Pt-DAS28 throughout the study.
• Disease activity classification agreement between DAS28 and Pt-DAS28 was 72% (kappa = 0.55) at Week 24.
• European League Against Rheumatism (EULAR) response rates showed good concordance: 78% for DAS28 vs. 72% for Pt-DAS28 at Week 24.

Conclusions:

• Patient-derived joint counts demonstrate a strong correlation with physician assessments in RA.
• Pt-DAS28 shows potential as a valid tool for assessing RA disease activity and treatment response.
• Incorporating patient-reported joint counts may enhance routine RA monitoring and patient care.