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Composite Measures for Routine Clinical Practice in Psoriatic Arthritis: Testing of Shortened Versions in a UK
William Tillett1, Oliver FitzGerald2, Laura C Coates3
1W. Tillett, BSc, MBChB, PhD, FRCP, N.J. McHugh, MBChB, MD, FRCP, FRCPath, Department of Pharmacy and Pharmacology, University of Bath, and Royal National Hospital for Rheumatic Diseases, Bath, UK; w.tillett@nhs.net.
The Journal of Rheumatology. Supplement
|June 2, 2021
Summary
Shortened psoriatic arthritis measures using visual analog scales (VAS) demonstrated superior performance for assessing disease activity and treatment response in clinical practice. These simplified tools enhance detection of disease status and responsiveness compared to existing composite measures.
Area of Science:
- Rheumatology
- Clinical Trial Design
- Patient-Reported Outcomes
Background:
- Psoriatic arthritis (PsA) requires effective composite measures for routine clinical practice.
- Existing composite measures may be lengthy, posing challenges for frequent use.
- Development of shortened measures is crucial for efficient patient assessment.
Purpose of the Study:
- To evaluate shortened versions of psoriatic arthritis composite measures.
- To assess the utility of these measures in routine clinical practice.
- To compare the performance of shortened measures against established indices.
Main Methods:
- A UK multicenter observational study assessed clinical and patient-reported outcomes (PROMs) in PsA patients.
- Shortened Composite Psoriatic Arthritis Disease Activity Index (sCPDAI) and GRAPPA Composite Exercise (sGRACE) were developed.
- Measures were tested against DAS28, Disease Activity in Psoriatic Arthritis, and RAPID3 using t-score, SRM, and ES.
Main Results:
- Shortened GRACE (3VAS and 4VAS) showed higher standardized response means (SRM) (0.77 and 0.63) than CPDAI/sCPDAI (0.54/0.55).
- 3VAS and 4VAS demonstrated superior performance characteristics compared to sCPDAI, DAS28, Disease Activity in Psoriatic Arthritis, and RAPID3.
- GRAPPA members favored VAS scales for assessing disease and treatment response, recommending further testing of 3VAS and 4VAS.
Conclusions:
- Shortening the GRACE to VAS scores alone improves detection of disease status and treatment responsiveness.
- VAS-based measures exhibit superior performance characteristics among the tested composite tools.
- Further validation of 3VAS and 4VAS in observational and trial datasets is recommended.
