Systemic Ama assessment and Clinical Disease Activity in patients with Amavata (Rheumatoid arthritis)

Objective assessment of disease severity is necessary during management and clinical studies of Amavata. Various validated instruments are available for measuring disease activity in Rheumatoid arthritis (RA). A validated instrument for systemic Ama assessment in Amavata (RA) measures Ama, but does not determine the disease activity in these cases. The Ama-score did not correlate well with the disease activity score (DAS) or erythrocyte sedimentation rate (ESR). We, therefore, used another composite score, viz. Clinical Disease Activity Index (CDAI) to assess its correlation with the Ama-score in patients with Amavata (RA). To evaluate the correlation between the Ama-score and CDAI in patients with Amavata (RA). CDAI and Ama-score were evaluated in two groups of patients with amavata (RA), Group A: treatment-naive patients (n = 13) and Group B: patients on treatment (n = 25) who are in remission. Ama-score was also assessed in apparently healthy volunteers without any overt symptoms, particularly gastrointestinal (Group C; n = 20). Spearman Rank Correlation was used for correlation between variables. Mann-Whitney U Test and Kruskal-Wallis Test were used for inter-group comparison. P value < 0.05 was considered significant. The median Ama-score and CDAI in Group A were 44 (12-76.5) and 32 (24-43), and those in Group B were 2 (0-22) and 0 (0-2), respectively. The difference in the Ama-score (P = < 0.0001) and CDAI (P = < 0.0001) between Groups A and B is significant. There was no significant difference between Group B and Group C (P > 0.05). There is a significant correlation between Ama-score and CDAI in these subjects (Spearman r 0.6447, P < 0.0001; 95 % CI 0.4012-0.8031). There is a good correlation between ama-score and CDAI. Ama-score and CDAI with additional joint assessment can be combined to develop an objective Ayurvedic tool that can be used for patient management and reporting clinical studies in amavata (RA).