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- Title
Predicting Low Disease State and Remission in Early Rheumatoid Arthritis in the First Six Months, Comparing the Simplified Disease Activity Index and European League Against Rheumatism Response Measures: Results From an Early Arthritis Cohort.
- Authors
Omair, Mohammed A.; Keystone, Edward; Bykerk, Vivian; Lin, Daming; Xiong, Juan; Sun, Ye; Boire, Gilles; Thorne, J. Carter; Tin, Diane; Pope, Janet; Hitchon, Carol; Haraoui, Boulos; Akhavan, Pooneh S.; Canadian Early Arthritis Cohort Investigators
- Abstract
<bold>Objective: </bold>To compare the European League Against Rheumatism (EULAR) and Simplified Disease Activity Index 50% (SDAI50) response measures (RMs) and their impact on future response to treatment in patients with early rheumatoid arthritis (ERA).<bold>Methods: </bold>Biologic agent-naive ERA patients from the Canadian Early Arthritis Cohort study with complete data at baseline, 3, and 6 months were evaluated. Kappa statistics were used to evaluate the agreement between the EULAR (moderate or good response) and SDAI50 RMs. The RMs at 3 months were also compared for their ability to predict low disease activity state (LDAS) or remission (REM) at 6 months.<bold>Results: </bold>A total of 1,124 patients were evaluated. Of those, 215 patients (30%) and 294 patients (45%) failed to achieve a EULAR and SDAI50 response, respectively. There was a good agreement between EULAR and SDAI50 RMs with a kappa of 0.59 (95% confidence interval 0.53-0.66). Throughout the range of disease activity, the SDAI50 response was shown to be more stringent than the EULAR response. Multivariable linear regression analysis demonstrated that both RMs at 3 months were associated with LDAS or REM at 6 months, and SDAI50 had a more significant impact on this outcome compared to the EULAR response.<bold>Conclusion: </bold>There is a good agreement between the EULAR and SDAI50 RMs. Although a minority of patients have discordant RMs at each end of the disease activity spectrum at baseline, the SDAI50 response at 3 months appears to be a more significant predictor of outcomes at 6 months than EULAR response.
- Subjects
CANADA; RHEUMATOID arthritis diagnosis; COMPARATIVE studies; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MULTIVARIATE analysis; REGRESSION analysis; RESEARCH; RESEARCH evaluation; RHEUMATOID arthritis; TIME; EVALUATION research; DISEASE remission; SEVERITY of illness index; DISEASE progression
- Publication
Arthritis Care & Research, 2017, Vol 69, Issue 5, p737
- ISSN
2151-464X
- Publication type
journal article
- DOI
10.1002/acr.22983