Higher patient-reported disease activity may indicate higher DAS28-CRP in patients with RA

Patients with rheumatoid arthritis who self-reported higher disease activity than that reported in their physician’s assessment may indicate higher results on the DAS28-CRP, according to recently published research.

Researchers conducted an observational study of 66 patients newly diagnosed with rheumatoid arthritis (RA) between July 2008 and December 2010. Patients’ mean age was 56.4 years, and 66% of the patients were female. Initial treatment was methotrexate in 51% of patients, followed by hydroxychloroquine in 25% and prednisone in 58%.

John M. Davis

At baseline and again at 24 weeks, standard disease activity assessments were made by a single, independent joint assessor blind to treatment decisions. Discordance between patient and physician global assessments of disease activity on 0 to 100 mm VAS was defined as a 25 mm or greater difference and was analyzed using linear regression models adjusted for covariates such as age, sex, disease duration, rheumatoid factor, anti-citrullinated peptide antibodies, baseline tender or swollen joint counts, baseline C-reactive protein (CRP) level, initial disease-modifying anti-rheumatic drugs, use of prednisone and smoking status.

Patient-physician discordance was present in 27% of baseline visits, 10% of which were positive (patient-high) discordance and 17% of which were negative discordance.

After 24 weeks of therapy, the presence of positive patient-physician discordance was associated with higher DAS28-CRP, but negative discordance was not predictive of disease activity, according to the researchers. – by Shirley Pulawski

Reference:

Davis JM III, et al. Paper #428. Presented at: American College of Rheumatology Annual Meeting. Nov. 14-19, 2014; Boston.

Disclosures:

The authors report no relevant financial disclosures.