Association of seventeen definitions of remission with functional status in a large clinical practice cohort of patients with rheumatoid arthritis
Objective: To compare the association between different remission criteria and physical function in rheumatoid arthritis patients followed in clinical practice. Methods: Longitudinal data from the METEOR database were used. Seventeen definitions of remission were tested: ACR/EULAR Boolean-based; Si...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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The Journal of Rheumatology Publishing Company
2020
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| Online Access: | http://eprints.uanl.mx/25403/7/25403.pdf |
| _version_ | 1824420200871624704 |
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| author | Carvalho, Danilo O. O. Ferreira, Ricardo J. Landewé, Robert Vega Morales, David Salomon Escoto, Karen Veale, Douglas J. Chopra, Arvind Da Silva, José A. P Machado, Pedro M. |
| author_facet | Carvalho, Danilo O. O. Ferreira, Ricardo J. Landewé, Robert Vega Morales, David Salomon Escoto, Karen Veale, Douglas J. Chopra, Arvind Da Silva, José A. P Machado, Pedro M. |
| author_sort | Carvalho, Danilo O. |
| collection | Repositorio Institucional |
| description | Objective: To compare the association between different remission criteria and physical function in rheumatoid arthritis patients followed in clinical practice.
Methods: Longitudinal data from the METEOR database were used. Seventeen definitions of remission were tested: ACR/EULAR Boolean-based; Simplified/Clinical Disease Activity Index (SDAI/CDAI); and fourteen Disease Activity Score (DAS)-based definitions. Health Assessment Questionnaire (HAQ)≤0.5 was defined as good functional status. Associations were investigated using generalised estimating equations (GEE). Potential confounders were tested and sensitivity analyses performed.
Results: Data from 32,915 patients (157,899 visits) were available. The most stringent definition of remission was the ACR/EULAR Boolean-based definition (1.9%). The proportion of patients with HAQ≤0.5 was higher for the most stringent definitions, although it never reached 100%. However, this also meant that, for the most stringent criteria, many patients in non-remission had HAQ≤0.5. All remission definitions were associated with better function, with the strongest degree of association observed for the SDAI (adjusted OR (95% CI): 3.36 (3.01-3.74)). However, only minor differences were noted between definitions (range of adjusted OR 1.99 to 3.36). Sensitivity analyses yield similar results.
Conclusions: The seventeen definitions of remission confirmed their validity against physical function in a large international clinical practice setting. Achievement of remission, according to any of the indices may be more important than the use of a specific index. A multidimensional approach, targeted at wider goals than disease control, is necessary to help all patients achieve the best possible functional status. |
| format | Article |
| id | eprints-25403 |
| institution | UANL |
| language | English |
| publishDate | 2020 |
| publisher | The Journal of Rheumatology Publishing Company |
| record_format | eprints |
| spelling | eprints-254032023-04-28T18:18:03Z http://eprints.uanl.mx/25403/ Association of seventeen definitions of remission with functional status in a large clinical practice cohort of patients with rheumatoid arthritis Carvalho, Danilo O. O. Ferreira, Ricardo J. Landewé, Robert Vega Morales, David Salomon Escoto, Karen Veale, Douglas J. Chopra, Arvind Da Silva, José A. P Machado, Pedro M. RA Aspectos Públicos de la Medicina Objective: To compare the association between different remission criteria and physical function in rheumatoid arthritis patients followed in clinical practice. Methods: Longitudinal data from the METEOR database were used. Seventeen definitions of remission were tested: ACR/EULAR Boolean-based; Simplified/Clinical Disease Activity Index (SDAI/CDAI); and fourteen Disease Activity Score (DAS)-based definitions. Health Assessment Questionnaire (HAQ)≤0.5 was defined as good functional status. Associations were investigated using generalised estimating equations (GEE). Potential confounders were tested and sensitivity analyses performed. Results: Data from 32,915 patients (157,899 visits) were available. The most stringent definition of remission was the ACR/EULAR Boolean-based definition (1.9%). The proportion of patients with HAQ≤0.5 was higher for the most stringent definitions, although it never reached 100%. However, this also meant that, for the most stringent criteria, many patients in non-remission had HAQ≤0.5. All remission definitions were associated with better function, with the strongest degree of association observed for the SDAI (adjusted OR (95% CI): 3.36 (3.01-3.74)). However, only minor differences were noted between definitions (range of adjusted OR 1.99 to 3.36). Sensitivity analyses yield similar results. Conclusions: The seventeen definitions of remission confirmed their validity against physical function in a large international clinical practice setting. Achievement of remission, according to any of the indices may be more important than the use of a specific index. A multidimensional approach, targeted at wider goals than disease control, is necessary to help all patients achieve the best possible functional status. The Journal of Rheumatology Publishing Company 2020-01 Article PeerReviewed text en cc_by_nc_nd http://eprints.uanl.mx/25403/7/25403.pdf http://eprints.uanl.mx/25403/7.haspreviewThumbnailVersion/25403.pdf Carvalho, Danilo O. y O. Ferreira, Ricardo J. y Landewé, Robert y Vega Morales, David y Salomon Escoto, Karen y Veale, Douglas J. y Chopra, Arvind y Da Silva, José A. P y Machado, Pedro M. (2020) Association of seventeen definitions of remission with functional status in a large clinical practice cohort of patients with rheumatoid arthritis. The Journal of Rheumatology, 47 (1). pp. 1-214. ISSN 0315-162X https://doi.org/10.3899/jrheum.181286 |
| spellingShingle | RA Aspectos Públicos de la Medicina Carvalho, Danilo O. O. Ferreira, Ricardo J. Landewé, Robert Vega Morales, David Salomon Escoto, Karen Veale, Douglas J. Chopra, Arvind Da Silva, José A. P Machado, Pedro M. Association of seventeen definitions of remission with functional status in a large clinical practice cohort of patients with rheumatoid arthritis |
| thumbnail | https://rediab.uanl.mx/themes/sandal5/images/online.png |
| title | Association of seventeen definitions of remission with functional status in a large clinical practice cohort of patients with rheumatoid arthritis |
| title_full | Association of seventeen definitions of remission with functional status in a large clinical practice cohort of patients with rheumatoid arthritis |
| title_fullStr | Association of seventeen definitions of remission with functional status in a large clinical practice cohort of patients with rheumatoid arthritis |
| title_full_unstemmed | Association of seventeen definitions of remission with functional status in a large clinical practice cohort of patients with rheumatoid arthritis |
| title_short | Association of seventeen definitions of remission with functional status in a large clinical practice cohort of patients with rheumatoid arthritis |
| title_sort | association of seventeen definitions of remission with functional status in a large clinical practice cohort of patients with rheumatoid arthritis |
| topic | RA Aspectos Públicos de la Medicina |
| url | http://eprints.uanl.mx/25403/7/25403.pdf |
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