Comparison of rheumatoid arthritis composite disease activity indices and residual activity in a Brazilian multicenter study- REAL study.

Autor: Santos IA; Universidade de São Paulo, Ribeirão Preto, Brazil., Donizeti Ribeiro de Oliveira R; Universidade de São Paulo, Ribeirão Preto, Brazil., Couto Luna Almeida S; Universidade de São Paulo, Ribeirão Preto, Brazil., Vargas-Santos AB; Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil., Balbino Chaves Amorim R; Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil., Monteiro Gomides AP; Universidade de Brasılia, Brasılia, Brazil., de Albuquerque CP; Universidade de Brasılia, Brasılia, Brazil., Barros Bertolo M; Universidade Estadual de Campinas, Campinas, Brazil., Brandão Resende Guimarães MF; Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., da Costa Pinto MR; Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Gomes Resende G; Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Dalva Neubarth Giorgi R; Hospital do Servidor Publico Estadual de São Paulo, São Paulo, Brazil., de Carvalho Saciloto N; Hospital do Servidor Publico Estadual de São Paulo, São Paulo, Brazil., Radominski SC; Universidade Federal do Paraná, Curitiba, Brazil., Borghi FM; Universidade Estadual de Maringá, Maringá, Brazil., Rossi Bonfiglioli K; Universidade de São Paulo, São Paulo, Brazil., Carrico da Silva H; Universidade de São Paulo, São Paulo, Brazil., de Fatima L da Cunha Sauma M; Universidade Federal do Para, Belém, Brazil., Alves Pereira I; Universidade Federal de Santa Catarina, Florianópolis, Brazil., Werner de Castro GR; Universidade do Sul de Santa Catarina-Unisul, Florianópolis, Brazil., Viegas Brenol C; Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Machado Xavier R; Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Maria Henrique Mota L; Universidade de Brasılia, Brasılia, Brazil., Louzada-Junior P; Universidade de São Paulo, Ribeirão Preto, Brazil., da Rocha Castelar-Pinheiro G; Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 Sep 29; Vol. 17 (9), pp. e0273789. Date of Electronic Publication: 2022 Sep 29 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0273789
Abstrakt: Introduction: Rheumatoid arthritis (RA) composite disease activity indices have become handy tools in daily clinical practice and crucial in defining remission or low disease activity, the main target of the RA treatment. However, there is no definition of the best index to assess disease activity in clinical practice.
Objectives: To compare the residual activity among the indices with the ACR/EULAR remission criteria (Boolean method) to identify the most feasible for assessing remission in daily practice, also considering correlation and concordance, sensibility, and specificity.
Patients and Methods: We selected 1116 patients with established RA from the real-life rheumatoid arthritis study database-REAL. The composite disease activity indices-DAS28-ESR, DAS28-CRP, SDAI, and CDAI-and their components were compared to the Boolean method to identify residual activity using binomial regression. The indices were analyzed for correlation and agreement using the Spearman index and weighted kappa. The chi-square test evaluated sensibility and specificity for remission based on the Boolean method.
Results: DAS28-CRP overestimated remission and confirmed higher residual activity than SDAI and CDAI. The indices showed good correlation and agreement, with a better relationship between SDAI and CDAI (k:0,88). CDAI and SDAI showed higher sensitivity and specificity for remission based on the Boolean method. CDAI was performed in 99% of patients, while DAS28 and SDAI were completed in approximately 85%.
Conclusions: Although all composite indices of activity can be used in clinical practice and showed good agreement, CDAI and SDAI have better performance in evaluating remission based on the Boolean method, showing less residual activity and higher sensibility and specificity. In addition, CDAI seems to be more feasible for disease activity evaluation in daily clinical practice, especially in developing countries.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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