RMD Open (Oct 2024)

Combining patient-reported outcome measures to screen for active disease in rheumatoid arthritis and psoriatic arthritis

  • Annette H M van der Helm-van Mil,
  • Pascal H P de Jong,
  • Paco M J Welsing,
  • Ilja Tchetverikov,
  • Jolanda J Luime,
  • Marijn Vis,
  • Marc R Kok,
  • Paul Baudoin,
  • Lindy-Anne Korswagen,
  • Selinde V J Snoeck Henkemans,
  • Agnes E M Looijen,
  • Gonul Hazal Koc

DOI
https://doi.org/10.1136/rmdopen-2024-004687
Journal volume & issue
Vol. 10, no. 4

Abstract

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Objectives To investigate whether a combination of general health (Visual Analogue Scale (VAS)), Health Assessment Questionnaire-Disability Index (HAQ-DI), pain (VAS/Numerical Rating Scale (NRS)), quality of life (EQ-5D), fatigue (VAS/NRS) and presenteeism (0%–100% productivity loss) could aid as a screening tool to detect active disease in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA).Methods RA patients from the tREACH trial and TARA trial (n=683) and PsA patients from the DEPAR cohort (n=525) were included. The association of a deterioration in the aforementioned patient-reported outcome measure (PROM) scores between two consecutive visits and having active disease was assessed. Active disease was defined as a change from disease activity score (DAS) ≤2.4 to DAS >2.4 in RA or Disease Activity Index in Psoriatic Arthritis (DAPSA) ≤14 to DAPSA >14 in PsA. The area under the curve (AUC) of the sum score of deteriorated PROMs was evaluated.Results 4594 RA and 1154 PsA visits were evaluated and active disease occurred in 358 (8%) RA and 177 (15%) PsA visits. In both RA and PsA, a deterioration in general health (VAS), HAQ-DI, EQ-5D and pain (VAS/NRS) was significantly associated with active disease. The combination of these PROMs showed acceptable to excellent discriminative ability (RA AUC=0.76, PsA AUC=0.85). If a cut-point of ≥1 deteriorated PROMs is used, 40% of the visits in which RA patients have remission or low disease activity are correctly specified (specificity of 40%), while 10% of visits with active disease are overlooked (sensitivity of 90%). In PsA, these percentages are 41% and 4%, respectively.Conclusion A combination of general health, HAQ-DI, EQ-5D and pain could aid as a screening tool for active disease in patients with RA and PsA. These data could help facilitate remote monitoring of RA and PsA patients in the future.Trial registration numbers ISRCTN26791028, NTR2754.