Journal Article

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

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

2024

Overview

ObjectivesTo 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).MethodsRA 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.Results4594 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.ConclusionA 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 numbersISRCTN26791028, NTR2754.

• Publisher: EULAR,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Adult / Aged / Arthritis, Psoriatic - complications / Arthritis, Psoriatic - diagnosis / Arthritis, Psoriatic - psychology / Arthritis, Rheumatoid - complications / Arthritis, Rheumatoid - diagnosis / Clinical outcomes / Fatigue - diagnosis / Fatigue - etiology / Female / Humans / Inflammatory Arthritis / Male / Mass Screening - methods / Middle Aged / Original Research / Pain / Patient Reported Outcome Measures / Patients / Presenteeism / Psoriatic arthritis / Quality of Life / Questionnaires / Remission (Medicine) / Rheumatoid arthritis / Rheumatology / Severity of Illness Index / Surveys and Questionnaires / TNF inhibitors