Information de reference pour ce titreAccession Number: | 00000652-200906000-00031.
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Author: | Wells, G 1; Becker, J-C 2; Teng, J 2; Dougados, M 3; Schiff, M 4; Smolen, J 5; Aletaha, D 6; van Riel, P L C M 7
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Institution: | (1)Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada (2)Bristol-Myers Squibb, Princeton, New Jersey, USA (3)Paris-Descartes University, Medicine Faculty and UPRES-EA 4058, AP-HP, Cochin Hospital, Paris, France (4)University of Colorado, Denver, Colorado, USA (5)Second Department of Medicine, Hietzing Hospital, Vienna, Austria (6)Department of Rheumatology, Medical University of Vienna, Vienna, Austria (7)University Medical Centre, Nijmegen, The Netherlands
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Title: | Validation of the 28-joint Disease Activity Score (DAS28) and European League Against Rheumatism response criteria based on C-reactive protein against disease progression in patients with rheumatoid arthritis, and comparison with the DAS28 based on erythrocyte sedimentation rate.[Report]
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Source: | Annals of the Rheumatic Diseases. 68(6):954-960, June 2009.
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Abstract: | Objective: To validate and compare the definition of the Disease Activity Score 28 based on C-reactive protein (DAS28 (CRP)) to the definition based on erythrocyte sedimentation rate (ESR).
Methods: Data were analysed from two randomised, double-blind, placebo-controlled trials of abatacept of 6-month and 12-month duration in patients with rheumatoid arthritis. European League Against Rheumatism (EULAR) response criteria and the proportion of patients in remission (DAS28 <2.6) based on the two DAS28 definitions were examined. Trends in radiographic progression (erosion score, joint space narrowing score and total score) and physical function (Health Assessment Questionnaire Disability Index (HAQ-DI)) across the EULAR responder states (none, moderate and good) were analysed.
Results: There was general agreement in determining the EULAR responder state using both DAS28 definitions ([kappa] = 0.80, 95% CI 0.76 to 0.83). Overall, there was 82.4% agreement on the EULAR response criteria; when disagreements occurred, the DAS28 (CRP) yielded a better EULAR response more often then DAS28 (ESR) (12.6% vs 4.9%, respectively). There was also agreement in determining remission: [kappa] = 0.69 (95% CI 0.60 to 0.78). Radiographic progression decreased in patients treated with abatacept across EULAR states (from none to moderate to good) based on both definitions. For patients treated with placebo, the trend was not as pronounced, with radiographic scores higher for moderate vs non-responders. For physical function, similar trends were observed across the EULAR states for both DAS28 definitions.
Conclusions: The DAS28 (CRP) has been validated against radiographic progression and physical function. While the DAS28 (CRP) yielded a better EULAR response more often than the DAS28 (ESR), the validation profile was similar to the DAS28 (ESR), indicating that both measures are useful for assessing disease activity in patients with rheumatoid arthritis.
(C) 2009 BMJ Publishing Group Ltd and European League Against Rheumatism
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References: | 1. Felson DT, Anderson JJ, Boers M, Bombardier C, Furst D, Goldsmith C, et al. American College of Rheumatology. Preliminary definition of improvement in rheumatoid arthritis. Arthritis Rheum 1995;38:727-35.
2. van der Heijde DM, van't Hof MA, van Riel PL, Theunisse LA, Lubberts EW, van Leeuwen MA, et al. Judging disease activity in clinical practice in rheumatoid arthritis: first step in the development of a disease activity score. Ann Rheum Dis 1990;49:916-20.
3. Prevoo ML, van't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 1995;38:44-8.
4. Fransen J, van Riel PL. The Disease Activity Score and the EULAR response criteria. Clin Exp Rheumatol 2005;23:S93-9.
5. van Gestel AM, Haagsma CJ, van Riel PL. Validation of rheumatoid arthritis improvement criteria that include simplified joint counts. Arthritis Rheum 1998;41:1845-50.
6. Fransen J, van Riel PL. DAS remission cut points. Clin Exp Rheumatol 2006;24:S029-32.
7. UMC Nijmegen. DAS score. http://www.das-score.nl/- ouverture dans une nouvelle fenêtre (accessed 12 April 2007).
8. Prevoo ML, van Gestel AM, van THMA, van Rijswijk MH, van de Putte LB, van Riel PL. Remission in a prospective study of patients with rheumatoid arthritis. American Rheumatism Association preliminary remission criteria in relation to the disease activity score. Br J Rheumatol 1996;35:1101-5.
9. Vander Cruyssen B, Van Looy S, Wyns B, Westhovens R, Durez P, Van den Bosch F, et al. DAS28 best reflects the physician's clinical judgment of response to infliximab therapy in rheumatoid arthritis patients: validation of the DAS28 score in patients under infliximab treatment. Arthritis Res Ther 2005;7:R1063-71.
10. Smolen JS, Han C, Bala M, Maini RN, Kalden JR, van der Heijde D, et al. Evidence of radiographic benefit of treatment with infliximab plus methotrexate in rheumatoid arthritis patients who had no clinical improvement: a detailed subanalysis of data from the anti-tumor necrosis factor trial in rheumatoid arthritis with concomitant therapy study. Arthritis Rheum 2005;52:1020-30.
11. Weinblatt ME, Keystone EC, Furst DE, Kavanaugh AF, Chartash EK, Segurado OG. Long term efficacy and safety of adalimumab plus methotrexate in patients with rheumatoid arthritis: ARMADA 4 year extended study. Ann Rheum Dis 2006;65:753-9.
12. Fransen J, Welsing P, Keijzer Rd, Riel Pv. Disease Activity Scores using C-reactive protein: CRP may replace ESR in the assessment of RA disease activity. Ann Rheum Dis 2004;62:151.
13. Genovese MC, Becker JC, Schiff M, Luggen M, Sherrer Y, Kremer J, et al. Abatacept for rheumatoid arthritis refractory to tumor necrosis factor alpha inhibition. N Engl J Med 2005;353:1114-23.
14. Kremer JM, Genant HK, Moreland LW, Russell AS, Emery P, Abud-Mendoza C, et al. Effects of abatacept in patients with methotrexate-resistant active rheumatoid arthritis: a randomized trial. Ann Intern Med 2006;144:865-76.
15. Wells GA, Tugwell P, Kraag GR, Baker PR, Groh J, Redelmeier DA. Minimum important difference between patients with rheumatoid arthritis: the patient's perspective. J Rheumatol 1993;20:557-60.
16. Genant HK. Methods of assessing radiographic change in rheumatoid arthritis. Am J Med 1983;75:35-47.
17. Genant HK, Jiang Y, Peterfy C, Lu Y, Redei J, Countryman PJ. Assessment of rheumatoid arthritis using a modified scoring method on digitized and original radiographs. Arthritis Rheum 1998;41:1583-90.
18. Genant HK. Interleukin-1 receptor antagonist treatment of rheumatoid arthritis patients: radiologic progression and correlation of Genant/Sharp and Larsen scoring methods. Semin Arthritis Rheum 2001;30:26-32.
19. Kremer J, Genant H, Moreland L, Russell A, Emery P, Abud-Mendoza C, et al. Effects of abatacept in patients with active rheumatoid arthritis despite methotrexate: a randomized trial. Ann Intern Med 2006;144:865-76.
20. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307-10.
21. Wells G, Li T, Maxwell L, Maclean R, Tugwell P. Responsiveness of patient reported outcomes including fatigue, sleep quality, activity limitation, and quality of life following treatment with abatacept for rheumatoid arthritis. Ann Rheum Dis 2008;67:260-5.
22. Kushner I. C-reactive protein in rheumatology. Arthritis Rheum 1991;34:1065-8.
23. Inoue E, Yamanaka H, Hara M, Tomatsu T, Kamatani N. Comparison of Disease Activity Score (DAS)28-erythrocyte sedimentation rate and DAS28-C-reactive protein threshold values. Ann Rheum Dis 2007;66:407-9.
24. Matsui T, Kuga Y, Kaneko A, Nishino J, Eto Y, Chiba N, et al. Disease Activity Score 28 (DAS28) using CRP underestimates the disease activity and overestimates the EULAR response criteria compared with DAS28 using ESR in a large observational cohort of rheumatoid arthritis patients in Japan. Ann Rheum Dis 2007;66:1221-6.
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Language: | English.
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Document Type: | Extended report.
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Journal Subset: | Clinical Medicine.
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ISSN: | 0003-4967
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NLM Journal Code: | 0372355, 62w
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DOI Number: | https://dx.doi.org/10.1136/ard.2...- ouverture dans une nouvelle fenêtre
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