Use of Disease Activity Score (DAS28) and Routine Assessment of Patient Index Data 3 (RAPID3) for Assessment of Rheumatoid Arthritis Disease Activity, in the Indian Setting

摘要

Introduction: Patient outcomes in rheumatoid arthritis (RA) have significantlyimproved with the advent of disease modifying anti rheumatic drugs and thenewer biological agents. Various scoring systems available for monitoring diseaseactivity in RA have not yet been put into full use in patient management in India.We aim to study the disease activity score 28 (DAS28) and Routine assessment ofpatient index 3 (RAPID3), their correlation and patient outcomes in RA.Materials and Methods: The study was conducted between March 2011-May2011. A total of 81 patients were included. Patient’s history was noted. Clinicalexamination for tender and swollen joint counts was performed. DAS28 wascalculated. MDHAQ was administered to each patient in a language theyunderstood and responses noted. Correlation between DAS28 and RAPID3 wasstudied using Pearson’s correlation coefficient.Results: RAPID3 and DAS28 showed Pearson’s correlation coefficient of 0.8699(p0.001). Of the 53 patients who met with DAS28 severity criteria of 5.1, 82.7%showed similar results with RAPID3 suggesting severe disease activity. (X2 =33.512 and p0.001). A greater proportion of those whose DMARD initiation was2 years after disease onset, had higher disease activity as compared to thosewith earlier initiation.Conclusion: Early diagnosis and immediate initiation of aggressive DMARDtherapy should be the protocol. Regular patient outcome assessment using eitherof the two proposed scoring systems can be a good adjunct to physician’s clinicaljudgment in treatment decisions.