New indicator for discordance between patient-reported and traditional disease activity outcomes in patients with early Rheumatoid Arthritis

Sofia Pazmino, Anikó Lovik, Annelies Boonen, Diederik De Cock, Veerle Stouten, Johan Joly, Michaël Doumen, Delphine Bertrand, René Westhovens, Patrick Verschueren

Onderzoeksoutput: Articlepeer review

6 Citaten (Scopus)
1 Downloads (Pure)


OBJECTIVE: To unravel disease impact in early RA by separately quantifying patient-reported (PRF), clinical (CF) and laboratory (LF) factors. We propose a new indicator, the discordance score (DS), for early identification and prediction of patient's unmet needs and of future achievement of sustained remission (SR) and RA-related quality of life (QoL). METHODS: Factor-scores obtained by factor analysis in the CareRA trial, allowed to compute DS, reflecting the difference between PRF and the mean of CF and LF. Improvement from baseline to week 104 (%) and area-under-the-curve (AUC) across time points per factor-score were calculated and compared between patients achieving/not achieving sustained (week 16-104) remission (DAS28CRP < 2.6) with ANOVA. Logistic and linear regressions were used to predict SR based on previous factor and discordance scores, and QoL at year 1 and 2 based on DS at week 16. RESULTS: PRF, CF and LF scores improved rapidly within 8 weeks. PRF improved 57%, CF 90% and LF 27%, in those achieving SR, compared with 32% (PRF: P = 0.13), 77% (CF: P < 0.001) and 9% (LF: P = 0.36) in patients not achieving SR. Patients achieving SR had an AUC of 15.7, 3.4 and 4.8 for PRF, CF and LF, respectively, compared with 33.2, 10.1 and 7.2 in participants not achieving SR (P < 0.001 for all). Early discordance was associated with later factor scores, QoL and self-efficacy. CONCLUSIONS: All factor scores improved rapidly, especially in patients achieving sustained remission. Patient-reported burden improved less. Discordance scores could help predicting the need for additional non-pharmacological interventions to achieve sustained remission and decrease disease impact.

Originele taal-2English
Pagina's (van-tot)108-115
Aantal pagina's8
TijdschriftRheumatology (Oxford, England)
Nummer van het tijdschrift1
Vroegere onlinedatum13 apr 2022
StatusPublished - 1 jan 2023

Bibliografische nota

Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.

Copyright 2023 Elsevier B.V., All rights reserved.


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