In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 9 ( 2022-9-29), p. e0273789-
Abstract:
Rheumatoid arthritis (RA) composite disease activity indices have become handy tools in daily clinical practice and crucial in defining remission or low disease activity, the main target of the RA treatment. However, there is no definition of the best index to assess disease activity in clinical practice. Objectives To compare the residual activity among the indices with the ACR/EULAR remission criteria (Boolean method) to identify the most feasible for assessing remission in daily practice, also considering correlation and concordance, sensibility, and specificity. Patients and methods We selected 1116 patients with established RA from the real-life rheumatoid arthritis study database—REAL. The composite disease activity indices—DAS28-ESR, DAS28-CRP, SDAI, and CDAI–and their components were compared to the Boolean method to identify residual activity using binomial regression. The indices were analyzed for correlation and agreement using the Spearman index and weighted kappa. The chi-square test evaluated sensibility and specificity for remission based on the Boolean method. Results DAS28-CRP overestimated remission and confirmed higher residual activity than SDAI and CDAI. The indices showed good correlation and agreement, with a better relationship between SDAI and CDAI ( k :0,88). CDAI and SDAI showed higher sensitivity and specificity for remission based on the Boolean method. CDAI was performed in 99% of patients, while DAS28 and SDAI were completed in approximately 85%. Conclusions Although all composite indices of activity can be used in clinical practice and showed good agreement, CDAI and SDAI have better performance in evaluating remission based on the Boolean method, showing less residual activity and higher sensibility and specificity. In addition, CDAI seems to be more feasible for disease activity evaluation in daily clinical practice, especially in developing countries.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0273789
DOI:
10.1371/journal.pone.0273789.g001
DOI:
10.1371/journal.pone.0273789.g002
DOI:
10.1371/journal.pone.0273789.t001
DOI:
10.1371/journal.pone.0273789.t002
DOI:
10.1371/journal.pone.0273789.t003
DOI:
10.1371/journal.pone.0273789.t004
DOI:
10.1371/journal.pone.0273789.t005
DOI:
10.1371/journal.pone.0273789.t006
DOI:
10.1371/journal.pone.0273789.t007
DOI:
10.1371/journal.pone.0273789.t008
DOI:
10.1371/journal.pone.0273789.t009
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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