Comparison of rheumatoid arthritis composite disease activity indices and residual activity in a Brazilian multicenter study - REAL study

Detalhes bibliográficos
Autor(a) principal: Santos, Isabela Araujo
Data de Publicação: 2022
Outros Autores: Brenol, Claiton Viegas, Xavier, Ricardo Machado, Pinheiro, Geraldo da Rocha Castelar
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UFRGS
Texto Completo: http://hdl.handle.net/10183/265629
Resumo: Introduction: 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.
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spelling Santos, Isabela AraujoBrenol, Claiton ViegasXavier, Ricardo MachadoPinheiro, Geraldo da Rocha Castelar2023-10-03T03:36:10Z20221932-6203http://hdl.handle.net/10183/265629001176070Introduction: 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.application/pdfengPloS one. San Francisco. Vol. 17, no. 9 (Sept. 2022), e0273789, 16 p.Artrite reumatóideDiagnósticoBases de dados factuaisProgressão da doençaComparison of rheumatoid arthritis composite disease activity indices and residual activity in a Brazilian multicenter study - REAL studyEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001176070.pdf.txt001176070.pdf.txtExtracted Texttext/plain53925http://www.lume.ufrgs.br/bitstream/10183/265629/2/001176070.pdf.txt2d2b7cdebafd61634a67bea63b82acaeMD52ORIGINAL001176070.pdfTexto completo (inglês)application/pdf838155http://www.lume.ufrgs.br/bitstream/10183/265629/1/001176070.pdf81deeef07657b4c7c62fb4174481e707MD5110183/2656292023-10-04 03:39:29.694498oai:www.lume.ufrgs.br:10183/265629Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-10-04T06:39:29Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false
dc.title.pt_BR.fl_str_mv Comparison of rheumatoid arthritis composite disease activity indices and residual activity in a Brazilian multicenter study - REAL study
title Comparison of rheumatoid arthritis composite disease activity indices and residual activity in a Brazilian multicenter study - REAL study
spellingShingle Comparison of rheumatoid arthritis composite disease activity indices and residual activity in a Brazilian multicenter study - REAL study
Santos, Isabela Araujo
Artrite reumatóide
Diagnóstico
Bases de dados factuais
Progressão da doença
title_short Comparison of rheumatoid arthritis composite disease activity indices and residual activity in a Brazilian multicenter study - REAL study
title_full Comparison of rheumatoid arthritis composite disease activity indices and residual activity in a Brazilian multicenter study - REAL study
title_fullStr Comparison of rheumatoid arthritis composite disease activity indices and residual activity in a Brazilian multicenter study - REAL study
title_full_unstemmed Comparison of rheumatoid arthritis composite disease activity indices and residual activity in a Brazilian multicenter study - REAL study
title_sort Comparison of rheumatoid arthritis composite disease activity indices and residual activity in a Brazilian multicenter study - REAL study
author Santos, Isabela Araujo
author_facet Santos, Isabela Araujo
Brenol, Claiton Viegas
Xavier, Ricardo Machado
Pinheiro, Geraldo da Rocha Castelar
author_role author
author2 Brenol, Claiton Viegas
Xavier, Ricardo Machado
Pinheiro, Geraldo da Rocha Castelar
author2_role author
author
author
dc.contributor.author.fl_str_mv Santos, Isabela Araujo
Brenol, Claiton Viegas
Xavier, Ricardo Machado
Pinheiro, Geraldo da Rocha Castelar
dc.subject.por.fl_str_mv Artrite reumatóide
Diagnóstico
Bases de dados factuais
Progressão da doença
topic Artrite reumatóide
Diagnóstico
Bases de dados factuais
Progressão da doença
description Introduction: 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.
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dc.relation.ispartof.pt_BR.fl_str_mv PloS one. San Francisco. Vol. 17, no. 9 (Sept. 2022), e0273789, 16 p.
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