Activity indices in rheumatoid arthritis

Objective. To determine which activity indices better correlate with assess or's (AGA) and patient's (PGA) global assessment of disease activity and to compare the improvement with American College of Rheumatology (ACR) and Eu ropean League Against Rheumatism (EULAR) criteria and their association wit h PGA and AGA of overall improvement. Methods. Seventy-five patients with rheumatoid arthritis (RA) were studied. Swollen and tender joints, morning stiffness, grip strength, pain, AGA, PG A, Health Assessment Questionnaire (HAQ) score, erythrocyte sedimentation r are (ESR), C-reactive protein (CPR), and hemoglobin were determined before and 6 months after treatment. Several activity indices were calculated: Dis ease Activity Score (DAS), DAS 3, DAS 28, DAS '28,' ACR greater than or equ al to 20%, Mallya, Riel, IDA, and a modification of the Stoke index. Results. All indices correlated with PGA and AGA before and after treatment (r > 0.38, p < 0.01), but better results were obtained with AGA than PGA. DAS, DAS 3, DAS 28, and modified Stoke had the best correlation with AGA (r <greater than or equal to> 0.77, p < 0.01). The indices that better detect ed the differences after treatment for AGA were DAS, DAS 3, DAS 28, and mod ified Stoke (r <greater than or equal to> -0.42, p < 0.01). The level of ag reement between EULAR and ACR improvement classifications with both reduced and extensive joint counts was comparable and its association with PCA and AGA overall improvement was significant (p < 0.01). Conclusion. All activity indices correlated with PGA and AGA, although the best results were: obtained with AGA. Although indices' correlations were s imilar, the DAS group and the modified Stoke seemed to be the most useful i ndices to measure disease activity in RA. The discriminating potential betw een ACR and EULAR improvement classification was comparable, as was the ass ociation with PGA and AGA overall improvement.