TY - JOUR
T1 - P280 Clinical burden of concomitant joint disease in psoriasis: a US-linked claims and electronic medical records database analysis
T2 - Do patient-reported swollen and tender joints match clinical and ultrasonography findings?
AU - Tillett, William
AU - Skornicki, Michelle
AU - Prince, Patricia
AU - Suruki, Robert
AU - Lee, Edward
AU - Louder, Anthony
N1 - Funding Information:
Funding: This work was supported by research grants from the Danish Rheumatism Association, University of Southern Denmark, The Region of Southern Denmark, Knud og Edith Eriksens Mindefond.
Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
PY - 2020/4/20
Y1 - 2020/4/20
N2 - Objectives: To investigate how patient-reported flares in RA are related to clinical joint examination and inflammation detected by US. Methods: Eighty RA patients with DAS28-CRP <3.2 and no swollen joints at baseline were followed for 1 year. In case of patient-reported hand flare with swollen and tender joints (SJ and TJ, respectively), patients underwent clinical examination for SJ/TJ and US of bilateral wrists, MCP and PIP 1st-5th, six extensor tendon compartments and wrist flexor tendons for synovitis/tenosynovitis. Percentage agreement and kappa were calculated between patient-reported SJ and TJ, clinical examination for SJ/TJ and US findings indicative of inflammation. With US as reference, sensitivity, specificity, positive/negative predictive value and accuracy of patient-reported and clinically examined joints were determined. Results: Hand flare was reported by 36% (29/80) of patients. At time of flare, all clinical and ultrasonographic measures of disease activity deteriorated compared with baseline. Agreement between patient-reported SJ/TJ, clinically examined SJ/TJ and US was slight (kappa = 0.02-0.20). Patients and clinicians agreed in 79-93% of joints, more frequently on SJ than TJ. With US as reference, specificities were 86-100% and 88-100%, and sensitivities 12-34% and 4-32% for patient-reported SJ/TJ and clinically examined SJ/TJ, respectively. Conclusion: Over 12 months of follow-up, hand flare was reported by every third RA patient. Self-reported flares were associated with increased disease activity as determined by clinical examination and US. Patient-reported joint assessment may aid in capturing flares between routine clinical visits.
AB - Objectives: To investigate how patient-reported flares in RA are related to clinical joint examination and inflammation detected by US. Methods: Eighty RA patients with DAS28-CRP <3.2 and no swollen joints at baseline were followed for 1 year. In case of patient-reported hand flare with swollen and tender joints (SJ and TJ, respectively), patients underwent clinical examination for SJ/TJ and US of bilateral wrists, MCP and PIP 1st-5th, six extensor tendon compartments and wrist flexor tendons for synovitis/tenosynovitis. Percentage agreement and kappa were calculated between patient-reported SJ and TJ, clinical examination for SJ/TJ and US findings indicative of inflammation. With US as reference, sensitivity, specificity, positive/negative predictive value and accuracy of patient-reported and clinically examined joints were determined. Results: Hand flare was reported by 36% (29/80) of patients. At time of flare, all clinical and ultrasonographic measures of disease activity deteriorated compared with baseline. Agreement between patient-reported SJ/TJ, clinically examined SJ/TJ and US was slight (kappa = 0.02-0.20). Patients and clinicians agreed in 79-93% of joints, more frequently on SJ than TJ. With US as reference, specificities were 86-100% and 88-100%, and sensitivities 12-34% and 4-32% for patient-reported SJ/TJ and clinically examined SJ/TJ, respectively. Conclusion: Over 12 months of follow-up, hand flare was reported by every third RA patient. Self-reported flares were associated with increased disease activity as determined by clinical examination and US. Patient-reported joint assessment may aid in capturing flares between routine clinical visits.
KW - flares
KW - patient-reported outcomes
KW - rheumatoid arthritis
KW - ultrasonography
UR - http://www.scopus.com/inward/record.url?scp=85076449395&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/kez231
DO - 10.1093/rheumatology/kez231
M3 - Meeting abstract
VL - 59
SP - 129
EP - 136
JO - Rheumatology
JF - Rheumatology
SN - 1462-0324
IS - 1
M1 - P280
ER -