ARE ALL PARAMETERS OF DISEASE ACTIVITY SCORE RELIABLE FOR ASSESSING ACTIVITY OF RHEUMATOID ARTHRITIS IN TUNISIAN PATIENTS?

Background: Rheumatoid arthritis (RA) is an inflammatory chronic disease with varying signs and outcomes. A valid, reliable and sensitive assessment tool that is able to assess activity is essential in clinical practice. Currently, to assess the activity of RA a combination of clinical signs, subjective parameters and laboratory tests are used as for the Disease Activity Score (DAS). Objectives: Our aim from this study was to define which parameter is more correlated to disease activity in RA patients. Methods: A prospective study of Tunisian patients followed up for RA was conducted. Only patients with DAS 28 joints <5,1 were recruited. They were devised into 2 groups: G1: patients in remission (DAS28 <2,6) and G2: patients with active disease. We compared parameters which were essential to calculate the DAS: number of tender joints (NTJ), number of swelling joints (NSJ), the global assessment of disease activity by the patient (GAP) and the erythrocyte sedimentation rate (ESR). All of these findings were compared between the two groups. Significant difference was considered if the p value was <0,05. Results: Fifty patients were recruited, aged of an average of 50 years-old. Among them, 30 were in remission (G1) and 20 were not (G2). The mean DAS28 was 2,03 for G1 ranging from 1,13 to 2,6 and was 4,2 ranging from 3,1 to 5,1 for G2. The mean NTJ and NSJ were respectively 0,03 and 0,3 for G1 and 2,5 and 3,4 for G2. The difference was significant between the 2 groups for NTJ and NSJ (p<0,0001 and 0,001 respectively). The GAP was higher for G2 than for G1 (46,5 vs 7,5) but the difference was not significant (p=0,47). The ESR was significantly higher for G2 than for G1 (p=0,0015). Conclusions: Between parameters of the DAS28, NTJ, NSJ and ESR were well correlated to disease activity. However, the GAP, the only subjective parameter, didn't differ from RA in remission or in active disease. References: 1. Moya Alvarado P. Is DAS a Profitable Score to Be Used for Rheumatoid Arthritis Patient Follow Up? Rheumatology 211 2. Burkhard F. A comparison of patient questionnaires and composite indexes in routine care of rheumatoid arthritis patients. Joint Bone Spine 2009 Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2014-eular.5253Citation: Annals of the Rheumatic Diseases, volume 73, supplement 2, year 2014, page 899Session: Rheumatoid arthritis - prognosis, predictors and outcome (Abstracts accepted for publication )