ARE PATIENT REPORTED OUTCOMES (PROS) COMPARABLE AMONG PATIENTS FROM DIFFERENT ECONOMIC/SOCIO-CULTURAL ENVIRONMENTS?

Background: Patient reported outcomes (PROs) in the Core Data Set for rheumatoid arthritis (RA) include physical function, pain, and global health (GH). An index of these measures, RAPID3, distinguishes active from control treatment in clinical trials involving traditional and biologic therapies at levels similar to the DAS28 and CDAI. Higher age and female gender are associated with higher values of PROs. Objectives: To analyze whether different economic/socio-cultural environments influence PROs in a multinational database of RA. Methods: Quantitative Standard Monitoring of Patients with RA (QUEST-RA) includes 8,039 patients (80% females, mean age 56yr, mean disease duration 11yr) in 86 sites in 32 countries in December 2009, of which 16 have high gross domestic product (GDP) (>24K USD per capita) and 16 low-GDP (<11K USD). DAS28(3) (0-9.4) was calculated for disease activity without GH. PROs included HAQ (0-3) for physical function, and 0-10cm visual analog scales for pain and GH, and are presented as RAPID3 (0-10). A possible association of DAS28(3) and RAPID3 was analyzed using regression models separately in rich and poor countries, adjusted for age, gender, and number of comorbidities. Results: Different PROs and their index RAPID3 were all associated significantly with DAS28(3) similarly in rich and poor countries. At each DAS28(3) level, RAPID3 was similar regardless of environment (Figure 1). An adjusted beta coefficient was 0.73 (0.70-0.77) for rich and 0.78 (0.73 to 0.82) for poor countries, p=0.19. Figure 1. An estimated regression line (95%CI) of RAPID3 against DAS28(3) in rich and poor countries in QUEST-RA. Conclusion: PROs including physical function, pain, and GH appear to perform similarly in different environments in relation to disease activity. Disclosure of Interest: None declaredCitation: Annals of the Rheumatic Diseases, volume 69, supplement 3, year 2010, page 502Session: Rheumatoid arthritis – prognosis, predictors and outcome (Poster Presentations )