Page 139 - THE EVOLUTION OF EARLY ARTHRITIS AND CARDIOVASCULAR RISK Samina A. Turk

PAIN, SLEEP AND EMOTIONAL WELL-BEING
clinical response and remission definitions were calculated, using the percentage of agreement as well as kappa values, according to the interpretation of Landis and Koch (<0 indicates no agreement, 0 to 0.2 slight, 0.21 to 0.40 fair, 0.41 to 0.60 moderate, 0.61 to 0.80 substantial and 0.81 to 1.0 as almost perfect agreement). Kappa can be interpreted as the percentage of agreement after correcting for chance(28;29). Third, analyses were performed in a subgroup of patients in physician-perceived remission. In this group, the differences between patients in and not in self-perceived remission, were assessed on several outcome measures: the improvement on clinical, laboratory and questionnaire data. This was analysed with the independent t-test (normal distribution) or the Mann-Whitney U test (skewed distribution). A p-value <0.05 was considered statistically significant, and all analyses were performed with SPSS software (version 21).
RESULTS
Total population
In total 84 patients with early RA of the ‘Early Arthritis Cohort’ were included. At baseline 10 patients did not complete the RAID questionnaire, and after 12 weeks three patients did not fill out the RAID questionnaire.
The mean (SD) age of the included patients was 50 (12) years, and 67% were female (Table 1). Mean (SD) DAS44 at baseline was 3.4 (1.2) and the seven questions on the RAID all had a median score between 4.0 and 7.0 at baseline. After 12 weeks of treatment, mean DAS44 (SD) improved to 1.4 (0.9) (p<0.01), and all questions on the RAID improved to a median score between 2.0 and 4.0 (p<0.01).
Patients who fulfil the different response and remission criteria 7 After 12 weeks of treatment, 65 patients (77%) reached an EULAR good response,
25 patients (30%) an ACR70 response and 23 patients (27%) were in Boolean-based remission (Additional file 1). Fifty-one patients (61%) reached DAS44 <1.6 and 50
patients (60%) had a HAQ score <0.5.
All analyses were repeated for a cut-off of VAS physician remission of ≤20 mm and showed similar results (data not shown) .
Remission according to the physician and patient
According to physician-perceived remission, 55 patients (66%) were in remission after 12 weeks of treatment.
Patients in self-perceived remission versus those not at week 12 (n=45, 54%) had a significantly lower DAS, tender joint count (TJC) and swollen joint count (SJC) of 44 joints and scored lower on all questions on the RAID (Table 1). The VAS physician was lower in patients who perceived themselves in remission, compared to those who did not 5.0
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