A Proposed Composite Disease Activity Score for Extra-articular Manifestations in Rheumatoid Arthritis
Published: October 1, 2019 | DOI: https://doi.org/10.7860/JCDR/2019/42346.13240
Bhaskar Thakur, Prasanta Padhan
1. Assistant Professor, Department of Biostatistics, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India.
2. Associate Professor, Department of Rheumatology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India.
Correspondence
Prasanta Padhan,
Department of Rheumatology, Kalinga Institue of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India.
E-mail: prasanta.padhan@gmail.com
Introduction: In Rheumatoid Arthritis (RA), extra-articular disease is single most important cause of morbidity and mortality. Although DAS-28 score is used for disease assessment in RA, extra-articular manifestations are not included in the same. Therefore an initial attempt was done for development of a composite Disease Assessment Score for Extra-Articular Manifestations (DAS-EAM) based on rheumatologists consensus.
Aim: The study was an initial attempt to make a composite disease assessment score for EAMs in RA.
Materials and Methods: A hospital based cross-sectional study done on 226 RA patients with various clinical parameters with waiting scores were included to develop the DAS-EAM score. This was compared with DAS-28 and Physician’s Global Assessment score and other demographic parameters and serology {RF, Anti-Cyclic Citrullinated Peptide (Anti-CCP)}. A Pearson’s correlation coefficient and Kappa agreement were calculated to find out the correlation as well as agreement between DAS-EAM score, Physician’s Global Assessment score and DAS-28 scores.
Results: Patient’s age was significantly different among the DAS-EAM score (p=0.001). Other parameters such as gender, duration of disease and serology were not significantly associated with DAS-EAM score. There was no agreement between DAS-28 and DAS EAM score.
Conclusion: Despite the major limitations such as single centered cross-sectional study design with small sample size, this is an initial attempt for development of a composite tool for extra-articular disease in RA.
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