AB1368 The comparative responsiveness of hospital universitario princesa index and other composite indices for assessing rheumatoid arthritis activity
Authors: I. Gonzalez-Alvaro, I. Castrejon, L. Carmona
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> HUPI was developed with data from the PEARL study (Princess Early Arthritis Register Longitudinal study) as an easy to calculate index, which avoided the gender bias affecting DAS28 and SDAI. In addition, it can be calculated either with erythrocyte sedimentation rate (ESR), C reactive protein (CRP) or both. Response criteria based on HUPI have also been developed<sup>1</sup>. <h3>Objectives</h3> To evaluate the responsiveness of the Hospital Universitario La Princesa Index (HUPI) comparatively to the traditional composite indices to assess disease activity in rheumatoid arthritis (RA), and to compare the performance of HUPI-based response criteria with that of the EULAR response criteria. <h3>Methods</h3> Post-hoc analyses were performed using data from the following studies: ACT-RAY (clinical trial), PROAR (early RA cohort) and EMECAR (pre-biologic era long term RA cohort). Responsiveness was evaluated by: 1) comparing change from baseline (Δ) of HUPI with Δ in other scores by calculating correlation coefficients; 2) calculating standardised effect sizes. The accuracy of response by HUPI and by EULAR criteria was analysed using linear regressions in which the dependent variable was change in global assessment by physician (ΔGDA-Phy). <h3>Results</h3> ΔHUPI correlation with change in all other indices ranged from 0.387 to 0.791); HUPI's standardised effect size was larger than those from the other indices in each database used. In ACT-RAY, depending on visit between 65% and 80% of patients were equally classified by HUPI and EULAR response criteria. However, HUPI criteria were slightly more stringent, with higher percentage of patients classified as non-responder, especially at early visits. HUPI response criteria showed a slightly higher accuracy than EULAR response criteria when using ΔGDA-Phy as gold standard. <h3>Conclusions</h3> HUPI shows good responsiveness in each studied scenario (clinical trial, early RA cohort, and established RA cohort). Response criteria by HUPI seem more stringent than EULAR's. <h3>Reference</h3> [1] Gonzalez-Alvaro I, Castrejon I, Ortiz AM, Toledano E, Castaneda S, Garcia-Vadillo A, et al. Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI) and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis. PLoS One. 2016;11(9):e0161727. <h3>Acknowledgements</h3> We are endebted to the Roche laboratory for the transfer of the ACT-RAY trial data and to the Spanish Rheumatology Society for the transfer of data from the EMECAR and PROAR projects. Without the work of all the researchers who participated in these three projects, this work could not have been developed. This work has been supported by project PI14/00442 to IG-A from the Ministry of Economy and Competitiveness (Carlos III Health Institute) and co-financed with the European Fund for Regional Development (FEDER). <h3>Disclosure of Interest</h3> I. Gonzalez-Alvaro Grant/research support from: UCB, Roche., Consultant for: Lilly, Pfizer, BMS, Sanofi, Speakers bureau: Abbvie, Lilly, UCB, SER, I. Castrejon: None declared, L. Carmona: None declared