THU0631-HPR EARLY ARTHRITIS GLOBAL ASSESSMENT: WHAT DIFFERENCES EXIST BETWEEN PATIENTS AND PHYSICIANS?
Authors: C. Valero, S. C. Rodriguez-García, N. García Castañeda, J. P. Baldivieso, E. Patiño, A. Ortiz, I. González-Álvaro
Journal: Annals of the Rheumatic Diseases (2020)

Background: In recent years there is a growing interest in the assessment of rheumatoid arthritis through patient reported outcomes measures (PROMs). Nonetheless, discrepancies in the disease global disease assessment reported by patients (PtGA) or physicians (PhGA) have been previously described. Objectives: Our aim was to evaluate differences between PtGA and PhGA and their predictors in an early arthritis cohort. Methods: Cross-sectional study analyzing data from the baseline visit of patients included in the PEARL study (Princess Early Arthritis Register Longitudinal Study) in which demographic, laboratory and clinical characteristics including PtGA and PhGA (0-100 mm) are systematically collected. The main variable was the difference between PtGA and PhGA (ΔGA). The descriptive analysis was performed using the Kruskal-Wallis, Mann-Whitney or Pearson correlation tests as appropriate. A multivariate linear regression model was developed with ΔGA as a dependent variable. All those predictors available at the baseline visit reaching a p &lt;0.15 in the univariate analysis were included in the initial model. The final one was obtained through the progressive elimination of those variables not showing an improvement in the model as assessed by the adjusted R 2 parameter considering those that had a p&gt; 0.15. To categorize the dependent variable, differences between PtGA and PhGA were considered relevant when greater than 5 points. Results: 530 patients were included, 422 (79.6%) were women with a mean age of 55.3 +/- 16 years, 21.2% current smokers, 54% and 50.4% rheumatoid factor and anti-CCP positive respectively. A 43.3% had moderate activity and 33.6% high, measured by DAS28-VSG. The median of ΔGA was 4, (interquartile range; -10 to 18; see figure 1). In 22% of the cases patients and physicians scored the same, in 46.5% the patients’ scores were higher and physicians’ were so in 31.5% of the cases. The variables that explained ΔGA after adjusting the multivariate model were pain [β=0.36 (95%CI 0.28 to 0.44)], number of swollen joints [β= -3.19 (95%CI -3.7 to -2.7)] and ESR [β=-0.11 (95%CI -0.2 to -0.03)]. Pain had a greater influence on patients’ opinion while the number of swollen joints and ESR were more relevant for physicians. Other variables such as race, marital status, profession, sex, smoking, seropositivity or disease activity were not relevant in the prediction of ΔGA. Conclusion: In our cohort, disagreements between PtGA and PhGA were observed. Patients scored higher based on painful perception and physicians did so relying on objective evidence of inflammation. Disclosure of Interests: Cristina Valero: None declared, Sebastian C Rodriguez-García Speakers bureau: Novartis Farmaceutica, S.A., Merck Sharp &amp; Dohme España, S.A., Sanofi Aventis, UCB Pharma, Noelia García Castañeda: None declared, Juan Pablo Baldivieso: None declared, Esther Patiño: None declared, Ana Ortiz: None declared, Isidoro González-Álvaro Grant/research support from: Roche Laboratories, Consultant of: Lilly, Sanofi, Paid instructor for: Lilly, Speakers bureau: Abbvie, MSD, Roche, Lilly