THU0132 The patient global assessment rating varies minimally if using arthritis or global health condition and agreement is high between common composite disease activitymeasures and remission classification using either: results from a national early ra cohort study
Authors: V.P. Bykerk, O. Schieir, M.-F. Valois, E.C. Keystone, G. Boire, J.E. Pope, D. Tin, B. Haraoui, C. Hitchon, C. Thorne, S.J. Bartlett
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The patient global assessment (PtGA) is a core domain in several RA composite disease activity (CDA) measures for trials, treat-to-target paradigms and practice, and can be asked differently, either referring to the patient’s global health or condition (PtGA-GH), or specifically to arthritis disease activity (PtGA-AR). <h3>Objectives</h3> To assess agreement between PtGA-GH vs. PtGA-AR ratings and commonly used CDA indices calculated using both versions of the PtGA. <h3>Methods</h3> We included classifiable RA patients enrolled in CATCH (Canadian Early Inflammatory Arthritis Cohort) between 2011 and 2017 who simultaneously completed both PtGA-GH and PtGA-AR using a 10 cm VAS (scored 0–10) at each of baseline, 6- and 12 months visits. Differences in descriptive statistics were compared using Wilcoxon-sign rank tests and chi-square tests for baseline characteristics, PtGA ratings and CDA indices. Agreement was assessed using Intraclass correlation coefficients (ICC) for continuous measures and weighted kappa coefficients for categorical measures. Stratified analyses were also performed by age (older &gt;65) and sex. <h3>Results</h3> Of 571 eligible early RA patients, 71% were female, 83% were white, 17% were current smokers, 17% had erosions, and 60% had completed high-school. Baseline mean(SD) age was 55(,<sup>15</sup> symptom duration was 5 (3) months and there were 2 (2) comorbid conditions. Agreement between PtGA ratings, composite CDA measures and remission classification by PtGA-GH and PtGA-AR are summarised in table 1. Mean(SD) PtGA-GH ratings were only marginally higher than PtGA-AR ratings and agreement was high between PtGA ratings at baseline and over the first year follow up (all ICCs&gt;0.8). Agreement in CDA scores calculated with either PtGA was higher at baseline and over time (all ICCs&gt;0.95). Concordance in classification of remission using either PtGA was also high at all time points (Kappa’s&gt;0.85). Results of stratified analyses showed that relative to men, women tended to report slightly higher differences in PtGA-GH vs. PtGA-AR (all p’s&lt;0.0001) but overall agreement in PGA ratings, CDA scores and remission classification was high and similar in both sexes. Age stratified analyses were similar to those in the whole sample. <h3>Conclusions</h3> Results from this large longitudinal study of early RA patients followed in routine practice settings, showed patients rated the PtGA-GH marginally higher than PtGA-AR but differences had minimal impact on commonly used CDA indices and remission classification. These findings suggest that common composite measures of RA disease activity can be calculated using either the PtGA-GH or PtGA-AR. Table 1 Agreement in Patient Global Assessment, RA Composite Disease Activity Indices and Classification of Remission calculated using PtGA-GH vs PGA-AR <h3>Acknowledgements</h3> Sponsors: Amgen &amp; Pfizer-Founding sponsors 2007+; UCB, AbbVie 2011+; Medexus 2013+; Eli Lilly, Sanofi- Genzyme 2016+; Merck 2017+; BMS 2011–2014, Hoffmann-LaRoche, Janssen 2011–2016 <h3>Disclosure of Interest</h3> None declared