POS0685 COMPARISON OF DIFFERENT COMPOSITE MEASURES (DAS28, CDAI, SDAI AND BOOLEAN CRITERIA) IN ASSESSING REMISSION IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: M. Rachdi, Y. Makhlouf, S. Miladi, A. Fazaa, H. Boussaa, L. Souebni, K. Ouenniche, S. Kassab, S. Chekili, K. Ben Abdelghani, A. Laatar
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The management of Rheumatoid arthritis (RA) is characterized by a "treat-to-target" approach with regular assessment of disease activity. Therefore, various RA composite disease activity scores have become important tools in everyday practice and crucial in defining remission or low disease activity, the main target of the RA treatment. <h3>Objectives:</h3> To assess achievement of remission according to different disease activity indices and to determine factors limiting patients from reaching Boolean remission. <h3>Methods:</h3> We conducted a cross-sectional study including patients with RA who fulfilled the 1987 American Rheumatism association or the 2010 ACR/ EULAR classification criteria for RA. Data were collected during medical appointments and from patients' medical records. Disease activity was measured using the Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI), 28-joint Disease Activity Score using C-reactive protein (DAS28(CRP)). Remission was defined as DAS28(CRP) ≤2.6, or CDAI≤2.8, or SDAI ≤3.3. The Boolean remission is defined as: Tender joint count 28 (TJC28) ≤1, Swollen joint count28 (SJC28) ≤1, CRP≤1mg/dl and Patient global assessment (PGA)≤1. The epidemiological data were analyzed using descriptive statistics. The indices were compared to the Boolean method using binominal regression. Correlation between pairs of indices was evaluated using the spearman index. P-values&lt;0.05 were considered significant for all analyses. Data were analyzed using SPSS. <h3>Results:</h3> Fourty-one patients with RA were enrolled. The mean age was 43.7 years [18-65]. There was a female predominance with a sex-ratio of 0.2. The median disease duration was 90.2 months [7-360]. The mean age of onset was 41.6 years [18-59]. The positivity rate of Rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (ACPA), and antinuclear antibody(AAN) was: 82%, 63.4% and 33% respectively. Disease modifying anti-rheumatic drugs were prescribed as follows: csDMARDs (n=29): Methotrexate (n=21), Sulfasalazine (n=5), Leflunomide (n=3), bDMARDs (n=11). One patient received Tofacitinib. The mean HAQ was 0.66 [0-2]. The median DAS<sub><b>28</b></sub>-CRP, CDAI, SDAI were 2.14 [2.01-3.21], 3 [2-13] and 5.1 [2.12-14.5] respectively. According to theses scores, remission was achieved in 87.8%, 26.8 %, 29.2 % of cases respectively. In contrast, remission according to the Boolean criteria remission was achieved in 36.5%.The majority of patients who achieved CDAI, SDAI remission also attained Boolean remission (62% and 58% respictively). The mean values of the different components of each indices were described in Table 1. <h3>Conclusion:</h3> Our study showed that differences in PGA limit patients in SDAI, CDAI remission from meeting Boolean criteria, SDAI and CDAI remission allows individual variables to be &gt;1 and still meeting the remission definition. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>