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Year : 2015  |  Volume : 10  |  Issue : 3  |  Page : 133-139

Review of rheumatoid arthritis disease outcome measures: Recommendations and its relevance in private practice

Apollo Hospital International Ltd, Ahmedabad 380054, India; Royal Adelaide Hospital/SA Pathology, Adelaide, SA 5000, Australia

Correspondence Address:
Pravin Hissaria
Apollo Hospital International Ltd, Ahmedabad 380054, India; Royal Adelaide Hospital/SA Pathology, Adelaide, SA 5000, Australia

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Source of Support: None, Conflict of Interest: None

DOI: 10.1016/j.injr.2015.07.006

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The ultimate goal of pharmacological treatment in Rheumatoid Arthritis (RA) is to reach and sustain remission, prevent functional disability and organ damage. Recent improve- ments and insights in RA treatment such as availability of wider range of disease modi- fying agents including biological agents have made 'clinical remission' a realistic target for many patients. To optimise RA treatment physicians must monitor the disease activity accurately to adjust treatment according to disease activity levels. In RA, several disease outcomes such as painful and swollen joints, functional impairment and acute phase re- actants are recognized as manifestations of underlying disease process. To monitor the disease accurately, an index expressing these outcomes as a single continuous variable is required. The widely used disease outcome measures in clinical trials are the American College of Rheumatology (ACR) recommended indices: DAS28 (ESR or CRP), PAS, PAS-II, RAPID-3, SDAI and CDAI which have different relevance in clinical practice as compared to clinical trials. DAS28 hitherto considered gold standard in measuring RA outcomes in clinical trials may not hold appeal in clinical practice because of complexities associated with its calculations and waiting time due to inclusion of laboratory measurements. In recent times, simpler scores such as RAPID-3 and CDAI are being evaluated in global and Indian studies as a preferred outcome measure in point-of-care clinical setting because of their simplicity and ease of administration especially in a fund-stricken country like India.

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