The development of candidate composite disease activity and responder indices for psoriatic arthritis

Helliwell, Philip S., FitzGerald, Oliver, Fransen, Jaap, Gladman, Dafna D., Kreuger, Gerald G., Callis-Duffin, Kristina, McHugh, Neil, Mease, Philip J., Strand, Vibeke, Waxman, Robin, Azevedo, Valderilio Feijo, Ostos, Adriana Beltran, Carneiro, Sueli, Cauli, Alberto, Espinoza, Luis R., Flynn, John A., Hassan, Nada, Healy, Paul, Kerzberg, Eduardo Mario, Lee, Yun Jong, Lubrano, Ennio, Marchesoni, Antonio, Marzo-Ortega, Helena, Porru, Giovanni, Moreta, Elvia G., Nash, Peter, Raffayova, Helena, Ranza, Roberto, Raychaudhuri, Siba P, Roussou, Euthalia, Scarpa, Raphael, Song, Yeong Wook, Soriano, Enrique R, Tak, Enrique R., Ujfalussy, Ilona, de Vlam, Kurt and Walsh, Jessica A. (2012) The development of candidate composite disease activity and responder indices for psoriatic arthritis. Annals of the Rheumatic Diseases, 72 6: 986-991. doi:10.1136/annrheumdis-2012-201341

Author Helliwell, Philip S.
FitzGerald, Oliver
Fransen, Jaap
Gladman, Dafna D.
Kreuger, Gerald G.
Callis-Duffin, Kristina
McHugh, Neil
Mease, Philip J.
Strand, Vibeke
Waxman, Robin
Azevedo, Valderilio Feijo
Ostos, Adriana Beltran
Carneiro, Sueli
Cauli, Alberto
Espinoza, Luis R.
Flynn, John A.
Hassan, Nada
Healy, Paul
Kerzberg, Eduardo Mario
Lee, Yun Jong
Lubrano, Ennio
Marchesoni, Antonio
Marzo-Ortega, Helena
Porru, Giovanni
Moreta, Elvia G.
Nash, Peter
Raffayova, Helena
Ranza, Roberto
Raychaudhuri, Siba P
Roussou, Euthalia
Scarpa, Raphael
Song, Yeong Wook
Soriano, Enrique R
Tak, Enrique R.
Ujfalussy, Ilona
de Vlam, Kurt
Walsh, Jessica A.
Title The development of candidate composite disease activity and responder indices for psoriatic arthritis
Formatted title
The development of candidate composite disease activity and responder indices for psoriatic arthritis (GRACE project)
Journal name Annals of the Rheumatic Diseases   Check publisher's open access policy
ISSN 0003-4967
Publication date 2012
Sub-type Article (original research)
DOI 10.1136/annrheumdis-2012-201341
Volume 72
Issue 6
Start page 986
End page 991
Total pages 6
Place of publication London, England, U.K.
Publisher B M J Group
Collection year 2013
Language eng
Formatted abstract
Objective To develop new composite disease activity indices for psoriatic arthritis (PsA).

Methods Data from routine clinic visits at multiple centres were collected in a systematic manner. Data included all domains identified as important in randomised controlled trials in PsA. Decisions to change treatment were used as surrogates for high disease activity. New indices were developed by multiple linear regression (psoriatic arthritis disease activity score: PASDAS) and empirically, utilising physician-defined cut-offs for disease activity (arithmetic mean of desirability functions: AMDF). These were compared with existing composite measures: Composite Psoriatic arthritis Disease Activity Index (CPDAI), Disease Activity for PSoriatic Arthritis (DAPSA), and Disease Activity Score for rheumatoid arthritis (DAS28).

Results 161/503 (32%) subjects had treatment changes. Although all measures performed well, compared with existing indices, PASDAS was better able to discriminate between high and low disease activity (area under receiver operating curves (ROC)) curve with 95% CI: PASDAS 0.773 (0.723, 0.822); AMDF 0.730 (0.680, 0.780); CPDAI 0.719 (0.668, 0.770); DAPSA 0.710 (0.654, 0.766); DAS28 0.736 (0.680, 0.792). All measures were able to discriminate between disease activity states in patients with oligoarthritis, although area under the receiver operating curves (AUC) were generally smaller. In patients with severe skin disease (psoriasis area and severity index >10) both nonparametric and AUC curve statistics were nonsignificant for all measures.

Conclusions Two new composite measures to assess disease activity in PsA have been developed. Further testing in other datasets, including comparison with existing measures, is required to validate these instruments.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online: 13 July 2012

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
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Created: Thu, 02 Aug 2012, 13:48:04 EST by Matthew Lamb on behalf of School of Medicine