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See Latest ArticlesDetermining a low disease activity threshold for decision to maintain disease modifying antirheumatic drug treatment unchanged in rheumatoid arthritis patients
Arthritis Research & Therapy, 10/27/09
De Bandt M et al. – As a conclusion, panelists suggested that in clinical practice there is no need to change DMARD treatment in RA patients
Methods- 967 case scenarios with various levels for each component of DAS28 score (resulting in a DAS score between 2 and 3.2), presented to 44 panelists
- For each scenario, panelists had to decide whether or not DMARD treatment (excluding steroids) could be maintained unchanged
- Relationship between panelists' decision, DAS28 score, and components of score analysed by multiple logistic regression analysis
- Each panelist analysed 160 randomized scenarios
- Intra- and inter-rater reproducibility assessed
- 44 panelists participated in study
- Inter-panelists agreement good
- Quasi-perfect agreement observed for DAS28 less than or equal to 2.4, less pronounced between 2.5 and 2.9 and almost no agreement for DAS28 > 3.0
- For values below 2.5, panelists agreed to maintain unchanged DMARDs; for values above 2.5, discrepancies occurred more frequently as DAS28 value increased
- Multivariate analysis confirmed relationship between panelists decision, DAS28 value and components of DAS28
- Between DAS28 2.4 and 3.2, major determinant for panelists' decision swollen joint count (SJC)
- Female and public practice physicians decided more often to maintain treatment unchanged
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