Routine Quantitative Measurements for Patients With RA Remains Low


Despite a trend toward increased metric use, approximately 50% of patients with rheumatoid arthritis (RA) are not routinely assessed with a disease activity metric, according to the results of a recent survey.

The evidence that rheumatologists use these quantitative disease activity measurements in a target-to-treat practice is lacking, survey results also showed.

Jeffrey R Curtis, MD, MS, MPH, University of Alabama at Birmingham, and colleagues conducted a study to examine why real-world practices and attitudes regarding quantitative measurements of RA have received limited attention. Researchers sent an email survey to 1918 rheumatologists in the United States imploring them to self-report on their use of quantitative measurements.

A total of 439 rheumatologists responded. Researchers compared their responses to similar surveys completed in 2005 and 2008.

The study was published in The Journal of Rheumatology (January 2018;45[1]:40-44).

Results of the survey showed that those who used metrics (metric rheumatologists; 58%) were more likely to be in a group practice and to use tumor necrosis factor inhibitors. The most commonly employed metrics included the HAQ (35.5% vs 22.9% in 2008 and 17.6% in 2005), RAPID3 (27.1% vs 3.1% in 2008 and 0.0% in 2005), CDAI (17.5% vs 2.3% in 2008 and 0.0% in 2005), DAS28 (15.7% vs 12.2% in 2008 and 5.9% in 2005), and the VECTRA MBDA (12.8% vs 0.0% in 2008 and 0.0% in 2005).

Among the most frequently reported reasons for not using metrics included time needed and electronic availability.


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According to results of simulated case scenarios, providing more quantitative information may increase the likelihood that a patient would change to a different disease-modifying antirheumatic drug or biologic, researchers wrote.

Dr Curtis and colleagues concluded that “Routine use of quantitative measurement for patients in the United States with RA is increasing over time but remains low.”—Zachary Bessette