RA Disease Activity Seen Differently by Patients and Their Doctors

Patients with rheumatoid arthritis (RA) and their doctors differ on their perception of RA disease activity, according to researchers from Austria. Patients cite joint pain as the reason for their perception of a change in their disease activity, but rheumatologists emphasize joint swelling as the major determinant.

Researchers identified 646 patients with RA, who began treatment with methotrexate, from an observational patient database. Patients and physicians completed the patient global assessment (PGA) and the evaluator global assessment (EGA), respectively, and the team used the assessments to analyze their determinants.

Different measures helped explain 78% of PGA variability and 67% of EGA variability in the patients with RA. About 76% of PGA variations were attributed to pain, 1.3% to function, and 0.5% to swollen joints; 61% of EGA variations were attributed to swollen joints, 5% to pain, 0.6% to function, 0.4% to C-reactive protein level, and 0.3% to tender joints.

The authors suggested that further understanding of the reasons behind the differing views of disease activity could lead to improved shared decision making between patients and physicians in managing RA. The study was published in Arthritis & Rheumatism, an American College of Rheumatology journal.