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Article: Is pre-assessment for anti-TNF therapy in RA necessary in the UK? Analysis of DAS28 in six centres

TitleIs pre-assessment for anti-TNF therapy in RA necessary in the UK? Analysis of DAS28 in six centres
Authors
Issue Date2007
PublisherOxford University Press. The Journal's web site is located at http://rheumatology.oxfordjournals.org/
Citation
Rheumatology, 2007, v. 46 n. 10, p. 1557-1559 How to Cite?
AbstractObjectives. National Institute for Health and Clinical Excellence (NICE) guidelines for anti-tumour necrosis factor (TNF) in rheumatoid arthritis (RA) state that two pre-assessments of Disease Activity Score (DAS28) should be performed a month apart. We performed a retrospective audit of data from six centres to determine the stability of DAS28 between assessments, and the proportion of patients still satisfying eligibility criteria at baseline. Methods. All RA patients assessed for anti-TNF from six centres had their pre-assessment DAS28 (DAS-1) compared with their baseline DAS28 (DAS0) using paired t -tests, and a similar analysis for the components of the DAS28. Patients who were no longer eligible for anti-TNF at DAS0 were noted. Results. Six hundred and seventy-nine RA patients showed no significant change in the DAS28, with a mean DAS-1 of 6.74 and DAS0 of 6.73. (P = 0.86). Of the patients, 97.2% fulfilled the UK eligibility criteria at DAS0. Comparison of the individual components of the DAS28 between the two pre-assessment dates showed that there was no significant difference between either the numbers of swollen joints or the erythrocyte sedimentation rate (ESR), but there was a significant increase in the numbers of tender joints of 1.41 (P < 0.001) and in the visual analogue scale (VAS) of 4.22 (P < 0.001). Discussion. The overwhelming majority of patients who fulfil eligibility criteria for anti-TNF drugs 1 month prior to baseline also fulfil the criteria at baseline. There is no significant change in the DAS28 over the month waiting to go onto anti-TNF therapy. A single assessment of the DAS28 would suffice to enable patients to go on to anti-TNF treatment. © The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/171359
ISSN
2023 Impact Factor: 4.7
2023 SCImago Journal Rankings: 1.721
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSmith, Nen_US
dc.contributor.authorGadsby, Ken_US
dc.contributor.authorButt, Sen_US
dc.contributor.authorCarruthers, Den_US
dc.contributor.authorDeeming, Aen_US
dc.contributor.authorLedingham, Jen_US
dc.contributor.authorFletcher, Men_US
dc.contributor.authorMulherin, Den_US
dc.contributor.authorRoskell, Sen_US
dc.contributor.authorKay, Len_US
dc.contributor.authorNicholl, Ken_US
dc.contributor.authorCooper, Ren_US
dc.contributor.authorWorsley, Aen_US
dc.contributor.authorDeighton, Cen_US
dc.date.accessioned2012-10-30T06:13:35Z-
dc.date.available2012-10-30T06:13:35Z-
dc.date.issued2007en_US
dc.identifier.citationRheumatology, 2007, v. 46 n. 10, p. 1557-1559en_US
dc.identifier.issn1462-0324en_US
dc.identifier.urihttp://hdl.handle.net/10722/171359-
dc.description.abstractObjectives. National Institute for Health and Clinical Excellence (NICE) guidelines for anti-tumour necrosis factor (TNF) in rheumatoid arthritis (RA) state that two pre-assessments of Disease Activity Score (DAS28) should be performed a month apart. We performed a retrospective audit of data from six centres to determine the stability of DAS28 between assessments, and the proportion of patients still satisfying eligibility criteria at baseline. Methods. All RA patients assessed for anti-TNF from six centres had their pre-assessment DAS28 (DAS-1) compared with their baseline DAS28 (DAS0) using paired t -tests, and a similar analysis for the components of the DAS28. Patients who were no longer eligible for anti-TNF at DAS0 were noted. Results. Six hundred and seventy-nine RA patients showed no significant change in the DAS28, with a mean DAS-1 of 6.74 and DAS0 of 6.73. (P = 0.86). Of the patients, 97.2% fulfilled the UK eligibility criteria at DAS0. Comparison of the individual components of the DAS28 between the two pre-assessment dates showed that there was no significant difference between either the numbers of swollen joints or the erythrocyte sedimentation rate (ESR), but there was a significant increase in the numbers of tender joints of 1.41 (P < 0.001) and in the visual analogue scale (VAS) of 4.22 (P < 0.001). Discussion. The overwhelming majority of patients who fulfil eligibility criteria for anti-TNF drugs 1 month prior to baseline also fulfil the criteria at baseline. There is no significant change in the DAS28 over the month waiting to go onto anti-TNF therapy. A single assessment of the DAS28 would suffice to enable patients to go on to anti-TNF treatment. © The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.en_US
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://rheumatology.oxfordjournals.org/en_US
dc.relation.ispartofRheumatologyen_US
dc.subject.meshAntirheumatic Agents - Therapeutic Useen_US
dc.subject.meshArthritis, Rheumatoid - Diagnosis - Drug Therapyen_US
dc.subject.meshHumansen_US
dc.subject.meshPatient Selectionen_US
dc.subject.meshPractice Guidelines As Topicen_US
dc.subject.meshReproducibility Of Resultsen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshSeverity Of Illness Indexen_US
dc.subject.meshTumor Necrosis Factor-Alpha - Antagonists & Inhibitorsen_US
dc.titleIs pre-assessment for anti-TNF therapy in RA necessary in the UK? Analysis of DAS28 in six centresen_US
dc.typeArticleen_US
dc.identifier.emailWorsley, A:alanwor@hku.hken_US
dc.identifier.authorityWorsley, A=rp01395en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1093/rheumatology/kem188en_US
dc.identifier.pmid17666440-
dc.identifier.scopuseid_2-s2.0-34848928468en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34848928468&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume46en_US
dc.identifier.issue10en_US
dc.identifier.spage1557en_US
dc.identifier.epage1559en_US
dc.identifier.isiWOS:000250622900009-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridSmith, N=7403173677en_US
dc.identifier.scopusauthoridGadsby, K=8959871100en_US
dc.identifier.scopusauthoridButt, S=16835853900en_US
dc.identifier.scopusauthoridCarruthers, D=7005297969en_US
dc.identifier.scopusauthoridDeeming, A=36817803500en_US
dc.identifier.scopusauthoridLedingham, J=7101769920en_US
dc.identifier.scopusauthoridFletcher, M=22133932000en_US
dc.identifier.scopusauthoridMulherin, D=7003990740en_US
dc.identifier.scopusauthoridRoskell, S=22136258700en_US
dc.identifier.scopusauthoridKay, L=7202300519en_US
dc.identifier.scopusauthoridNicholl, K=16837048700en_US
dc.identifier.scopusauthoridCooper, R=7404338623en_US
dc.identifier.scopusauthoridWorsley, A=16445153200en_US
dc.identifier.scopusauthoridDeighton, C=7004183480en_US
dc.identifier.issnl1462-0324-

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