Proposed Severity and Response Criteria for Routine Assessment of Patient Index Data (RAPID3): Results for Categories of Disease Activity and Response Criteria in Abatacept Clinical Trials

Abstract

Proposed RAPID3 severity and response categories yield comparable results to DAS28 and EULAR criteria in AIM and ATTAIN. DAS28 is more specific for clinical trials. RAPID3 does not preclude also scoring DAS28, and may be informative in the infrastructure of routine care.

MDHAQ/RAPID3 to Recognize Improvement Over 2 Months in Usual Care of Patients With Osteoarthritis, Systemic Lupus Erythematosus, Spondyloarthropathy, and Gout, as Well as Rheumatoid Arthritis

“…RAPID3 severity categories, defined in RA, are 3 or less for remission, 3.1 to 6.0 for low severity, 6.1 to 12.0 for moderate severity, and more than 12 for high severity. 15,16,34 Physician Global Estimate (DOCGL) also is scored 0 to 10 on a 21-circle visual analog scale. 35 In patients with RA, a 28-joint count is performed, which generally involves about 90 seconds.…”

Evidence from a Multidimensional Health Assessment Questionnaire (MDHAQ) of the Value of a Biopsychosocial Model to Complement a Traditional Biomedical Model in Care of Patients with Rheumatoid Arthritis

“…CDAI RAPID3 is correlated significantly with DAS28 and CDAI in clinical trials [82,[107][108][109] and clinical care (Figure 8) [60,90], including categories for high, moderate, low disease severity and remission [60,83,84,107]. RAPID3 gives similar results to DAS28 and CDAI to distinguish active from control treatments in clinical trials of leflunomide [108], methotrexate [108], adalimumab [109], abatacept [82] and certolizumab [107].…”

“…Four categories of RAPID3 scores-for high, moderate, low disease severity, and remission in RA-are correlated significantly with similar categories using DAS28 and CDAI [60,83,84]. Thus RAPID3 can be useful in implementing a treat-to-target strategy in usual clinical care, analogous to DAS28 [46] or CDAI [47] while offering a number of pragmatic advantages over the other indices [8,85].…”

“…The MDHAQ facilitates collection of a patient's level of formal education as an important demographic variable, with no extra work on the part of a health professional or surrogate. 3) Patient self-report measures are as efficient as joint counts and laboratory tests to distinguish active from control treatments in clinical trials Individual patient self-report measures of physical function, pain, and patient global estimate of status are as efficient as joint counts and laboratory tests to distinguish active from control treatments in clinical trials involving adalimumab [106], abatacept [82,84], certolizumab [107], and infliximab ( Figure 7) [55]. Physician and patient global estimates tend to have the highest relative efficiencies, followed by SJC, physical function and pain on a patient questionnaire, while ESR or CRP and TJC are generally the least efficient among the seven core Data Set measures [55].…”

Outcome Measures in Rheumatoid Arthritis

“…RAPID3 can be included in the infrastructure of care of patients with RA and all rheumatic diseases to provide a baseline assessment and to monitor and document improvement or worsening over time, for all patients seen by a rheumatologist [ 22 ]. The capacity of RAPID3 to distinguish active from control treatments has been documented to be similar to that of DAS28 and CDAI in clinical trials of methotrexate, lefl unomide, adalimumab, and abatacept [ 23 ]. Comparison of RAPID3 with DAS28 and CDAI indicated Spearman rank order correlation coeffi cients for DAS28 with RAPID3 of 0.66 and for CDAI with RAPID3 of 0.74, all highly signifi cant ( p < 0.001) [ 24 ].…”