AB0318 DAS28 WITH THREE VARIABLES PERFORMANCE IN A COHORT OF RHEUMATOID ARTHRITIS PATIENTS WITH AND WITHOUT CONCOMITANT FIBROMYALGIA

Background

Several studies have shown that rheumatoid arthritis (RA) patients with concomitant fibromyalgia (FM) can cause an overestimation of the disease. activity assessed by the 28 disease activity score (DAS28) by inflating the patient reported components. DAS28 V3 is calculated based on only three variables: swollen and tender joint counts and CRP.

Objectives

The aim of this study was to evaluate the performance of the DAS28 V3 in a cohort of RA patients with and without concomitant FM.

Methods

Cross-sectional observational study that included consecutive patients with diagnosis of RA (ACR/EULAR 2010 criteria) with and without concomitant FM (ACR 2016). Demographic and RA characteristics were collected. All patients underwent a clinico-biological and an ultrasound (US) assessment of RA activity. US examination included the assessment of synovial/tenosynovial hypertrophy in grey scale and in Power Doppler (PD). P<0.5 was accepted for significance.

Results

Eighty patients distributed into 40 patients in each group were recruited. Epidemiological and RA characteristics were comparable between groups. Subjective. activity parameters were higher in RA with FM group (p ≤0.05). No significant difference was observed between the groups in regards to mean DAS28, DAS28 V3, SDAI and CDAI (p=0.12, p=0.14, p=0.2 and p=0.5 respectively). DAS28 was significantly greater than DAS28 V3 in RA with FM group (p=0.000). However, no difference between DAS28 and DAS28 V3 was not significant in the PR without FM group. Multivariate analysis in RA with FM group showed that DAS28 V3 was significantly positively associated with the presence of US synovial hypertrophy (r=0.494, p=0.001) and the presence of US PD synovitis (r=0.155, p=0.032), while Patient Global Activity expressed a significant negative association (r=-0.392, p=0.049 and r=-0.642, p=0.005 respectively).

Conclusion

Our study confirms that DAS28 V3 score would represent a better alternative for the clinical assessment of disease activity in RA patients with concomitant FM.

REFERENCES:

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Acknowledgements:

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Disclosure of Interests

None Declared.