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Table 2 Comparison of the ACR/EULAR RA remission definition candidate for patients meeting ACR/EULAR classification criteria for rheumatoid arthritis (ESPOIR STUDY).

From: Validation of ACR/EULAR definition of remission in rheumatoid arthritis from RA practice: the ESPOIR cohort

 

Prevalence of good outcome in patients**:

  

Candidate remission definition (* definitions are those recommended by ACR/EULAR)

In remission

Not in remission *

Positive likelihood ratio

*(95% CI)

P-value

Boolean-based definition

TJC28, SJC28, CRP ≤ 1

25% (29/118)

12%

1.4 (1.1, 1.7)

0.0526

TJC28, SJC28, CRP, PhGA ≤ 1

32% (23/71)

13%

1.9 (1.4, 2.7)

0.0034

TJC28, SJC28, CRP, PtGA ≤ 1*

39% (23/59)

12%

2.4 (1.6,3.5)

0.0002

TJC28, SJC28, CRP, pain ≤ 1

34% (24/70)

13%

2.0 (1.4, 2.8)

0.0023

TJC28, SJC28, CRP, PhGA, PtGA ≤ 1

40% (22/55)

12%

2.6 (1.7, 3.8)

0.0002

TJC28, SJC28, CRP, PhGA, pain ≤ 1

38% (21/55)

13%

2.3 (1.6, 3.5)

0.0006

TJC28, SJC28, CRP, PtGA, pain ≤ 1

40% (21/53)

12%

2.6 (1.7, 3.9)

0.0002

TJC28, SJC28, CRP, PhGA, PtGA, pain ≤ 1

39% (20/51)

13%

2.5 (1.6, 3.9)

0.0005

Index-based definition

DAS28 < 2.6

25% (35/146)

11%

1.3 (1.1, 1.5)

0.0383

DAS28 < 2.0

28% (24/85)

12%

1.6 (1.2, 2.2)

0.0148

SDAI ≤ 3.3*

39% (27/69)

12%

2.3 (1.6, 3.2)

0.0001

Definitions without CRP (for clinical practice)

TJC28, SJC28, PhGA, PtGA ≤ 1

38% (23/60)

13%

2.3(1.6,3.4)

0.0003

TJC28, SJC28, PtGA < 1*

37% (24/65)

12%

2.0(1.4,2.9)

0.0004

CDAI ≤ 2.8*

36% (26/72)

12%

2.0(1.5,2.8)

0.0005

  1. *Average values calculated from the 500 bootstrap samples of patients not in remission.
  2. **Good outcome defined in a person when they had both good function and good radiographic outcomes (see Methods). CDAI: clinical disease activity index; CRP: C-reactive protein; DAS: disease activity score; EULAR: European League Against Rheumatism; PtGA: patient global assessment; PhGA: physician global assessment; RA: rheumatoid arthritis; SJC28: 28 swollen joint count; TJC28: 28 tender joint count.