AustralieFrV1, PascalFrancis, Corpus, bibRecord, 004689

Minimal disease activity for rheumatoid arthritis : A preliminary definition

Identifieur interne : 004689 ( PascalFrancis/Corpus ); précédent : 004688; suivant : 004690

Minimal disease activity for rheumatoid arthritis : A preliminary definition

Auteurs : George A. Wells ; Maarten Boers ; Beverley Shea ; Peter M. Brooks ; Lee S. Simon ; C. Vibeke Strand ; Daniel Aletaha ; Jennifer J. Anderson ; Claire Bombardier ; Maxime Dougados ; Paul Emery ; David T. Felson ; Jaap Fransen ; Dan E. Furst ; Johanna M. W. Hazes ; Kent R. Johnson ; John R. Kirwan ; Robert B. M. Landewe ; Marissa N. D. Lassere ; Kaleb Michaud ; Maria Suarez-Almazor ; Alan J. Silman ; Josef S. Smolen ; Desiree M. F. M. Van Der Heijde ; Piet L. C. M. Van Riel ; Fred Wolfe ; Peter S. Tugwell

Source :

Journal of rheumatology [ 0315-162X ] ; 2005.

RBID : Pascal:05-0480266

Descripteurs français

Pascal (Inist)
- Polyarthrite rhumatoïde, Définition, Pronostic, Essai clinique, Enquête, Articulation, Douleur, Rhumatologie, Chronique.

English descriptors

KwdEn :
- Chronic, Clinical trial, Definition, Joint, Pain, Prognosis, Rheumatoid arthritis, Rheumatology, Survey.

Abstract

Agreement on response criteria in rheumatoid arthritis (RA) has allowed better standardization and interpretation of clinical trial reports. With recent advances in therapy, the proportion of patients achieving a satisfactory state of minimal disease activity (MDA) is becoming a more important measure with which to compare different treatment strategies. The threshold for MDA is between high disease activity and remission and, by definition, anyone in remission will also be in MDA. True remission is still rare in RA; in addition, the American College of Rheumatology definition is difficult to apply in the context of trials. Participants at OMERACT 6 in 2002 agreed on a conceptual definition of minimal disease activity (MDA): "that state of disease activity deemed a useful target of treatment by both the patient and the physician, given current treatment possibilities and limitations." To prepare for a preliminary operational definition of MDA for use in clinical trials, we asked rheumatologists to assess 60 patient profiles describing real RA patients seen in routine clinical practice. Based on their responses, several candidate definitions for MDA were designed and discussed at the OMERACT 7 in 2004. Feedback from participants and additional on-site analyses in a cross-sectional database allowed the formulation of 2 preliminary, equivalent definitions of MDA: one based on the Disease Activity Score 28 (DAS28) index, and one based on meeting cutpoints in 5 out the 7 WHO/ILAR core set measures. Researchers applying these definitions first need to choose whether to use the DAS28 or the core set definition, because although each selects a similar proportion in a population, these are not always the same patients. In both MDA definitions, an initial decision node places all patients in MDA who have a tender joint count of 0 and a swollen joint count of 0, and an erythrocyte sedimentation rate (ESR) no greater than 10 mm. If this condition is not met: ● The DAS28 definition places patients in MDA when DAS28 < 2.85 ● The core set definition places patients in MDA when they meet 5 of 7 criteria: (1) Pain (0-10) ≤ 2; (2) Swollen joint count (0-28) ≤ 1; (3) Tender joint count (0-28) ≤ 1; (4) Health Assessment Questionnaire (HAQ, 0-3) ≤ 0.5; (5) Physician global assessment of disease activity (0-10) ≤ 1.5; (6) Patient global assessment of disease activity (0-10) ≤ 2; (7) ESR ≤ 20. This set of 2 definitions gained approval of 73% of the attendees. These (and other) definitions will now be subject to further validation in other databases.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

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C01	`01`		`ENG`	@0 Agreement on response criteria in rheumatoid arthritis (RA) has allowed better standardization and interpretation of clinical trial reports. With recent advances in therapy, the proportion of patients achieving a satisfactory state of minimal disease activity (MDA) is becoming a more important measure with which to compare different treatment strategies. The threshold for MDA is between high disease activity and remission and, by definition, anyone in remission will also be in MDA. True remission is still rare in RA; in addition, the American College of Rheumatology definition is difficult to apply in the context of trials. Participants at OMERACT 6 in 2002 agreed on a conceptual definition of minimal disease activity (MDA): "that state of disease activity deemed a useful target of treatment by both the patient and the physician, given current treatment possibilities and limitations." To prepare for a preliminary operational definition of MDA for use in clinical trials, we asked rheumatologists to assess 60 patient profiles describing real RA patients seen in routine clinical practice. Based on their responses, several candidate definitions for MDA were designed and discussed at the OMERACT 7 in 2004. Feedback from participants and additional on-site analyses in a cross-sectional database allowed the formulation of 2 preliminary, equivalent definitions of MDA: one based on the Disease Activity Score 28 (DAS28) index, and one based on meeting cutpoints in 5 out the 7 WHO/ILAR core set measures. Researchers applying these definitions first need to choose whether to use the DAS28 or the core set definition, because although each selects a similar proportion in a population, these are not always the same patients. In both MDA definitions, an initial decision node places all patients in MDA who have a tender joint count of 0 and a swollen joint count of 0, and an erythrocyte sedimentation rate (ESR) no greater than 10 mm. If this condition is not met: ● The DAS28 definition places patients in MDA when DAS28 < 2.85 ● The core set definition places patients in MDA when they meet 5 of 7 criteria: (1) Pain (0-10) ≤ 2; (2) Swollen joint count (0-28) ≤ 1; (3) Tender joint count (0-28) ≤ 1; (4) Health Assessment Questionnaire (HAQ, 0-3) ≤ 0.5; (5) Physician global assessment of disease activity (0-10) ≤ 1.5; (6) Patient global assessment of disease activity (0-10) ≤ 2; (7) ESR ≤ 20. This set of 2 definitions gained approval of 73% of the attendees. These (and other) definitions will now be subject to further validation in other databases.
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Format Inist (serveur)

NO :	PASCAL 05-0480266 INIST
ET :	Minimal disease activity for rheumatoid arthritis : A preliminary definition
AU :	WELLS (George A.); BOERS (Maarten); SHEA (Beverley); BROOKS (Peter M.); SIMON (Lee S.); STRAND (C. Vibeke); ALETAHA (Daniel); ANDERSON (Jennifer J.); BOMBARDIER (Claire); DOUGADOS (Maxime); EMERY (Paul); FELSON (David T.); FRANSEN (Jaap); FURST (Dan E.); HAZES (Johanna M. W.); JOHNSON (Kent R.); KIRWAN (John R.); LANDEWE (Robert B. M.); LASSERE (Marissa N. D.); MICHAUD (Kaleb); SUAREZ-ALMAZOR (Maria); SILMAN (Alan J.); SMOLEN (Josef S.); VAN DER HEIJDE (Desiree M. F. M.); VAN RIEL (Piet L. C. M.); WOLFE (Fred); TUGWELL (Peter S.)
AF :	Department of Epidemiology and Community Medicine, University of Ottawa/Ottawa/Canada (1 aut.); Institution of Population Health/Ottawa/Canada (3 aut.); University of Queensland, Royal Brisbane Hospital/Brisbane/Australie (4 aut.); Medical University Vienna/Vienna/Autriche (7 aut.); Boston University School of Public Health/Boston/Etats-Unis (8 aut.); Institution of Work and Health, University of Toronto/Toronto/Canada (9 aut.); Hopital Cochin. Rene Descartes University/Paris/France (10 aut.); University of Leeds/Leeds/Royaume-Uni (11 aut.); School of Medicine/Boston/Etats-Unis (12 aut.); Department of Rheumatology, University Hospital Nijmegen/Pays-Bas (13 aut.); David Geffen School of Medicine, UCLA/Los Angeles/Etats-Unis; Erasmus University Medical Center/Rotterdam/Pays-Bas; Mater Hospital, University of Newcastle/Newcastle/Australie; University of Bristol, Bristol Royal Infirmary/Bristol/Royaume-Uni; University Hospital Maastricht/Maastricht/Pays-Bas; Department of Rheumatology, St. George Hospital/Sydney/Australie; National Data Bank for Rheumatic Diseases/Wichita/Etats-Unis; Baylor College of Medicine and Michael E. De Bakey VAMC/Houston/Etats-Unis; University of Manchester/Manchester/Royaume-Uni; Harvard Medical School, Beth Israel Deaconess Medical Center/Boston/Etats-Unis; Stanford University School of Medicine/Stanford/Etats-Unis
DT :	Publication en série; Congrès; Niveau analytique
SO :	Journal of rheumatology; ISSN 0315-162X; Coden JRHUA9; Canada; Da. 2005; Vol. 32; No. 10; Pp. 2016-2024; Bibl. 11 ref.
LA :	Anglais
EA :	Agreement on response criteria in rheumatoid arthritis (RA) has allowed better standardization and interpretation of clinical trial reports. With recent advances in therapy, the proportion of patients achieving a satisfactory state of minimal disease activity (MDA) is becoming a more important measure with which to compare different treatment strategies. The threshold for MDA is between high disease activity and remission and, by definition, anyone in remission will also be in MDA. True remission is still rare in RA; in addition, the American College of Rheumatology definition is difficult to apply in the context of trials. Participants at OMERACT 6 in 2002 agreed on a conceptual definition of minimal disease activity (MDA): "that state of disease activity deemed a useful target of treatment by both the patient and the physician, given current treatment possibilities and limitations." To prepare for a preliminary operational definition of MDA for use in clinical trials, we asked rheumatologists to assess 60 patient profiles describing real RA patients seen in routine clinical practice. Based on their responses, several candidate definitions for MDA were designed and discussed at the OMERACT 7 in 2004. Feedback from participants and additional on-site analyses in a cross-sectional database allowed the formulation of 2 preliminary, equivalent definitions of MDA: one based on the Disease Activity Score 28 (DAS28) index, and one based on meeting cutpoints in 5 out the 7 WHO/ILAR core set measures. Researchers applying these definitions first need to choose whether to use the DAS28 or the core set definition, because although each selects a similar proportion in a population, these are not always the same patients. In both MDA definitions, an initial decision node places all patients in MDA who have a tender joint count of 0 and a swollen joint count of 0, and an erythrocyte sedimentation rate (ESR) no greater than 10 mm. If this condition is not met: ● The DAS28 definition places patients in MDA when DAS28 < 2.85 ● The core set definition places patients in MDA when they meet 5 of 7 criteria: (1) Pain (0-10) ≤ 2; (2) Swollen joint count (0-28) ≤ 1; (3) Tender joint count (0-28) ≤ 1; (4) Health Assessment Questionnaire (HAQ, 0-3) ≤ 0.5; (5) Physician global assessment of disease activity (0-10) ≤ 1.5; (6) Patient global assessment of disease activity (0-10) ≤ 2; (7) ESR ≤ 20. This set of 2 definitions gained approval of 73% of the attendees. These (and other) definitions will now be subject to further validation in other databases.
CC :	002B15D
FD :	Polyarthrite rhumatoïde; Définition; Pronostic; Essai clinique; Enquête; Articulation; Douleur; Rhumatologie; Chronique
FG :	Maladie autoimmune; Rhumatisme inflammatoire; Système ostéoarticulaire pathologie
ED :	Rheumatoid arthritis; Definition; Prognosis; Clinical trial; Survey; Joint; Pain; Rheumatology; Chronic
EG :	Autoimmune disease; Inflammatory joint disease; Diseases of the osteoarticular system
SD :	Poliartritis reumatoidea; Definición; Pronóstico; Ensayo clínico; Encuesta; Articulación; Dolor; Reumatología; Crónico
LO :	INIST-16024.354000132761500290
ID :	05-0480266

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Pascal:05-0480266

Le document en format XML

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<author><name sortKey="Emery, Paul" sort="Emery, Paul" uniqKey="Emery P" first="Paul" last="Emery">Paul Emery</name>
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<affiliation><inist:fA14 i1="10"><s1>Department of Rheumatology, University Hospital Nijmegen</s1>
<s3>NLD</s3>
<sZ>13 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Furst, Dan E" sort="Furst, Dan E" uniqKey="Furst D" first="Dan E." last="Furst">Dan E. Furst</name>
</author>
<author><name sortKey="Hazes, Johanna M W" sort="Hazes, Johanna M W" uniqKey="Hazes J" first="Johanna M. W." last="Hazes">Johanna M. W. Hazes</name>
</author>
<author><name sortKey="Johnson, Kent R" sort="Johnson, Kent R" uniqKey="Johnson K" first="Kent R." last="Johnson">Kent R. Johnson</name>
</author>
<author><name sortKey="Kirwan, John R" sort="Kirwan, John R" uniqKey="Kirwan J" first="John R." last="Kirwan">John R. Kirwan</name>
</author>
<author><name sortKey="Landewe, Robert B M" sort="Landewe, Robert B M" uniqKey="Landewe R" first="Robert B. M." last="Landewe">Robert B. M. Landewe</name>
</author>
<author><name sortKey="Lassere, Marissa N D" sort="Lassere, Marissa N D" uniqKey="Lassere M" first="Marissa N. D." last="Lassere">Marissa N. D. Lassere</name>
</author>
<author><name sortKey="Michaud, Kaleb" sort="Michaud, Kaleb" uniqKey="Michaud K" first="Kaleb" last="Michaud">Kaleb Michaud</name>
</author>
<author><name sortKey="Suarez Almazor, Maria" sort="Suarez Almazor, Maria" uniqKey="Suarez Almazor M" first="Maria" last="Suarez-Almazor">Maria Suarez-Almazor</name>
</author>
<author><name sortKey="Silman, Alan J" sort="Silman, Alan J" uniqKey="Silman A" first="Alan J." last="Silman">Alan J. Silman</name>
</author>
<author><name sortKey="Smolen, Josef S" sort="Smolen, Josef S" uniqKey="Smolen J" first="Josef S." last="Smolen">Josef S. Smolen</name>
</author>
<author><name sortKey="Van Der Heijde, Desiree M F M" sort="Van Der Heijde, Desiree M F M" uniqKey="Van Der Heijde D" first="Desiree M. F. M." last="Van Der Heijde">Desiree M. F. M. Van Der Heijde</name>
</author>
<author><name sortKey="Van Riel, Piet L C M" sort="Van Riel, Piet L C M" uniqKey="Van Riel P" first="Piet L. C. M." last="Van Riel">Piet L. C. M. Van Riel</name>
</author>
<author><name sortKey="Wolfe, Fred" sort="Wolfe, Fred" uniqKey="Wolfe F" first="Fred" last="Wolfe">Fred Wolfe</name>
</author>
<author><name sortKey="Tugwell, Peter S" sort="Tugwell, Peter S" uniqKey="Tugwell P" first="Peter S." last="Tugwell">Peter S. Tugwell</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">INIST</idno>
<idno type="inist">05-0480266</idno>
<date when="2005">2005</date>
<idno type="stanalyst">PASCAL 05-0480266 INIST</idno>
<idno type="RBID">Pascal:05-0480266</idno>
<idno type="wicri:Area/PascalFrancis/Corpus">004689</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Minimal disease activity for rheumatoid arthritis : A preliminary definition</title>
<author><name sortKey="Wells, George A" sort="Wells, George A" uniqKey="Wells G" first="George A." last="Wells">George A. Wells</name>
<affiliation><inist:fA14 i1="01"><s1>Department of Epidemiology and Community Medicine, University of Ottawa</s1>
<s2>Ottawa</s2>
<s3>CAN</s3>
<sZ>1 aut.</sZ>
</inist:fA14>
</affiliation>
<affiliation><inist:fA14 i1="11"><s1>David Geffen School of Medicine, UCLA</s1>
<s2>Los Angeles</s2>
<s3>USA</s3>
</inist:fA14>
</affiliation>
<affiliation><inist:fA14 i1="12"><s1>Erasmus University Medical Center</s1>
<s2>Rotterdam</s2>
<s3>NLD</s3>
</inist:fA14>
</affiliation>
<affiliation><inist:fA14 i1="13"><s1>Mater Hospital, University of Newcastle</s1>
<s2>Newcastle</s2>
<s3>AUS</s3>
</inist:fA14>
</affiliation>
<affiliation><inist:fA14 i1="14"><s1>University of Bristol, Bristol Royal Infirmary</s1>
<s2>Bristol</s2>
<s3>GBR</s3>
</inist:fA14>
</affiliation>
<affiliation><inist:fA14 i1="15"><s1>University Hospital Maastricht</s1>
<s2>Maastricht</s2>
<s3>NLD</s3>
</inist:fA14>
</affiliation>
<affiliation><inist:fA14 i1="16"><s1>Department of Rheumatology, St. George Hospital</s1>
<s2>Sydney</s2>
<s3>AUS</s3>
</inist:fA14>
</affiliation>
<affiliation><inist:fA14 i1="17"><s1>National Data Bank for Rheumatic Diseases</s1>
<s2>Wichita</s2>
<s3>USA</s3>
</inist:fA14>
</affiliation>
<affiliation><inist:fA14 i1="18"><s1>Baylor College of Medicine and Michael E. De Bakey VAMC</s1>
<s2>Houston</s2>
<s3>USA</s3>
</inist:fA14>
</affiliation>
<affiliation><inist:fA14 i1="19"><s1>University of Manchester</s1>
<s2>Manchester</s2>
<s3>GBR</s3>
</inist:fA14>
</affiliation>
<affiliation><inist:fA14 i1="20"><s1>Harvard Medical School, Beth Israel Deaconess Medical Center</s1>
<s2>Boston</s2>
<s3>USA</s3>
</inist:fA14>
</affiliation>
<affiliation><inist:fA14 i1="21"><s1>Stanford University School of Medicine</s1>
<s2>Stanford</s2>
<s3>USA</s3>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Boers, Maarten" sort="Boers, Maarten" uniqKey="Boers M" first="Maarten" last="Boers">Maarten Boers</name>
</author>
<author><name sortKey="Shea, Beverley" sort="Shea, Beverley" uniqKey="Shea B" first="Beverley" last="Shea">Beverley Shea</name>
<affiliation><inist:fA14 i1="02"><s1>Institution of Population Health</s1>
<s2>Ottawa</s2>
<s3>CAN</s3>
<sZ>3 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Brooks, Peter M" sort="Brooks, Peter M" uniqKey="Brooks P" first="Peter M." last="Brooks">Peter M. Brooks</name>
<affiliation><inist:fA14 i1="03"><s1>University of Queensland, Royal Brisbane Hospital</s1>
<s2>Brisbane</s2>
<s3>AUS</s3>
<sZ>4 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Simon, Lee S" sort="Simon, Lee S" uniqKey="Simon L" first="Lee S." last="Simon">Lee S. Simon</name>
</author>
<author><name sortKey="Strand, C Vibeke" sort="Strand, C Vibeke" uniqKey="Strand C" first="C. Vibeke" last="Strand">C. Vibeke Strand</name>
</author>
<author><name sortKey="Aletaha, Daniel" sort="Aletaha, Daniel" uniqKey="Aletaha D" first="Daniel" last="Aletaha">Daniel Aletaha</name>
<affiliation><inist:fA14 i1="04"><s1>Medical University Vienna</s1>
<s2>Vienna</s2>
<s3>AUT</s3>
<sZ>7 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Anderson, Jennifer J" sort="Anderson, Jennifer J" uniqKey="Anderson J" first="Jennifer J." last="Anderson">Jennifer J. Anderson</name>
<affiliation><inist:fA14 i1="05"><s1>Boston University School of Public Health</s1>
<s2>Boston</s2>
<s3>USA</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Bombardier, Claire" sort="Bombardier, Claire" uniqKey="Bombardier C" first="Claire" last="Bombardier">Claire Bombardier</name>
<affiliation><inist:fA14 i1="06"><s1>Institution of Work and Health, University of Toronto</s1>
<s2>Toronto</s2>
<s3>CAN</s3>
<sZ>9 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Dougados, Maxime" sort="Dougados, Maxime" uniqKey="Dougados M" first="Maxime" last="Dougados">Maxime Dougados</name>
<affiliation><inist:fA14 i1="07"><s1>Hopital Cochin. Rene Descartes University</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>10 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Emery, Paul" sort="Emery, Paul" uniqKey="Emery P" first="Paul" last="Emery">Paul Emery</name>
<affiliation><inist:fA14 i1="08"><s1>University of Leeds</s1>
<s2>Leeds</s2>
<s3>GBR</s3>
<sZ>11 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Felson, David T" sort="Felson, David T" uniqKey="Felson D" first="David T." last="Felson">David T. Felson</name>
<affiliation><inist:fA14 i1="09"><s1>School of Medicine</s1>
<s2>Boston</s2>
<s3>USA</s3>
<sZ>12 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Fransen, Jaap" sort="Fransen, Jaap" uniqKey="Fransen J" first="Jaap" last="Fransen">Jaap Fransen</name>
<affiliation><inist:fA14 i1="10"><s1>Department of Rheumatology, University Hospital Nijmegen</s1>
<s3>NLD</s3>
<sZ>13 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Furst, Dan E" sort="Furst, Dan E" uniqKey="Furst D" first="Dan E." last="Furst">Dan E. Furst</name>
</author>
<author><name sortKey="Hazes, Johanna M W" sort="Hazes, Johanna M W" uniqKey="Hazes J" first="Johanna M. W." last="Hazes">Johanna M. W. Hazes</name>
</author>
<author><name sortKey="Johnson, Kent R" sort="Johnson, Kent R" uniqKey="Johnson K" first="Kent R." last="Johnson">Kent R. Johnson</name>
</author>
<author><name sortKey="Kirwan, John R" sort="Kirwan, John R" uniqKey="Kirwan J" first="John R." last="Kirwan">John R. Kirwan</name>
</author>
<author><name sortKey="Landewe, Robert B M" sort="Landewe, Robert B M" uniqKey="Landewe R" first="Robert B. M." last="Landewe">Robert B. M. Landewe</name>
</author>
<author><name sortKey="Lassere, Marissa N D" sort="Lassere, Marissa N D" uniqKey="Lassere M" first="Marissa N. D." last="Lassere">Marissa N. D. Lassere</name>
</author>
<author><name sortKey="Michaud, Kaleb" sort="Michaud, Kaleb" uniqKey="Michaud K" first="Kaleb" last="Michaud">Kaleb Michaud</name>
</author>
<author><name sortKey="Suarez Almazor, Maria" sort="Suarez Almazor, Maria" uniqKey="Suarez Almazor M" first="Maria" last="Suarez-Almazor">Maria Suarez-Almazor</name>
</author>
<author><name sortKey="Silman, Alan J" sort="Silman, Alan J" uniqKey="Silman A" first="Alan J." last="Silman">Alan J. Silman</name>
</author>
<author><name sortKey="Smolen, Josef S" sort="Smolen, Josef S" uniqKey="Smolen J" first="Josef S." last="Smolen">Josef S. Smolen</name>
</author>
<author><name sortKey="Van Der Heijde, Desiree M F M" sort="Van Der Heijde, Desiree M F M" uniqKey="Van Der Heijde D" first="Desiree M. F. M." last="Van Der Heijde">Desiree M. F. M. Van Der Heijde</name>
</author>
<author><name sortKey="Van Riel, Piet L C M" sort="Van Riel, Piet L C M" uniqKey="Van Riel P" first="Piet L. C. M." last="Van Riel">Piet L. C. M. Van Riel</name>
</author>
<author><name sortKey="Wolfe, Fred" sort="Wolfe, Fred" uniqKey="Wolfe F" first="Fred" last="Wolfe">Fred Wolfe</name>
</author>
<author><name sortKey="Tugwell, Peter S" sort="Tugwell, Peter S" uniqKey="Tugwell P" first="Peter S." last="Tugwell">Peter S. Tugwell</name>
</author>
</analytic>
<series><title level="j" type="main">Journal of rheumatology</title>
<title level="j" type="abbreviated">J. rheumatol.</title>
<idno type="ISSN">0315-162X</idno>
<imprint><date when="2005">2005</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Journal of rheumatology</title>
<title level="j" type="abbreviated">J. rheumatol.</title>
<idno type="ISSN">0315-162X</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Chronic</term>
<term>Clinical trial</term>
<term>Definition</term>
<term>Joint</term>
<term>Pain</term>
<term>Prognosis</term>
<term>Rheumatoid arthritis</term>
<term>Rheumatology</term>
<term>Survey</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Polyarthrite rhumatoïde</term>
<term>Définition</term>
<term>Pronostic</term>
<term>Essai clinique</term>
<term>Enquête</term>
<term>Articulation</term>
<term>Douleur</term>
<term>Rhumatologie</term>
<term>Chronique</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Agreement on response criteria in rheumatoid arthritis (RA) has allowed better standardization and interpretation of clinical trial reports. With recent advances in therapy, the proportion of patients achieving a satisfactory state of minimal disease activity (MDA) is becoming a more important measure with which to compare different treatment strategies. The threshold for MDA is between high disease activity and remission and, by definition, anyone in remission will also be in MDA. True remission is still rare in RA; in addition, the American College of Rheumatology definition is difficult to apply in the context of trials. Participants at OMERACT 6 in 2002 agreed on a conceptual definition of minimal disease activity (MDA): "that state of disease activity deemed a useful target of treatment by both the patient and the physician, given current treatment possibilities and limitations." To prepare for a preliminary operational definition of MDA for use in clinical trials, we asked rheumatologists to assess 60 patient profiles describing real RA patients seen in routine clinical practice. Based on their responses, several candidate definitions for MDA were designed and discussed at the OMERACT 7 in 2004. Feedback from participants and additional on-site analyses in a cross-sectional database allowed the formulation of 2 preliminary, equivalent definitions of MDA: one based on the Disease Activity Score 28 (DAS28) index, and one based on meeting cutpoints in 5 out the 7 WHO/ILAR core set measures. Researchers applying these definitions first need to choose whether to use the DAS28 or the core set definition, because although each selects a similar proportion in a population, these are not always the same patients. In both MDA definitions, an initial decision node places all patients in MDA who have a tender joint count of 0 and a swollen joint count of 0, and an erythrocyte sedimentation rate (ESR) no greater than 10 mm. If this condition is not met: ● The DAS28 definition places patients in MDA when DAS28 < 2.85 ● The core set definition places patients in MDA when they meet 5 of 7 criteria: (1) Pain (0-10) ≤ 2; (2) Swollen joint count (0-28) ≤ 1; (3) Tender joint count (0-28) ≤ 1; (4) Health Assessment Questionnaire (HAQ, 0-3) ≤ 0.5; (5) Physician global assessment of disease activity (0-10) ≤ 1.5; (6) Patient global assessment of disease activity (0-10) ≤ 2; (7) ESR ≤ 20. This set of 2 definitions gained approval of 73% of the attendees. These (and other) definitions will now be subject to further validation in other databases.</div>
</front>
</TEI>
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<fA08 i1="01" i2="1" l="ENG"><s1>Minimal disease activity for rheumatoid arthritis : A preliminary definition</s1>
</fA08>
<fA11 i1="01" i2="1"><s1>WELLS (George A.)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>BOERS (Maarten)</s1>
</fA11>
<fA11 i1="03" i2="1"><s1>SHEA (Beverley)</s1>
</fA11>
<fA11 i1="04" i2="1"><s1>BROOKS (Peter M.)</s1>
</fA11>
<fA11 i1="05" i2="1"><s1>SIMON (Lee S.)</s1>
</fA11>
<fA11 i1="06" i2="1"><s1>STRAND (C. Vibeke)</s1>
</fA11>
<fA11 i1="07" i2="1"><s1>ALETAHA (Daniel)</s1>
</fA11>
<fA11 i1="08" i2="1"><s1>ANDERSON (Jennifer J.)</s1>
</fA11>
<fA11 i1="09" i2="1"><s1>BOMBARDIER (Claire)</s1>
</fA11>
<fA11 i1="10" i2="1"><s1>DOUGADOS (Maxime)</s1>
</fA11>
<fA11 i1="11" i2="1"><s1>EMERY (Paul)</s1>
</fA11>
<fA11 i1="12" i2="1"><s1>FELSON (David T.)</s1>
</fA11>
<fA11 i1="13" i2="1"><s1>FRANSEN (Jaap)</s1>
</fA11>
<fA11 i1="14" i2="1"><s1>FURST (Dan E.)</s1>
</fA11>
<fA11 i1="15" i2="1"><s1>HAZES (Johanna M. W.)</s1>
</fA11>
<fA11 i1="16" i2="1"><s1>JOHNSON (Kent R.)</s1>
</fA11>
<fA11 i1="17" i2="1"><s1>KIRWAN (John R.)</s1>
</fA11>
<fA11 i1="18" i2="1"><s1>LANDEWE (Robert B. M.)</s1>
</fA11>
<fA11 i1="19" i2="1"><s1>LASSERE (Marissa N. D.)</s1>
</fA11>
<fA11 i1="20" i2="1"><s1>MICHAUD (Kaleb)</s1>
</fA11>
<fA11 i1="21" i2="1"><s1>SUAREZ-ALMAZOR (Maria)</s1>
</fA11>
<fA11 i1="22" i2="1"><s1>SILMAN (Alan J.)</s1>
</fA11>
<fA11 i1="23" i2="1"><s1>SMOLEN (Josef S.)</s1>
</fA11>
<fA11 i1="24" i2="1"><s1>VAN DER HEIJDE (Desiree M. F. M.)</s1>
</fA11>
<fA11 i1="25" i2="1"><s1>VAN RIEL (Piet L. C. M.)</s1>
</fA11>
<fA11 i1="26" i2="1"><s1>WOLFE (Fred)</s1>
</fA11>
<fA11 i1="27" i2="1"><s1>TUGWELL (Peter S.)</s1>
</fA11>
<fA14 i1="01"><s1>Department of Epidemiology and Community Medicine, University of Ottawa</s1>
<s2>Ottawa</s2>
<s3>CAN</s3>
<sZ>1 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>Institution of Population Health</s1>
<s2>Ottawa</s2>
<s3>CAN</s3>
<sZ>3 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>University of Queensland, Royal Brisbane Hospital</s1>
<s2>Brisbane</s2>
<s3>AUS</s3>
<sZ>4 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>Medical University Vienna</s1>
<s2>Vienna</s2>
<s3>AUT</s3>
<sZ>7 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>Boston University School of Public Health</s1>
<s2>Boston</s2>
<s3>USA</s3>
<sZ>8 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>Institution of Work and Health, University of Toronto</s1>
<s2>Toronto</s2>
<s3>CAN</s3>
<sZ>9 aut.</sZ>
</fA14>
<fA14 i1="07"><s1>Hopital Cochin. Rene Descartes University</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>10 aut.</sZ>
</fA14>
<fA14 i1="08"><s1>University of Leeds</s1>
<s2>Leeds</s2>
<s3>GBR</s3>
<sZ>11 aut.</sZ>
</fA14>
<fA14 i1="09"><s1>School of Medicine</s1>
<s2>Boston</s2>
<s3>USA</s3>
<sZ>12 aut.</sZ>
</fA14>
<fA14 i1="10"><s1>Department of Rheumatology, University Hospital Nijmegen</s1>
<s3>NLD</s3>
<sZ>13 aut.</sZ>
</fA14>
<fA14 i1="11"><s1>David Geffen School of Medicine, UCLA</s1>
<s2>Los Angeles</s2>
<s3>USA</s3>
</fA14>
<fA14 i1="12"><s1>Erasmus University Medical Center</s1>
<s2>Rotterdam</s2>
<s3>NLD</s3>
</fA14>
<fA14 i1="13"><s1>Mater Hospital, University of Newcastle</s1>
<s2>Newcastle</s2>
<s3>AUS</s3>
</fA14>
<fA14 i1="14"><s1>University of Bristol, Bristol Royal Infirmary</s1>
<s2>Bristol</s2>
<s3>GBR</s3>
</fA14>
<fA14 i1="15"><s1>University Hospital Maastricht</s1>
<s2>Maastricht</s2>
<s3>NLD</s3>
</fA14>
<fA14 i1="16"><s1>Department of Rheumatology, St. George Hospital</s1>
<s2>Sydney</s2>
<s3>AUS</s3>
</fA14>
<fA14 i1="17"><s1>National Data Bank for Rheumatic Diseases</s1>
<s2>Wichita</s2>
<s3>USA</s3>
</fA14>
<fA14 i1="18"><s1>Baylor College of Medicine and Michael E. De Bakey VAMC</s1>
<s2>Houston</s2>
<s3>USA</s3>
</fA14>
<fA14 i1="19"><s1>University of Manchester</s1>
<s2>Manchester</s2>
<s3>GBR</s3>
</fA14>
<fA14 i1="20"><s1>Harvard Medical School, Beth Israel Deaconess Medical Center</s1>
<s2>Boston</s2>
<s3>USA</s3>
</fA14>
<fA14 i1="21"><s1>Stanford University School of Medicine</s1>
<s2>Stanford</s2>
<s3>USA</s3>
</fA14>
<fA20><s1>2016-2024</s1>
</fA20>
<fA21><s1>2005</s1>
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</fA44>
<fA45><s0>11 ref.</s0>
</fA45>
<fA47 i1="01" i2="1"><s0>05-0480266</s0>
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<fA60><s1>P</s1>
<s2>C</s2>
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<fA61><s0>A</s0>
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<fA64 i1="01" i2="1"><s0>Journal of rheumatology</s0>
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<fA66 i1="01"><s0>CAN</s0>
</fA66>
<fC01 i1="01" l="ENG"><s0>Agreement on response criteria in rheumatoid arthritis (RA) has allowed better standardization and interpretation of clinical trial reports. With recent advances in therapy, the proportion of patients achieving a satisfactory state of minimal disease activity (MDA) is becoming a more important measure with which to compare different treatment strategies. The threshold for MDA is between high disease activity and remission and, by definition, anyone in remission will also be in MDA. True remission is still rare in RA; in addition, the American College of Rheumatology definition is difficult to apply in the context of trials. Participants at OMERACT 6 in 2002 agreed on a conceptual definition of minimal disease activity (MDA): "that state of disease activity deemed a useful target of treatment by both the patient and the physician, given current treatment possibilities and limitations." To prepare for a preliminary operational definition of MDA for use in clinical trials, we asked rheumatologists to assess 60 patient profiles describing real RA patients seen in routine clinical practice. Based on their responses, several candidate definitions for MDA were designed and discussed at the OMERACT 7 in 2004. Feedback from participants and additional on-site analyses in a cross-sectional database allowed the formulation of 2 preliminary, equivalent definitions of MDA: one based on the Disease Activity Score 28 (DAS28) index, and one based on meeting cutpoints in 5 out the 7 WHO/ILAR core set measures. Researchers applying these definitions first need to choose whether to use the DAS28 or the core set definition, because although each selects a similar proportion in a population, these are not always the same patients. In both MDA definitions, an initial decision node places all patients in MDA who have a tender joint count of 0 and a swollen joint count of 0, and an erythrocyte sedimentation rate (ESR) no greater than 10 mm. If this condition is not met: ● The DAS28 definition places patients in MDA when DAS28 < 2.85 ● The core set definition places patients in MDA when they meet 5 of 7 criteria: (1) Pain (0-10) ≤ 2; (2) Swollen joint count (0-28) ≤ 1; (3) Tender joint count (0-28) ≤ 1; (4) Health Assessment Questionnaire (HAQ, 0-3) ≤ 0.5; (5) Physician global assessment of disease activity (0-10) ≤ 1.5; (6) Patient global assessment of disease activity (0-10) ≤ 2; (7) ESR ≤ 20. This set of 2 definitions gained approval of 73% of the attendees. These (and other) definitions will now be subject to further validation in other databases.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B15D</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE"><s0>Polyarthrite rhumatoïde</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG"><s0>Rheumatoid arthritis</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA"><s0>Poliartritis reumatoidea</s0>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE"><s0>Définition</s0>
<s5>07</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG"><s0>Definition</s0>
<s5>07</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA"><s0>Definición</s0>
<s5>07</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE"><s0>Pronostic</s0>
<s5>08</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG"><s0>Prognosis</s0>
<s5>08</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA"><s0>Pronóstico</s0>
<s5>08</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE"><s0>Essai clinique</s0>
<s5>09</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG"><s0>Clinical trial</s0>
<s5>09</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA"><s0>Ensayo clínico</s0>
<s5>09</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE"><s0>Enquête</s0>
<s5>13</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG"><s0>Survey</s0>
<s5>13</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA"><s0>Encuesta</s0>
<s5>13</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE"><s0>Articulation</s0>
<s5>14</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG"><s0>Joint</s0>
<s5>14</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Articulación</s0>
<s5>14</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE"><s0>Douleur</s0>
<s5>15</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG"><s0>Pain</s0>
<s5>15</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Dolor</s0>
<s5>15</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE"><s0>Rhumatologie</s0>
<s5>16</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Rheumatology</s0>
<s5>16</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Reumatología</s0>
<s5>16</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE"><s0>Chronique</s0>
<s5>30</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG"><s0>Chronic</s0>
<s5>30</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA"><s0>Crónico</s0>
<s5>30</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Maladie autoimmune</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Autoimmune disease</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Enfermedad autoinmune</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Rhumatisme inflammatoire</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Inflammatory joint disease</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Reumatismo inflamatorio</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Système ostéoarticulaire pathologie</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Diseases of the osteoarticular system</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Sistema osteoarticular patología</s0>
<s5>39</s5>
</fC07>
<fN21><s1>339</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
</pA>
<pR><fA30 i1="01" i2="1" l="ENG"><s1>OMERACT 7 - International Consensus on Outcome Measures in Rheumatology Clinical Trials</s1>
<s2>7</s2>
<s3>Asilomar, California USA</s3>
<s4>2004-03-08</s4>
</fA30>
</pR>
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<server><NO>PASCAL 05-0480266 INIST</NO>
<ET>Minimal disease activity for rheumatoid arthritis : A preliminary definition</ET>
<AU>WELLS (George A.); BOERS (Maarten); SHEA (Beverley); BROOKS (Peter M.); SIMON (Lee S.); STRAND (C. Vibeke); ALETAHA (Daniel); ANDERSON (Jennifer J.); BOMBARDIER (Claire); DOUGADOS (Maxime); EMERY (Paul); FELSON (David T.); FRANSEN (Jaap); FURST (Dan E.); HAZES (Johanna M. W.); JOHNSON (Kent R.); KIRWAN (John R.); LANDEWE (Robert B. M.); LASSERE (Marissa N. D.); MICHAUD (Kaleb); SUAREZ-ALMAZOR (Maria); SILMAN (Alan J.); SMOLEN (Josef S.); VAN DER HEIJDE (Desiree M. F. M.); VAN RIEL (Piet L. C. M.); WOLFE (Fred); TUGWELL (Peter S.)</AU>
<AF>Department of Epidemiology and Community Medicine, University of Ottawa/Ottawa/Canada (1 aut.); Institution of Population Health/Ottawa/Canada (3 aut.); University of Queensland, Royal Brisbane Hospital/Brisbane/Australie (4 aut.); Medical University Vienna/Vienna/Autriche (7 aut.); Boston University School of Public Health/Boston/Etats-Unis (8 aut.); Institution of Work and Health, University of Toronto/Toronto/Canada (9 aut.); Hopital Cochin. Rene Descartes University/Paris/France (10 aut.); University of Leeds/Leeds/Royaume-Uni (11 aut.); School of Medicine/Boston/Etats-Unis (12 aut.); Department of Rheumatology, University Hospital Nijmegen/Pays-Bas (13 aut.); David Geffen School of Medicine, UCLA/Los Angeles/Etats-Unis; Erasmus University Medical Center/Rotterdam/Pays-Bas; Mater Hospital, University of Newcastle/Newcastle/Australie; University of Bristol, Bristol Royal Infirmary/Bristol/Royaume-Uni; University Hospital Maastricht/Maastricht/Pays-Bas; Department of Rheumatology, St. George Hospital/Sydney/Australie; National Data Bank for Rheumatic Diseases/Wichita/Etats-Unis; Baylor College of Medicine and Michael E. De Bakey VAMC/Houston/Etats-Unis; University of Manchester/Manchester/Royaume-Uni; Harvard Medical School, Beth Israel Deaconess Medical Center/Boston/Etats-Unis; Stanford University School of Medicine/Stanford/Etats-Unis</AF>
<DT>Publication en série; Congrès; Niveau analytique</DT>
<SO>Journal of rheumatology; ISSN 0315-162X; Coden JRHUA9; Canada; Da. 2005; Vol. 32; No. 10; Pp. 2016-2024; Bibl. 11 ref.</SO>
<LA>Anglais</LA>
<EA>Agreement on response criteria in rheumatoid arthritis (RA) has allowed better standardization and interpretation of clinical trial reports. With recent advances in therapy, the proportion of patients achieving a satisfactory state of minimal disease activity (MDA) is becoming a more important measure with which to compare different treatment strategies. The threshold for MDA is between high disease activity and remission and, by definition, anyone in remission will also be in MDA. True remission is still rare in RA; in addition, the American College of Rheumatology definition is difficult to apply in the context of trials. Participants at OMERACT 6 in 2002 agreed on a conceptual definition of minimal disease activity (MDA): "that state of disease activity deemed a useful target of treatment by both the patient and the physician, given current treatment possibilities and limitations." To prepare for a preliminary operational definition of MDA for use in clinical trials, we asked rheumatologists to assess 60 patient profiles describing real RA patients seen in routine clinical practice. Based on their responses, several candidate definitions for MDA were designed and discussed at the OMERACT 7 in 2004. Feedback from participants and additional on-site analyses in a cross-sectional database allowed the formulation of 2 preliminary, equivalent definitions of MDA: one based on the Disease Activity Score 28 (DAS28) index, and one based on meeting cutpoints in 5 out the 7 WHO/ILAR core set measures. Researchers applying these definitions first need to choose whether to use the DAS28 or the core set definition, because although each selects a similar proportion in a population, these are not always the same patients. In both MDA definitions, an initial decision node places all patients in MDA who have a tender joint count of 0 and a swollen joint count of 0, and an erythrocyte sedimentation rate (ESR) no greater than 10 mm. If this condition is not met: ● The DAS28 definition places patients in MDA when DAS28 < 2.85 ● The core set definition places patients in MDA when they meet 5 of 7 criteria: (1) Pain (0-10) ≤ 2; (2) Swollen joint count (0-28) ≤ 1; (3) Tender joint count (0-28) ≤ 1; (4) Health Assessment Questionnaire (HAQ, 0-3) ≤ 0.5; (5) Physician global assessment of disease activity (0-10) ≤ 1.5; (6) Patient global assessment of disease activity (0-10) ≤ 2; (7) ESR ≤ 20. This set of 2 definitions gained approval of 73% of the attendees. These (and other) definitions will now be subject to further validation in other databases.</EA>
<CC>002B15D</CC>
<FD>Polyarthrite rhumatoïde; Définition; Pronostic; Essai clinique; Enquête; Articulation; Douleur; Rhumatologie; Chronique</FD>
<FG>Maladie autoimmune; Rhumatisme inflammatoire; Système ostéoarticulaire pathologie</FG>
<ED>Rheumatoid arthritis; Definition; Prognosis; Clinical trial; Survey; Joint; Pain; Rheumatology; Chronic</ED>
<EG>Autoimmune disease; Inflammatory joint disease; Diseases of the osteoarticular system</EG>
<SD>Poliartritis reumatoidea; Definición; Pronóstico; Ensayo clínico; Encuesta; Articulación; Dolor; Reumatología; Crónico</SD>
<LO>INIST-16024.354000132761500290</LO>
<ID>05-0480266</ID>
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Minimal disease activity for rheumatoid arthritis : A preliminary definition

Minimal disease activity for rheumatoid arthritis : A preliminary definition

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