Cut-offs and response criteria for the Hospital Universitario la Princesa Index (HUPI) and their comparison to widely-used indices of disease activity in rheumatoid arthritis

González-Álvaro, I. ; Castrejón, I. ; Ortiz, A.M. ; Toledano, E. ; Castañeda, S. ; García-Vadillo, A. ; Carmona, L. ; Abasolo Alcazar, L. ; Miguel, Alegre De ; Andreu Sánchez, J.L. ; Aragón Díez, A. ; Balsa Criado, A. ; Batlle Gualda, E. ; Belmonte Serrano, M.A. ; Beltrán Audera, J. ; Beltrán Fabregat, J. ; Bonilla Hernan, G. ; Carmona Ortells, L. ; Caro Fernández, N. ; Casado, E. ; Cebrian Mendez, L. ; Corteguera Coro, M. ; Cuadra Díaz, J.L. ; Cuesta, E. ; Fiter Aresté, J. ; Freire Gonzalez, M. ; Galindo Izquierdo, M. ; García Meijide, J.A. ; García Gómez, M.C. ; Giménez Ubeda, E. ; Gómez Centeno, E. ; Gómez Vaquero, C. ; González Fernández, M.J. ; González Gómez, M.L. ; González Hernández, T. ; González-Alvaro, I. ; González-Montagut Gómez, C. ; Grandal Delgado, Y. ; Gratacos Masmitja, J. ; Hernández, Del R. ; Instxaurbe, A.R. ; Irigoyen Oyarzabal, M.V. ; Jiménez Palop, M. ; Juan Mas, A. ; Júdez Navarro, E. ; Larrosa Padro, M. ; López Longo, F.J. ; Loza Santamaria, E. ; Maese Manzano, J. ; Manero Ruiz, F.J. ; Mateo Bernardo, I. ; Mayordomo González, L. ; Mazzucheli, R. ; Medrano, San Idelfonso (Universidad de Zaragoza) ; Naranjo Hernández, A. ; Pecondón Español, A. (Universidad de Zaragoza) ; Peiró Callizo, E. ; Quirós Donate, J. ; Ramos López, P. ; Rivera Redondo, J. ; Rodríguez Gómez, M. ; Rodríguez López, M. ; Roselló Pardo, R. ; Sampedro Alvarez, J. ; Sanmartí Sala, R. ; Santos, Rey Rey ; Tena Marsá, X. ; Tenorio Martín, M. ; Torres Martín, Mc ; Ureña Garnica, I. ; Diego, Valdazo De ; Valls, M. ; Villaverde García, V. ; Zarco Montejo, P. ; Zubieta Tabernero, J.

Resumen: Objective To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Methods Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. Results The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if =2, low disease activity if >2 and =5), moderate if >5 and <9 and high if =9. HUPI''s AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28''s AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. Conclusions The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis.

Idioma: Inglés

DOI: 10.1371/journal.pone.0161727

Año: 2016

Publicado en: PloS one 11, 9 (2016), 0161727[]
ISSN: 1932-6203

Factor impacto JCR: 2.806 (2016)

Categ. JCR: MULTIDISCIPLINARY SCIENCES rank: 15 / 63 = 0.238 (2016) - Q1 - T1

Factor impacto SCIMAGO: 1.236 - Agricultural and Biological Sciences (miscellaneous) (Q1) - Medicine (miscellaneous) (Q1) - Biochemistry, Genetics and Molecular Biology (miscellaneous) (Q1)

Financiación: info:eu-repo/grantAgreement/ES/MINECO/ISCIII-PI14-00442
Financiación: info:eu-repo/grantAgreement/ES/MINECO/ISCIII-RD12-0009-0017

Tipo y forma: Article (Published version)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)