Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.
Faculty of Medicine, Western University, London, Ontario, Canada.
Rheumatology (Oxford). 2020 Jan 1;59(1):69-76. doi: 10.1093/rheumatology/kez202.
The Psoriatic Arthritis Disease Activity Score (PASDAS) and Disease Activity Index for Psoriatic Arthritis (DAPSA) are composite PsA disease activity measures. We sought to identify the PASDAS and DAPSA cut-off points consistent with patient acceptable symptom state (PASS), the threshold of symptoms beyond which patients consider themselves well, and examine PASS across published PASDAS and DAPSA thresholds for low, moderate and high disease activity.
We used a standard protocol including physician assessment and patient-reported outcomes to prospectively record measures required to calculate PASDAS and DAPSA. We identified PASS thresholds for the PASDAS and DAPSA using receiver operating characteristics curve analyses. We assessed the frequency of reporting acceptable symptom state across disease activity thresholds for PASDAS and DAPSA scores.
A total of 229 patients (58.5% male, mean age 55.5 years, mean disease duration 17.1 years) were recruited. The PASS threshold for the PASDAS was 3.79 [area under the curve (AUC) 0.86, sensitivity 0.75, specificity 0.82] and for the DAPSA was 11.10 (AUC 0.91, sensitivity 0.89, specificity 0.82). With the PASDAS, 90% of patients defined as having low disease activity considered their symptom state acceptable, compared with 55% and 17% among those with moderate and high disease activity, respectively. With the DAPSA, 98% of patients in disease remission considered their symptom state acceptable compared with 85, 22 and 18% among those with low, moderate and high disease activity, respectively.
We have defined PASS thresholds for PASDAS and DAPSA. The PASDAS target for low disease activity and DAPSA targets of low disease activity or remission align well with PASS.
银屑病关节炎疾病活动评分（PASDAS）和银屑病关节炎疾病活动指数（DAPSA）是综合的银屑病关节炎疾病活动测量指标。我们旨在确定与患者可接受的症状状态（PASS）一致的 PASDAS 和 DAPSA 截断值，该阈值表示患者认为自己病情良好的症状程度，并在已发表的用于低、中、高度疾病活动的 PASDAS 和 DAPSA 截断值范围内检查 PASS。
我们使用包括医生评估和患者报告的结果在内的标准方案，前瞻性地记录计算 PASDAS 和 DAPSA 所需的指标。我们使用受试者工作特征曲线分析确定 PASDAS 和 DAPSA 的 PASS 截断值。我们评估了 PASDAS 和 DAPSA 评分在不同疾病活动阈值下报告可接受的症状状态的频率。
共纳入 229 例患者（58.5%为男性，平均年龄 55.5 岁，平均疾病病程 17.1 年）。PASDAS 的 PASS 截断值为 3.79（曲线下面积（AUC）为 0.86，敏感性为 0.75，特异性为 0.82），DAPSA 的 PASS 截断值为 11.10（AUC 为 0.91，敏感性为 0.89，特异性为 0.82）。在 PASDAS 中，90%被定义为低疾病活动的患者认为其症状状态可接受，而中、高度疾病活动的患者分别为 55%和 17%。在 DAPSA 中，98%处于疾病缓解的患者认为其症状状态可接受，而低、中、高度疾病活动的患者分别为 85%、22%和 18%。
我们已经为 PASDAS 和 DAPSA 定义了 PASS 截断值。PASDAS 用于低疾病活动的目标和 DAPSA 用于低疾病活动或缓解的目标与 PASS 很好地一致。
