Department of Gastroenterology, Infectiology and Rheumatology (Including Nutrition Medicine), Charité Universitätsmedizin Berlin, Berlin, Germany
Department of Gastroenterology, Infectiology and Rheumatology (Including Nutrition Medicine), Charité Universitätsmedizin Berlin, Berlin, Germany.
RMD Open. 2022 Nov;8(2). doi: 10.1136/rmdopen-2022-002626.
This study aimed to evaluate the Disease Activity index for PSoriatic Arthritis (DAPSA) based on a quick quantitative C reactive protein (qCRP) assay (Q-DAPSA) in a multicentre, prospective, cross-sectional study in patients with psoriatic arthritis (PsA).
The assessment of prospectively recruited study patients included joint examination and patient reported outcome (PRO) measures (patient global assessment, patient pain assessment). Following, the DAPSA based on a routine laboratory CRP measurement, Q-DAPSA and clinical DAPSA (cDAPSA) were calculated. Cross-tabulations and weighted Cohen's kappa were performed to analyse the agreement of disease activity categories. Bland-Altman plots and intraclass correlation coefficients were used to determine the agreement of numerical values regarding CRP and qCRP as well as different disease activity scores.
Altogether, 104 patients with PsA could be included in the statistical analysis. With Q-DAPSA, 102 of 104 (98.1%) patients achieved identical disease activity categories in comparison to DAPSA with a weighted Cohen's kappa of 0.980 (95% CI: 0.952 to 1.000). The agreement between DAPSA and cDAPSA was slightly lower with identical disease activity categories seen in 97 of 104 (93.3%) of patients and with a weighted Cohen's kappa of 0.932 (95% CI 0.885 to 0.980).
The Q-DAPSA showed an almost perfect agreement with the conventional DAPSA regarding identical disease activity categories. Thus, the Q-DAPSA can be used as a timely available disease activity score in patients with PsA with the additional benefit of CRP involvement. Consequently, the Q-DAPSA could facilitate the implementation of the treat-to-target concept in clinical routine and clinical trials.
本研究旨在通过一项多中心、前瞻性、横断面研究，评估基于快速定量 C 反应蛋白（qCRP）检测的银屑病关节炎疾病活动指数（DAPSA）（Q-DAPSA）在银屑病关节炎（PsA）患者中的应用。
前瞻性招募的研究患者的评估包括关节检查和患者报告的结局（PRO）测量（患者整体评估、患者疼痛评估）。随后，计算了基于常规实验室 CRP 测量的 DAPSA、Q-DAPSA 和临床 DAPSA（cDAPSA）。进行交叉表和加权 Cohen's kappa 分析以分析疾病活动类别之间的一致性。Bland-Altman 图和组内相关系数用于确定 CRP 和 qCRP 以及不同疾病活动评分的数值一致性。
共有 104 例 PsA 患者纳入统计分析。与 DAPSA 相比，Q-DAPSA 中 104 例患者中有 102 例（98.1%）达到相同的疾病活动类别，加权 Cohen's kappa 值为 0.980（95%CI：0.952 至 1.000）。DAPSA 与 cDAPSA 的一致性略低，97 例患者（93.3%）达到相同的疾病活动类别，加权 Cohen's kappa 值为 0.932（95%CI 0.885 至 0.980）。
Q-DAPSA 与传统 DAPSA 相比，在相同的疾病活动类别方面具有几乎完美的一致性。因此，Q-DAPSA 可作为 PsA 患者及时可用的疾病活动评分，且具有 CRP 参与的额外益处。因此，Q-DAPSA 可促进治疗目标在临床常规和临床试验中的实施。
