Responsiveness of Keitel functional index compared with laboratory measures of disease activity in rheumatoid arthritis

This study compares functional changes to change in measures of disease activity following the introduction of slow-acting anti-rheumatic drugs (SAARD) in patients with active rheumatoid arthritis (RA). Clinical and laboratory variables were simultaneously monitored at 6-monthly intervals, over appr...

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Bibliographic Details
Published in:British journal of rheumatology 1995-02, Vol.34 (2), p.141-149
Main Authors: KALLA, A. A, SMITH, P. R, BROWN, G. M. M, MEYERS, O. L, CHALTON, D
Format: Article
Language:English
Subjects:
Anti-Inflammatory Agents - therapeutic use
Arthritis, Rheumatoid - drug therapy
Arthritis, Rheumatoid - physiopathology
Biological and medical sciences
Blood Sedimentation
C-Reactive Protein - analysis
Cohort Studies
Disability Evaluation
Diseases of the osteoarticular system
Extremities - physiopathology
Female
Hand - physiopathology
Humans
Inflammatory joint diseases
Joints - physiopathology
Male
Medical sciences
Middle Aged
Regression Analysis
Wrist - physiopathology
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Summary:This study compares functional changes to change in measures of disease activity following the introduction of slow-acting anti-rheumatic drugs (SAARD) in patients with active rheumatoid arthritis (RA). Clinical and laboratory variables were simultaneously monitored at 6-monthly intervals, over approximately 18 months. Function was measured by a performance testing, the Keitel function index (KFI), which was divided into sections representing small and large joints [hand (HFI); wrist (WFI) and limb function index (LFI)]. One-hundred-and-fifteen patients were studied, of whom 21 were male. The mean age of the subjects was 49 yr (S.D. +/- 12) and mean duration of disease 7 yr (S.D. +/- 7). The mean KFI at entry was 38 (S.D. +/- 18) while at the end of the study it was 31 (S.D. +/- 17) (P < 0.0001). The change in KFI following therapy correlated with the change in Ritchie articular index (RAI) (r = 0.4; P < 0.0001), early morning stiffness (EMS) (r = 0.3; P = 0.004), swollen joint count (JC) (r = 0.4; P = 0.0005), C-reactive protein (CRP) (r = 0.2; P < 0.05) and Lansbury systemic index (LSI) (r = 0.35; P = 0.002), but not with change in Westergren erythrocyte sedimentation rate (ESR) or change in time to onset of fatigue. Multiple regression analysis showed that 32% of the variation in KFI at the end of the study could be predicted by a combination of ESR, sulphasalazine therapy, RAI, disease duration and chloroquine treatment at onset (P < 0.05).
ISSN:0263-7103
1460-2172