Abstract
Objective: To compare the ACR and the EULAR response criteria in RA patients treated with infliximab.
Methods: Two rheumatologists evaluated 33 patients with RA who were injected IFX more than 5 times. Tender joint count, swollen joint count, physician global assessment, patient assessment of pain, patient global assessment, patient assessment of physical function, and C-reactive protein (CRP) were examined just before each IFX injection.
Results: The achievement rates of the ACR response gradually elevated after the start of IFX treatment, while the achievement rates of the EULAR response plateaued just after the second IFX injection. The ACR response was worse than the EULAR response throughout the observation periods. The 20%-achievement rates of patient assessments of global and physical function in the high disease activity group (having 6 or more tender and swollen joints and CRR level 2 mg/dl or more) were around 20% higher than those in the low disease activity group. The ACR response was affected by the disease activity at the baseline, while the EULAR response was not. Patient assessments had relatively wide variation (noise) compared to improvements (signal) that may cause the invalidity of the ACR response.
Conclusion: The EULAR criteria responded more rapidly than the ACR criteria. The ACR response was poor compared to the EULAR response especially in the low disease activity group.
