Abstract
Objective: Sometimes there is some discordance in patient’s response and patient’s global assessment (PGA). We investigated the relationship of 5 kinds of patient’s response and PGA with actual patient’ rheumatoid activity in 104 patients with rheumatoid arthritis (RA).
Methods: 5 kinds of patient’s response (very good, good, tolerable, bad and very bad) to doctor’s question about the state of their rheumatism and other indices (PGA, doctor’s global assessment: DGA, serum CRP levels, DAS28CRP levels, modified HAQ levels) were compared. Furthermore, sex differences of two groups (very good, tolerable) were compared.
Results: 17 male and 87 female patients were enrolled. Average age was 63 years and average duration was 13 years. There were 10 very good cases, 30 good cases, 49 tolerable cases, 14 bad cases, and 1 very bad case. The clinical data (PGA, DGA, DAS28CRP, mHAQ) deteriorated in parallel with deterioration of response. On the other hand, age, duration, stage, class and serum CRP levels did not show consistent trends. In PGA, the mean value deteriorated according to the deterioration of response although each patient’s PGA showed a large variation. PGA showed highest correlation with patient response and the second highest correlation was mHAQ. As a result of considering gender differences, the very good group showed that the rheumatoid activity was relatively worse in males, and in the tolerable group, the rheumatoid activity was relatively worse in females.
Conclusion: Sometimes there is a large dissociation with patient’s response and PGA, It is necessary to consider the backgrounds and gender differences in individual patients.
