The comparative responsiveness of Hospital Universitario Princesa Index and other composite indices for assessing rheumatoid arthritis activity

Isidoro Gonzalez-Alvaro; Isabel Castrejon; Loreto Carmona; M. Dougados; T. Huizinga; M. Abu Shakra; A. Alberts; M. Alperi Lopez; H. Amital; M. Aringer; S. Aslanidis; F. Berenbaum; H. Bijlsma; F. J. Blanco Garcia; H. Bliddal; M. Borofsky; O. Brocq; S. Buldakov; F. Cantini; L. Carreno Perez; W. Chahade; R. Ciconelli; C. Codreanu; S. R. Dahlqvist; N. Damjanov; A. Diamantopoulos; L. Dimdina; A. Dimic; A. Dorokhov; A. Dubikov; G. Fadienko; N. Fano; G. Ferreira; A. Gabrielli; K. Gaffney; P. Gaudin; D. M. Gerlag; R. Gerli; C. R. Goncalves; M. S. Hansen; P. Hanvivadhanakul; C. Hoili; A. Hou; J. Hunter; T. Ilic; R. Ionescu; J. Kaine; N. Kakurina; J. Van Laar; D. Vosse; ACT-RAY Study Group; PROAR Study Group; EMECAR Study Group

doi:10.1371/journal.pone.0214717

The comparative responsiveness of Hospital Universitario Princesa Index and other composite indices for assessing rheumatoid arthritis activity

Isidoro Gonzalez-Alvaro^*, Isabel Castrejon, Loreto Carmona, M. Dougados, T. Huizinga, M. Abu Shakra, A. Alberts, M. Alperi Lopez, H. Amital, M. Aringer, S. Aslanidis, F. Berenbaum, H. Bijlsma, F. J. Blanco Garcia, H. Bliddal, M. Borofsky, O. Brocq, S. Buldakov, F. Cantini, L. Carreno PerezW. Chahade, R. Ciconelli, C. Codreanu, S. R. Dahlqvist, N. Damjanov, A. Diamantopoulos, L. Dimdina, A. Dimic, A. Dorokhov, A. Dubikov, G. Fadienko, N. Fano, G. Ferreira, A. Gabrielli, K. Gaffney, P. Gaudin, D. M. Gerlag, R. Gerli, C. R. Goncalves, M. S. Hansen, P. Hanvivadhanakul, C. Hoili, A. Hou, J. Hunter, T. Ilic, R. Ionescu, J. Kaine, N. Kakurina, J. Van Laar, D. Vosse, ACT-RAY Study Group, PROAR Study Group, EMECAR Study Group

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective

To evaluate the responsiveness in terms of correlation of the Hospital Universitario La Princesa Index (HUPI) comparatively to the traditional composite indices used to assess disease activity in rheumatoid arthritis (RA), and to compare the performance of HUPI-based response criteria with that of the EULAR response criteria.

Methods

Secondary data analysis from the following studies: ACT-RAY (clinical trial), PROAR (early RA cohort) and EMECAR (pre-biologic era long term RA cohort). Responsiveness was evaluated by: 1) comparing change from baseline (Delta) of HUPI with Delta in other scores by calculating correlation coefficients; 2) calculating standardised effect sizes. The accuracy of response by HUPI and by EULAR criteria was analyzed using linear regressions in which the dependent variable was change in global assessment by physician (Delta GDA-Phy).

Results

Delta HUPI correlation with change in all other indices ranged from 0.387 to 0.791); HUPI's standardized effect size was larger than those from the other indices in each database used. In ACT-RAY, depending on visit, between 65 and 80% of patients were equally classified by HUPI and EULAR response criteria. However, HUPI criteria were slightly more stringent, with higher percentage of patients classified as non-responder, especially at early visits. HUPI response criteria showed a slightly higher accuracy than EULAR response criteria when using Delta GDA-Phy as gold standard.

Conclusion

HUPI shows good responsiveness in terms of correlation in each studied scenario (clinical trial, early RA cohort, and established RA cohort). Response criteria by HUPI seem more stringent than EULAR's.

Original language	English
Article number	0214717
Number of pages	19
Journal	PLOS ONE
Volume	14
Issue number	4
DOIs	https://doi.org/10.1371/journal.pone.0214717
Publication status	Published - 10 Apr 2019

Keywords

DISEASE-ACTIVITY MEASURES
RECOMMENDATIONS
VALIDATION
VARIABLES
GENDER
SCORES

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Gonzalez-Alvaro, I., Castrejon, I., Carmona, L., Dougados, M., Huizinga, T., Abu Shakra, M., Alberts, A., Alperi Lopez, M., Amital, H., Aringer, M., Aslanidis, S., Berenbaum, F., Bijlsma, H., Blanco Garcia, F. J., Bliddal, H., Borofsky, M., Brocq, O., Buldakov, S., Cantini, F., ... EMECAR Study Group (2019). The comparative responsiveness of Hospital Universitario Princesa Index and other composite indices for assessing rheumatoid arthritis activity. PLOS ONE, 14(4), Article 0214717. https://doi.org/10.1371/journal.pone.0214717

@article{570afb4771ca4ada855a9f7b21924bc5,

title = "The comparative responsiveness of Hospital Universitario Princesa Index and other composite indices for assessing rheumatoid arthritis activity",

abstract = "ObjectiveTo evaluate the responsiveness in terms of correlation of the Hospital Universitario La Princesa Index (HUPI) comparatively to the traditional composite indices used to assess disease activity in rheumatoid arthritis (RA), and to compare the performance of HUPI-based response criteria with that of the EULAR response criteria.MethodsSecondary data analysis from the following studies: ACT-RAY (clinical trial), PROAR (early RA cohort) and EMECAR (pre-biologic era long term RA cohort). Responsiveness was evaluated by: 1) comparing change from baseline (Delta) of HUPI with Delta in other scores by calculating correlation coefficients; 2) calculating standardised effect sizes. The accuracy of response by HUPI and by EULAR criteria was analyzed using linear regressions in which the dependent variable was change in global assessment by physician (Delta GDA-Phy).ResultsDelta HUPI correlation with change in all other indices ranged from 0.387 to 0.791); HUPI's standardized effect size was larger than those from the other indices in each database used. In ACT-RAY, depending on visit, between 65 and 80% of patients were equally classified by HUPI and EULAR response criteria. However, HUPI criteria were slightly more stringent, with higher percentage of patients classified as non-responder, especially at early visits. HUPI response criteria showed a slightly higher accuracy than EULAR response criteria when using Delta GDA-Phy as gold standard.ConclusionHUPI shows good responsiveness in terms of correlation in each studied scenario (clinical trial, early RA cohort, and established RA cohort). Response criteria by HUPI seem more stringent than EULAR's.",

keywords = "DISEASE-ACTIVITY MEASURES, RECOMMENDATIONS, VALIDATION, VARIABLES, GENDER, SCORES",

author = "Isidoro Gonzalez-Alvaro and Isabel Castrejon and Loreto Carmona and M. Dougados and T. Huizinga and {Abu Shakra}, M. and A. Alberts and {Alperi Lopez}, M. and H. Amital and M. Aringer and S. Aslanidis and F. Berenbaum and H. Bijlsma and {Blanco Garcia}, {F. J.} and H. Bliddal and M. Borofsky and O. Brocq and S. Buldakov and F. Cantini and {Carreno Perez}, L. and W. Chahade and R. Ciconelli and C. Codreanu and Dahlqvist, {S. R.} and N. Damjanov and A. Diamantopoulos and L. Dimdina and A. Dimic and A. Dorokhov and A. Dubikov and G. Fadienko and N. Fano and G. Ferreira and A. Gabrielli and K. Gaffney and P. Gaudin and Gerlag, {D. M.} and R. Gerli and Goncalves, {C. R.} and Hansen, {M. S.} and P. Hanvivadhanakul and C. Hoili and A. Hou and J. Hunter and T. Ilic and R. Ionescu and J. Kaine and N. Kakurina and {Van Laar}, J. and D. Vosse and {ACT-RAY Study Group} and {PROAR Study Group} and {EMECAR Study Group}",

note = "Funding Information: Our study was supported by grants RD16/0012/0011 and PI14/00442 from the Ministerio de Economia y Competitividad (Instituto de Salud Carlos III; Spain) and cofunded by the Fondo Europeo de Desarrollo Regional (FEDER). Data from ACT-RAY clinical trial were kindly provided by Hoffmann-La Roche Ltd. No financial support was received from Hoffmann-La Roche Ltd Data from EMECAR and PROAR cohorts were provided by the Spanish Society of Rheumatology. No financial support was received from the Spanish Society of Rheumatology. None of these institutions played any role in the analysis or interpretation of data, nor were they involved in the writing of the manuscript. Roche and Sociedad Espa{\~n}ola de Reumatolog{\'i}a were involved in the collection of data from ACT-RAY, and EMECAR and PROAR, respectively. However, these funders had no role in study design, analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2019 Gonz{\'a}lez-{\'A}lvaro et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2019",

month = apr,

day = "10",

doi = "10.1371/journal.pone.0214717",

language = "English",

volume = "14",

journal = "PLOS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "4",

}

Gonzalez-Alvaro, I, Castrejon, I, Carmona, L, Dougados, M, Huizinga, T, Abu Shakra, M, Alberts, A, Alperi Lopez, M, Amital, H, Aringer, M, Aslanidis, S, Berenbaum, F, Bijlsma, H, Blanco Garcia, FJ, Bliddal, H, Borofsky, M, Brocq, O, Buldakov, S, Cantini, F, Carreno Perez, L, Chahade, W, Ciconelli, R, Codreanu, C, Dahlqvist, SR, Damjanov, N, Diamantopoulos, A, Dimdina, L, Dimic, A, Dorokhov, A, Dubikov, A, Fadienko, G, Fano, N, Ferreira, G, Gabrielli, A, Gaffney, K, Gaudin, P, Gerlag, DM, Gerli, R, Goncalves, CR, Hansen, MS, Hanvivadhanakul, P, Hoili, C, Hou, A, Hunter, J, Ilic, T, Ionescu, R, Kaine, J, Kakurina, N, Van Laar, J, Vosse, D, ACT-RAY Study Group, PROAR Study Group & EMECAR Study Group 2019, 'The comparative responsiveness of Hospital Universitario Princesa Index and other composite indices for assessing rheumatoid arthritis activity', PLOS ONE, vol. 14, no. 4, 0214717. https://doi.org/10.1371/journal.pone.0214717

TY - JOUR

T1 - The comparative responsiveness of Hospital Universitario Princesa Index and other composite indices for assessing rheumatoid arthritis activity

AU - Gonzalez-Alvaro, Isidoro

AU - Castrejon, Isabel

AU - Carmona, Loreto

AU - Dougados, M.

AU - Huizinga, T.

AU - Abu Shakra, M.

AU - Alberts, A.

AU - Alperi Lopez, M.

AU - Amital, H.

AU - Aringer, M.

AU - Aslanidis, S.

AU - Berenbaum, F.

AU - Bijlsma, H.

AU - Blanco Garcia, F. J.

AU - Bliddal, H.

AU - Borofsky, M.

AU - Brocq, O.

AU - Buldakov, S.

AU - Cantini, F.

AU - Carreno Perez, L.

AU - Chahade, W.

AU - Ciconelli, R.

AU - Codreanu, C.

AU - Dahlqvist, S. R.

AU - Damjanov, N.

AU - Diamantopoulos, A.

AU - Dimdina, L.

AU - Dimic, A.

AU - Dorokhov, A.

AU - Dubikov, A.

AU - Fadienko, G.

AU - Fano, N.

AU - Ferreira, G.

AU - Gabrielli, A.

AU - Gaffney, K.

AU - Gaudin, P.

AU - Gerlag, D. M.

AU - Gerli, R.

AU - Goncalves, C. R.

AU - Hansen, M. S.

AU - Hanvivadhanakul, P.

AU - Hoili, C.

AU - Hou, A.

AU - Hunter, J.

AU - Ilic, T.

AU - Ionescu, R.

AU - Kaine, J.

AU - Kakurina, N.

AU - Van Laar, J.

AU - Vosse, D.

AU - ACT-RAY Study Group

AU - PROAR Study Group

AU - EMECAR Study Group

N1 - Funding Information: Our study was supported by grants RD16/0012/0011 and PI14/00442 from the Ministerio de Economia y Competitividad (Instituto de Salud Carlos III; Spain) and cofunded by the Fondo Europeo de Desarrollo Regional (FEDER). Data from ACT-RAY clinical trial were kindly provided by Hoffmann-La Roche Ltd. No financial support was received from Hoffmann-La Roche Ltd Data from EMECAR and PROAR cohorts were provided by the Spanish Society of Rheumatology. No financial support was received from the Spanish Society of Rheumatology. None of these institutions played any role in the analysis or interpretation of data, nor were they involved in the writing of the manuscript. Roche and Sociedad Española de Reumatología were involved in the collection of data from ACT-RAY, and EMECAR and PROAR, respectively. However, these funders had no role in study design, analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2019 González-Álvaro et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2019/4/10

Y1 - 2019/4/10

N2 - ObjectiveTo evaluate the responsiveness in terms of correlation of the Hospital Universitario La Princesa Index (HUPI) comparatively to the traditional composite indices used to assess disease activity in rheumatoid arthritis (RA), and to compare the performance of HUPI-based response criteria with that of the EULAR response criteria.MethodsSecondary data analysis from the following studies: ACT-RAY (clinical trial), PROAR (early RA cohort) and EMECAR (pre-biologic era long term RA cohort). Responsiveness was evaluated by: 1) comparing change from baseline (Delta) of HUPI with Delta in other scores by calculating correlation coefficients; 2) calculating standardised effect sizes. The accuracy of response by HUPI and by EULAR criteria was analyzed using linear regressions in which the dependent variable was change in global assessment by physician (Delta GDA-Phy).ResultsDelta HUPI correlation with change in all other indices ranged from 0.387 to 0.791); HUPI's standardized effect size was larger than those from the other indices in each database used. In ACT-RAY, depending on visit, between 65 and 80% of patients were equally classified by HUPI and EULAR response criteria. However, HUPI criteria were slightly more stringent, with higher percentage of patients classified as non-responder, especially at early visits. HUPI response criteria showed a slightly higher accuracy than EULAR response criteria when using Delta GDA-Phy as gold standard.ConclusionHUPI shows good responsiveness in terms of correlation in each studied scenario (clinical trial, early RA cohort, and established RA cohort). Response criteria by HUPI seem more stringent than EULAR's.

AB - ObjectiveTo evaluate the responsiveness in terms of correlation of the Hospital Universitario La Princesa Index (HUPI) comparatively to the traditional composite indices used to assess disease activity in rheumatoid arthritis (RA), and to compare the performance of HUPI-based response criteria with that of the EULAR response criteria.MethodsSecondary data analysis from the following studies: ACT-RAY (clinical trial), PROAR (early RA cohort) and EMECAR (pre-biologic era long term RA cohort). Responsiveness was evaluated by: 1) comparing change from baseline (Delta) of HUPI with Delta in other scores by calculating correlation coefficients; 2) calculating standardised effect sizes. The accuracy of response by HUPI and by EULAR criteria was analyzed using linear regressions in which the dependent variable was change in global assessment by physician (Delta GDA-Phy).ResultsDelta HUPI correlation with change in all other indices ranged from 0.387 to 0.791); HUPI's standardized effect size was larger than those from the other indices in each database used. In ACT-RAY, depending on visit, between 65 and 80% of patients were equally classified by HUPI and EULAR response criteria. However, HUPI criteria were slightly more stringent, with higher percentage of patients classified as non-responder, especially at early visits. HUPI response criteria showed a slightly higher accuracy than EULAR response criteria when using Delta GDA-Phy as gold standard.ConclusionHUPI shows good responsiveness in terms of correlation in each studied scenario (clinical trial, early RA cohort, and established RA cohort). Response criteria by HUPI seem more stringent than EULAR's.

KW - DISEASE-ACTIVITY MEASURES

KW - RECOMMENDATIONS

KW - VALIDATION

KW - VARIABLES

KW - GENDER

KW - SCORES

U2 - 10.1371/journal.pone.0214717

DO - 10.1371/journal.pone.0214717

M3 - Article

C2 - 30969989

SN - 1932-6203

VL - 14

JO - PLOS ONE

JF - PLOS ONE

IS - 4

M1 - 0214717

ER -