Concordance and agreement between different activity scores in polymyalgia rheumatica
Objective The C reactive protein polymyalgia rheumatica activity score (CRP-PMR-AS) is a composite index that includes CRP levels and was developed specifically for PMR. As treatments such as interleukin-6 antagonists can normalise CRP levels, the erythrocyte sedimentation rate (ESR) of PMR-AS, the...
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BMJ Publishing Group
2024-02-01
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| author | Bruno Fautrel Eric Toussirot Renaud Felten Emmanuel Nowak Christophe Richez Jacques-Eric Gottenberg Isabelle Chary-Valckenaere Alain Saraux Aleth Perdriger Emanuelle Dernis Thierry Marhadour Marie-Elise Truchetet Divi Cornec Valérie Devauchelle-Pensec Daniel Wendling Guillaume Direz Anne Lohse Laurent Chiche PASCAL HILLIQUIN Guillermo Carvajal Alegria Dewi Guellec Justine D'Agostino Aghiles Souki Catherine Le Henaff Benjamin Dervieux |
| author_facet | Bruno Fautrel Eric Toussirot Renaud Felten Emmanuel Nowak Christophe Richez Jacques-Eric Gottenberg Isabelle Chary-Valckenaere Alain Saraux Aleth Perdriger Emanuelle Dernis Thierry Marhadour Marie-Elise Truchetet Divi Cornec Valérie Devauchelle-Pensec Daniel Wendling Guillaume Direz Anne Lohse Laurent Chiche PASCAL HILLIQUIN Guillermo Carvajal Alegria Dewi Guellec Justine D'Agostino Aghiles Souki Catherine Le Henaff Benjamin Dervieux |
| author_sort | Bruno Fautrel |
| collection | DOAJ |
| description | Objective The C reactive protein polymyalgia rheumatica activity score (CRP-PMR-AS) is a composite index that includes CRP levels and was developed specifically for PMR. As treatments such as interleukin-6 antagonists can normalise CRP levels, the erythrocyte sedimentation rate (ESR) of PMR-AS, the clinical (clin)-PMR-AS and the imputed-CRP (imp-CRP)-PMR-AS have been developed to avoid such bias. Our primary objective was to measure the correlation of these activity scores. Our secondary objective was to evaluate the concordance between different cutoffs of the PMR-ASs.Method Data from the Safety and Efficacy of tocilizumab versus Placebo in Polymyalgia rHeumatica With glucocORticoid dEpendence (SEMAPHORE) trial, a superiority randomised double-blind placebo-controlled trial, were subjected to post hoc analysis to compare the efficacy of tocilizumab versus placebo in patients with active PMR. The CRP-PMR-AS, ESR-PMR-AS, clin-PMR-AS and imp-CRP-PMR-AS were measured at every visit. The concordance and correlation between these scores were evaluated using kappa correlation coefficients, Bland-Altman correlations, intraclass correlation coefficients (ICCs) and scatter plots.Results A total of 101 patients were included in the SEMAPHORE trial, and 100 were analysed in this study. The correlation between the PMR-ASs was excellent, as the ICC and kappa were >0.85 from week 4 until week 24 (CRP-PMR-AS ≤10 or >10). Bland-Altman plots revealed that the differences between the CRP-PMR-AS and the other threescores were low. The cut-off values for the clin-PMR-AS were similar to those for the CRP-PMR-AS 86% of the time.Conclusion The correlation between all the PMR-ASs was excellent, reflecting the low weight of CRP. In clinical trials using drugs that have an impact on CRP, the derived activity scores can be used.Trial registration number NTC02908217. |
| format | Article |
| id | doaj-art-9499a341795643138b2448d008eebb52 |
| institution | Kabale University |
| issn | 2056-5933 |
| language | English |
| publishDate | 2024-02-01 |
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| spelling | doaj-art-9499a341795643138b2448d008eebb522025-08-20T03:48:31ZengBMJ Publishing GroupRMD Open2056-59332024-02-0110110.1136/rmdopen-2023-003741Concordance and agreement between different activity scores in polymyalgia rheumaticaBruno Fautrel0Eric Toussirot1Renaud Felten2Emmanuel Nowak3Christophe Richez4Jacques-Eric Gottenberg5Isabelle Chary-Valckenaere6Alain Saraux7Aleth Perdriger8Emanuelle Dernis9Thierry Marhadour10Marie-Elise Truchetet11Divi Cornec12Valérie Devauchelle-Pensec13Daniel Wendling14Guillaume Direz15Anne Lohse16Laurent Chiche17PASCAL HILLIQUIN18Guillermo Carvajal Alegria19Dewi Guellec20Justine D'Agostino21Aghiles Souki22Catherine Le Henaff23Benjamin Dervieux241 Rheumatology, CEREMAIA Reference Center (ERN RITA) , Sorbonne Université – AP-HP, Pitié-Salpêtrière Hospital, Paris, FranceINSERM Clinical Investigation Center 1431, Centre Hospitalier Universitaire de Besancon, Besancon, France1 Department of Rheumatology - Centre National de Référence des Maladies Systémiques Rares Est Sud-Ouest (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, FrancePublic Agency for Clinical Research and Innovation (DRCI), Brest University Hospital, Centre Hospitalier Universitaire de Brest, Brest, France38Rheumatology Department, FHU ACRONIM, Pellegrin Hospital and UMR CNRS 5164, Bordeaux University, Bordeaux, FranceRheumatology, Hopitaux universitaires de Strasbourg, Strasbourg, FranceDepartment of Rheumatology, Centre Hospitalier Universitaire de Nancy, Nancy, FranceDepartment of Rheumatology, Hopital Cavale Blanche, Brest, FrancePolyclinique du Maine, Laval, FranceRheumatology, Le Mans Hospital, Le Mans, FranceRheumatology Department, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINOM), CHU Brest, Brest, FranceService de Rhumatologie, CHU Bordeaux, Bordeaux, FranceU1227, LBAI, Univ Brest, Inserm, and CHU Brest, Brest, France, Brest, FranceRheumatology, Brest University and La Cavale Blanche Hospital, Brest, France11 Rheumatology, CHU J Minjoz, Besancon, France19 Rheumatology Department, Le Mans General Hospital, Le Mans, France4 Department of Rheumatology, Competence center FAI2R, Franche-Comte Hospital, Belfort, France1 Internal Medicine, European Hospital Marseille, Marseille, FranceDepartment of Rhumatology, Centre Hospitalier Sud Francilien, Corbeil-Essonnes, FranceRheumatology, CHU Tours, Tours, FranceRheumatology Department, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINOM), CHU Brest, Brest, FranceDepartment of Rheumatology, Centre Hospitalier Universitaire de Brest, Brest, FrancePublic Agency for Clinical Research and Innovation (DRCI), Brest University Hospital, Centre Hospitalier Universitaire de Brest, Brest, FranceDepartment of Rheumatology, Pays de Morlaix Hospital Centre, Morlaix, FranceDepartment of Rhuamtology, GHR Mulhouse Sud Alsace, Mulhouse, FranceObjective The C reactive protein polymyalgia rheumatica activity score (CRP-PMR-AS) is a composite index that includes CRP levels and was developed specifically for PMR. As treatments such as interleukin-6 antagonists can normalise CRP levels, the erythrocyte sedimentation rate (ESR) of PMR-AS, the clinical (clin)-PMR-AS and the imputed-CRP (imp-CRP)-PMR-AS have been developed to avoid such bias. Our primary objective was to measure the correlation of these activity scores. Our secondary objective was to evaluate the concordance between different cutoffs of the PMR-ASs.Method Data from the Safety and Efficacy of tocilizumab versus Placebo in Polymyalgia rHeumatica With glucocORticoid dEpendence (SEMAPHORE) trial, a superiority randomised double-blind placebo-controlled trial, were subjected to post hoc analysis to compare the efficacy of tocilizumab versus placebo in patients with active PMR. The CRP-PMR-AS, ESR-PMR-AS, clin-PMR-AS and imp-CRP-PMR-AS were measured at every visit. The concordance and correlation between these scores were evaluated using kappa correlation coefficients, Bland-Altman correlations, intraclass correlation coefficients (ICCs) and scatter plots.Results A total of 101 patients were included in the SEMAPHORE trial, and 100 were analysed in this study. The correlation between the PMR-ASs was excellent, as the ICC and kappa were >0.85 from week 4 until week 24 (CRP-PMR-AS ≤10 or >10). Bland-Altman plots revealed that the differences between the CRP-PMR-AS and the other threescores were low. The cut-off values for the clin-PMR-AS were similar to those for the CRP-PMR-AS 86% of the time.Conclusion The correlation between all the PMR-ASs was excellent, reflecting the low weight of CRP. In clinical trials using drugs that have an impact on CRP, the derived activity scores can be used.Trial registration number NTC02908217.https://rmdopen.bmj.com/content/10/1/e003741.full |
| spellingShingle | Bruno Fautrel Eric Toussirot Renaud Felten Emmanuel Nowak Christophe Richez Jacques-Eric Gottenberg Isabelle Chary-Valckenaere Alain Saraux Aleth Perdriger Emanuelle Dernis Thierry Marhadour Marie-Elise Truchetet Divi Cornec Valérie Devauchelle-Pensec Daniel Wendling Guillaume Direz Anne Lohse Laurent Chiche PASCAL HILLIQUIN Guillermo Carvajal Alegria Dewi Guellec Justine D'Agostino Aghiles Souki Catherine Le Henaff Benjamin Dervieux Concordance and agreement between different activity scores in polymyalgia rheumatica RMD Open |
| title | Concordance and agreement between different activity scores in polymyalgia rheumatica |
| title_full | Concordance and agreement between different activity scores in polymyalgia rheumatica |
| title_fullStr | Concordance and agreement between different activity scores in polymyalgia rheumatica |
| title_full_unstemmed | Concordance and agreement between different activity scores in polymyalgia rheumatica |
| title_short | Concordance and agreement between different activity scores in polymyalgia rheumatica |
| title_sort | concordance and agreement between different activity scores in polymyalgia rheumatica |
| url | https://rmdopen.bmj.com/content/10/1/e003741.full |
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