BackgroundClinical disease activity index (CDAI) and simplified disease activity index (SDAI) are useful tools for the evaluation of disease activity in patients with rheumatoid arthritis (RA), but have not been comparatively validated in Moroccan population. Therefore, this study was designed to assess validity and reliability of CDAI and SDAI in comparison to disease activity score-28 joints (DAS-28) in Moroccan patients with RA.MethodsPatients with RA were included in a cross-sectional study. Patient characteristics and RA were collected. The disease activity was assessed by DAS-28, CDAI and SDAI. Patients were splitted into groups of remission, low, moderate and high activity on the basis of predefined cut-offs for DAS-28, CDAI, and SDAI. A Spearman correlation between composite indexes and inter-group comparison of the indexes were performed. Using DAS-28 as a gold standard, the Receiver operator characteristic (ROC) curve was used to assess the performance of a screening test at different levels.ResultsThe study was conducted with 103 patients of female predominance (87.4 %). Mean age was 49.7 ± 11.4 years. Median disease duration was in the order of 8 years [3-14]. There was an excellent correlation between DAS-28 and CDAI (r = 0.95, p <0.001), CDAI and SDAI (r = 0.90, p <0.001), and DAS-28 and SDAI (r = 0.92, p <0.001). There was a good inter-rater alignment between the DAS-28 and CDAI (Weighted kappa =0.743) and there was a moderate inter-rater alignment between the DAS-28 and SDAI (Weighted kappa =0.60), and also between the SDAI and CDAI (Weighted kappa = 0.589). There was no statistically significant difference between AUROC of CDAI and SDAI as both were performed equally well.DiscussionThis study is the first Moroccan case study to compare the performance of both CDAI and SDAI in evaluation of disease activity in patients with RA. Our study showed that there was a direct and excellent correlation between DAS-28 and CDAI, and SDAI and DAS-28.ConclusionOur study shows a strong positive correlation between DAS-28, CDAI and SDAI. The cut-off values for CDAI and SDAI used in western literature can be used with minor modifications in Moroccan scenario.

Our study shows a significant association between vitamin D deficiency and chronic LBP in Moroccan postmenopausal women. Further studies are clearly warranted to determine the effectiveness and the mechanism(s) of this links between vitamin D deficiency and chronic LBP.

Objectives This study aimed to evaluate the frequency of sleep disorders in patients with rheumatoid arthritis (RA) and to explore the determinants of these disorders. Methods It is a cross-sectional study including patients with RA. Patients with a known psychiatric disorder were excluded from the study. The demographic characteristics of patients and the characteristics of RA were collected. Pain and fatigue were assessed by a visual analogue scale (0-100 mm), the disease activity by DAS28 - ESR (Disease Activity Score), the Functional Disability by the Arabic validated version of the Health Assessment Questionnaire (HAQ), the quality of life by Euroqol 5D and psychological state by the Arabic validated version of the questionnaire Hospital Anxiety and Depression (HAD) with its two items anxiety and depression. Participants completed the self-rated questionnaire “Pittsburgh Sleep Quality Index (PSQI)” that assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven “component” scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The total score ranges from 0 (no disorder) and 21 (major problems) 1. Univariate and multivariate linear regression was performed to determine factors associated with poor sleep quality. Results 103 patients were included with a mean age of 49.7±11.4 years and a female predominance (90 (87.4%)). The median of RA duration was 8.16 years [3.25 to 14.16]. The median of global score PSQI was 5 [2-9]. Poorer Sleep quality was significantly associated with high disease activity (r =0.381, 95% CI [0.465, 1.320], p<0.001), lower quality of life (r = -0.327, 95% CI [-5.396 - 1.474], p=0.001), greater functional disability (r =0.289, 95% CI [ 0.323, 1.539], p=0.003), greater pain severity VAS (r =0.350, 95% CI [0.023, 0.075], p<0.001), increased fatigue VAS (r =0.380, 95% CI [0.030, 0.084], p<0.001), higher levels of anxiety (r =0.385, 95% CI [0.178, 0.498], p<0.001) and depression (r =0.310, 95% CI [0.103, 0.417]. In multivariate analysis, sleep disorders were associated with only higher levels of anxiety (r =0.254, 95% CI [0.033, 0.413], p=0.022). Conclusions Our study suggests that sleep disorders, in rheumatoid arthritis, are more frequently found in patients with associated anxiety disorders. References Sleep Quality and Functional Disability in Patients with Rheumatoid Arthritis; FS Luyster, ER Chasens, MCM Wasko et al; Journal of Clinical Sleep Medicine, Vol. 7, No. 1, 2011 Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4772

Objectives Score distributions and associations between the RAID score and RA demographic and disease related variables were examined in rheumatoid arthritis (RA) patients. Methods 103 patients diagnosed were enrolled in the study. Disease activity was assessed through the Disease Activity Score (DAS) 28 scale. quality of life was evaluated with The EQ-5D, and Health Assessment Questionnaire (HAQ) was completed by all patients. Pain and fatigue were evaluated with pain Visual analogic scale (VAS) and fatigue VAS respectively. The Rheumatoid Arthritis Impact disease (RAID) was used for the evaluation of the impact of rheumatoid arthritis. Results The mean RAID was 3,78±2,15. The distribution of the RAID: 32% had a score between 0 and 2, and 13.5% between 7 and 10. In univariate analysis the RAID score correlated with pain (r=0,79; IC95% (0,05-0,06); p<0,001), fatigue (r=0,80; IC95% (2,2-3,7); p<0,001), morning stiffness (r=0.53; IC95% (0,017-0,03); p<0.001), DAS28 (r=0.75; IC95% (0,7-1); p<0.001), HAQ (r=0,75; IC95% (1,7-2,4); p<0,001), EQ-5D (r= -0,72; IC95% (-4,7_-3,2) p<0.001). After multivariate analysis the pain (r=0,15; IC95% (0,01-0,35); p<0,001), fatigue (r=0,18; IC95% (0,17-1,2); p<0,01), DAS28 (r=0,26; IC95% (0,2-0,3); p<0,001), HAQ (r=0,2; IC95% (0,18-0,9); p<0,01) and EQ-5D (r= -0,26; IC95% (-1,9_-0,4); p=0,001) still strongly associated with RAID. Conclusions This study suggested that RAID associated with disease activity, functional capacity, Pain, fatigue and EQ-5D. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4863