Documenting the Value of Care for Rheumatoid Arthritis, Analogous to Hypertension, Diabetes, and Hyperlipidemia: Is Control of Individual Patient Self-Report Measures of Global Estimate and Physical Function More Valuable Than Laboratory Tests, Radiographs, Indices, or Remission Criteria?

Tight control of disease activity fails to improve body composition or physical function in rheumatoid arthritis patients

“…Another point to raise is the failure of widely-used measures of treatment efficacy for T2T (e.g. DAS28) to assess function, either objectively or subjectively, which is counter to both the prominence that restoration of physical function has amongst the goals of this treatment, and the strong associations function has with morbidity, mortality, treatment costs and patient quality of life in RA [47].…”

Association of Improvement in Pain With Therapeutic Response as Determined by Individual Improvement Criteria in Patients With Rheumatoid Arthritis

“…These outcomes, including patient global disease assessment, pain, function, and fatigue can be used to accurately discriminate between active treatment and placebo in patients with rheumatoid arthritis (RA) and may be more sensitive to treatment effectiveness than objective clinical assessments 1. Furthermore, certain PROs, including patient global disease assessment and functional questionnaires, are more closely related to clinical outcomes than objective assessments of disease activity such as laboratory markers, joint counts, or radiographs 2. In multiple studies, patient‐reported functional status has been shown to be the most significant predictor of mortality in patients with RA, outweighing clinical or laboratory assessments such as joint counts, rheumatoid factor seropositivity, or erythrocyte sedimentation rate (ESR) (reviewed by Pincus et al [2]).…”