Proposing a method of regional assessment and a novel outcome measure in rheumatoid arthritis.

ABSTRACT

We proposed a method of regional assessment in patients with rheumatoid arthritis. The utility of this method was demonstrated by assessing drug efficacy in patients who received infliximab (n = 31) or tocilizumab (n = 6). Joints were divided into four regions upper/large, upper/small, lower/large, and lower/small. The total joint index was calculated as follows the sum of tender and swollen joint counts divided by the number of evaluable joints in each region. At the baseline, the total joint index of the upper/small region was the lowest and that of the lower/large region was the highest compared with other regions. The change in the total joint index from the baseline to the 30-week point (Δ) did not differ among the four regions. There were significant close relations of Δ between the upper/small and the upper/large region and between the lower/small and the lower/large region. This method allows us to focus on a specific region and to compare and contrast among them.