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Y. El Miedany (ed.), Patient Reported Outcome Measures in Rheumatic Diseases,
DOI 10.1007/978-3-319-32851-5_4
Chapter 4
PROMs for Rheumatoid Arthritis
Yasser El Miedany
Introduction
Rheumatoid arthritis (RA) has become a major health concern due to the fi nding
that the aging of the population has led to a marked increase in the prevalence of the
disease with its consequences [ 1 ]. In the meantime, the medical research has brought
about major advances to the therapeutic tools for RA; resulting in signifi cant change
in the disease treatment paradigms. Earlier, more aggressive and timely treatment
has made remission a realistic target. These advances led to transformation of the
arthritic patients’ management pathways, and the development of new models of
integrated care in infl ammatory arthritis (Fig. 4.1 ) [ 2 ]. Furthermore, these advances
mandated a redefi nition of health outcomes for RA patients’ management, which
has expanded to include: disease activity remission, structural remission, patient
remission, medication compliance, as well as low incidence of comorbidities
(Fig. 4.2 ) [ 3 ].
The interest in patient-reported outcomes in infl ammatory arthritis started in the
early 1990s. The World Health Organization/International League of Associations
for Rheumatology (WHO–ILAR) core set of outcome measures to be reported in
RA randomized trials was published in 1994 [ 4 ] and, since then, various organiza-
tion authorities have made further recommendations regarding the reporting of
RA-specifi c disease states. The American College of Rheumatology (ACR) core set
of RA outcomes was published in 1993 and included 7 parameters namely: tender
and swollen joints, physician global assessment, infl ammatory markers, as well as
patient global assessment, pain score, and functional disability [ 5 ]. Although fatigue
Y. El Miedany (*)
Honorary Senior Clinical Lecturer, King’s College London , London , UK
Professor of Rheumatology and Rehabilitation, Ain Shams University , Cairo , Egypt
Department of Rheumatology , Darent Valley Hospital , Gravesend , Kent , UK
e-mail: [email protected]