Associations between five important domains of health and the Patient Acceptable Symptom State in rheumatoid arthritis and psoriatic arthritis: A cross sectional study of 977 patients

International audienceIntroduction: The objective was to explore the link between a patient acceptable symptom state (PASS) and patient-perceived impact in rheumatoid arthritis (RA) and psoriatic arthritis (PsA).Patients and Methods: Cross-sectional study of unselected patients with definite RA or PsA. Pain, functional capacity, fatigue, coping and sleep disturbance were assessed by a numeric rating scale (0-10) and compared between patients in PASS or not (Cohen's effect sizes). The domains of health associated with PASS status were assessed by multivariate forward logistic regression, and PASS thresholds were determined using the 75th percentile method and ROC analyses.Results: Among 977 patients (531 RA, 446 PsA) mean age was 53.4±13.2 yrs; mean disease duration was 11.2±10.0 yrs; 637 (65.8%) were females. In all, 595 patients (60.9%) were in PASS: they had lower symptom levels, and all domains of health except sleep disturbance discriminated clearly between patients in PASS or not (effect sizes, 0.73 to 1.45 in RA and 0.82 to 1.52 in PsA). In multivariate analysis, less pain and better coping were predictive of being in PASS: odds ratio [95% confidence interval] 0.80 [0.67-0.96] and 0.63 [0.52-0.75] for pain and 0.84 [0.74-0.96] and 0.83 [0.71-0.97] for coping, in RA and PsA respectively. The cut-offs of symptom intensity (range 0-10) corresponding to PASS for the five domains of health and the two diseases were similar, i.e. around 4-5.Conclusion:In RA and PsA, PASS was associated with the five domains of health analysed, and in particular with less pain and better coping. This article is protected by copyright. All rights reserved