RT Journal Article
T1 Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI) and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis
A1 Gonzalez-Alvaro, Isidoro
A1 Castrejon, Isabel
A1 Ortiz, Ana M.
A1 Toledano, Esther
A1 Castaneda, Santos
A1 Garcia-Vadillo, Alberto
A1 Carmona, Loreto
A1 EMECAR Study Grp, 
K1 C-reactive protein
K1 Activity score
K1 Sedimentation-rate
K1 Validation
K1 Therapies
K1 Remission
K1 Consensus
K1 Society
K1 Gender
K1 Values
AB ObjectiveTo estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis.MethodsTwo cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal [PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresion Clinica de la Artritis Reumatoide [EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI.ResultsThe best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if  2 and  5 and = 9. HUPI's AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28's AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values.ConclusionsThe cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis.
PB Public library science
SN 1932-6203
YR 2016
FD 2016-09-07
LK https://hdl.handle.net/10668/25079
UL https://hdl.handle.net/10668/25079
LA en
DS RISalud
RD Apr 12, 2025