title: Responsiveness of Keitel functional index compared with laboratory measures of disease activity in rheumatoid arthritis.
abstract: This study compares functional changes to change in measures of disease activity following the introduction of slow-acting anti-rheumatic drugs (SAARD) in patients with active rheumatoid arthritis (RA). Clinical and laboratory variables were simultaneously monitored at 6-monthly intervals, over approximately 18 months. Function was measured by a performance testing, the Keitel function index (KFI), which was divided into sections representing small and large joints [hand (HFI); wrist (WFI) and limb function index (LFI)]. One-hundred-and-fifteen patients were studied, of whom 21 were male. The mean age of the subjects was 49 yr (S.D. +/- 12) and mean duration of disease 7 yr (S.D. +/- 7). The mean KFI at entry was 38 (S.D. +/- 18) while at the end of the study it was 31 (S.D. +/- 17) (P < 0.0001). The change in KFI following therapy correlated with the change in Ritchie articular index (RAI) (r = 0.4; P < 0.0001), early morning stiffness (EMS) (r = 0.3; P = 0.004), swollen joint count (JC) (r = 0.4; P = 0.0005), C-reactive protein (CRP) (r = 0.2; P < 0.05) and Lansbury systemic index (LSI) (r = 0.35; P = 0.002), but not with change in Westergren erythrocyte sedimentation rate (ESR) or change in time to onset of fatigue. Multiple regression analysis showed that 32% of the variation in KFI at the end of the study could be predicted by a combination of ESR, sulphasalazine therapy, RAI, disease duration and chloroquine treatment at onset (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Medicine, Groote Schuur Hospital, Cape, South Africa.
authors.forename: A A
authors.initials: AA
authors.lastname: Kalla
authors.forename: P R
authors.initials: PR
authors.lastname: Smith
authors.forename: G M
authors.initials: GM
authors.lastname: Brown
authors.forename: O L
authors.initials: OL
authors.lastname: Meyers
authors.forename: D
authors.initials: D
authors.lastname: Chalton
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000503:physiopathology*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D004185:Disability Evaluation; D005121:Extremities / Q000503:physiopathology; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D007596:Joints / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D014953:Wrist / Q000503:physiopathology
chemical_list: D000893:Anti-Inflammatory Agents; D002097:C-Reactive Protein