title: 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.
abstract: To explore the link between a patient acceptable symptom state (PASS) and patient-perceived impact in rheumatoid arthritis (RA) and psoriatic arthritis (PsA).
  
  
  
  This was a cross-sectional study of unselected patients with definite RA or PsA. Pain, functional capacity, fatigue, coping, and sleep disturbance were assessed using 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 receiver operating characteristic analyses.
  
  
  
  Among 977 patients (531 with RA, 446 with PsA), the mean ± SD age was 53.4 ± 13.2 years, mean ± SD disease duration was 11.2 ± 10.0 years, and 637 (65.8%) were women. 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 0.73-1.45 in RA and 0.82-1.52 in PsA). In multivariate analysis, less pain and better coping were predictive of being in PASS. Odds ratios were: RA pain 0.80 (95% confidence interval [95% CI] 0.67-0.96), PsA pain 0.63 (95% CI 0.52-0.75), RA coping 0.84 (95% CI 0.74-0.96), and PsA coping 0.83 (95% CI 0.71-0.97). The cutoffs of symptom intensity (range 0-10), corresponding to PASS for the 5 domains of health and the 2 diseases were similar, i.e., approximately 4-5.
  
  
  
  In RA and PsA, PASS was associated with the 5 domains of health analyzed, and in particular with less pain and better coping.
authors.affiliation: Sorbonne University, UPMC University Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Paris, France.
authors.forename: Déborah
authors.initials: D
authors.lastname: Puyraimond-Zemmour
authors.affiliation: Paris Descartes University, Cochin Hospital, AP-HP, INSERM, PRES Sorbonne Paris-Cité, Paris, France.
authors.forename: Adrien
authors.initials: A
authors.lastname: Etcheto
authors.affiliation: Sorbonne University, UPMC University Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Fautrel
authors.affiliation: Sf. Maria Hospital, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
authors.forename: Andra
authors.initials: A
authors.lastname: Balanescu
authors.affiliation: EULAR Standing Committee of People With Arthritis/Rheumatism in Europe, Zurich, Switzerland.
authors.forename: Maarten
authors.initials: M
authors.lastname: de Wit
authors.affiliation: Østfold University College, Halden, Norway.
authors.forename: Turid
authors.initials: T
authors.lastname: Heiberg
authors.affiliation: Tallinn Central Hospital, Tallinn, Estonia.
authors.forename: Kati
authors.initials: K
authors.lastname: Otsa
authors.affiliation: Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Tore K
authors.initials: TK
authors.lastname: Kvien
authors.affiliation: Paris Descartes University, Cochin Hospital, AP-HP, INSERM, PRES Sorbonne Paris-Cité, Paris, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
authors.affiliation: Sorbonne University, UPMC University Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Paris, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D018771:Arthralgia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D015535:Arthritis, Psoriatic / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010147:Pain Measurement; D010465:Perception; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012372:ROC Curve; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires