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The controversy of using PGA to define remission in RA

Nature Reviews Rheumatology volume 14, page 245 (2018)Cite this article

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We read with interest the commentary by van Tuyl and Boers (van Tuyl, L. H. D. & Boers, M. Remission — keeping the patient experience front and centre. Nat. Rev. Rheumatol. 13, 573–574 (2017))1 referring to our paper on the role of patient global assessment (PGA) in the definition of remission in rheumatoid arthritis (RA)2. However, we cannot agree with their interpretation that by suggesting to remove the PGA from the ACR/EULAR remission definition we are “calling for a paradigm change that limits the responsibility of the rheumatologist to prescribing immunosuppressive therapy,” or that our proposal is “taking away the incentive to improve RA care by removing the patient's perspective from the remission criteria.”1

Nothing could be further from the interpretation we made of our own data and from our proposals. What we actually proposed is that the management of RA should be guided by two separate targets: a measure of inflammatory activity (physician's perspective) and a measure of disease impact (patient's perspective).

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References

  1. van Tuyl, L. H. D. & Boers, M. Remission — keeping the patient experience front and centre. Nat. Rev. Rheumatol. 13, 573–574 (2017).

    Article  Google Scholar 

  2. Ferreira, R. J. O. et al. Suppressing inflammation in rheumatoid arthritis: does patient global assessment blur the target? A practice-based call for a paradigm change. Arthritis Care Res. https://doi.org/10.1002/acr.23284 (2017).

  3. Ferreira, R. J. O. et al. Drivers of patient global assessment in patients with rheumatoid arthritis who are close to remission: an analysis of 1588 patients. Rheumatology. (Oxford). 56, 1573–1578 (2017).

    Article  Google Scholar 

  4. Gossec, L. et al. Finalisation and validation of the rheumatoid arthritis impact of disease score, a patient-derived composite measure of impact of rheumatoid arthritis: a EULAR initiative. Ann. Rheum. Dis. 70, 935–942 (2011).

    Article  CAS  Google Scholar 

  5. Ferreira, R. J. O. et al. The impact of patient global assessment in the definition of remission as a predictor of long-term radiographic damage in patients with rheumatoid arthritis: protocol for an individual patient data meta-analysis. Acta Rheumatol. Port. http://www.actareumatologica.pt/article_abstract.php?id=1197 (2018).

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Authors and Affiliations

  1. Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

    Ricardo J. O. Ferreira, Cátia Duarte & J. A. P. da Silva

  2. Health Sciences Research Unit: Nursing (UICiSA:E), Coimbra, Portugal

    Ricardo J. O. Ferreira

  3. Clínica Universitária de Reumatologia, Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    Cátia Duarte & J. A. P. da Silva

  4. Department of Nursing and Midwifery, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK

    Mwidimi Ndosi

  5. Patient research partner, EULAR standing committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland

    Maarten de Wit

  6. Department of Medical Humanities, VU University Medical Centre, Amsterdam, Netherlands

    Maarten de Wit

  7. Sorbonne Universités, UPMC Univ. Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS), Paris, France

    Laure Gossec

  8. Rheumatology Department, AP-HP, Pitié-Salpetrière Hospital, Paris, France

    Laure Gossec

Authors
  1. Ricardo J. O. Ferreira
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  2. Cátia Duarte
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  3. Mwidimi Ndosi
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  4. Maarten de Wit
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  5. Laure Gossec
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  6. J. A. P. da Silva
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Contributions

R.J.O.F. and J.A.P.S researched data for the article and wrote the article. R.J.O.F., C.D., M.N., L.X., M.W., L.G. and J.A.P.S. made substantial contributions to discussion of its content and reviewed and/or edited the manuscript before submission.

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Correspondence to Ricardo J. O. Ferreira.

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The authors declare no competing financial interests.

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Ferreira, R., Duarte, C., Ndosi, M. et al. The controversy of using PGA to define remission in RA. Nat Rev Rheumatol 14, 245 (2018). https://doi.org/10.1038/nrrheum.2018.35

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