Assessment Of Efficacy Of Patient Reported Outcome Clinical Arthritis Activity Index (Proclara) In Evaluating Disease Activity In Rheumatoid Arthritis

Background: Patient reported Outcome - Clinical Arthritis Activity Index (PRO-CLARA) is a new, continuous and feasible index to assess the impact on activity of daily living (which is the patient’s prime concern) so it could be useful in regular clinical practice for monitoring Rheumatoid Arthritis (RA) patients. Objective: Assessment of disease activity in Rheumatoid Arthritis using Patient reported Outcome - Clinical Arthritis Activity Index (PRO-CLARA). Material and method: The present study was a cross sectional study done on hundred RA patients as per American College of Rheumatology criteria (ACR criteria) who presented in Rheumatology clinic at PGIMS, Rohtak (Haryana). Patients were assessed for disease activity using Disease activity score-28 (DAS28), Clinical disease activity index (CDAI) and PRO-CLARA at baseline thereafter two months and at four months on therapy. Results: The mean age was 44.4±11.8 yrs with 84 females and 16 males. At baseline the mean DAS28, CDAI and PRO-CLARA score was 6.65±0.68, 36.5±9.7 and 8.78±0.64 respectively, at two months 4.58±0.81, 18.36±6.58 and 6.62±1.31 respectively while at four months was 3.33±0.96, 9.69±6.69, and 4.21±1.59, respectively. At baseline, 2 months and 4 months Pearson’s Correlation Coefficient of PRO-CLARA with DAS28 was 0.931, 0.889 and 0.893 respectively, and with CDAI was 0.517, 0.674 and 0.682 respectively (all P value <0.001). Reliability index (as assessed by Cronbach’s alfa) at baseline, 2 months and 4 months for DAS28 was 0.662, 0.569 and 0.685; for CDAI was 0.574, 0.586 and 0.767 for PROCLARA was 0.862, 0.980 and 0.987 respectively. Conclusion: PRO-CLARA was found to be significantly correlated with DAS28 and CDAI. The components of PRO-CLARA include all important measures of disease activity, so it could be useful in regular clinical practice for monitoring RA patients.