Abstract

BARRIOS, B.I. et al. Correlation of different methods of assessment of morning stiffness with activity and disability indexes in patients with rheumatoid arthritis. Rev. argent. reumatolg. [online]. 2017, vol.28, n.1, pp.9-13. ISSN 0327-4411.

Morning stiffness (MS) is a complex symptom in rheumatoid arthritis (RA) patients. There are different ways to assess MS. However, the best way to evaluate it is still controversial. Objectives: To compare the severity and duration of MS (assessed by the physician and by self-report questionnaires) with disease activity and functional disability in a cohort of RA patients. Methods: We conducted a cross-sectional observational study. Patients with RA were included. Demographic data, RA characteristics and clinimetric measures were collected. Patients were randomly assigned to one of two groups: the first group was asked about the MS duration in minutes; those in the second group were evaluated using a self-reported questionnaire which included severity (numerical and non-numerical VAS) and duration (in minutes and Likert Scale) of the MS. Results: One hundred and eleven patients were included (86% women). Mean age was 52 years and median disease duration was 8 years. MS was reported by 51% of the patients. MS measured in minutes by the physician showed a good correlation with HAQ-A and an acceptable correlation with DAS28 and CDAI; MS severity assessed by VAS correlated better with RA activity indexes than with disability. When intensity of MS was evaluated by VAS, we observed that a value >5.5 centimeters was associated with severe disease activity (sensitivity 44% and specificity 100%). Conclusion: MS duration in minutes assessed by the physician would be associated with both disease activity and disability. Intensity of morning stiffness was most strongly associated with inflammatory activity in RA patients.

Keywords : rheumatoid arthritis; morning stiffness.