Aileen Y Chang, Samuel Simmens, Hugh Watson, Richard L Amdur, André Siqueira, Abigale Proctor, Sarah Tritsch, Carlos Andres Herrera Gomez, Liliana Encinales, Alfonso Sucerquia Hernández, Jose Forero-Mejía, Alejandro Jaller, Juan Jose Jaller, J Kennedy Amaral, Ilana Heckler, Gary L Simon, Larry Moreland, Andres Cadena, Gary S Firestein
{"title":"基于前瞻性队列研究的基孔肯雅关节炎疾病活动评分（CHIK-DAS）的开发","authors":"Aileen Y Chang, Samuel Simmens, Hugh Watson, Richard L Amdur, André Siqueira, Abigale Proctor, Sarah Tritsch, Carlos Andres Herrera Gomez, Liliana Encinales, Alfonso Sucerquia Hernández, Jose Forero-Mejía, Alejandro Jaller, Juan Jose Jaller, J Kennedy Amaral, Ilana Heckler, Gary L Simon, Larry Moreland, Andres Cadena, Gary S Firestein","doi":"10.33696/immunology.6.211","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Chikungunya virus is spread by mosquitos and causes a debilitating chronic arthritis that has no standard treatment to date and no specific measures of disease activity. The objective of this expert group was to develop a measure of chikungunya arthritis that would be useful for clinical trials and patient care.</p><p><strong>Methods: </strong>A group of rheumatologists and biostatisticians experienced in the clinical and pathological mechanisms of chikungunya evaluated component measures for inclusion in a chikungunya arthritis disease activity score (CHIK-DAS). Utilizing data from a Colombian cohort of 158 chikungunya arthritis patients, linear regression identified components that were independently associated with patient reported outcomes assessing disability, pain, physical and mental quality of life and mobility. A preliminary instrument was developed using multiple imputation and regression backward selection. Cutoffs for grading disease severity were determined.</p><p><strong>Results: </strong>Stiffness, ankle tenderness, and a 30 tender joint count that included the 28 joints traditionally included in the Disease Activity Score-28 were selected in a regression model predicting a composite of five patient reported outcomes. A CHIK-DAS scoring formula was developed through a weighted combination of these selected variables. In comparison to the DAS-28, the CHIK-DAS had improved predictive value for a composite outcome of disability, pain, physical and mental quality of life and mobility. Disease activity cutoffs were defined for remission (<40), mild (40-49.99), moderate (50-59.99) and severe (60+) disease.</p><p><strong>Conclusion: </strong>The CHIK-DAS is a chikungunya specific measure of disease activity that includes the DAS-28 with the addition of ankle tenderness and a stiffness item that are prominent components of chikungunya arthritis. CHIK-DAS may be used as a specific measure of disease activity in chikungunya arthritis in clinical trials and patient care. This metric needs further validation in additional cohorts.</p>","PeriodicalId":73644,"journal":{"name":"Journal of cellular immunology","volume":"6 6","pages":"236-246"},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074665/pdf/","citationCount":"0","resultStr":"{\"title\":\"Development of a Chikungunya Arthritis Disease Activity Score (CHIK-DAS) Based on a Prospective Cohort Study.\",\"authors\":\"Aileen Y Chang, Samuel Simmens, Hugh Watson, Richard L Amdur, André Siqueira, Abigale Proctor, Sarah Tritsch, Carlos Andres Herrera Gomez, Liliana Encinales, Alfonso Sucerquia Hernández, Jose Forero-Mejía, Alejandro Jaller, Juan Jose Jaller, J Kennedy Amaral, Ilana Heckler, Gary L Simon, Larry Moreland, Andres Cadena, Gary S Firestein\",\"doi\":\"10.33696/immunology.6.211\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Chikungunya virus is spread by mosquitos and causes a debilitating chronic arthritis that has no standard treatment to date and no specific measures of disease activity. The objective of this expert group was to develop a measure of chikungunya arthritis that would be useful for clinical trials and patient care.</p><p><strong>Methods: </strong>A group of rheumatologists and biostatisticians experienced in the clinical and pathological mechanisms of chikungunya evaluated component measures for inclusion in a chikungunya arthritis disease activity score (CHIK-DAS). Utilizing data from a Colombian cohort of 158 chikungunya arthritis patients, linear regression identified components that were independently associated with patient reported outcomes assessing disability, pain, physical and mental quality of life and mobility. A preliminary instrument was developed using multiple imputation and regression backward selection. Cutoffs for grading disease severity were determined.</p><p><strong>Results: </strong>Stiffness, ankle tenderness, and a 30 tender joint count that included the 28 joints traditionally included in the Disease Activity Score-28 were selected in a regression model predicting a composite of five patient reported outcomes. A CHIK-DAS scoring formula was developed through a weighted combination of these selected variables. In comparison to the DAS-28, the CHIK-DAS had improved predictive value for a composite outcome of disability, pain, physical and mental quality of life and mobility. Disease activity cutoffs were defined for remission (<40), mild (40-49.99), moderate (50-59.99) and severe (60+) disease.</p><p><strong>Conclusion: </strong>The CHIK-DAS is a chikungunya specific measure of disease activity that includes the DAS-28 with the addition of ankle tenderness and a stiffness item that are prominent components of chikungunya arthritis. CHIK-DAS may be used as a specific measure of disease activity in chikungunya arthritis in clinical trials and patient care. This metric needs further validation in additional cohorts.</p>\",\"PeriodicalId\":73644,\"journal\":{\"name\":\"Journal of cellular immunology\",\"volume\":\"6 6\",\"pages\":\"236-246\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074665/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of cellular immunology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.33696/immunology.6.211\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cellular immunology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.33696/immunology.6.211","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Development of a Chikungunya Arthritis Disease Activity Score (CHIK-DAS) Based on a Prospective Cohort Study.
Objective: Chikungunya virus is spread by mosquitos and causes a debilitating chronic arthritis that has no standard treatment to date and no specific measures of disease activity. The objective of this expert group was to develop a measure of chikungunya arthritis that would be useful for clinical trials and patient care.
Methods: A group of rheumatologists and biostatisticians experienced in the clinical and pathological mechanisms of chikungunya evaluated component measures for inclusion in a chikungunya arthritis disease activity score (CHIK-DAS). Utilizing data from a Colombian cohort of 158 chikungunya arthritis patients, linear regression identified components that were independently associated with patient reported outcomes assessing disability, pain, physical and mental quality of life and mobility. A preliminary instrument was developed using multiple imputation and regression backward selection. Cutoffs for grading disease severity were determined.
Results: Stiffness, ankle tenderness, and a 30 tender joint count that included the 28 joints traditionally included in the Disease Activity Score-28 were selected in a regression model predicting a composite of five patient reported outcomes. A CHIK-DAS scoring formula was developed through a weighted combination of these selected variables. In comparison to the DAS-28, the CHIK-DAS had improved predictive value for a composite outcome of disability, pain, physical and mental quality of life and mobility. Disease activity cutoffs were defined for remission (<40), mild (40-49.99), moderate (50-59.99) and severe (60+) disease.
Conclusion: The CHIK-DAS is a chikungunya specific measure of disease activity that includes the DAS-28 with the addition of ankle tenderness and a stiffness item that are prominent components of chikungunya arthritis. CHIK-DAS may be used as a specific measure of disease activity in chikungunya arthritis in clinical trials and patient care. This metric needs further validation in additional cohorts.
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