Prevalence and Predictors of Residual Symptoms in Rheumatoid Arthritis Patients in SDAI Remission: A Cross-Sectional Study Using the Illustrated Okomarigoto Sheet.

Objectives: This study investigated residual symptoms in patients with rheumatoid arthritis (RA) who had achieved remission based on the Simplified Disease Activity Index (SDAI) using the "Okomarigoto sheet" (OS) assessment tool.

Methods: The OS measures morning stiffness, pain, and fatigue through five questions. Each item was rated from 0 (none) to 2 (severe), yielding a total score between 0 and 30, with higher scores indicating greater symptom severity. OS scores were evaluated in 200 patients in SDAI remission. Patients were classified based on OS scores (0 vs. non-zero), and regression analysis was conducted to identify factors associated with residual symptoms.

Results: Residual symptoms were observed in 61.5% of patients. The most persistent symptoms were morning stiffness (27%), pain (21.5%), and fatigue (23%). Significant predictors of a non-zero OS score included female sex (OR 2.70, 95%CI 1.27-5.73), disease duration (OR 0.96, 95%CI 0.92-0.99), tender joint counts (OR 5.75, 95%CI 1.15-28.9), and Patient Global Assessment (OR 2.91, 95% CI 1.32-6.38).

Conclusions: The OS effectively detected residual symptoms in RA patients who had reached SDAI remission. Incorporating OS into patient-reported outcome measures and shared decision-making may enhance treatment strategies and improve patient satisfaction.

Key points: • Utilizing a novel patient-reported outcome assessment tool incorporating illustrations and onomatopoeia for individuals with rheumatoid arthritis, 61.5% of patients were identified as experiencing residual symptoms despite achieving remission according to the Simplified Disease Activity Index. Risk factors for residual symptoms identified through the Okomarigoto sheet included female sex, the number of tender joints, and the patient global assessment.