QUEST-RA: quantitative clinical assessment of patients with rheumatoid arthritis seen in standard rheumatology care in 15 countries

Objective: To conduct a cross- sectional review of non- selected consecutive outpatients with rheumatoid arthritis ( RA) as part of standard clinical care in 15 countries for an overview of the characteristics of patients with RA. Methods: The review included current disease activity using data from clinical assessment and a patient self-report questionnaire, which was translated into each language. Data on demographic, disease and treatment- related variables were collected and analysed using descriptive statistics. Variation in disease activity on DAS28 ( disease activity score on 28- joint count) within and between countries was graphically analysed. A median regression model was applied to analyse differences in disease activity between countries. Results: Between January 2005 and October 2006, the QUEST- RA ( Quantitative Patient Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis) project included 4363 patients from 48 sites in 15 countries; 78% were female,. >90% Caucasian, mean age was 57 years and mean disease duration was 11.5 years. More than 80% of patients had been treated with methotrexate in all but three countries. Overall, patients had an active disease with a median DAS28 of 4.0, with a significant variation between countries ( p < 0.001). Among 42 sites with >50 patients included, low disease activity of DAS28 <= 3.2 was found in the majority of patients in seven sites in five countries; in eight sites in five other countries, >50% of patients had high disease activity of DAS28 > 5.1. Conclusions: This international multicentre cross- sectional database provides an overview of clinical status and treatments of patients with RA in standard clinical care in 2005 - 6 including countries that are infrequently involved in clinical research projects.