RESEARCH - Study of pregnant patients with RA and AS using validated clinical instruments

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Ann Rheum Dis. 2004 Oct;63(10):1212-7.

A prospective study of pregnant patients with rheumatoid arthritis and

ankylosing spondylitis using validated clinical instruments.

OStensen M, Fuhrer L, Mathieu R, Seitz M, Villiger PM.

Department of Rheumatology and Clinical Immunology and Allergy,

University Hospital, CH-3010 Bern, Switzerland.

monika.oestensen@...

OBJECTIVE: : To analyse the disease course of patients with rheumatoid

arthritis (RA) and ankylosing spondylitis (AS) during and after

pregnancy by validated clinical instruments for measurement of disease

activity, and assess their usefulness in pregnant patients. METHODS:

Included were 10 patients with RA and 9 with AS (10 pregnancies).

Clinical examination and blood/urine sampling was performed before

conception, at each trimester, and weeks 6, 12, and 24 post partum.

Assessment of RA was by the RA Disease Activity Index (RADAI), the 44

joint count, and the Health Assessment Questionnaire; assessment of AS

by the Bath Ankylosing Spondylitis Activity Index (BASDAI), the Dougados

Functional and Articular Index, and a night pain index. Common for all

patients were the patient's and physician's global assessment. RESULTS:

: Most patients with RA showed sustained or increased improvement of

disease activity during pregnancy. Higher disease activity scores were

found in the patients with AS with a frequent increase of disease

activity in the second trimester and mitigation of symptoms in the third

trimester. Analysis specifically for the patient's assessment of pain

showed continuously higher pain scores in the patients with AS than in

those with RA. Rank correlation showed good to moderate correlation

between most clinical measurements and RADAI or BASDAI, respectively.

Functional indices were confounded by physiological changes of late

pregnancy.

CONCLUSION: RA can be monitored during and after pregnancy by the

swollen joint count and RADAI without interference from pregnancy

related symptoms, whereas usual measures of disease activity are not

always applicable in pregnant patients with AS.

PMID: 15361373

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5361373 & dopt=Abstract

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