Digital monitoring linked to clinical improvement of disease activity in RA patients: JAMA

A new study by Chun Li and team showed that using digital health applications to evaluate patient-reported outcomes enhanced the proportion of rheumatoid arthritis (RA) patients who had a DAS28-CRP value of 3.2 or below at month six. The findings of this study were published in the Journal of American Medical Association.

Applications for digital health have been proven to be successful in the management of chronic diseases with straightforward treatment goals. There hasn't been much research done on the potential clinical utility of digital health applications for rheumatoid arthritis. Therefore, the purpose of this study was to determine if RA patients could control their condition by utilizing digital health applications to analyze patient-reported outcomes.

In 22 tertiary hospitals across China, this multicenter, open-label randomized clinical study is taking place. Adult RA patients qualified as participants. From November 1, 2018, through May 28, 2019, participants were enrolled, with a 12-month follow-up. Blinding was used by the statisticians and rheumatologists who evaluated disease activity. Both the researchers and the participants knew which groups they were in. The analysis was carried out between October 2020 and May 2022. A smart system of disease management (SSDM) group or a control group receiving standard medical treatment was allocated to each participant at random in a 1:1 ratio (block size of 4). Patients in the conventional care control group were asked to continue using the SSDM program for an additional 6 months after the 6-month parallel comparison was finished.

The key findings of this study were:

1. 2204 of the 3374 individuals who underwent screening were randomly assigned, and 2197 RA patients were included.

2. 1099 people in the SSDM group and 1098 in the control group participated in the study. At month 6, there were 71.0% of SSDM patients with a DAS28-CRP of 3.2 or less compared to 64.5% of control patients (708 out of 1098 patients).

3. At month 12, the proportion of patients in the control group with a DAS28-CRP of 3.2 or less rose to a level (77.7%) that was equivalent to that (78,2%) in the SSDM group.

Reference:

Li, C., Huang, J., Wu, H., Li, F., Zhao, Y., Zhang, Z., Li, S., Wei, H., Zhang, M., Sun, H., Yang, J., Li, Q., Li, X., Qi, W., Wei, W., Li, Y., Li, Z., Wang, Y., Zhang, F., … Li, Z. (2023). Management of Rheumatoid Arthritis With a Digital Health Application. In JAMA Network Open (Vol. 6, Issue 4, p. e238343). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2023.8343