Presentation (CTI)

OBJECTIVES: To describe change in disease activity, measured by the Routine Assessment of Patient Index Data 3 (RAPID3) and Disease Activity Score in 28 Joints (DAS28-CRP), by treatment class among adults with rheumatoid arthritis (RA) in the real-world setting.
METHODS: This retrospective study used electronic health records from the OMNY Health real-world data platform (2020-2025). Adults with RA were indexed at their first receipt of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), targeted synthetic DMARDs (tsDMARDs), biologics/biosimilars, or systemic steroids. Patients required disease activity measures (RAPID3 or DAS28-CRP) both before and >28 days after index. DAS28-CRP response was categorized as major (>1.2 points), moderate (0.6-1.2), or minimal (<0.6). RAPID3 response was defined as improvement >3.8 points. Demographics and comorbidities were assessed on or before the index.
RESULTS: 8,164 adults with RA were selected, with the following index treatment distribution: csDMARDs (49%), steroids (43%), biologics/biosimilars (5%), and tsDMARDs (3%). The cohort was predominantly female (81%) and White (75%) across treatment classes. The median time between disease activity assessments was 249 days. Shorter intervals between DAS28-CRP assessments were associated with moderate/major response among biologic and steroid users, whereas longer intervals between RAPID3 assessments were associated with nonresponse across all treatment classes. The tsDMARD and steroid groups showed the lowest responsiveness (24% moderate/major DAS28-CRP; 10% RAPID3 responders), whereas the biologic group showed the highest responsiveness across both measures (29% moderate/major DAS28-CRP; 13% RAPID3 responders). A high comorbidity burden was observed across treatments, with higher prevalence of mental health issues and fatigue, and hypertension among systemic steroid users, and higher prevalence of osteoporosis and vitamin D deficiency among biologic users.
CONCLUSIONS: In real-world practice, disease activity measurement documentation frequency varies by assessment type and is associated with treatment responsiveness. These findings highlight the importance of consistent and timely disease activity monitoring and documentation to help guide RA management.