If none of these apply, the next step is to assess treatment response by measuring changes in five parameters and then integrating them into a single number using a mathematical formula. The five elements in the equation are:
- Modified Rodnan skin score.
- Percent of predicted forced vital capacity.
- Health Assessment Questionnaire-Disability Index.
- Patient’s global assessment.
- Physician’s global assessment.
When factored together, changes in these five measures determine the probability that the patient responded to the intervention.
One limitation of the CRISS is that it only measures change from baseline, which makes it similar to the ACR 20, Dr. Furst noted. Another useful score would be one that reflects the status of a patient with systemic sclerosis at a specific point in time, a type of disease activity score. Dr. Furst said that he and others active in the systemic sclerosis field would like to develop a method that provides this type of patient assessment. Another addition would be to develop a “minimally clinically important change” in the score, which would make the CRISS more intuitive to understand.
Dr. Furst has received research support from Amgen, Bristol-Myers Squibb, Celgene, Corbus, Genentech-Roche, GlaxoSmithKline, Pfizer, and Novartis.
mzoler@mdedge.com
SOURCE: Furst DE. EULAR 2018. Abstract SP0012.