The comparative responsiveness of Hospital Universitario Princesa Index and other composite indices for assessing rheumatoid arthritis activity

Objective To evaluate the responsiveness in terms of correlation of the Hospital Universitario La Princesa Index (HUPI) comparatively to the traditional composite indices used to assess disease activity in rheumatoid arthritis (RA), and to compare the performance of HUPI-based response criteria with that of the EULAR response criteria. Methods Secondary data analysis from the following studies: ACT-RAY (clinical trial), PROAR (early RA cohort) and EMECAR (pre-biologic era long term RA cohort). Responsiveness was evaluated by: 1) comparing change from baseline (Delta) of HUPI with Delta in other scores by calculating correlation coefficients; 2) calculating standardised effect sizes. The accuracy of response by HUPI and by EULAR criteria was analyzed using linear regressions in which the dependent variable was change in global assessment by physician (Delta GDA-Phy). Results Delta HUPI correlation with change in all other indices ranged from 0.387 to 0.791); HUPI's standardized effect size was larger than those from the other indices in each database used. In ACT-RAY, depending on visit, between 65 and 80% of patients were equally classified by HUPI and EULAR response criteria. However, HUPI criteria were slightly more stringent, with higher percentage of patients classified as non-responder, especially at early visits. HUPI response criteria showed a slightly higher accuracy than EULAR response criteria when using Delta GDA-Phy as gold standard. Conclusion HUPI shows good responsiveness in terms of correlation in each studied scenario (clinical trial, early RA cohort, and established RA cohort). Response criteria by HUPI seem more stringent than EULAR''s

Comparative bone microstructure of three archosauromorphs from the Carnian, Late Triassic Chanares Formation of Argentina

The Chañares Formation exhibits one of the most important archosauriform records of early Carnian ecosystems. Here we present new data on the palaeohistology of Chañares archosauriforms and provide new insights into their paleobiology, as well as possible phylogenetically informative traits. Bone microstructure of Lagerpeton chanarensis and Tropidosuchus romeri is dominated by fibro-lamellar tissue and dense vascularization. On the other hand, Chanaresuchus bonapartei is more densely vascularized, but with cyclical growth characterized by alternate fibro-lamellar, parallel-fibered and lamellar-zonal tissues. Dense vascularization and fibro-lamellar tissue imply fast growth and high metabolic rates for all these taxa. These histological traits may be tentatively interpreted as a possible adaptative advantage in front of Chañares Formation environmental conditions