scholarly journals Disease Activity Score 28 (DAS28) using C-reactive protein underestimates disease activity and overestimates EULAR response criteria compared with DAS28 using erythrocyte sedimentation rate in a large observational cohort of rheumatoid arthritis patients in Japan

2007 ◽  
Vol 66 (9) ◽  
pp. 1221-1226 ◽  
Author(s):  
T. Matsui ◽  
Y. Kuga ◽  
A. Kaneko ◽  
J. Nishino ◽  
Y. Eto ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Disease Activity Score ◽  
C Reactive Protein ◽  
Eular Response ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Observational Cohort

scholarly journals DAS28-ESR and DAS28-CRP - are they Interchangeable in Measuring the Activity of Rheumatoid Arthritis in Response to Treatment with Biological Agents?

Folia Medica ◽  
2020 ◽  
Vol 62 (1) ◽  
pp. 46-51
Author(s):  
Tanya K. Shivacheva
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Disease Activity Score ◽  
Activity Score ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Low Activity

Introduction: The European League Against Rheumatism updates the recommendations for managing rheumatoid arthritis. Again, it is not specified which DAS28 is there in view (with erythrocyte sedimentation rate or C-reactive protein). &nbsp; Aim: The aim of the study is to check whether Disease Activity Score-28 (erythrocyte sedimentation rate) and Disease Activity Score-28 (C-reactive protein) represent equally the activity of rheumatoid arthritis in the course of treatment with biological agents. &nbsp; Materials and methods: In a retrospective study we analyzed the database of real clinical practice over a 12-month period of biological treatment of rheumatoid arthritis. Disease Activity Score-28 (erythrocyte sedimentation rate) and (C-reactive protein) are compared at the start and at the end of the study. &nbsp; Results: The mean difference between the two variants of disease activity scores at baseline and at the end of the study is significant (p < 0.001). The Disease Activity Score-28 (erythrocyte sedimentation rate) represents a remarkably small proportion of patients with remission and low activity (<3.2) at baseline (18.46%) and at the end of the study (40.51%). Disease Activity Score-28 (C-reactive protein) represents a significantly high proportion of patients in remission and low activity (<3.2) at the end of the study (69.74%). Estimates of activity according to the two variants show significant discrepancy between each other and low level of agreement (kappa = 0.235-0.464). Discrepancies are not related to the type of biological drug (anti-TNF or not). &nbsp; Conclusion: The two DAS28 variants are not interchangeable with the same threshold for low activity in measuring the response to biological therapy.

scholarly journals Comparison of the Disease Activity Score Using Erythrocyte Sedimentation Rate and C-reactive Protein in African Americans with Rheumatoid Arthritis

2013 ◽  
Vol 40 (11) ◽  
pp. 1812-1822 ◽  
Author(s):  
Ashutosh Tamhane ◽  
David T. Redden ◽  
Gerald McGwin ◽  
Elizabeth E. Brown ◽  
Andrew O. Westfall ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
African Americans ◽  
Disease Activity ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Disease Activity Score ◽  
Disease Duration ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation

Objective.The Disease Activity Score based on 28 joints (DAS28) has been increasingly used in clinical practice and research studies of rheumatoid arthritis (RA). Studies have reported discordance between DAS28 based on erythrocyte sedimentation rate (ESR) versus C-reactive protein (CRP) in patients with RA. However, such comparison is lacking in African Americans with RA.Methods.This analysis included participants from the Consortium for the Longitudinal Evaluation of African Americans with Early Rheumatoid Arthritis (CLEAR) registry, which enrolls self-declared African Americans with RA. Using tender and swollen joint counts, separate ESR-based and CRP-based DAS28 scores (DAS28-ESR3 and DAS28-CRP3) were calculated, as were DAS28-ESR4 and DAS28-CRP4, which included the patient’s assessment of disease activity. The scores were compared using paired t-test, simple agreement and κ, correlation coefficient, and Bland-Altman plots.Results.Of the 233 included participants, 85% were women, mean age at enrollment was 52.6 years, and median disease duration at enrollment was 21 months. Mean DAS28-ESR3 was significantly higher than DAS28-CRP3 (4.8 vs 3.9; p < 0.001). Similarly, mean DAS28-ESR4 was significantly higher than DAS28-CRP4 (4.7 vs 3.9; p < 0.001). ESR-based DAS28 remained higher than CRP-based DAS28 even when stratified by age, sex, and disease duration. Overall agreement was not high between DAS28-ESR3 and DAS28-CRP3 (50%) or between DAS28-ESR4 and DAS28-CRP4 (59%). DAS28-CRP3 underestimated disease activity in 47% of the participants relative to DAS28-ESR3 and DAS28-CRP4 in 40% of the participants relative to DAS28-ESR4.Conclusion.There was significant discordance between the ESR-based and CRP-based DAS28, a situation that could affect clinical treatment decisions for African Americans with RA.

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