Disease activity score
Disease activity score, also called DAS28, is a measure widely used in measuring the response to treatment in rheumatoid arthritis.
Joints included in DAS28[edit | edit source]
Bilateral proximal interphalangeal joints total of 10 joints Bilateral metacarpophalangeal joints total of 10 Bilateral wrists total of 2, Bilateral elbows total of 2, Bilateral shoulders total of 2 and Bilateral knees total of 2.
What is measured in DAS28?[edit | edit source]
In any of the joints, tenderness upon touching which gives the TEN28 score and joint swelling of the joints which gives SW28 are counted.
Sed rate measurement[edit | edit source]
The erythrocyte sedimentation rate (ESR) is also measured.
Subjective assessment[edit | edit source]
The affected person makes a subjective assessment (SA) of disease activity during the preceding 7 days on a scale between 0 and 100, where 0 is "no activity" and 100 is "highest activity possible".
How is DAS28 calculated?[edit | edit source]
With the above parameters, DAS28 is calculated as:
From this, the disease activity of the affected person can be classified as follows:
Current
DAS28 |
DAS28 decrease from initial value | |||
---|---|---|---|---|
> 1.2 | > 0.6 but ≤ 1.2 | ≤ 0.6 | ||
≤ 3.2 | Inactive | Good improvement | Moderate improvement | No improvement |
> 3.2 but ≤ 5.1 | Moderate | Moderate improvement | Moderate improvement | No improvement |
> 5.1 | Very active | Moderate improvement | No improvement | No improvement |
Clinical utility of DAS28 score[edit | edit source]
Although it gives a good indication of the disease activity, it is not always a reliable indicator of treatment effect.
Limitations of DAS28 score[edit | edit source]
One major limitation is that low-grade synovitis may be missed.
Also see[edit | edit source]
- ACR-EULAR Provisional Definition of Remission of Rheumatoid arthritis,
- Simplified Disease Activity Index and
- Clinical Disease Activity Index.
- Some scores do not require input from a healthcare professional and allow self-monitoring by the person, like Health Assessment Questionnaire Disability Index (HAQ-DI).
Disease activity score Resources | ||
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