Validity of simplified disease activity index using CRP titer in comparison to disease activity score-28 joints in Iraqi patients with active Rheumatoid arthritis (original) (raw)
Clinical Rheumatology, 2012
Serial objective assessment of disease activity in rheumatoid arthritis (RA) is imperative to achieve remission. Routine Assessment of Patient Index Data 3 (RAPID3), an index without formal joint counts, appears attractive for evaluation of disease activity in RA patients in a busy clinical setting. This study aims to evaluate correlation and agreement of RAPID3 with Disease Activity Score 28 (DAS28) and Clinical Disease Activity Index (CDAI) in RA patients. All patients completed a Multidimensional Health Assessment Questionnaire (MDHAQ) at each visit. A physician/assessor 28-joint count and erythrocyte sedimentation rate were completed in 200 literate patients with RA to score DAS28, CDAI, and RAPID3. RAPID3 includes the three MDHAQ patient self-report RA core dataset measures for physical function, pain, and patient global estimate. Proposed RAPID3 (range, 0-30) severity categories of high (>12), moderate (6.1-12.0), low (3.1-6.0), and near remission
Lupus: Open Access, 2016
Objectives: Our objective was to evaluate the level of similarity between SDAI, CDAI, DAS28-ESR and DAS28-CRP in our study population which will help in the quick assessment of the disease for immediate treatment modalities. Methods: The study population consisted of 38 Rheumatoid Arthritis (RA) patients attending the OPD of our hospital. After a detailed medical history and anthropometric evaluation, all the participants were subjected to biochemical analysis like CRP, ESR and their disease activity scores were calculated using DAS calculator. SDAI and CDAI were also calculated. The correlations between the four indices were studied through the Pearson's correlation coefficient (r) and the similarity between these indices was evaluated through Kendall's (K) "tau" similarity coefficient. Results: The 38 RA patients were of mean age of 42.08 ± 12.92 years with the disease duration of mean of 36 months (1 month-20 years). The DAS28-ESR mean score was 5.56 ± 0.90. The DAS28-CRP mean score was 4.93 ± 0.86. The CDAI mean score was 26.45 ± 8.42 and that of SDAI was 28.20 ± 9.08. A positive, statistically significant correlation was noted between the four indices for RA activity. The level of similarity between these indices was good (K variation between 0.699 and 0.910). 42.1% of the patients were classified as 'high' disease activity level, when DAS28-ESR and DAS28-CRP scores were considered together. This proportion was of 42.1%, when comparing DAS28-CRP respectively to CDAI and SDAI, compared to 60.5% when DAS28-ESR and SDAI were considered whereas DAS28-ESR and CDAI classified 65.8% of the patients as 'high' disease activity. Finally, CDAI and SDAI classified the patients upto 60.5% as having a 'high' disease activity level. Conclusion: DAS28-CRP, DAS28-ESR, CDAI and SDAI correlated well for assessing the disease activity status for the RA patients. CDAI and especially SDAI have a good level of similarity with DAS28.
International Journal of Rheumatic Diseases, 2017
Background/Purpose: To compare the performance of Disease Assessment Score of 28 joints-C-reactive protein (DAS-28-CRP), Clinical Disease Activity Index (CDAI) and Simplified Disease Activity Index (SDAI) composite measures to assess status of patients with rheumatoid arthritis (RA) on methotrexate, versus DAS-28 CRP as the gold standard. Methods: One hundred and thirty-five patients with RA as per the 2010 American College of Rheumatology/ European League Against Rheumatism criteria were included in the prospective study. The disease activity was assessed at baseline and at every 6 weeks for 24 weeks, by DAS-28-CRP, CDAI and SDAI. Patients were divided into groups of remission, low, moderate and high activity on the basis of predefined cutoffs for DAS-28-CRP, CDAI and SDAI. A Spearman correlation between composite measures and inter-group comparison of the measures was performed. Results: There was an excellent positive correlation between DAS-28-CRP and CDAI (linear weighted j baseline-0.545), DAS-28 CRP and SDAI (linear weighted j-0.689) at baseline. There was moderate agreement between DAS-28-CRP and CDAI (linear weighted j final visit-0.458) at final visit. There was moderate correlation between SDAI and DAS-28-CRP at final visit (linear weighted j-0.470). However, correlation between CDAI versus SDAI remained excellent at baseline and final visit. Patients in remission as per DAS-28-CRP had significantly more residual disease activity compared to SDAI and CDAI remission criteria. Conclusion: The study shows an excellent strong positive correlation between DAS-28-CRP, CDAI and SDAI at initial evaluation but not at final visit. SDAI-and CDAI-based remission criteria seem to be better than DAS-28-CRP-based remission criteria.
Clinical Rheumatology, 2017
The aim of our work was to assess the performance of different Disease Activity Score (DAS) other than DAS-ESR in daily clinical practice in our Egyptian outpatient clinics and also to evaluate the accuracy of European League Against Rheumatism Classification (EULAR) proposed cutoffs for these scores to stratify Egyptian patients into different categories of disease activity. This study is a cross-sectional Egyptian multicenter study. It included 130 rheumatoid arthritis (RA) patients who visited our Rheumatology and Rehabilitation outpatient and inpatient clinics; 80 patients from Cairo University Hospitals and 50 patients from Zagazig University Hospitals. The patients fulfilled the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism Classification criteria for rheumatoid arthritis. Disease Activity Score 28-ESR (DAS28-ESR), DAS28-CRP, Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI) were calculated. A significant positive correlation was found between all three scores and morning stiffness, ESR, Modified Health Assessment Questionnaire (MHAQ), and DAS-ESR. Also, there was a significant negative correlation between DAS-CRP and hemoglobin and a significant positive correlation with CRP. Also, there was a highly significant moderate agreement between DAS-ESR and DAS-CRP using Fleischmann et al. thresholds and also between DAS-ESR and SDAI. While a highly significant fair agreement was found between DAS-ESR and DAS-CRP using DAS-ESR thresholds and between DAS-ESR and CDAI. We conclude that DAS-CRP, SDAI, and CDAI are very useful in representing disease activity in RA patients in our outpatient clinics being well correlated with many markers of disease activity. We recommend huge multicenter studies in Egypt and in different populations to define new cutoff values to optimize their use in clinical setting.
Arthritis, 2015
Objective. To validate the agreement between the 28-joint disease activity score based on erythrocyte sedimentation rate (DAS28-ESR) and the 28-joint disease activity score based on C-reactive protein (DAS28-CRP) in a group of Danish patients with rheumatoid arthritis (RA). Methods. Data from 109 Danish RA patients initiating biologic treatment were analysed at baseline and following one year of treatment. Participants were retrospectively enrolled from a previous cohort study and were considered eligible for this project if CRP and ESR were measured at baseline and at the follow-up visit. To assess the extent of agreement between the two DAS28 definitions, the "European League Against Rheumatism" (EULAR) response criteria based on each definition were calculated with cross-classification. Weighted Kappa (κ) coefficients were calculated, and Bland-Altman plots were used to illustrate degree of agreement between DAS28 definitions. Results. The 75 eligible patients were clas...
2017
Background:Clinical Disease Activity Index (CDAI) stands out amongst other methods in measuring disease activity of rheumatoid arthritis (RA) patient. CDAI is considered to be more practical and cost-effective in daily practice because it requires no laboratoryexamination. Previous studies conducted overseas revealed that CDAI has good correlation compared to other scoring index in measuring RA disease activity. However, those studies only included pure RA patients without any comorbidity diseases. Indonesian RA patients have distinct clinical profile, in terms of comorbidity conditions, and genetic predisposition which affect the fenotype of the disease.Objectives: Analyze correlation between CDAI compared to Disease Activity Score 28 CRP (DAS28- CRP) in measuring RA disease activity of RA patients in Indonesia.Methods: We conducted a cross sectional study to RA patients who visited rheumatology clinic at Cipto Mangunkusumo general hospital from April to May 2016. Data collected in...
2021
Objective To assess the utility of Patient Based Disease Activity Score 2 (PDAS 2) in assessing the disease activity in Rheumatoid arthritis (RA). Methods A prospective cohort study was conducted on 80 patients of RA. The demographic and clinical characteristics of the patients were recorded. They were assessed for disease activity using “Disease Activity Score 28” (DAS 28), “Clinical Disease Activity Index” (CDAI) and PDAS 2 score at baseline (M0), at 2 months (M2) and at 4 months(M4) while they were on treatment. Data was analyzed for correlation of PDAS-2 with other scores and internal reliability. P < 0.05 was considered for statistical significance. Results The mean age was 40.13\(\pm\) 11.74 years with 70 females and 10 males. There was significant reduction in DAS28, CDAI and PDAS 2 score over 4 month follow up (all scores’ p values < 0.001). Internal reliability (as assessed by Cronbach’s Alpha) of PDAS 2 was 0.578. PDAS 2 showed significant correlation with DAS28 at M...
Reumatologia/Rheumatology
Introduction: There is a lack of data assessing disease activity in patients with rheumatoid arthritis from Pakistan. We sought to determine the correlation between Disease Activity Score 28 (DAS28) and disease activity parameters and the modified Health Assessment Questionnaire (mHAQ). Secondarily, we evaluated the concordance of acute phase reactants with disease activity. Material and methods: We prospectively studied 132 patients with rheumatoid arthritis (RA) as per the 2010 American College of Rheumatology/European League Against Rheumatism criteria, not in clinical remission. Based on the DAS28 score, the patients were divided into low, moderate, and high activity groups. The patients were also categorized according to the elevation of acute phase reactants to determine concordance and discordance with DAS28-ESR and DAS28-CRP. Descriptive statistics and Pearson's correlation were computed. Results: Complete demographics was available for 132 participants. The mean age was 46.2 ±12.8 years; there were 85.6% (n = 113) females. The mean disease duration was 5.7 ±6.4 years. The (Rephrase as mean ±SD) DAS28 and mHAQ scores were 3.4 ±1.8 and 0.77 ±0.68, respectively. A significant correlation was observed between DAS28 and tender and swollen joint count (r = 0.64; p < 0.001); DAS28 and mHAQ (r = 0.47; p-value < 0.001), DAS28 and patient's global assessment (PGA) (r = 0.45; p-value < 0.001). A weak correlation was observed between mHAQ and CRP and ESR, with r = 0.242 and 0.225, respectively, p-value < 0.001. In comparison, no correlation of DAS28 with the rheumatoid factor (r =-0.035) or ACPA antibody (r =-0.094) was noted. A positive concordance between ESR and CRP was observed in severely active RA. Conclusions: From an outpatient setting in a South Asian country, DAS28-ESR emerged as the preferred choice for an accurate assessment of disease severity in RA when combined with the mHAQ. Acute phase reactants increase positively in concordance with severely active RA, although discordant in low to moderately active disease.
Arthritis & Rheumatism, 2005
Objective. To assess the reliability and congruency of the Simplified Disease Activity Index (SDAI) compared with the Disease Activity Score including 28 joints (DAS28) in daily practice. Methods. In 399 consecutive rheumatoid arthritis patients (307 women, 92 men), the SDAI and the DAS28 were calculated. Additionally, 115 of them were observed for 1 year and changes of both values were recorded. Joint assessments were performed by 4 experienced physicians. DAS28 and SDAI values and the respective changes were compared by correlation and regression analyses. Reliability assessment and factor analyses were performed. Disease activity categorizing was compared by the Wilcoxon's rank sum test. Results. The median ؎ SD scores were 3.42 ؎ 1.45 for the DAS28 and 11.50 ؎ 11.50 for the SDAI. Spearman's rho was 0.897 (P < 0.0001). Score changes were also significantly correlated. Reliability testing and factor analysis revealed that both scores can be regarded as monocomponent. Categorizing patients according to the European League Against Rheumatism response criteria (EULARC) or the SDAI revealed statistically significant differences between the 2 scales (P < 0.0001). Conclusion. SDAI values are considerably shifted to the left compared with DAS28 levels. Internal consistency and reliability of both scores are comparable. For the differences in disease activity categorizing due to the SDAI compared with the EULARC, a major limitation of the application of this newly developed disease activity score is given, unless these incongruencies can be cleared.