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Comparative Study
. 2007 Mar;66(3):407-9.
doi: 10.1136/ard.2006.054205. Epub 2006 Aug 22.

Comparison of Disease Activity Score (DAS)28- erythrocyte sedimentation rate and DAS28- C-reactive protein threshold values

Eisuke Inoue  1 , Hisashi Yamanaka, Masako Hara, Taisuke Tomatsu, Naoyuki Kamatani
Affiliations
Comparative Study

Comparison of Disease Activity Score (DAS)28- erythrocyte sedimentation rate and DAS28- C-reactive protein threshold values

Eisuke Inoue et al. Ann Rheum Dis. 2007 Mar.

Abstract

Objective: To estimate the disease activity score (DAS)28-C-reactive protein (CRP) threshold values that correspond to DAS28-erythrocyte sedimentation rate (ESR) values for remission, low disease activity and high disease activity in patients with rheumatoid arthritis.

Methods: DAS28 data were analysed using a large observational study (Institute of Rheumatology Rheumatoid Arthritis) database of 6729 patients with rheumatoid arthritis. Firstly, the relationship between the DAS28-ESR and the DAS28-CRP values was analysed. Secondly, the best DAS28-CRP trade-off values for each threshold were calculated using receiver operating characteristic (ROC) curves.

Results: The correlation coefficient of ESR versus CRP was 0.686, whereas that of DAS28-ESR versus DAS28-CRP was 0.946, showing the strong linear relationship between DAS28-ESR and DAS28-CRP values. DAS28-CRP threshold values corresponding to remission, low disease activity and high disease activity were 2.3, 2.7 and 4.1, respectively. The sensitivity and specificity from the ROC curves were gradually reduced as DAS28 values became lower.

Conclusions: This study showed that DAS28-CRP and DAS28-ESR were well correlated, but the threshold values should be reconsidered. As the results were derived from only Japanese patients, it is essential to compare DAS28-CRP threshold values in people of other ethnic groups.

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Conflict of interest statement

Competing interests: None declared.

References

    1. van der Heijde D M, van't Hof M A, van Riel P L, Theunisse L A, Lubberts E W, van Leeuwen M A.et al Judging disease activity in clinical practice in rheumatoid arthritis: first step in the development of a disease activity score. Ann Rheum Dis 199049916–920. - PMC - PubMed
    1. Prevoo M L, van't Hof M A, Kuper H H, van Leeuwen M A, van de Putte L B, van Riel P L. Modified disease activity scores that include twenty‐eight‐joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 19953844–48. - PubMed
    1. Smolen J S, Han C, Bala M, Maini R N, Kalden J R, van der Heijde D.et al Evidence of radiographic benefit of treatment with infliximab plus methotrexate in rheumatoid arthritis patients who had no clinical improvement: a detailed subanalysis of data from the anti‐tumor necrosis factor trial in rheumatoid arthritis with concomitant therapy study. Arthritis Rheum 2005521020–1030. - PubMed
    1. Vander Cruyssen B, Van Looy S, Wyns B, Westhovens R, Durez P, Van den Bosch F.et al DAS28 best reflects the physician's clinical judgment of response to infliximab therapy in rheumatoid arthritis patients: validation of the DAS28 score in patients under infliximab treatment. Arthritis Res Ther 20057R1063–R1071. - PMC - PubMed
    1. Weinblatt M E, Keystone E C, Furst D E, Kavanaugh A F, Chartash E K, Segurado O G. Long‐term efficacy and safety of adalimumab plus methotrexate in patients with rheumatoid arthritis: ARMADA 4‐year extended study. Ann Rheum Dis 200665753–759. - PMC - PubMed

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