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. 2015:2015:401690.
doi: 10.1155/2015/401690. Epub 2015 Jan 14.

Validity and Agreement between the 28-Joint Disease Activity Score Based on C-Reactive Protein and Erythrocyte Sedimentation Rate in Patients with Rheumatoid Arthritis

Louise Nielung  1 , Robin Christensen  1 , Bente Danneskiold-Samsøe  2 , Henning Bliddal  2 , Christian Cato Holm  1 , Karen Ellegaard  1 , Hanne Slott Jensen  3 , Else Marie Bartels  1
Affiliations

Validity and Agreement between the 28-Joint Disease Activity Score Based on C-Reactive Protein and Erythrocyte Sedimentation Rate in Patients with Rheumatoid Arthritis

Louise Nielung et al. Arthritis. 2015.

Abstract

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 classified as EULAR good, moderate, and nonresponders with good agreement (61/75; 81%) between DAS28-CRP and DAS28-ESR (κ = 0.75 (95% CI: 0.63 to 0.88)). Conclusions. According to our findings, DAS28-CRP and DAS28-ESR are interchangeable when assessing RA patients and the two versions of DAS28 are comparable between studies.

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Figures

Figure 1
Figure 1
(a) Bland-Altman plot of disease activity score (DAS28) C-reactive protein (CRP) and DAS28 erythrocyte sedimentation rate (ESR) values at baseline. Difference between DAS28-CRP and DAS28-ERS scores versus mean value of DAS28-CRP and DAS28-ESR at baseline is shown. The mean difference is represented by the central line and the upper and lower bound represent ±1.96SD from the mean. (b) Bland-Altman plot of the change in disease activity score (DAS28) C-reactive protein (CRP) and DAS28 erythrocyte sedimentation rate (ESR) values assessed after one year. Difference between changes in DAS28-CRP and DAS28-ESR scores versus mean value of the changes of DAS28-CRP and DAS28-ESR at baseline is shown. The mean difference is represented by the central line and the upper and lower bound represent ±1.96SD from the mean.
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