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LETTER |
1 Altnagelvin Hospital, Londonderry, N Ireland
2 Musgrave Park Hospital, Belfast, N Ireland
3 Northern Health and Social Services Board, Antrim, N Ireland
4 Ulster Hospital, Dundonald, N Ireland
5 Craigavon Hospital, Craigavon, N Ireland
6 Antrim Hospital, Antrim, N Ireland
Correspondence to:
Correspondence to:
Dr P V Gardiner
Altnagelvin Hospital, Glenshane Road, Londonderry BT47 1SB, N Ireland UK; pgardiner@alt.n-i.nhs.uk
Accepted 17 July 2004
Keywords: Disease Activity Score; erythrocyte sedimentation rate; rheumatoid arthritis
| The first 150 words of the full text of this article appear below. |
The Disease Activity Score1 is widely used to quantify disease activity and gauge response to treatment. A rather complex calculation conceals the relative contribution of each measure to the composite score. The 28 joint version (DAS28) is used in the British Society for Rheumatology guidelines to determine response to anti-tumour necrosis factor
(anti-TNF
) treatment.2 A reduction in DAS28 of
1.2 is considered significant improvement, as is a reduction in DAS28 score to <3.2. These figures are important, as under current guidelines clinicians are advised to discontinue anti-TNF treatment if either of these criteria is not achieved at 3 months.
In the course of reviewing decisions on whether or not to continue anti-TNF therapy, we identified several patients in whom the change in DAS28 score did not correlate with clinical findings. It was also noted that the clinicians relied heavily on the change in DAS28 score to determine if the
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