Background The disease activity scored based on 28 joints (DAS28) has been widely used in clinical practice and research studies of rheumatoid arthritis (RA).
Objectives The objective of this study was to evaluate discordance between DAS28 based on erythrocyte sedimentation rate (ESR) versus C-reactive protein (CRP) in patients with RA.
Methods From August to December 2011, 540 RA patients who visited 2 rheumatology clinics affiliated to Hallym University and had at least one DAS28 evaluation were examined.
Results The mean age of the included patients was 53 years, and 82% were female. The mean duration of disease was 32.9±41.2 months. The mean DAS28-ESR was higher than DAS28-CRP (3.65 vs 3.44; p<0.001). The number of patients who satisfied the criteria of remission was 126 (23.3%) in DAS28-ESR versus 134 (24.8%) in DAS28-CRP and the number of patients with high disease activity was 81 (15%) versus 44 (8.1%) for DAS28-ESR and DAS28-CRP. When DAS28-ESR and DAS-CRP were compared with regard to 4 disease activity categories, agreement with regard to DAS28 disease activity categories was observed in 344 (53.7%) with κ=0.45. The improvement of disease activity based on EULAR response in classifying patients EULAR responders using the two DAS28 definitions, there was 201 (71.7%) agreement with κ=0.665 between two methods.
Conclusions There was discordance between the ESR based and CRP based DAS28, a situation that could affect clinical treatment decisions for RA patients.
Disclosure of Interest None declared
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