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To DAPSA or not to DAPSA? That is not the question
  1. Monika M Schoels,
  2. Josef S Smolen,
  3. Daniel Aletaha
  1. Department of Rheumatology, Medical University of Vienna, Vienna, Austria
  1. Correspondence to Dr Monika M Schoels, Medical University of Vienna, Vienna 1090, Austria; monika.schoels{at}

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In a recent publication in the Annals of the Rheumatic Diseases, van Mens et al have provided an analysis of different criteria for assessment of remission and low disease activity (LDA) in psoriatic arthritis (PsA).1 We would like to congratulate the authors for a thoughtful and thorough analysis of various disease activity measures in PsA and for providing the readers with interesting data. As so often, interpretations of data and conclusions may be seen diversely from different angles and we take the liberty to interpreting the data differently than the authors themselves.

The authors have evaluated remission (REM) and LDA by the disease activity in psoriatic arthritis (DAPSA), clinical disease activity in psoriatic arthritis (cDAPSA), minimal disease activity (MDA), psoriatic arthritis disease activity score (PASDAS) and very low disease activity (VLDA) for residual disease activity. These scores differ on two accounts: first, MDA and VLDA are solely state measures and, therefore, do not provide information on the actual level of disease activity, while DAPSA, cDAPSA and PASDAS are continuous measures that allow following patients’ disease activity through their whole disease history and define disease activity states, including remission and LDA; second, the philosophy behind DAPSA and cDAPSA on the one hand and MDA, PASDAS and VLDA on the other hand differs, since the latter scores comprise many aspects of psoriatic disease (PsoD) and thus include skin …

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