DAS28
The DAS28 ( Disease Activity Score 28 : score = score / evaluation; disease activity = disease activity ) is a system developed and validated by the EULAR (The European League Against Rheumatism) for the quantitative assessment of the disease status and progression of rheumatoid arthritis . It is used in both patient care and clinical research.
Due to the good traceability of the DAS28, different examiners can compare the findings with one another. This, in turn, is the basis for greater treatment security, for example when it comes to the question of the effectiveness of a drug.
DAS28 values range from 2.0 to 10.0, with higher values reflecting higher disease activity. A DAS28 below 2.6 is rated as remission .
The DAS28 is the further development of the DAS (or DAS44) developed since 1983, which is more complex to collect. "28" refers to the number of joints examined (finger, hand, elbow, shoulder and knee joints). One variant is the three-parameter DAS28, which does not include an assessment of the disease status. A further development is DAS-CRP, which instead of the sedimentation rate (ESR) contains the CRP value as an inflammation parameter. He reacts faster to short-term changes.
Parameters of the DAS28
The following parameters flow into the DAS28:
- Number of tender joints (0-28; each measurement on 28 joints defined by the EULAR)
- Number of swollen joints (0-28)
- Sedimentation rate (mm / h)
- Assessments of the disease state / activity of the disease by the patient (0-100 mm VAS )
The DAS28 is calculated using the following formula:
After completing the examination, the result obtained with this formula is described with a point value between 0 and 10:
- a value between 0 and 3.2: absent to low disease activity
- a value between 3.2 and 5.1: mean disease activity
- Values> 5.1: high disease activity
Standardized questionnaires and calculation aids are available for the DAS28.
literature
- Peter Matthias Villiger, Michael Seitz: Rheumatology in brief ; Thieme Verlag; 2nd, completely revised and expanded edition; (Chapter 4 - Rheumatoid Arthritis)
- Fransen J, van Riel PL: The Disease Activity Score and the EULAR response criteria . In: Clin Exp Rheumatol . 23, No. 5 Suppl 39, 2005, pp. S93-9. PMID 16273792 .
- van Gestel AM, Prevoo ML, van 't Hof MA, van Rijswijk MH, van de Putte LB, van Riel PL: Development and validation of the European League Against Rheumatism response criteria for rheumatoid arthritis. Comparison with the preliminary American College of Rheumatology and the World Health Organization / International League Against Rheumatism Criteria . In: Arthritis Rheum . 39, No. 1, January 1996, pp. 34-40. PMID 8546736 .
- Wells G, Becker JC, Teng J, et al. : Validation of the 28-joint Disease Activity Score (DAS28) and European League Against Rheumatism response criteria based on C-reactive protein against disease progression in patients with rheumatoid arthritis, and comparison with the DAS28 based on erythrocyte sedimentation rate . In: Ann Rheum Dis . 68, No. 6, June 2009, pp. 954-60. doi : 10.1136 / ard.2007.084459 . PMID 18490431 . PMC 2674547 (free full text).