RESEARCH - Patient-derived joint counts are a potential alternative for determining DAS

August 4, 2010

J Rheumatol. 2010 May;37(5):1035-41. Epub 2010 Feb 15.

Patient-derived joint counts are a potential alternative for

determining Disease Activity Score.

Kavanaugh A, Lee SJ, Weng HH, Chon Y, Huang XY, Lin SL.

Division of Rheumatology, Allergy and Immunology, University of

California, San Diego, La Jolla, CA 92037-0943, USA.

akavanaugh@...

Abstract

OBJECTIVE: To investigate the correlation between the Disease Activity

Score using a 28-joint count (DAS28) based on physician-derived joint

counts and the DAS28 based on patient-derived joint counts (Pt-DAS28)

in rheumatoid arthritis (RA).

METHODS: Data from a multicenter, open-label study investigating the

immunogenicity of etanercept (ETN) were analyzed. ETN-naive patients

with active RA received ETN 50 mg once weekly alone or with

methotrexate (MTX). Joint counts were performed at baseline, Week 12,

and Week 24 by the physician and patient independently. Patients

received instruction in performing joint assessments.

RESULTS: Of 447 patients enrolled (ETN, n = 218; ETN + MTX, n = 229),

most were women (79%) and the mean age was 54.5 years. Correlation

coefficients between DAS28 and Pt-DAS28 were > or = 0.57 at baseline,

Week 12, and Week 24. At Week 24, 48%, 39%, and 12% of patients could

be classified as having low, moderate, or high disease activity,

respectively, using DAS28. Using Pt-DAS28, 43%, 39%, and 18% were

similarly classified. Agreement in the category of disease activity

classification occurred in 72% of patients (kappa = 0.55). At Week 24,

78% of patients using DAS28 and 72% of patients using Pt-DAS28 were

classified as moderate or good European League Against Rheumatism

responders.

CONCLUSION: These results support the possible use of patient-derived

tender and swollen joint counts to aid in the assessment of disease

activity and clinical response in patients with RA.

PMID: 20156946

Not an MD

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