DAS28-ESR for Rheumatoid Arthritis (2024)

FAQs

What is a good DAS28 score for rheumatoid arthritis? ›

A patient with a DAS28 score of less than 2.6 is in remission; a score greater than or equal to 2.6 and less than 3.1 indicates low activity; a score greater than or equal to 3.1 and <5.1 indicates moderate activity and a score 5.1 or more indicates high activity⁶.

The degree of elevation of these acute phase reactants varies with the severity of inflammation and synovitis. As an example, an ESR of 50 to 80 is not uncommon in patients with severely active RA. By comparison, an ESR of 20 to 30 can be observed with only a few mildly to moderately active joints.

Patients are considered to have shown a good response if their DAS28 is ≤3.2 and has decreased by >1.2. A moderate response is defined as a DAS28 ≤3.2 plus a decrease >0.6 and ≤1.2, or a DAS28 ≤5.1 >3.2 and a decrease >0.6, or a DAS28 >5.1 and a decrease >1.2 (Table 1).

A major drawback of the DAS28 score in the authors' opinion is related to the difference in the effects of tender and swollen joint counts. Based on formula [1] the effect of the number of tender joints is two-fold larger than the effect of the swollen joint count.

A normal, healthy amount of rheumatoid factor is less than 20 units per milliliter (<20 U/mL). Your provider might also refer to your test as being negative or positive. A negative result means you have a normal amount of RF in your blood. Positive means you have high levels of rheumatoid factor.

An evaluation results in a score between 0 and 10. Rheumatoid arthritis is diagnosed if the score is 6 or more.

The DAS provides a score between 0 and 10, a larger number indicating more active disease. When using the score to assess response to treatment, a DAS-28 reduction by 0.6 represents a moderate improvement, while a reduction more than 1.2 represents a major improvement. <2.6 suggests disease remission.

DAS28 scores range from 0 to 9.4 and are calculated using tender joints, swollen joints, general health, and a laboratory measure of acute inflammation (³). DAS28 can be characterized using erythrocyte sedimentation rate (ESR) or C‐reactive protein (CRP).

Assessment of Disease Activity

A score greater than 5.1 indicates active disease and less than 3.2 indicates well-controlled disease. A score of less of than 2.6 indicates remission.

According to the DAS28, the disease is considered to be the following: Very active disease if DAS28 > 5.1. Active if the DAS28 is between 5.1 and 3.2. In low disease activity if DAS28 is 2.6–3.2.

What is the disease activity score in 28 joint count DAS28? ›

Disease Activity Score in 28 Joints (DAS28) is a scoring system to evaluate disease activity and treatment response in rheumatoid arthritis (RA). A DAS28 score of greater than 3.2 is a well-described limit for treatment intensification; however, the reliability of DAS28 might be overestimated.

DAS28 is calculated according to the formula that is composed of the number of tender joints and swollen joints, patient's global assessment of disease activity on a visual analogue scale (VAS), and erythrocyte sedimentation rate (ESR), not C‐reactive protein (CRP).

Some doctors define normal RF levels as 0–20 units per milliliter (U/ml) of blood. On the other hand, one 2012 study designated the upper limit of regular levels as 25 U/ml . A person's risk of developing rheumatoid arthritis typically increases with their RF level.

The 28-joint count [3] evaluates the following joints: upper—shoulder, elbow, wrist, metacarpophalangeal and proximal interphalangeal; lower—knee. WEIGHTED JOINT COUNTS There are two main weighted counts: the Ritchie articular index [2] and the Thompson-Kirwan index [4].

DAS28 scores range from 0 to 9.4 and are calculated using tender joints, swollen joints, general health, and a laboratory measure of acute inflammation (³). DAS28 can be characterized using erythrocyte sedimentation rate (ESR) or C‐reactive protein (CRP).