Gender stratified adjustment of the DAS28-CRP improves inter-score agreement with the DAS28-ESR in rheumatoid arthritis

BSRBR-RA Contributors Group

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives. To evaluate determinants of discordance between DAS28-ESR and DAS28-CRP and resulting impact on disease activity stratification in RA. Methods. Paired DAS28-ESR and DAS28-CRP readings (n = 31 074) were obtained from the British Society for Rheumatology Biologics Register for RA. Factors influencing discordance between DAS28-ESR and DAS28-CRP were evaluated alongside the resulting effect on disease activity stratification. The impact of gender adjustment to the DAS28-CRP was evaluated. Results. DAS28-CRP scores were 0.3 lower than DAS28-ESR overall, with greatest differences for women (0.35) and patients over 50 years old (0.34). Mean male DAS28-CRP scores were 0.15 less than corresponding DAS28-ESR scores. Discordance between DAS28-ESR and DAS28-CRP significantly impacted disease activity stratification at low disease activity and remission thresholds (32.0% and 66.6% concordance, respectively). Adjusting DAS28-CRP scores by gender significantly (P & 0.001) improved agreement with the DAS28-ESR. Conclusion. Discordance between DAS28-ESR and DAS28-CRP is greatest for women and patients over 50 years of age, and influences disease activity stratification. The proposed gender-adjusted DAS28-CRP improves inter-score agreement with DAS28-ESR, supporting more reliable disease activity stratification in treat-to-target approaches for RA.

Original languageEnglish
Pages (from-to)831-835
Number of pages5
JournalRheumatology (United Kingdom)
Volume58
Issue number5
Early online date19 Dec 2018
DOIs
Publication statusPublished - 1 May 2019

Keywords

  • Age
  • Biologics
  • BMI
  • BSRBR
  • CRP
  • DAS
  • DAS28
  • ESR
  • Gender
  • RA

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