Disease severity must be regularly quantified to implement a T2T strategy, but many RA disease activity measures exist, with varying performance.1
CDAI1,2
Score
Low DA: >2.8 to 10
Moderate DA: >10 to 22
High DA: >22
Attributes
SDAI1,2
Score
Low DA: >3.3 to ≤11.0
Moderate DA: >11.0 to ≤26
High DA: >26
Attributes
DAS28-ESR/CRP1,3
Score
Low DA: 2.6 to <3.2
Moderate DA: 3.2 to ≤5.1
High DA: >5.1
Attributes
RAPID31,4,5
Score
Low DA: 4 to 6
Moderate DA: 7 to 12
High DA: ≥13
Attributes
PAS-II1,4
Score
Low DA: >0.26 to 3.70
Moderate DA: 3.71 to <8.0
High DA: ≥8.0
Attributes
ACR, American College of Rheumatologists; CDAI, Clinical Disease Activity Index; CRP, C-reactive protein; DA, disease activity; DAS28, Disease Activity Score 28 Joints; DAS28-ESR/CRP, Disease Activity Score 28 Joints with Erythrocyte Sedimentation Rate or C-Reactive Protein; ESR, erythrocyte sedimentation rate; HAQ, Health Assessment Questionnaire; HAQ-II, Health Assessment Questionnaire II; MDHAQ, Multidimensional Health Assessment Questionnaire; PAS-II, Patient Activity Scale-II; PrGA, provider global assessment; PtGA, patient global assessment; QoL, quality of life; RA, rheumatoid arthritis; RAPID3, Routine Assessment of Patient Index Data 3; SDAI, Simplified Disease Activity Index; SJC, swollen joint count; T2T, treat to target; TJC, tender joint count; VAS, visual analogue scale.
* PAS-II was nevertheless recommended due to its feasibility, current use, inclusion in prior ACR recommendations, and alignment with the concurrent functional status assessment project.1
REFERENCES
1. England BR, Tiong BK, Bergman MJ, et al. Arthritis Care Res (Hoboken). 2019;71(12):1540-1555. 2. Smolen JS, Aletaha D. Clin Exp Rheumatol. 2014;32(5 Suppl 85):S75-S79. 3. Nikiphorou E, Norton SJ, Carpenter L, et al. Rheumatology (Oxford). 2020;59(6):1272-1280. 4. Anderson J, Caplan L, Yazdany J, et al. Arthritis Care Res (Hoboken). 2012;64(5):640-647. 5. Pincus T, Yazici Y, Bergman MJ. Rheum Dis Clin North Am. 2009;35(4):773-778.
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