Measuring disease activity in patients with early rheumatoid arthritis

TL;DRAbstract

Current treatment strategies for rheumatoid arthritis (RA) aim to suppress the patient’s disease activity as early as possible. This requires valid and reliable measurements of disease activity. The DAS28 (Disease Activity Score for 28 joints) is an index measure that combines a 28‐tender joint count, a 28‐swollen joint count, a laboratory measure of inflammation (either the ESR or the CRP), and a patient‐reported feeling of general health (VAS-GH) into a single measure of disease activity. Though the DAS28 is frequently used, several concerns have been expressed. First, disease activity in omitted joints. Since assessing all joints is unfeasible, 28 joint counts (of the hands, wrists, elbows, shoulders, and knees) have been proposed. Although our studies showed that the inclusion of forefoot joints did not significantly improve the measurement range nor the measurement precision of the joint counts, these joints were frequently affected. This suggests that the assessment of omitted jo

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