期刊
JCR-JOURNAL OF CLINICAL RHEUMATOLOGY
卷 15, 期 5, 页码 223-225出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/RHU.0b013e3181b126b1
关键词
DAS28 (disease activity score of 28 joints); rheumatoid arthritis; DMARD (disease modifying antirheumatic drug)
类别
Introduction and Background: The disease activity score for 28 joints (DAS28) is widely used for assessing disease activity in rheumatoid arthritis and its use is recommended for establishing the need for anti- tumor necrosis factor drugs, according to British Society for Rheumatology guidelines. However, calculation of the score requires a laboratory measurement of inflammation (either erythrocyte sedimentation rate or C-reactive protein) so that it is not possible to have the actual score when the patient seen in the clinic and, therefore, it is not possible to make immediate treatment decisions based on the DAS28 score. Methods: This is an audit of clinic-based treatment decisions, collecting data for the DAS28 on consecutive patients with rheumatoid arthritis. The nonlaboratory elements of the DAS score were completed along with a physician global assessment and any treatment decisions were recorded. Results: Data on 100 patients were collected. Even when the patients were judged to have active disease by DAS28 treatment switches or increases were not always made. In logistic regression analyses, using treatment increase or switch as the dependent variable, only the swollen joint count was significant. Conclusion: There is evidence from this study that the DAS score is limited in daily clinical practice. In this audit of practice treatment, changes seem to be made oil objective physician assessments rather than patient recorded assessments.
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