Response to 'Pain persists in DAS28 rheumatoid arthritis remission but not in ACR/EULAR remission: a longitudinal observational study'
© BioMed Central Ltd 2011
Published: 18 August 2011
We read with interest the report by Lee and colleagues in the June issue of Arthritis Research & Therapy . The study compared the Disease Activity Score in 28 joints calculated by using C-reactive protein (DAS28-CRP) versus American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) remission in terms of residual pain. The authors stated that DAS28-CRP remission criteria allowed for persistence of pain in more than 10% of patients, whereas there were very few complaints of pain among patients in ACR/EULAR remission. This is a very important finding as it clearly demonstrated incompetence of the DAS28-CRP remission criteria in defining remission that is meaningful for patients, thus encouraging transition to new ACR/EULAR remission criteria.
in which TJC stands for tender joint count, SJC for swollen joint count, ln for natural logarithm, CRP for C-reactive protein, and GH for global health as reported by the patient.
We therefore wonder whether Lee and colleagues performed the same analysis with DAS28-ESR remission criteria. We think it may be interesting to perform the same analysis with DAS28-ESR remission criteria or a stricter DAS28-CRP cut-off point of 2.3.
American College of Rheumatology/European League Against Rheumatism
Disease Activity Score in 28 joints calculated by using C-reactive protein
Disease Activity Score in 28 joints calculated by using erythrocyte sedimentation rate.
- Lee YC, Cui J, Lu B, Frits ML, Iannaccone CK, Shadick NA, Weinblatt ME, Solomon DH: Pain persists in DAS28 rheumatoid arthritis remission but not in ACR/EULAR remission: a longitudinal observational study. Arthritis Res Ther. 2011, 13: R83-10.1186/ar3353.PubMed CentralView ArticlePubMedGoogle Scholar
- Wells G, Becker J-C, Teng J, Dougados M, Schiff M, Smolen J, Aletaha D, van Riel PLCM: Validation of the 28-joint Disease Activity Score (DAS28) and European League Against Rheumatism response criteria based on C-reactive protein against disease progression in patients with rheumatoid arthritis, and comparison with the DAS28 based on erythrocyte sedimentation rate. Ann Rheum Dis. 2009, 68: 954-960. 10.1136/ard.2007.084459.PubMed CentralView ArticlePubMedGoogle Scholar
- Inoue E, Yamanaka H, Hara M, Tomatsu T, Kamatani N: Comparison of Disease Activity Score (DAS)28-erythrocyte sedimentation rate and DAS28-C-reactive protein threshold values. Ann Rheum Dis. 2007, 66: 407-409. 10.1136/ard.2006.054205.PubMed CentralView ArticlePubMedGoogle Scholar
- DAS-SCORE.NL: Home of the DAS. [http://www.das-score.nl/]