Disease activity score-28 values differ considerably depending on patient's pain perception and sex.
OBJECTIVE
To determine if the Disease Activity Index including a 28-joint count (DAS28) is equally applicable for the total population with rheumatoid arthritis (RA).


METHODS
Five hundred fifty-seven outpatients with RA [432 women, 125 men; median age 64 yrs (range 0-85), median disease duration 48 mo (range 2-548)] were enrolled consecutively into this cross-sectional study. DAS28, physician's global assessment of disease activity, patient's assessment of pain on visual analog scale, C-reactive protein (mg/dl), rheumatoid factor (RF), and disease duration were recorded. t-tests were applied for all comparisons of DAS28 values. Linear regression analysis was performed for each confounding factor.


RESULTS
The mean DAS28 in female patients was 3.66 +/- 0.57 SEM, and in males 3.01 +/- 1.12 (p < 0.001). DAS values in patients with early RA (< 37 mo) were significantly higher than in patients with advanced RA (3.62 +/- 0.67 vs 3.37 +/- 0.81, respectively; p < 0.017). Regression analysis revealed a highly significant relationship between DAS28 score and patient's pain rating (r = 0.592, p < 0.0001). Pain exerted the greatest influence on the DAS28 (p < 0.0001), while of the other factors only age (p < 0.008 for females, p < 0.007 for males) was also significantly correlated with the DAS28 values.


CONCLUSIONS
DAS28 values differ considerably depending primarily on the patient's pain perception and gender and to a lesser degree on patient's age, whereas results for disease duration and RF were inconclusive.
Leeb
Burkhard F
BF
2nd Department of Medicine, Center for Rheumatology, State Hospital Korneuburg-Stockerau, Karl Landsteiner Institute for Clinical Rheumatology; A-2000 Stockerau, Landstrasse 18, Austria. leeb.humanis@kav-kost.at
Haindl
Pia M
PM
Maktari
Adil
A
Nothnagl
Thomas
T
Rintelen
Bernhard
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000032:analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017288:Pain Threshold; D012217:Rheumatoid Factor / Q000097:blood; D012720:Severity of Illness Index; D012737:Sex Factors
D002097:C-Reactive Protein; D012217:Rheumatoid Factor