Gender stratified adjustment of the DAS28-CRP improves inter-score agreement with the DAS28-ESR in rheumatoid arthritis

Hamann, Philip D.H., Shaddick, Gavin ORCID: https://orcid.org/0000-0002-4117-4264, Hyrich, Kimme, Green, Amelia, McHugh, Neil, Pauling, John D. and BSRBR-RA, Contributors Group 2019. Gender stratified adjustment of the DAS28-CRP improves inter-score agreement with the DAS28-ESR in rheumatoid arthritis. Rheumatology 58 (5) , pp. 831-835. 10.1093/rheumatology/key374

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Abstract

Objectives To evaluate determinants of discordance between DAS28-ESR and DAS28-CRP and resulting impact on disease activity stratification in RA. Methods Paired DAS28-ESR and DAS28-CRP readings (n = 31 074) were obtained from the British Society for Rheumatology Biologics Register for RA. Factors influencing discordance between DAS28-ESR and DAS28-CRP were evaluated alongside the resulting effect on disease activity stratification. The impact of gender adjustment to the DAS28-CRP was evaluated. Results DAS28-CRP scores were ∼0.3 lower than DAS28-ESR overall, with greatest differences for women (−0.35) and patients over 50 years old (−0.34). Mean male DAS28-CRP scores were 0.15 less than corresponding DAS28-ESR scores. Discordance between DAS28-ESR and DAS28-CRP significantly impacted disease activity stratification at low disease activity and remission thresholds (32.0% and 66.6% concordance, respectively). Adjusting DAS28-CRP scores by gender significantly (P < 0.001) improved agreement with the DAS28-ESR. Conclusion Discordance between DAS28-ESR and DAS28-CRP is greatest for women and patients over 50 years of age, and influences disease activity stratification. The proposed gender-adjusted DAS28-CRP improves inter-score agreement with DAS28-ESR, supporting more reliable disease activity stratification in treat-to-target approaches for RA.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	?? VCO ??
Publisher:	Oxford University Press
ISSN:	1462-0324
Last Modified:	06 Aug 2024 13:01
URI:	https://orca.cardiff.ac.uk/id/eprint/170746

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