University of Hertfordshire

Standard

Interpretation of DAS28 and its components in the assessment of inflammatory and non-inflammatory aspects of rheumatoid arthritis. / Young, Keith; McWilliams, Daniel F; Kiely, Patrick; Joharatnam, Nalinie; Wilson, Deborah ; Walsh, David.

In: BMC Rheumatology, Vol. 2, 8, 23.03.2018, p. 1-12.

Research output: Contribution to journalArticlepeer-review

Harvard

APA

Vancouver

Author

Young, Keith ; McWilliams, Daniel F ; Kiely, Patrick ; Joharatnam, Nalinie ; Wilson, Deborah ; Walsh, David. / Interpretation of DAS28 and its components in the assessment of inflammatory and non-inflammatory aspects of rheumatoid arthritis. In: BMC Rheumatology. 2018 ; Vol. 2. pp. 1-12.

Bibtex

@article{f9a00a1f60544717ab43e5a24fdda884,
title = "Interpretation of DAS28 and its components in the assessment of inflammatory and non-inflammatory aspects of rheumatoid arthritis",
abstract = "BackgroundDAS28 is interpreted as the inflammatory disease activity of RA. Non-inflammatory pain mechanisms can confound assessment. We aimed to examine the use of DAS28 components or DAS28-derived measures that have been published as indices of non-inflammatory pain mechanisms, to inform interpretation of disease activity.MethodsData were used from multiple observational epidemiology studies of people with RA. Statistical characteristics of DAS28 components and derived indices were assessed using baseline and follow up data from British Society for Rheumatology Biologics Registry participants (1) commencing anti-TNF therapy (n = 10,813), or (2) changing between non-biologic DMARDs (n = 2992), (3) Early Rheumatoid Arthritis Network participants (n = 813), and (4) participants in a cross-sectional study exploring fibromyalgia and pain thresholds (n = 45). Repeatability was tested in 34 patients with active RA. Derived indices were the proportion of DAS28 attributable to patient-reported components (DAS28-P), tender-swollen difference and tender:swollen ratio. Pressure pain detection threshold (PPT) was used as an index of pain sensitisation.ResultsDAS28, tender joint count, visual analogue scale, DAS28-P, tender-swollen difference and tender:swollen ratio were more strongly associated with pain, PPT and fibromyalgia status than were swollen joint count or erythrocyte sedimentation rate. DAS28-P, tender-swollen difference and tender:swollen ratio better predicted pain over 1 year than did DAS28 or its individual components.ConclusionsDAS28 is strongly associated both with inflammation and with patient-reported outcomes. DAS28-derived indices such as tender-swollen difference are associated with non-inflammatory pain mechanisms, can predict future pain and should inform how DAS28 is interpreted as an index of inflammatory disease activity in RA.",
author = "Keith Young and McWilliams, {Daniel F} and Patrick Kiely and Nalinie Joharatnam and Deborah Wilson and David Walsh",
note = "{\textcopyright} The Author(s) 2018",
year = "2018",
month = mar,
day = "23",
doi = "10.1186/s41927-018-0016-9",
language = "English",
volume = "2",
pages = "1--12",
journal = "BMC Rheumatology",
issn = "2520-1026",
publisher = "BioMed Central Ltd.",

}

RIS

TY - JOUR

T1 - Interpretation of DAS28 and its components in the assessment of inflammatory and non-inflammatory aspects of rheumatoid arthritis

AU - Young, Keith

AU - McWilliams, Daniel F

AU - Kiely, Patrick

AU - Joharatnam, Nalinie

AU - Wilson, Deborah

AU - Walsh, David

N1 - © The Author(s) 2018

PY - 2018/3/23

Y1 - 2018/3/23

N2 - BackgroundDAS28 is interpreted as the inflammatory disease activity of RA. Non-inflammatory pain mechanisms can confound assessment. We aimed to examine the use of DAS28 components or DAS28-derived measures that have been published as indices of non-inflammatory pain mechanisms, to inform interpretation of disease activity.MethodsData were used from multiple observational epidemiology studies of people with RA. Statistical characteristics of DAS28 components and derived indices were assessed using baseline and follow up data from British Society for Rheumatology Biologics Registry participants (1) commencing anti-TNF therapy (n = 10,813), or (2) changing between non-biologic DMARDs (n = 2992), (3) Early Rheumatoid Arthritis Network participants (n = 813), and (4) participants in a cross-sectional study exploring fibromyalgia and pain thresholds (n = 45). Repeatability was tested in 34 patients with active RA. Derived indices were the proportion of DAS28 attributable to patient-reported components (DAS28-P), tender-swollen difference and tender:swollen ratio. Pressure pain detection threshold (PPT) was used as an index of pain sensitisation.ResultsDAS28, tender joint count, visual analogue scale, DAS28-P, tender-swollen difference and tender:swollen ratio were more strongly associated with pain, PPT and fibromyalgia status than were swollen joint count or erythrocyte sedimentation rate. DAS28-P, tender-swollen difference and tender:swollen ratio better predicted pain over 1 year than did DAS28 or its individual components.ConclusionsDAS28 is strongly associated both with inflammation and with patient-reported outcomes. DAS28-derived indices such as tender-swollen difference are associated with non-inflammatory pain mechanisms, can predict future pain and should inform how DAS28 is interpreted as an index of inflammatory disease activity in RA.

AB - BackgroundDAS28 is interpreted as the inflammatory disease activity of RA. Non-inflammatory pain mechanisms can confound assessment. We aimed to examine the use of DAS28 components or DAS28-derived measures that have been published as indices of non-inflammatory pain mechanisms, to inform interpretation of disease activity.MethodsData were used from multiple observational epidemiology studies of people with RA. Statistical characteristics of DAS28 components and derived indices were assessed using baseline and follow up data from British Society for Rheumatology Biologics Registry participants (1) commencing anti-TNF therapy (n = 10,813), or (2) changing between non-biologic DMARDs (n = 2992), (3) Early Rheumatoid Arthritis Network participants (n = 813), and (4) participants in a cross-sectional study exploring fibromyalgia and pain thresholds (n = 45). Repeatability was tested in 34 patients with active RA. Derived indices were the proportion of DAS28 attributable to patient-reported components (DAS28-P), tender-swollen difference and tender:swollen ratio. Pressure pain detection threshold (PPT) was used as an index of pain sensitisation.ResultsDAS28, tender joint count, visual analogue scale, DAS28-P, tender-swollen difference and tender:swollen ratio were more strongly associated with pain, PPT and fibromyalgia status than were swollen joint count or erythrocyte sedimentation rate. DAS28-P, tender-swollen difference and tender:swollen ratio better predicted pain over 1 year than did DAS28 or its individual components.ConclusionsDAS28 is strongly associated both with inflammation and with patient-reported outcomes. DAS28-derived indices such as tender-swollen difference are associated with non-inflammatory pain mechanisms, can predict future pain and should inform how DAS28 is interpreted as an index of inflammatory disease activity in RA.

U2 - 10.1186/s41927-018-0016-9

DO - 10.1186/s41927-018-0016-9

M3 - Article

VL - 2

SP - 1

EP - 12

JO - BMC Rheumatology

JF - BMC Rheumatology

SN - 2520-1026

M1 - 8

ER -