Rheumatoid Arthritis Disease Activity Score DAS-28

 
DAS28 = ( 0.56 * sqr(TJC)) + (0.28 * sqr(SJC)) + ( 0.7 * ln(ESR)) + (0.014 * GH)

 
Input:
 
ESR  
GH  

 
Result:
 
DAS 28  
 
Decimal Precision  

 
Tender Joint Count

  Shoulder

  Elbow

  Wrist

Right hand
  MCP 1-5
IP 1, PIP 2-5








   
 
 
 









  Knee
Shoulder  
Elbow  
Wrist  
Left hand
MCP 1-5
IP 1, PIP 2-5
 








 
 
 
 










Knee  
TJC          
Swollen Joint Count

  Shoulder

  Elbow

  Wrist

Right hand
  MCP 1-5
IP 1, PIP 2-5








   
 
 
 









  Knee
Shoulder  
Elbow  
Wrist  
Left hand
MCP 1-5
IP 1, PIP 2-5
 








 
 
 
 










Knee  
SJC          

 

DAS 28 Interpretation

 
DAS28 < 2.6: Remission
DAS28 >= 2.6 and <= 3.2: Low Disease Activity
DAS28 > 3.2 and <= 5.1: Moderate Disease Activity
DAS28 > 5.1: High Disease Activity

 
 
Notes
  • In the hands, the joints that are evaluated include the first through fifth metacarpophalangeal joint, the interphalangeal joint of the thumb, and the second through fifth proximal interphalangeal joint.
  • The GH or Global Health parameter represents the patient's self assessment of disease activity on a 0-100 scale where 100 means maximal activity.
  • A DAS-28 reduction by 0.6 represents a moderate improvement. A reduction more than 1.2 represents a major improvement.

 
References
  1. Aletaha D, Ward MM, Machold KP, et al. Remission and active disease in rheumatoid arthritis: defining criteria for disease activity states. Arthritis Rheum. 2005 Sep;52(9):2625-36. PubMed ID: 16142705 PubMed Logo
  2. van der Heijde DM, van 't Hof M, van Riel PL, van de Putte LB. Development of a disease activity score based on judgment in clinical practice by rheumatologists. J Rheumatol. 1993 Mar;20(3):579-81. PubMed ID: 8478878 PubMed Logo
  3. Prevoo ML, van 't Hof MA, Kuper HH, et al. Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995 Jan;38(1):44-8. PubMed ID: 7818570 PubMed Logo
  4. Saag KG, Teng GG, Patkar NM, et al. American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis Rheum. 2008 Jun 15;59(6):762-84. PubMed ID: 18512708 PubMed Logo

 

 
 
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