DAS28-CRP for Rheumatoid Arthritis

The development of the DAS (Disease Activity Score) was important because it provided a global summative and continuous score for disease activity assessment.

The original DAS was modified into the DAS28, and is felt to be considerably more practical. The DAS28 eliminated the grading of joints and reduced the number of joints evaluated to 28. It has largely replaced the traditional DAS in clinical trials and in practice.

Evaluation of response to a treatment can be made much easier and more objective using the DAS28. The DAS provides a score between 0 and 10, a larger number indicating more active disease.

When using the score to assess response to treatment, a DAS-28 reduction by 0.6 represents a moderate improvement, while a reduction more than 1.2 represents a major improvement.

Score interpretation

• <2.6 suggests disease remission.
• 2.6-3.2 suggests low disease activity
• >3.2-5.1 suggests moderate disease activity
• >5.1 suggest high disease activity

It should be noted that almost 15% of patients with DAS28 scores of 2.6 (the cut-point for remission) continue to have at least two swollen joints; some may have more than 10 swollen joints yet still be categorized as in "remission" using this composite index.