Comparison of Disease Severity in Established Rheumatoid Arthritis by DAS28-ESR and Clinical Disease Activity Index

Objective: To compare disease severity in established rheumatoid arthritis by Disease Activity Score-28 for Rheumatoid Arthritis with Erythrocyte sedimentation rate (DAS28-ESR) and Clinical Disease Activity Index. Study Design: Cross-sectional study. Place and Duration of Study: Rheumatology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jul 2021 to Feb 2022. Methodology: Patients diagnosed with active Rheumatoid Arthritis were clinically evaluated in detail by consultant rheumatologist. Disease activity and severity was assessed by using DAS-28 and Clinical Disease Activity Index. Association of disease severity on DAS-28 was established with severity on Clinical Disease Activity Index and other socio-demographic factors. Results: Mean age of the study participants was 35.81±8.45 years. In our sample, 303(75.75%) patients were female while 97(24.25%) were male. As per DAS-28 scoring, 175(43.75%) had mild, 142(35.5%) had moderate while 83(20.75%) had severe Rheumatoid Arthritis while as per Clinical Disease Activity Index scoring, 176(44%) had mild, 145(36.25%) had moderate while 79(19.75%) had severe Rheumatoid Arthritis. Disease severity on DAS-28 was strongly associated with disease severity on Clinical Disease Activity Index (p-value <0.001). Conclusion: Severity of illness with DAS28-ESR had significant association with severity on Clinical Disease Activity Index, thus, both scales can be used interchangeably depending upon choice of clinician and availability of resources.