Evaluation of Performance of Different Disease Activity Scores in Rheumatoid Arthritis Patients

Background: Making informed therapeutic decisions and evaluating the effectiveness of treatments depend on accurately detecting disease activity. Therefore, this study set out to evaluate the utility of various disease activity scores in a group of RA patients. Methods: modified Health Assessment Questionnaire (mHAQ) , Routine Assessment of Patient Index Data (RAPID3), Patient Activity Scale (PAS), Patient Activity Scale II (PASII), Disease Activity Score 28 erythrocyte sedimentation rate (DAS28-ESR) and DAS28-C-reactive protein (CRP), Clinical Disease Activity Index (CDAI) and Simplified Disease Activity Index (SDAI) were assessed. Results: All disease activity scores showed significant positive correlation in between them but there were insignificant relations between RAPID3 with DAS28-ESR and DAS28- CRP. DAS28-ESR and DAS28-CRP had a significant very good agreement in-between each other, but fair agreement exists between each of them with SDAI, CDAI, PAS and PASII. Also, there was a significant very good agreement between SDAI and CDAI but fair agreement between each of them with RAPID3 and there was non-significant agreement between each of them with PAS and PASII. Also, results showed significant very good agreement between PAS and PASII. According to RAPID3 there was fair agreement with DAS28-ESR, SDAI and CDAI. mHAQ was significantly related with the Patient-Reported Outcome Measures (PROMs). Conclusions: this study clarified that (DAS28-ESR/CRP, CDAI and SDAI) and (RAPID3, PAS and PASII), which have substantial associations with clinical and laboratory parameters of disease activity are highly efficient. It is advisable to use CDAI and PROMs in routine clinical practice, particularly where laboratory data are unavailable.