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DAS28 remission commonly linked with disease activity despite stringent cut-off points
DAS28 remission was commonly linked with clinical disease activity despite more stringent cut-points, according to a recently published study.
“Lower, more stringent remission thresholds for DAS28, as a consequence of the construction of the formula, do not convey sufficient stringency to comply with full clinical remission defined as a state of no or at most minimal disease activity,” Daniel Aleteha, MD, from the University of Vienna, and colleagues wrote.
Researchers assessed data from three randomized controlled trials of tocilizumab, with cut-off points of 1.9 for DAS C-reactive protein (CRP) and 2.2 for DAS erythrocyte sedimentation rate (ESR). There were 1,613 patients on tocilizumab and 810 patients on placebo.
Investigators found 50% of patients who had a DAS-CRP score of less than 1.9 had higher disease activity according to clinical disease activity index, simple disease activity index or Boolean criteria. In addition, 15% of patients had at least three swollen joint counts.
“Our data further confirm the validity of the ACR/EULAR remission definition, especially when agents interfering directly with [acute-phase reactants] APR are employed,” the researchers wrote. – by Will A. Offit
Disclosures: Aleteha reports he received grants from MSD and BMS and was a speaker for AbbVie Merck, UCB, Janssen, BMS, Pfizer, Medac and Roche and provided consultancy for AbbVie, Eli Lilly, MSD, Centocor and Janssen.