Comparison of the disease activity score using the erythrocyte sedimentation rate and C‐reactive protein levels in Koreans with rheumatoid arthritis

Abstract

The discordance between the ESR-based and CRP-based DAS28 could affect clinical treatment decisions for patients with RA.

Comparison of the Disease Activity Score-28 Based on the Erythrocyte Sedimentation Rate and C-reactive Protein in Rheumatoid Arthritis

“…They determined the percentages of patients categorized as having high, moderate, or low disease activity or being in remission based on DAS28-ESR or DAS28-CRP. Although Son et al [17] did not investigate cutoff adjustment, they demonstrated that 14.8% and 8.0% of patients were classified as having high disease activity based on DAS28-ESR and DAS28-CRP, respectively. In 2016, Song and Lee [18] published a meta-analysis of 11 previous studies concerning DAS28-ESR and DAS28-CRP, and concluded that DAS28-CRP underestimates disease activity and overestimates the EULAR response.…”

“…In 2015, Son et al [17] compared DAS28-ESR and DAS28-CRP in 540 Korean RA patients due to the previously noted discrepancy between DAS28 and DAS28-CRP. Disease activity varied in their cohort, and the mean DAS28-ESR was 3.65±1.37 and the mean DAS28-CRP was 3.44±1.15.…”

Comparison of Disease Activity Score 28 Using C-reactive Protein and Disease Activity Score 28 Using Erythrocyte Sedimentation Rate in Assessing Activity and Treatment Response in Rheumatoid Arthritis: A Meta-analysis

“…Three of these were excluded, because they had no data, or were a review. Thus, a total of 11 articles including 15,353 RA patients met the inclusion criteria [6][7][8][9][10][11][12][13][14][15][16] (Table 1, Figure 1). Seven of these studies provided data on comparisons between DAS28-CRP and DAS28-ESR based on RA activity, and four of these studies provided data on comparisons between DAS28-CRP and DAS28-ESR in determining EULAR response criteria.…”

“…Comparative studies between DAS28-CRP and DAS-28-ESR have shown inconsistent results when classifying RA activity and determining EULAR response criteria [6][7][8][9][10][11][12][13][14][15][16]. This disparity may be due to small sample sizes, low statistical power, and/or clinical heterogeneity.…”

The Need for New Criteria to Define Disease Activity and Treatment Response Using Disease Activity Score (DAS)28-C-reactive Protein

“…Third, the fomula of DAS28-CRP could be incongruent in substitution of DAS28-ESR. Many studies show the mean DAS28-CRP is significantly lower than the mean DAS28-ESR [4,9,10]. Japanese cohort study suggests DAS28-CRP=0.893×DAS28-ESR-0.253 and the average value of DAS28 increases, the difference between DAS38-CRP and DAS28-ESR becomes larger.…”