Patients

Introduction

Know your Disease Activity Score and stay one step ahead of your rheumatoid arthritis

A  Disease Activity Score (DAS) is a measurement of rheumatoid arthritis (RA) disease activity.  It is an assessment which gives you a score, rather like a blood glucose measurement in diabetes or cholesterol measurement, which tells you how well controlled your RA is and therefore reflect how well your treatment is working for you and whether any changes need to be made.i  The score can also be used as a treatment goal, providing you a drive towards a score of less than 2.6 which indicates disease remission.

A leading DAS assessment is DAS28, an examination that looks at 28 joints in your hands, wrists, elbows, shoulders and knees to determine whether they are tender and/or swollen. DAS28 also includes a blood test, which measures inflammation in the blood and a consultation in which you score how you are feeling and if you are in any pain on a scale of nought to ten. These results are then combined to produce your DAS28 score, which sits within one of four categories indicating how well your RA is responding to treatment:

•    Less than 2.6: Disease remission
•    2.6 – 3.2: Low disease activity
•    >3.2 – 5.1: Moderate disease activity, may merit a change in treatment for some people
•    More than 5.1: Severe disease activity, will merit a change in treatment for most people i

National guidelines state that you should have a DAS assessment carried out at least twice a year, and ideally at every consultation, so that your symptoms and treatment are being monitored on a regular basis and adapted when needed, to ensure your disease is being tightly controlled. If you have been diagnosed with RA recently, the guidelines recommend that you should have monthly checks until your RA is brought under control. ii, iii

“The DAS28 helps me to understand the status of my RA in clinical terms, beyond how I’m feeling.  It also helps to identify if there has been any change in my RA, for better or worse, what this might mean and whether my treatment needs to change as a result.”

- Christine, patient with RA

DAS28 and the feet

The joints in your feet are not included in the assessment for DAS28.  This is because any inflammation or joint damage in the feet may be a chronic effect of RA, which could occur because your feet are in constant use, and not related to ongoing disease activity.  Joints in the hands are therefore seen as a more reliable way of tracking your RA and seeing how well controlled your disease is.

If your RA does affect your feet, you should inform your healthcare professional so that your feet can be looked at within your consultation.

Know about your DAS Video



To download the video please click here



Ailsa Bosworth, Chief Executive and Founder of NRAS, explains what a DAS is and why disease monitoring is so important.

Prof John Isaacs, Professor of Clinical Rheumatology at Newcastle Hospital, Consultant Rheumatologist at Freeman Hospital provides an overview of the consultation process, explaining how the DAS28 is calculated and what it means.

This short film identifies how a DAS28 is calculated, showing how examinations are conducted to assess joint swelling and tenderness and how the results are captured to identify your DAS28 score.


Know about your DAS information booklet

 
Please click here to download the 'Know about your DAS' information booklet as a PDF





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Your DAS28 score is a score which is used to measure RA and helps to identify how well you are responding to treatment.  This information booklet provides you with further details of how it is calculated, what it actually means and how your DAS might affect the treatment your doctor prescribes.



References


iJ. Fransen, P.L.C.M. van Riel. The Disease Activity Score and the EULAR response criteria. Clin Exp Rheumatol 2005;23 (Suppl.39): S93-S99
iiNational Institute for Health and Clinical Excellence. CG79 The management of rheumatoid arthritis in adults. February 2009. http://www.nice.org.uk/nicemedia/live/12131/43327/43327.pdf(Accessed October 2012)
iiiBritish Society of Rheumatology guidelines. BSR and BHPR rheumatoid arthritis guidelines on eligibility criteria for the first biological therapy. March 2010. http://www.rheumatology.org.uk/includes/documents/cm_docs/2009/m/management_of_rheumatoid_arthritis_after_first_2_years.pdf(Accessed October 2012)

This is a joint collaboration between Roche Products Ltd, Chugai Pharma UK Ltd and the National Rheumatoid Arthritis Society. The development of the content of the website, including the booklets and DVDs has been funded by Roche and Chugai.

Date of preparation: February 2013
RCUKCOMM00137