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The DAS28 score

The DAS28 is a measure of disease activity in rheumatoid arthritis (RA). DAS stands for ‘disease activity score’, and the number 28 refers to the 28 joints that are examined in this assessment.

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DAS stands for Disease Activity Score. It assesses your joints, blood test results – C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) – and also your own view of how you have been feeling over the past week. The reason it’s called DAS 28 is because it assesses 28 specific joints for tenderness and/or swelling. While other joints can be affected by RA, research has shown that these 28 give the best indication of how active your disease is. All these results are then added up to give you a personal score result.

The National Institute for Health and Care Excellence (NICE) RA Guidelines recommend that, following diagnosis, DAS 28 assessments are performed monthly until your disease is under control.

If you don’t know your DAS, ask your healthcare team about this at your next appointment.

Knowing your disease activity is really helpful and can reassure you that if you see your score decreasing your treatment and therapy is working. Equally important, an increased DAS may mean that you need an adjustment to dosage or even a change in
medication. Keeping an eye on your own disease activity will help you have informed and balanced interactions with your clinical team. A true DAS28 score will include results from monitoring 28 joints but also take into account blood test results. However, just examining your own joints on a fairly regular basis can be hugely beneficial for you and your treating physician as it can demonstrate what’s been happening in between appointments.

DAS SCORESUGGESTS
Less than 2.6RA is in remission
2.6 to 3.2A low level of disease activity
More than 3.2Active disease that may require change in medication
More than 5.1Very active disease that requires careful monitoring and adjustment to medication
What your DAS level means

The University of Manchester has been working on developing useful tools for remote monitoring patients with RA and there is a simple, easy to follow video available to demonstrate how to examine your own joints. This is part of a wider study called ‘REMORA’, REmote MOnitoring of Rheumatoid Arthritis. The study aims to develop, test and evaluate a system for tracking daily symptoms in people living with RA, where data are collected using a smartphone app and integrated into NHS electronic patient records. However anyone can access the demonstration video on Youtube: youtu.be/SBSJKMYNOaw and the chart and table for tracking your self-examinations can be downloaded from the patient resources on the study’s webpage:

https://sites.manchester.ac.uk/remora

Taken from the NRAS booklet: New2RA – A self-help guide for people newly diagnosed with rheumatoid arthritis