Gender stratified adjustment of the DAS28-CRP improves inter-score agreement with the DAS28-ESR in rheumatoid arthritis

BSRBR-RA Contributors Group

doi:10.1093/rheumatology/key374

Gender stratified adjustment of the DAS28-CRP improves inter-score agreement with the DAS28-ESR in rheumatoid arthritis

BSRBR-RA Contributors Group

Bristol Medical School (THS)

Research output: Contribution to journal › Article (Academic Journal) › peer-review

10 Citations (Scopus)

334 Downloads (Pure)

Abstract

Objectives: To evaluate determinants of discordance between DAS28-ESR and DAS28-CRP and resulting impact on disease activity stratification in RA.

Methods: Paired DAS28-ESR and DAS28-CRP readings (n = 31 074) were obtained from the British Society for Rheumatology Biologics Register for RA. Factors influencing discordance between DAS28-ESR and DAS28-CRP were evaluated alongside the resulting effect on disease activity stratification. The impact of gender adjustment to the DAS28-CRP was evaluated.

Results: DAS28-CRP scores were ∼0.3 lower than DAS28-ESR overall, with greatest differences for women (-0.35) and patients over 50 years old (-0.34). Mean male DAS28-CRP scores were 0.15 less than corresponding DAS28-ESR scores. Discordance between DAS28-ESR and DAS28-CRP significantly impacted disease activity stratification at low disease activity and remission thresholds (32.0% and 66.6% concordance, respectively). Adjusting DAS28-CRP scores by gender significantly (P < 0.001) improved agreement with the DAS28-ESR.

Conclusion: Discordance between DAS28-ESR and DAS28-CRP is greatest for women and patients over 50 years of age, and influences disease activity stratification. The proposed gender-adjusted DAS28-CRP improves inter-score agreement with DAS28-ESR, supporting more reliable disease activity stratification in treat-to-target approaches for RA.

Original language	English
Article number	key374
Pages (from-to)	831-835
Number of pages	5
Journal	Rheumatology
Volume	58
Issue number	5
Early online date	19 Dec 2018
DOIs	https://doi.org/10.1093/rheumatology/key374 https://doi.org/10.1093/rheumatology/key374
Publication status	Published - 1 May 2019

Keywords

RA
DAS28
CRP
ESR
DAS
BSRBR
biolgics
gender
age
BMI

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This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Oxford University Press at https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/key374/5253842?searchresult=1. Please refer to any applicable terms of use of the publisher.
Final published version, 101 KBLicence: CC BY
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This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Oxford University Press at https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/key374/5253842?searchresult=1. Please refer to any applicable terms of use of the publisher.
Final published version, 184 KBLicence: CC BY

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@article{f04eff777b8b46b3ab18adee899f902a,

title = "Gender stratified adjustment of the DAS28-CRP improves inter-score agreement with the DAS28-ESR in rheumatoid arthritis",

abstract = "Objectives: To evaluate determinants of discordance between DAS28-ESR and DAS28-CRP and resulting impact on disease activity stratification in RA.Methods: Paired DAS28-ESR and DAS28-CRP readings (n = 31 074) were obtained from the British Society for Rheumatology Biologics Register for RA. Factors influencing discordance between DAS28-ESR and DAS28-CRP were evaluated alongside the resulting effect on disease activity stratification. The impact of gender adjustment to the DAS28-CRP was evaluated.Results: DAS28-CRP scores were ∼0.3 lower than DAS28-ESR overall, with greatest differences for women (-0.35) and patients over 50 years old (-0.34). Mean male DAS28-CRP scores were 0.15 less than corresponding DAS28-ESR scores. Discordance between DAS28-ESR and DAS28-CRP significantly impacted disease activity stratification at low disease activity and remission thresholds (32.0% and 66.6% concordance, respectively). Adjusting DAS28-CRP scores by gender significantly (P < 0.001) improved agreement with the DAS28-ESR.Conclusion: Discordance between DAS28-ESR and DAS28-CRP is greatest for women and patients over 50 years of age, and influences disease activity stratification. The proposed gender-adjusted DAS28-CRP improves inter-score agreement with DAS28-ESR, supporting more reliable disease activity stratification in treat-to-target approaches for RA.",

keywords = "RA, DAS28, CRP, ESR, DAS, BSRBR, biolgics, gender, age, BMI",

author = "{BSRBR-RA Contributors Group} and Hamann, {Philip D.H.} and Gavin Shaddick and Kimme Hyrich and Amelia Green and Neil McHugh and Pauling, {John D.}",

year = "2019",

month = may,

day = "1",

doi = "10.1093/rheumatology/key374",

language = "English",

volume = "58",

pages = "831--835",

journal = "Rheumatology",

issn = "1462-0324",

publisher = "Oxford University Press",

number = "5",

}

TY - JOUR

T1 - Gender stratified adjustment of the DAS28-CRP improves inter-score agreement with the DAS28-ESR in rheumatoid arthritis

AU - BSRBR-RA Contributors Group

AU - Hamann, Philip D.H.

AU - Shaddick, Gavin

AU - Hyrich, Kimme

AU - Green, Amelia

AU - McHugh, Neil

AU - Pauling, John D.

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Objectives: To evaluate determinants of discordance between DAS28-ESR and DAS28-CRP and resulting impact on disease activity stratification in RA.Methods: Paired DAS28-ESR and DAS28-CRP readings (n = 31 074) were obtained from the British Society for Rheumatology Biologics Register for RA. Factors influencing discordance between DAS28-ESR and DAS28-CRP were evaluated alongside the resulting effect on disease activity stratification. The impact of gender adjustment to the DAS28-CRP was evaluated.Results: DAS28-CRP scores were ∼0.3 lower than DAS28-ESR overall, with greatest differences for women (-0.35) and patients over 50 years old (-0.34). Mean male DAS28-CRP scores were 0.15 less than corresponding DAS28-ESR scores. Discordance between DAS28-ESR and DAS28-CRP significantly impacted disease activity stratification at low disease activity and remission thresholds (32.0% and 66.6% concordance, respectively). Adjusting DAS28-CRP scores by gender significantly (P < 0.001) improved agreement with the DAS28-ESR.Conclusion: Discordance between DAS28-ESR and DAS28-CRP is greatest for women and patients over 50 years of age, and influences disease activity stratification. The proposed gender-adjusted DAS28-CRP improves inter-score agreement with DAS28-ESR, supporting more reliable disease activity stratification in treat-to-target approaches for RA.

AB - Objectives: To evaluate determinants of discordance between DAS28-ESR and DAS28-CRP and resulting impact on disease activity stratification in RA.Methods: Paired DAS28-ESR and DAS28-CRP readings (n = 31 074) were obtained from the British Society for Rheumatology Biologics Register for RA. Factors influencing discordance between DAS28-ESR and DAS28-CRP were evaluated alongside the resulting effect on disease activity stratification. The impact of gender adjustment to the DAS28-CRP was evaluated.Results: DAS28-CRP scores were ∼0.3 lower than DAS28-ESR overall, with greatest differences for women (-0.35) and patients over 50 years old (-0.34). Mean male DAS28-CRP scores were 0.15 less than corresponding DAS28-ESR scores. Discordance between DAS28-ESR and DAS28-CRP significantly impacted disease activity stratification at low disease activity and remission thresholds (32.0% and 66.6% concordance, respectively). Adjusting DAS28-CRP scores by gender significantly (P < 0.001) improved agreement with the DAS28-ESR.Conclusion: Discordance between DAS28-ESR and DAS28-CRP is greatest for women and patients over 50 years of age, and influences disease activity stratification. The proposed gender-adjusted DAS28-CRP improves inter-score agreement with DAS28-ESR, supporting more reliable disease activity stratification in treat-to-target approaches for RA.

KW - RA

KW - DAS28

KW - CRP

KW - ESR

KW - DAS

KW - BSRBR

KW - biolgics

KW - gender

KW - age

KW - BMI

UR - http://www.scopus.com/inward/record.url?scp=85067638448&partnerID=8YFLogxK

U2 - 10.1093/rheumatology/key374

DO - 10.1093/rheumatology/key374

M3 - Article (Academic Journal)

C2 - 30590784

AN - SCOPUS:85067638448

SN - 1462-0324

VL - 58

SP - 831

EP - 835

JO - Rheumatology

JF - Rheumatology

IS - 5

M1 - key374

ER -

Gender stratified adjustment of the DAS28-CRP improves inter-score agreement with the DAS28-ESR in rheumatoid arthritis

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