The Role of Disease Activity Score 28 in the Evaluation of Articular Involvement in Systemic Lupus Erythematosus

Objectives. To evaluate the application of Disease Activity Score 28 (DAS28) to assess joint involvement in Systemic Lupus Erythematosus (SLE). Methods. Sixty-nine SLE patients, complaining of joint symptoms, and 44 rheumatoid arthritis (RA) patients were enrolled. In SLE patients disease activity was assessed with SLEDAI-2K. DAS28 was calculated in all the patients. Results. Thirty SLE patients (43.5%) showed clinical signs of arthritis. Mean DAS28 was 4.0 ± 1.4, 22 patients (31.9%) had low disease activity, 29 (42.0%) moderate, and 18 (26.1%) high. We dichotomized SLE patients according to the presence (Group 1) or absence (Group 2) of articular involvement according to SLEDAI-2K: 56.3% of the patients of the second group had a moderate/high activity according to DAS28. We compared SLE patients with 44 RA patients (M/F 9/35, mean age 55.6 ± 14.5 years; mean disease duration 140.4 ± 105.6 months). No significant differences were found regarding the values of DAS28 between SLE and RA patients. On the contrary, the values of tender and swollen joint count were significantly higher in RA compared to SLE patients (P = 0.0002 and P = 0.0001, resp.). Conclusions. We suggest the use of the DAS28 in the assessment of joint involvement in SLE patients.

[1]  F. Salaffi,et al.  Disease Activity in Psoriatic Arthritis: Comparison of the Discriminative Capacity and Construct Validity of Six Composite Indices in a Real World , 2014, BioMed research international.

[2]  A. Iagnocco,et al.  Ultrasound evaluation of hand, wrist and foot joint synovitis in systemic lupus erythematosus. , 2014, Rheumatology.

[3]  T. Pincus,et al.  Patient self‐report RADAI (Rheumatoid Arthritis Disease Activity Index) joint counts on an MDHAQ (Multidimensional Health Assessment Questionnaire) in usual care of consecutive patients with rheumatic diseases other than rheumatoid arthritis , 2013, Arthritis care & research.

[4]  G. Valesini,et al.  Flare, Persistently Active Disease, and Serologically Active Clinically Quiescent Disease in Systemic Lupus Erythematosus: A 2-Year Follow-Up Study , 2012, PloS one.

[5]  A. Perl,et al.  T lymphocytes from patients with systemic lupus erythematosus are resistant to induction of autophagy , 2012, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[6]  A. Bell,et al.  Lupus arthritis--do we have a clinically useful classification? , 2012, Rheumatology.

[7]  G. Valesini,et al.  Autoantibodies to estrogen receptor α interfere with T lymphocyte homeostasis and are associated with disease activity in systemic lupus erythematosus. , 2012, Arthritis and rheumatism.

[8]  Md Nazrul Islam,et al.  Efficacy and safety of methotrexate in articular and cutaneous manifestations of systemic lupus erythematosus , 2012, International journal of rheumatic diseases.

[9]  G. Valesini,et al.  Toll-like Receptors and Lupus Nephritis , 2011, Clinical reviews in allergy and immunology.

[10]  M. Petri,et al.  Biologics in the treatment of systemic lupus erythematosus , 2010, Current opinion in rheumatology.

[11]  A. Silman,et al.  Rheumatoid arthritis classifi cation criteria : an American College of Rheumatology / European League Against Rheumatism collaborative initiative , 2010 .

[12]  J. Smolen,et al.  The assessment of disease activity in rheumatoid arthritis. , 2010, Clinical and experimental rheumatology.

[13]  T. Ortel,et al.  Update of the guidelines for lupus anticoagulant detection , 2009, Journal of thrombosis and haemostasis : JTH.

[14]  A. Iagnocco,et al.  Ultrasonographic depiction of knee joint alterations in systemic lupus erythematosus. , 2009, Clinical and experimental rheumatology.

[15]  I. Bruce,et al.  British isles lupus assessment group 2004 index is valid for assessment of disease activity in systemic lupus erythematosus , 2007, Arthritis and rheumatism.

[16]  G. Valesini,et al.  Anti‐Endothelial Antibodies and Neuropsychiatric Systemic Lupus Erythematosus , 2006, Annals of the New York Academy of Sciences.

[17]  L. Pasquier,et al.  Orphanet Journal of Rare Diseases , 2006 .

[18]  P. V. van Riel,et al.  Remission in rheumatoid arthritis: agreement of the disease activity score (DAS28) with the ARA preliminary remission criteria. , 2004, Rheumatology.

[19]  A. Iagnocco,et al.  Wrist joint involvement in systemic lupus erythematosus. An ultrasonographic study. , 2004, Clinical and experimental rheumatology.

[20]  D. Gladman,et al.  Systemic lupus erythematosus disease activity index 2000. , 2002, The Journal of rheumatology.

[21]  M. Hochberg,et al.  Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. , 1997, Arthritis and rheumatism.

[22]  J. Goust,et al.  Systemic lupus erythematosus. , 1976, Immunology series.

[23]  D. Isenberg,et al.  Systemic lupus erythematosus , 1956, The Lancet.

[24]  L. Caniatti,et al.  Factors and comorbidities associated with first neuropsychiatric event in systemic lupus erythematosus: does a risk profile exist? A large multicentre retrospective cross-sectional study on 959 Italian patients. , 2012, Rheumatology.

[25]  J. Piette.  COMMENT ON : UPDATING THE AMERICAN COLLEGE OF RHEUMATOLOGY CRITERIA FOR SYSTEMIC LUPUS ERYTHEMATOSUS BY HOCHBERG , 1998 .

[26]  M. Prevoo,et al.  Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. , 1995, Arthritis and rheumatism.

[27]  Y. Nietosvaara.  AN ULTRASONOGRAPHIC STUDY , 1994 .