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dc.contributor.authorYoung, Keith
dc.contributor.authorMcWilliams, Daniel F
dc.contributor.authorKiely, Patrick
dc.contributor.authorJoharatnam, Nalinie
dc.contributor.authorWilson, Deborah
dc.contributor.authorWalsh, David
dc.date.accessioned2019-04-10T14:11:23Z
dc.date.available2019-04-10T14:11:23Z
dc.date.issued2018-03-23
dc.identifier.citationYoung , K , McWilliams , D F , Kiely , P , Joharatnam , N , Wilson , D & Walsh , D 2018 , ' Interpretation of DAS28 and its components in the assessment of inflammatory and non-inflammatory aspects of rheumatoid arthritis ' , BMC Rheumatology , vol. 2 , 8 , pp. 1-12 . https://doi.org/10.1186/s41927-018-0016-9
dc.identifier.issn2520-1026
dc.identifier.otherPURE: 16570051
dc.identifier.otherPURE UUID: f9a00a1f-6054-4717-ab43-e5a24fdda884
dc.identifier.urihttp://hdl.handle.net/2299/21244
dc.description© The Author(s) 2018
dc.description.abstractBackground DAS28 is interpreted as the inflammatory disease activity of RA. Non-inflammatory pain mechanisms can confound assessment. We aimed to examine the use of DAS28 components or DAS28-derived measures that have been published as indices of non-inflammatory pain mechanisms, to inform interpretation of disease activity. Methods Data were used from multiple observational epidemiology studies of people with RA. Statistical characteristics of DAS28 components and derived indices were assessed using baseline and follow up data from British Society for Rheumatology Biologics Registry participants (1) commencing anti-TNF therapy (n = 10,813), or (2) changing between non-biologic DMARDs (n = 2992), (3) Early Rheumatoid Arthritis Network participants (n = 813), and (4) participants in a cross-sectional study exploring fibromyalgia and pain thresholds (n = 45). Repeatability was tested in 34 patients with active RA. Derived indices were the proportion of DAS28 attributable to patient-reported components (DAS28-P), tender-swollen difference and tender:swollen ratio. Pressure pain detection threshold (PPT) was used as an index of pain sensitisation. Results DAS28, tender joint count, visual analogue scale, DAS28-P, tender-swollen difference and tender:swollen ratio were more strongly associated with pain, PPT and fibromyalgia status than were swollen joint count or erythrocyte sedimentation rate. DAS28-P, tender-swollen difference and tender:swollen ratio better predicted pain over 1 year than did DAS28 or its individual components. Conclusions DAS28 is strongly associated both with inflammation and with patient-reported outcomes. DAS28-derived indices such as tender-swollen difference are associated with non-inflammatory pain mechanisms, can predict future pain and should inform how DAS28 is interpreted as an index of inflammatory disease activity in RA.en
dc.format.extent12
dc.language.isoeng
dc.relation.ispartofBMC Rheumatology
dc.titleInterpretation of DAS28 and its components in the assessment of inflammatory and non-inflammatory aspects of rheumatoid arthritisen
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionDepartment of Clinical and Pharmaceutical Sciences
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionBasic and Clinical Science Unit
dc.description.statusPeer reviewed
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1186/s41927-018-0016-9
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue


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