https://doi.org/10.4081/reumatismo.2022.1501
Implication and utility of DAS-28 squeeze in rheumatoid arthritis: an Indian experience
Submitted: 3 May 2022
Accepted: 10 August 2022
Published: 13 September 2022
Accepted: 10 August 2022
Abstract Views: 1045
PDF: 438
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
The purpose of this study was to compare and correlate disease activity score including 28 joints counts (DAS-28) Squeeze with DAS-28 and clinical disease activity index (CDAI) to assess disease activity (DA) in rheumatoid arthritis (RA) patients. A total of 100 RA patients were included in the study. All subjects were evaluated for disease activity using the DAS-28 Squeeze, DAS-28, and CDAI. Spearman’s rho (ρ) was calculated to determine the correlation between DAS-28 Squeeze, DAS-28, and CDAI. Cross-tabulation was performed to compare and calculate the kappa coefficient for the link between two indices. For each scale, Cronbach’s alpha was also calculated to test dependability. The average age of the study group was 43.9±11.3. The mean scores on the DAS-28 Squeeze, DAS-28, and CDAI were, respectively, 3.58±1.06, 5.06±1.56, and 22.81±14.92. p=0.001 indicated a significant correlation between DAS-28 Squeeze and DAS-28 (ρ=0.986) and CDAI (ρ=0.939) for DAS-28 Squeeze. There was a considerable correlation between all three measures at various DA levels. Cronbach’s alpha for DAS-28 Squeeze, DAS-28, and CDAI were respectively 0.716, 0.663, and 0.734. DAS-28 Squeeze exhibited a substantial positive association with DAS-28 and CDAI for assessing disease activity and appears to be a more useful and reliable method than DAS-28 and CDAI for monitoring disease activity in RA patients.
Bichile L. Clinical features and organ involvement in RA. In: Rao URK, Mahendranath KM, Misra R, Gupta SJ, Handa R, Chaturvedi V, eds. Manual of Rheumatology. 4th ed. Mumbai: Indian Rheumatology Association; 2014. pp. 176-84.
Shah A, Clair EW. Rheumatoid arthritis. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, eds. Harrison’s Principles Internal Medicine. 18th ed. New York: McGraw-Hill; 2011. pp. 2738-52.
Voskuyl AE, Dijkmans BA. Remission and radiographic progression in rheumatoid arthritis. Clin Exp Rheumatol. 2006; 24: S-37-40.
Machold KP, Stamm TA, Nell VP. Very recent onset rheumatoid arthritis: clinical and serological patient characteristics associated with radiographic progression over the first years of disease. Rheumatology (Oxford). 2007; 46: 342-9.
DOI: https://doi.org/10.1093/rheumatology/kel237
Makinen H, Kautiainen H, Hannonen P. Sustained remission and reduced radiographic progression with combination disease modifying antirheumatic drugs in early rheumatoid arthritis. J Rheumatol. 2007; 34: 316-21.
Prevoo ML, van’t Hof MA, Kuper HH, 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. Arthritis Rheum. 1995; 38: 44-8.
DOI: https://doi.org/10.1002/art.1780380107
Aletaha D, Smolen J. The Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI): a review of their usefulness and validity in rheumatoid arthritis. Clin Exp Rheumatol. 2005; 23: S100-8.
Bakker MF, Jacobs JW, Kruize AA, et al. Misclassification of disease activity when assessing individual patients with early rheumatoid arthritis using disease activity indices that do not include joints of feet. Ann Rheum Dis. 2012; 71: 830-5.
DOI: https://doi.org/10.1136/annrheumdis-2011-146670
de Jong PH, Weel AE, de Man YA, et al. Optimizing the disease activity score in 28 joints by adding the Squeeze test of metatarsophalangeal joints in early rheumatoid arthritis. Arthritis Rheum. 2012; 64: 3095-101.
DOI: https://doi.org/10.1002/art.34568
Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988; 31: 315-24.
DOI: https://doi.org/10.1002/art.1780310302
Van Gestel AM, Haagsma CJ, Van Riel PL. Validation of rheumatoid arthritis improvement criteria that include simplified joint counts. Arthritis Rheum. 1998; 41: 1845-50.
DOI: https://doi.org/10.1002/1529-0131(199810)41:10<1845::AID-ART17>3.0.CO;2-K
Aletaha D, Nell VP, Stamm T, et al. Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: validation of a clinical activity score. Arthritis Res Ther. 2005; 7: R796-R806.
DOI: https://doi.org/10.1186/ar1740
Fransen J, Creemers MC, Van Riel PL. Remission in rheumatoid arthritis: agreement of the disease activity score (DAS-28) with the ARA preliminary remission criteria. Rheumatology (Oxford). 2004; 43: 1252-5.
DOI: https://doi.org/10.1093/rheumatology/keh297
Pincus T. Advantages and limitations of quantitative measures to assess rheumatoid arthritis: joint counts, radiographs, laboratory tests, and patient questionnaires. Bull NYU Hosp Jt Dis. 2006; 64: 32-9.
Pincus T, Sokka T. Complexities in the quantitative assessment of patients with rheumatic diseases in clinical trials and clinical care. Clin Exp Rheumatol. 2005; 23: S1-9.
Van der Heijde DM, van’t Hof M, van Riel PL, van de Putte LB. Validity of single variables and indices to measure disease activity in rheumatoid arthritis. J Rheumatol. 1993; 20: 538-41.
Van der Leeden M, Steultjens MP, Ursum J, et al. Prevalence and course of forefoot impairments and walking disability in the first eight years of rheumatoid arthritis. Arthritis Rheum. 2008; 59: 1596-602.
DOI: https://doi.org/10.1002/art.24188
Brenton-Rule A, Dalbeth N, Menz HB, et al. Foot and ankle characteristics associated with falls in adults with established rheumatoid arthritis: a cross-sectional study. BMC Musculoskelet Disord. 2016; 17: 22.
DOI: https://doi.org/10.1186/s12891-016-0888-z
Lee SW, Kim SY, Chang SH. Prevalence of feet and ankle arthritis and their impact on clinical indices in patients with rheumatoid arthritis: a cross-sectional study. BMC Musculoskelet Disord. 2019; 20: 420.
DOI: https://doi.org/10.1186/s12891-019-2773-z
Visser H, le Cessie S, Vos K, et al. How to diagnose rheumatoid arthritis early: a prediction model for persistent (erosive) arthritis. Arthritis Rheum. 2002; 46: 357-65.
DOI: https://doi.org/10.1002/art.10117
Ajeganova S, Andersson ML, Hafstrom I, Group BS. Association of obesity with worse disease severity in rheumatoid arthritis as well as with comorbidities: a long-term follow up from disease onset. Arthritis Care Res (Hoboken). 2013; 65: 78-87.
DOI: https://doi.org/10.1002/acr.21710
Van der Leeden M, Steultjens MP, van Schaardenburg D, Dekker J. Forefoot disease activity in rheumatoid arthritis patients in remission: results of a cohort study. Arthritis Res Ther. 2010; 12: R3.
DOI: https://doi.org/10.1186/ar2901
Pincus T, Sokka T, Kautiainen H. Patients seen for standard rheumatoid arthritis care have significantly better articular, radiographic, laboratory, and functional status in 2000 than in 1985. Arthritis Rheum. 2005; 52: 1009-19.
DOI: https://doi.org/10.1002/art.20941
Bossert M, Prati C, Vidal C, et al. Evaluation of self-report questionnaires for assessing rheumatoid arthritis activity: a cross-sectional study of RAPID3 and RADAI5 and are detection in 200 patients. Joint Bone Spine. 2012; 79: 57-62.
DOI: https://doi.org/10.1016/j.jbspin.2011.03.014
Wechalekar MD, Lester S, Proudman SM, et al. Active foot synovitis in patients with rheumatoid arthritis: applying clinical criteria for disease activity and remission may result in underestimation of foot joint involvement. Arthritis Rheum. 2012; 64: 1316-22.
DOI: https://doi.org/10.1002/art.33506
Leeb BF, Andel I, Sautner J, et al. The DAS-28 in rheumatoid arthritis and fibromyalgia patients. Rheumatology (Oxford). 2004; 43: 1504-7.
DOI: https://doi.org/10.1093/rheumatology/keh322
How to Cite
Singh, H., Tanwar, V., Kalra, A., Saini, A., Arora, S., & Govil, N. (2022). Implication and utility of DAS-28 squeeze in rheumatoid arthritis: an Indian experience. Reumatismo, 74(2). https://doi.org/10.4081/reumatismo.2022.1501
Copyright (c) 2022 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.