Rheumatoid arthritis disease activity indices: Calculation, cutpoints, and ranges of composite indices

	No of variables	Acute phase reactant	Formulae (CRP in mg/L for DAS and DAS28, and in mg/dL for SDAI; GH: VAS in mm; PGA and EGA: VAS in cm)	Cutpoints	Response criteria
DAS*	4	ESR	= 0.54 x √(Ritchie) + 0.065 x SJC44 + 0.33 x log_nat(ESR) + 0.0072 x GH	REM <1.6 LDA <2.4 MDA <3.7 HDA ≥3.7
	4	CRP	= 0.54 x √(Ritchie) + 0.065 x SJC44 + 0.17 x log_nat(CRP+1) + 0.0072 x GH + 0.45		n.v.
	3	ESR	= 0.54 x √(Ritchie) + 0.065 x SJC44 + 0.33 x log_nat(ESR) + 0.22		n.v.
	3	CRP	= 0.54 x √(Ritchie) + 0.065 x SJC44 + 0.17 x log_nat(CRP+1) + 0.65		n.v.
DAS28*	4	ESR	= 0.56 x √(TJC28) + 0.28 x √(SJC28) + 0.70 x log_nat(ESR) + 0.014 x GH	REM <2.6 LDA 2.6-3.2 MDA >3.2-5.1 HDA >5.1	Moderate >0.6 Major >1.2^¶
	4	CRP	= 0.56 x √(TJC28) + 0.28 x √(SJC28) + 0.36 x log_nat(CRP+1) + 0.014 x GH + 0.96		n.v.
	3	ESR	= [0.56 x √(TJC28) + 0.28 x √(SJC28) + 0.70* x log_nat(ESR)] x 1.08 + 0.16		n.v.
	3	CRP	= [0.56 x √(TJC28) + 0.28√(SJC28) + 0.36 log_nat(CRP+1)] x 1.10 + 1.15		n.v.
SDAI	5	CRP	SJC28 + TJC28 + PGA + EGA + CRP	REM ≤3.3 LDA ≤11 MDA ≤26 HDA >26	Minor ≥50% Moderate ≥70% Major ≥85%
CDAI	4	-	SJC28 + TJC28 + PGA + EGA	REM ≤2.8 LDA ≤10 MDA ≤22 HDA >22	Minor ≥50% Moderate ≥70% Major ≥85%

CRP: C-reactive protein; DAS: Disease Activity Score; DAS28: DAS based on 28 joint counts; SDAI: Simplified Disease Activity Index; GH: global health; VAS: visual analog scale; PGA: patient global assessment of disease activity; EGA: evaluator global assessment of disease activity; ESR: erythrocyte sedimentation rate; Ritchie: Ritchie articular index; SJC28, SJC44: swollen joint counts based on the evaluation of 28 or 44 joints, respectively; REM: remission; LDA: low disease activity; MDA: moderate disease activity; HDA: high disease activity; n.v.: not validated; TJC28: tender joint count based on 28 joints; CDAI: Clinical Disease Acvitity index.
* Formulae for the DAS and the DAS28 variations obtained from the internet: www.das-score.nl/index.html (Accessed Sept 13, 2006).
¶ Plus change in category as detailed in the text.

Data from:

Aletaha D, Ward MM, Machold KP, Nell VPK, et al. Remission and active Disease in Rheumatoid arthritis: Defining criteria for disease activity states. Arthritis Rheum 2005; 52:2625.
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.
Aletaha D, Martinez-Avila J, Kvien TK, Smolen JS. Definition of treatment response in rheumatoid arthritis based on the simplified and the clinical disease activity index. Ann Rheum Dis 2012.

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Rheumatoid arthritis disease activity indices: Calculation, cutpoints, and ranges of composite indices