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Validation of the articular disease activity indices in SSc patients

Aim of this subtask was to validate the Disease Activity Score of 28 Joints using ESR (DAS28-ESR) and CRP (DAS28-CRP), the Simplified Disease Activity Index (SDAI), and the Clinical Disease Activity Index (CDAI) used in rheumatoid arthritis (RA) for SSc patients.

Short summary

Background

Aim of this subtask was to validate the Disease Activity Score of 28 Joints using ESR (DAS28-ESR) and CRP (DAS28-CRP), the Simplified Disease Activity Index (SDAI), and the Clinical Disease Activity Index (CDAI) used in rheumatoid arthritis (RA) for SSc patients.

Methods

Seventy-seven SSc patients, 40 RA patients, 20 patients with primary Raynaud’s syndrome (PR), and 28 healthy volunteers were assessed. Besides the DAIs, the European Scleroderma Study Group Activity Index (EScSG-AI), the HAQ-DI, the Cochin Hand Function Scale (CHFS) and the Short Form Health Survey (SF36) were evaluated. The validation procedure included the assessment for truth, discrimination and feasibility.

Results

DAS28-ESR, DAS28-CRP, SDAI and CDAI showed significant correlation with EScSG-AI, HAQ-DI, CHFS, and the physical component of SF36 (p<0.001). All four indices discriminated patients with SSc from RA, PR and healthy controls, respectively (p<0.01). With the exception of DAS28-CRP, the other three indices also discriminated between subgroups of SSc based on value of EScSG-AI (≤3 and >3) (p<0.05). All four DAIs showed a good inter- and intraobserver reliability based on repeated measures of two independent investigators (p<0.001).

Conclusion

All four disease activity composite indices were found to be valid measures for assessing arthritis in SSc. DAS28-ESR showed the best performance regarding reliability and construct validity.

Poster publications

Full-text publications

A full-text paper has been submitted to Rheumatology and is currently under revision.