Best parameters for assessment

responder, a subject has to show a 20% improvement in tender and swollen

joints count and 20% improvement in at least three of the following five criteria:

patient global assessment, physician global assessment, pain intensity, physical

function or disability (e.g. HAQ) and level of acute-phase reactant or erythrocyte

sedimentation rate (Felson, Anderson, Boers, Bombardier, 1993).

Count of tender joints is based on 68 joints assessments by pressure and joint

manipulation on physical examination, and count of swollen joint is based on

66 joint assessments. Percentage changes in the tender joint and swollen joint

counts are based on the number of evaluable joints at a visit. Physician and patient

assessment of global RA disease activity is based on a ten-point (10 cm line) non-

anchored horizontal visual analogue scale (VAS) ranging from 1(very good) to

10 (very poor) and pain intensity assessment is based on a visual analogue scale

(VAS), made up of a 10 cm line which also ranges from 0 (no pain) to 10 (severe

pain) point scale.

Sixty-Eight Joint counts: Sixty eight joint are Metacarpophallenges (MCP-

10),

Metatarsophallenges

(MTP-10),

Distalinterphallenges

(DIP-8),

Proximalinterphallenges (PIP-20), wrist (2), elbow (2), shoulder (2), knee (2),

Hip (2), ankle (2), Subtalar (2), Temporomandibular (2), Sternoclavicular (2) and

Acromioclavicular (2)

Secondary outcome included in ACR are ACR50 and ACR 70 responder rates.

The ACR50 and ACR70 are defined as at least 50% and 70% improvement,

respectively, assessed by the same criteria used to calculate ACR20 response (Van

der et al., Felson, Anderson, Boers, Bombardier, 1993).

(ii) EuropeanLeagueofAssociationagainstRheumatism(EULAR) : TheEULAR

criteria is based on both an improvement and the achievement of a low disease

activity state, as measured by the DAS-28 (Prevoo, van’t Hof, Kuper, Van, Van de

Putte, Van Riel, 1995). Disease Activity Score involving 28 joints (DAS28). It is

a linear sum of four outcome parameters: tender joint count, swollen joint count,

Patients’ global assessment of disease activity and a level of C – reactive proteins

or Erythrocyte sedimentation rate (ESR) (Gestel et al., 1990).

DAS-28 = 0.56√TJC + 0.28√SJC + 0.70[In ESR] + 0.014 (VASGH)

TJC = Tender joint Count

SJC = Swollen Joint Count

ESR = Erythrocyte Sedimentation Rate in mm first hour.

VASGH = Patient global assessment of general health.

Disease activity by DAS scores is interpreted as:

DAS < 3.2 = mild disease activity.

DAS 3.2-5.1 = moderate disease activity

DAS > 5.1 = severe disease activity

Int. J. Bioinformatics and Biological Sci.: v.2 n.1&2, p. 85-94. March & June 2014

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