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Desiree Van Der Heijde - One of the best experts on this subject based on the ideXlab platform.
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ankylosing spondylitis Disease Activity Score asdas 2018 update of the nomenclature for Disease Activity states
Annals of the Rheumatic Diseases, 2018Co-Authors: Pedro Machado, R Landewe, Desiree Van Der HeijdeAbstract:The Ankylosing Spondylitis Disease Activity Score (ASDAS) is a measure of axial spondyloarthritis (axSpA) Disease Activity with validated cut-offs endorsed by the Assessment of SpondyloArthritis international Society (ASAS) and Outcome Measures in Rheumatology (OMERACT).1 2 In the 2016 update of the ASAS-European League Against Rheumatism (EULAR) management recommendations for axSpA, it is recommended that biological Disease-modifying antirheumatic drugs should be considered in patients with persistently high Disease Activity despite conventional treatments, and that the preferred measure to define active Disease should be the ASDAS (ASDAS of at least 2.1, ie, high Disease Activity).3 The 2017 update of treat-to-target recommendations in axial and peripheral SpA recommends that the treatment target should be inactive Disease/clinical remission and that low/minimal Disease Activity may be an alternative treatment target. The same recommendations state that the preferred measure to define the target in axSpA is the ASDAS.4 ASDAS cut-offs for Disease Activity states are 1.3, separating ‘inactive Disease’ from ‘moderate Disease Activity’, 2.1, …
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how much does Disease Activity Score in 28 joints esr and crp calculations underestimate Disease Activity compared with the simplified Disease Activity index
Annals of the Rheumatic Diseases, 2015Co-Authors: Roy Fleischmann, Desiree Van Der Heijde, Andrew S Koenig, R Pedersen, A Szumski, L Marshall, Eustratios BananisAbstract:Objectives Disease Activity Score in 28 joints calculated with C-reactive protein (DAS28-CRP) is used instead of erythrocyte sedimentation rate (DAS28-ESR) to assess rheumatoid arthritis Disease Activity; however, values for remission and low Disease Activity (LDA) for DAS28-CRP have not been validated. American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) guidelines suggest remission should be calculated by Simplified Disease Activity Index (SDAI) rather than DAS28-ESR. We examined values of remission and LDA of DAS28-CRP that correspond to the respective cut-off points for DAS28-ESR and SDAI from five clinical trials. Methods DAS28-CRP cut-offs that best correspond to DAS28-ESR remission Results Percentage of patients who achieved remission and LDA by DAS28-ESR cut-offs was greater for DAS28-CRP versus DAS28-ESR regardless of patient population or treatment group. Discordance between CRP and ESR cut-offs ranged from 4%–26% and 8%–23% for remission and LDA, respectively, and 19%–40% and 6%–11% for DAS28-CRP versus SDAI, respectively. Estimated (range) remission and LDA thresholds were 2.4 (2.2–2.6) and 2.9 (2.6–3.3), 1.9 (1.6–2.2) and 3.1 (3.1–3.3) and 2.2 (1.1–2.9) and 3.6 (3.4–4.0) for DAS28-CRP versus DAS28-ESR, DAS28-CRP versus SDAI and DAS28-ESR versus SDAI, respectively. Conclusions DAS28-CRP underestimates Disease Activity when using cut-off points validated for DAS28-ESR; therefore, DAS28-ESR cut-off values should not be applied to DAS28-CRP. Although DAS28-CRP and DAS28-ESR cut-offs for LDA ≤3.2 correspond to SDAI LDA, neither corresponds well to SDAI remission.
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calculating the ankylosing spondylitis Disease Activity Score if the conventional c reactive protein level is below the limit of detection or if high sensitivity c reactive protein is used an analysis in the desir cohort
Arthritis & Rheumatism, 2015Co-Authors: Pedro Machado, Robert Landewe, Floris A Van Gaalen, V Navarrocompan, Christian Roux, Desiree Van Der HeijdeAbstract:Objective The Ankylosing Spondylitis Disease Activity Score (ASDAS) is a composite measure of Disease Activity in axial spondyloarthritis. The aims of this study were to determine the most appropriate method for calculating the ASDAS using the C-reactive protein (CRP) level when the conventional CRP level was below the limit of detection, to determine how low CRP values obtained by high-sensitivity CRP (hsCRP) measurement influence ASDAS-CRP results, and to test agreement between different ASDAS formulae. Methods Patients with axial spondyloarthritis who had a conventional CRP level below the limit of detection (5 mg/liter) were selected (n = 257). The ASDAS–conventional CRP with 11 different imputations for the conventional CRP value (range 0–5 mg/liter, at 0.5-mg/liter intervals) was calculated. The ASDAS-hsCRP and ASDAS using the erythrocyte sedimentation rate (ESR) were also calculated. Agreement between the ASDAS formulae was tested. Results The ASDAS-hsCRP showed better agreement with the ASDAS-CRP calculated using the conventional CRP imputation values of 1.5 and 2.0 mg/liter and with the ASDAS-ESR than with other imputed formulae. Disagreement occurred mainly in lower Disease Activity states (inactive/moderate Disease Activity). When the CRP value was <2 mg/liter, the resulting ASDAS-CRP Scores may have been inappropriately low. Conclusion When the conventional CRP level is below the limit of detection or when the hsCRP level is <2 mg/liter, the constant value of 2 mg/liter should be used to calculate the ASDAS-CRP Score. There is good agreement between the ASDAS-hsCRP and ASDAS-ESR; however, formulae are not interchangeable.
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timing and magnitude of initial change in Disease Activity Score 28 predicts the likelihood of achieving low Disease Activity at 1 year in rheumatoid arthritis patients treated with certolizumab pegol a post hoc analysis of the rapid 1 trial
The Journal of Rheumatology, 2012Co-Authors: Desiree Van Der Heijde, R Landewe, Tore K Kvien, Edward C Keystone, Jeffrey R Curtis, Michael Schiff, Dinesh Khanna, Lucian Ionescu, L Gervitz, O DaviesAbstract:Objective. To determine the relationship between timing and magnitude of Disease Activity Score [DAS28(ESR)] nonresponse (DAS28 improvement thresholds not reached) during the first 12 weeks of treatment with certolizumab pegol (CZP) plus methotrexate, and the likelihood of achieving low Disease Activity (LDA) at 1 year in patients with rheumatoid arthritis. Methods. In a post-hoc analysis of the RAPID 1 study, patients achieving LDA [DAS28(ESR) ≤ 3.2] at Year 1 were assessed according to DAS28 nonresponse at various timepoints within the first 12 weeks. Results. Seven-hundred eighty-three patients were included (CZP 200 mg, n = 393; CZP 400 mg, n = 390). A total of 86.9% of patients in the CZP 200 mg group had a DAS28 improvement of ≥ 1.2 by Week 12. Of the 13.1% of patients with DAS28 improvement Conclusion. Failure to achieve improvement in DAS28 within the first 12 weeks of therapy was predictive of a low probability of achieving LDA at Year 1. Moreover, the accuracy of the prediction was found to be strongly dependent on the magnitude and timing of the lack of the response. (Clinical Trial Registration Nos. NCT00152386 and NCT00175877).
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endorsement of definitions of Disease Activity states and improvement Scores for the ankylosing spondylitis Disease Activity Score results from omeract 10
The Journal of Rheumatology, 2011Co-Authors: Pedro Machado, Robert Landewe, Desiree Van Der HeijdeAbstract:The Ankylosing Spondylitis Disease Activity Score (ASDAS) is a new composite index to assess Disease Activity in ankylosing spondylitis (AS). Criteria for Disease Activity states and improvement Scores are important for use in clinical practice, observational studies, and clinical trials, and have been proposed by the Assessment of SpondyloArthritis international Society (ASAS). At OMERACT 10, our aim was to obtain endorsement from OMERACT for the ASDAS Disease Activity states and response criteria proposed by the ASAS membership. This article summarizes the associated discussions, the scientific basis of the validation process, and the results from the voting sessions, and identifies areas for research using the ASDAS. OMERACT participants agreed with the selection of cutoff values, which now have the combined endorsement of ASAS and OMERACT and are ready to be used in clinical practice and in research settings.
Pier Andrea Borea - One of the best experts on this subject based on the ideXlab platform.
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a2a and a3 adenosine receptor expression in rheumatoid arthritis upregulation inverse correlation with Disease Activity Score and suppression of inflammatory cytokine and metalloproteinase release
Arthritis Research & Therapy, 2011Co-Authors: Katia Varani, Marcello Govoni, M Padovan, Fabrizio Vincenzi, Martina Targa, Francesco Trotta, Pier Andrea BoreaAbstract:Introduction The reduction of the inflammatory status represents one of the most important targets in rheumatoid arthritis (RA). A central role of A2A and A3 adenosine receptors (ARs) in mechanisms of inflammation has been reported in different pathologies. The primary aim of this study was to investigate the A2A and A3ARs and their involvement in RA progression measured by Disease Activity Score in 28 or 44 joints (DAS28 or DAS).
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a2a and a3 adenosine receptor expression in rheumatoid arthritis upregulation inverse correlation with Disease Activity Score and suppression of inflammatory cytokine and metalloproteinase release
Arthritis Research & Therapy, 2011Co-Authors: Katia Varani, Marcello Govoni, M Padovan, Fabrizio Vincenzi, Martina Targa, Francesco Trotta, Pier Andrea BoreaAbstract:The reduction of the inflammatory status represents one of the most important targets in rheumatoid arthritis (RA). A central role of A2A and A3 adenosine receptors (ARs) in mechanisms of inflammation has been reported in different pathologies. The primary aim of this study was to investigate the A2A and A3ARs and their involvement in RA progression measured by Disease Activity Score in 28 or 44 joints (DAS28 or DAS). ARs were analyzed by saturation binding assays, mRNA and Western blotting analysis in lymphocytes from early and established RA patients. The effect of A2A and A3AR agonists in nuclear factor kB (NF-kB) pathway was evaluated. Tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) release was carried out by A2A and A3AR activation. AR pharmacological regulation in matrix metalloproteinase-1 (MMP-1) and metalloproteinase-3 (MMP-3) release was also studied. In lymphocytes obtained from RA patients, A2A and A3ARs were up-regulated if compared with healthy controls. A2A and A3AR activation inhibited the NF-kB pathway and diminished inflammatory cytokines such as TNF-α, IL-1β and IL-6. A2A and A3AR agonists mediated a reduction of MMP-1 and MMP-3 release. A2A and A3AR density inversely correlated with DAS28 and DAS suggesting a direct role of the endogenous activation of these receptors in the control of RA joint inflammation. Taken together these data demonstrate that the inflammatory and clinical responses in RA are regulated by A2A and A3ARs and support the use of A2A and/or A3AR agonists as novel and effective pharmacological treatment in RA patients.
Andrew P Cope - One of the best experts on this subject based on the ideXlab platform.
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a multi biomarker Disease Activity Score can predict sustained remission in rheumatoid arthritis
Arthritis Research & Therapy, 2020Co-Authors: Eric H Sasso, David Scott, Nadine Defranoux, Margaret H Y, Fowzia Ibrahim, Andrew P CopeAbstract:Reliable assessment of remission is important for the optimal management of rheumatoid arthritis (RA) patients. In this study, we used the multi-biomarker Disease Activity (MBDA) test to explore the role of biomarkers in predicting point remission and sustained remission. RA patients on > 6 months stable therapy in stable low Disease Activity (DAS28-ESR ≤ 3.2) were assessed every 3 months for 1 year. Baseline, intermittent (IR) and sustained (SR) remission were defined by DAS28-ESR, DAS28-CRP, simple Disease Activity index (SDAI), clinical Disease Activity index (CDAI) and ACR/EULAR Boolean criteria. Patients not fulfilling any remission criteria at baseline were classified as ‘low Disease Activity state’ (LDAS). Patients not fulfilling any remission criteria over 1 year were classified as ‘persistent Disease Activity’ (PDA). MBDA Score was measured at baseline/3/6 months. The baseline MBDA Score, the 6-month time-integrated MBDA Score and MBDA biomarkers were used for analyses. The area under the receiver operating characteristic curve (AUROC) assessed the ability of the MBDA Score to discriminate between remission and non-remission. Biomarkers were analysed at baseline using the Mann-Whitney test and over time using the Jonckheere-Terpstra trend test. Of 148 patients, 27% were in the LDAS, 65% DAS28-ESR remission, 51% DAS28-CRP remission, 40% SDAI remission, 43% CDAI remission and 25% ACR/EULAR Boolean remission at baseline. Over 1 year, 9% of patients were classified as PDA. IR and SR were achieved in 42%/47% by DAS28-ESR, 46%/29% by DAS28-CRP, 45%/20% by SDAI, 44%/21% by CDAI and 35%/9% by ACR/EULAR Boolean criteria, respectively. By all remission criteria, baseline MBDA Score discriminated baseline remission (AUROCs 0.68–0.75) and IR/SR (AUROCs 0.65–0.74). The 6-month time-integrated MBDA Score discriminated IR/SR (AUROCs 0.65–0.79). Baseline MBDA Score and concentrations of IL-6, leptin, SAA and CRP were significantly lower in all baseline remission criteria groups vs LDAS. They and the 6-month time-integrated values were lower among patients who achieved IR/SR vs PDA over 1 year. This study demonstrated that the MBDA Score and its biomarkers IL-6, leptin, SAA and CRP differentiated between small differences in Disease Activity (i.e. between low Disease Activity and remission states). They were also predictors of remission over 1 year.
Margaret H Y - One of the best experts on this subject based on the ideXlab platform.
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a multi biomarker Disease Activity Score can predict sustained remission in rheumatoid arthritis
Arthritis Research & Therapy, 2020Co-Authors: Eric H Sasso, David Scott, Nadine Defranoux, Margaret H Y, Fowzia Ibrahim, Andrew P CopeAbstract:Reliable assessment of remission is important for the optimal management of rheumatoid arthritis (RA) patients. In this study, we used the multi-biomarker Disease Activity (MBDA) test to explore the role of biomarkers in predicting point remission and sustained remission. RA patients on > 6 months stable therapy in stable low Disease Activity (DAS28-ESR ≤ 3.2) were assessed every 3 months for 1 year. Baseline, intermittent (IR) and sustained (SR) remission were defined by DAS28-ESR, DAS28-CRP, simple Disease Activity index (SDAI), clinical Disease Activity index (CDAI) and ACR/EULAR Boolean criteria. Patients not fulfilling any remission criteria at baseline were classified as ‘low Disease Activity state’ (LDAS). Patients not fulfilling any remission criteria over 1 year were classified as ‘persistent Disease Activity’ (PDA). MBDA Score was measured at baseline/3/6 months. The baseline MBDA Score, the 6-month time-integrated MBDA Score and MBDA biomarkers were used for analyses. The area under the receiver operating characteristic curve (AUROC) assessed the ability of the MBDA Score to discriminate between remission and non-remission. Biomarkers were analysed at baseline using the Mann-Whitney test and over time using the Jonckheere-Terpstra trend test. Of 148 patients, 27% were in the LDAS, 65% DAS28-ESR remission, 51% DAS28-CRP remission, 40% SDAI remission, 43% CDAI remission and 25% ACR/EULAR Boolean remission at baseline. Over 1 year, 9% of patients were classified as PDA. IR and SR were achieved in 42%/47% by DAS28-ESR, 46%/29% by DAS28-CRP, 45%/20% by SDAI, 44%/21% by CDAI and 35%/9% by ACR/EULAR Boolean criteria, respectively. By all remission criteria, baseline MBDA Score discriminated baseline remission (AUROCs 0.68–0.75) and IR/SR (AUROCs 0.65–0.74). The 6-month time-integrated MBDA Score discriminated IR/SR (AUROCs 0.65–0.79). Baseline MBDA Score and concentrations of IL-6, leptin, SAA and CRP were significantly lower in all baseline remission criteria groups vs LDAS. They and the 6-month time-integrated values were lower among patients who achieved IR/SR vs PDA over 1 year. This study demonstrated that the MBDA Score and its biomarkers IL-6, leptin, SAA and CRP differentiated between small differences in Disease Activity (i.e. between low Disease Activity and remission states). They were also predictors of remission over 1 year.
Katia Varani - One of the best experts on this subject based on the ideXlab platform.
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a2a and a3 adenosine receptor expression in rheumatoid arthritis upregulation inverse correlation with Disease Activity Score and suppression of inflammatory cytokine and metalloproteinase release
Arthritis Research & Therapy, 2011Co-Authors: Katia Varani, Marcello Govoni, M Padovan, Fabrizio Vincenzi, Martina Targa, Francesco Trotta, Pier Andrea BoreaAbstract:Introduction The reduction of the inflammatory status represents one of the most important targets in rheumatoid arthritis (RA). A central role of A2A and A3 adenosine receptors (ARs) in mechanisms of inflammation has been reported in different pathologies. The primary aim of this study was to investigate the A2A and A3ARs and their involvement in RA progression measured by Disease Activity Score in 28 or 44 joints (DAS28 or DAS).
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a2a and a3 adenosine receptor expression in rheumatoid arthritis upregulation inverse correlation with Disease Activity Score and suppression of inflammatory cytokine and metalloproteinase release
Arthritis Research & Therapy, 2011Co-Authors: Katia Varani, Marcello Govoni, M Padovan, Fabrizio Vincenzi, Martina Targa, Francesco Trotta, Pier Andrea BoreaAbstract:The reduction of the inflammatory status represents one of the most important targets in rheumatoid arthritis (RA). A central role of A2A and A3 adenosine receptors (ARs) in mechanisms of inflammation has been reported in different pathologies. The primary aim of this study was to investigate the A2A and A3ARs and their involvement in RA progression measured by Disease Activity Score in 28 or 44 joints (DAS28 or DAS). ARs were analyzed by saturation binding assays, mRNA and Western blotting analysis in lymphocytes from early and established RA patients. The effect of A2A and A3AR agonists in nuclear factor kB (NF-kB) pathway was evaluated. Tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) release was carried out by A2A and A3AR activation. AR pharmacological regulation in matrix metalloproteinase-1 (MMP-1) and metalloproteinase-3 (MMP-3) release was also studied. In lymphocytes obtained from RA patients, A2A and A3ARs were up-regulated if compared with healthy controls. A2A and A3AR activation inhibited the NF-kB pathway and diminished inflammatory cytokines such as TNF-α, IL-1β and IL-6. A2A and A3AR agonists mediated a reduction of MMP-1 and MMP-3 release. A2A and A3AR density inversely correlated with DAS28 and DAS suggesting a direct role of the endogenous activation of these receptors in the control of RA joint inflammation. Taken together these data demonstrate that the inflammatory and clinical responses in RA are regulated by A2A and A3ARs and support the use of A2A and/or A3AR agonists as novel and effective pharmacological treatment in RA patients.