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What is the optimal target for treat-to-target strategies in rheumatoid arthritis?

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Table 1. Overview of cut-off values for low disease activity and remission for different composite scores.

Composite score Formula Low disease

activity

Remission

DASa 0.54*√RAI + 0.065*SJC + 0.33*ln(ESR) + 0.007*PTGLBL

≤2.4 <1.6

DAS28a 0.56*√TJC28 + 0.28*√SJC28 + 0.70*ln(ESR) + 0.014* PTGLBL

≤3.2 <2.6

DAS28-CRPa 0.56*√TJC28 + 0.28*√SJC28 +

0.36*ln(CRP+1) + 0.014* PTGLBL + 0.96

≤2.9 <2.4

SDAI SJC + TJC + PTGLBL + DRGLBL + CRP ≤11 ≤3.3

CDAI SJC + TJC + PTGLBL + DRGLBL ≤10 ≤2.8

ACR/EULAR Boolean remission

TJC, SJC, CRP mg/dl and PTGLB (0-10 scale)

-- All measures

≤1

Ultrasound remission

Various definitions including no or limited power Doppler activity and limited Grey scale ultrasound, possibly combined with clinical remission.

DAS = disease activity score, ESR = erythrocyte sedimentation rate, CRP = c-reactive protein, RAI = Ritchie Articular Index, TJC = tender joint count, SJC = swollen joint count, PTGLBL = visual

analogue scale patient assessment of global health, DRGLBL = visual analogue scale physician assessment of global health.

aAlternative formulas exist for the DAS(28) based on CRP, based on 3 components (no PTGLBL) or based on 3 components and CRP. These use the cut-offs of the original DAS(28).

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