Comparison of Disease Activity Score 28 Using C-reactive Protein and Disease Activity Score 28 Using Erythrocyte Sedimentation Rate in Assessing Activity and Treatment Response in Rheumatoid Arthritis: A Meta-analysis

Abstract

Objective. We compared the Disease Activity Score 28 (DAS28) using C-reactive protein (DAS28-CRP) with DAS28 using erythrocyte sedimentation rate (DAS28-ESR) in assessing rheumatoid arthritis (RA) activity and determining European League Against Rheumatism (EULAR) response criteria. Methods. We searched the PubMed, EMBASE, and Cochrane databases and performed a meta-analysis to examine comparisons between DAS28-CRP and DAS28-ESR by RA activity and EULAR response criteria. Results. A total of ten studies were included in this meta-analysis. Significantly more patients were classified as having remission or low disease activity when using DAS28-CRP than when using DAS28-ESR (odds ratio [OR]=1.869, 95% confidence interval [CI]=1.180 to 2.959, p=0.008; OR=1.411, 95% CI=1.256 to 1.586, p=7.0×10 −8 ), whereas fewer patients were classified as having high disease activity when using DAS28-CRP than when using DAS28-ESR (OR=0.534, 95% CI=0.388 to 0.734, p=1.1×10 −4 ). More patients were classified as having good response with criteria were based on DAS28-CRP than with DAS28-ESR (OR=1.390, 95% CI=1.183 to 1.632, p=6.10×10 −5 ). Conclusion. Our meta-analysis demonstrates that DAS28-CRP underestimates disease activity and overestimates response by the EULAR response criteria compared to DAS28-ESR. (J Rheum Dis 2016;23:241-249)

Circulating macrophage migration inhibitory factor levels and its polymorphisms in systemic lupus erythematosus: A meta-analysis

“…Studies investigating circulating MIF levels in SLE patients in comparison to healthy controls, and the MIF -173 C/G and -794CATT 5-8 polymorphisms have demonstrated associations with SLE pathogenesis and disease susceptibility in some, but not all, studies (9)(10)(11)(12)(13)(14)(15)(16)(17). In this study, we performed a meta-analysis to overcome the limitations of the individual studies and resolve inconsistencies in the obtained findings (18). The aim of our meta-analysis was to systematically review evidence on serum/plasma MIF levels in SLE patients compared to those in controls and to determine whether the MIF -173 C/G allele and -794CATT 5-8 polymorphisms are associated with SLE susceptibility.…”

Comparison of the Disease Activity Score-28 Based on the Erythrocyte Sedimentation Rate and C-reactive Protein in Rheumatoid Arthritis

“…Although Son et al [17] did not investigate cutoff adjustment, they demonstrated that 14.8% and 8.0% of patients were classified as having high disease activity based on DAS28-ESR and DAS28-CRP, respectively. In 2016, Song and Lee [18] published a meta-analysis of 11 previous studies concerning DAS28-ESR and DAS28-CRP, and concluded that DAS28-CRP underestimates disease activity and overestimates the EULAR response. The tendency of ESR elevation with aging was also observed in this study; however, neither gender nor obesity affected the ESR in our cohort (data now shown).…”

The Need for New Criteria to Define Disease Activity and Treatment Response Using Disease Activity Score (DAS)28-C-reactive Protein

“…Meta-analysis of Song and Lee [5] demonstrates DAS28-CRP underestimates disease activity and overestimates response by the European League against Rheumatism (EULAR) response criteria compared to DAS28-ESR. Total 10 studies are included in this meta-analysis with various ethnity (6 studies for Caucasian, 3 studies for Asian, 1 study for Afrian and 1 study for Turkish), ages (range, 50.8∼61.1 years) and disease duration (range, 5.1∼13.5 years).…”