Defining remission and treatment success using the DAPSA score: response to letter by Helliwell and Coates

Disease activity states of the DAPSA, a psoriatic arthritis specific instrument, are valid against functional status and structural progression

“…Several other instruments, such as Psoriatic Arthritis Disease Activity Score and Composite Psoriatic Disease Activity Index capture additional important variables related to psoriatic disease, such as physical function, skin and nail involvement or enthesitis. It is currently still debated if a PsA instrument should comprise only the arthritis activity, and other validated measures should be used to determine other manifestations of the disease, as needed, or to encompass the totality of the disease 14. DAPSA does not require transformation nor a calculator and the joint count used is related to PsA and not to RA, contrasting measures often used in clinical trials which only include 28 joint counts.…”

To DAPSA or not to DAPSA? That is not the question

“…As elaborated in previous discussions,2 4 the difference between a holistic, multidimensional measure of disease activity, such as the PASDAS and MDA, and unidimensional measures, such as DAPSA or psoriasis area and severity index (PASI), has nothing to do with neglecting important aspects of disease. The authors imply this by stating that ‘residual skin disease was highest in patients achieving DAPSA or cDAPSA remission…’.…”