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Disease Activity Score-28 for Rheumatoid Arthritis with ESR (DAS28-ESR)
RA disease activity using 28-joint counts, patient global health, and ESR.
Disease Activity Score-28 for Rheumatoid Arthritis with ESR (DAS28-ESR)
Tender joint count (28-joint)
joints
Swollen joint count (28-joint)
joints
ESR
mm/hr
Patient global health assessment
0-100 mm visual analogue scale (0 = very well, 100 = very poor).
mm (0-100)
Complete the fields above to see the result.
When to use
- Standardized quantification of rheumatoid arthritis disease activity for treat-to-target management and EULAR response assessment.
- Original 28-joint DAS variant when ESR, rather than CRP, is the available acute-phase marker.
Formula
DAS28-ESR = 0.56 x sqrt(TJC28) + 0.28 x sqrt(SJC28) + 0.70 x ln(ESR) + 0.014 x patient global health (0-100 mm VAS). Remission <2.6, low activity 2.6-<3.2, moderate activity 3.2-5.1, high activity >5.1.
Pearls and pitfalls
- ESR must be greater than 0 for the logarithm term to be defined; use a nominal minimum value (e.g., 1 mm/hr) if the reported ESR is 0.
- Requires a 28-joint tender and swollen joint count (not the full 68/66-joint exam).