THU0082 Comparison of M-DAS and DAS28, Two Composite Scores for Prediction of Structural Damages in Early Arthritis: Data from the Espoir Cohort
Authors: M. Couderc, B. Pereira, V. Devauchelle-Pensec, X. Mariette, M. Soubrier
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> For the assessment of disease activity in rheumatoid arthritis (RA), numbers of composite scores are available: Disease-Activity-Score in 28 joints (DAS28), the Simplified-Disease-Activity-Index (SDAI), and the Clinical-Disease-Activity-Score (CDAI). Baker et al. have recently developed a modified version of these scores based on widely available clinical measures (swollen joint count [SJC] evaluator global assessment of disease activity [EvGA] and CRP level). (1) These scores demonstrated superior correlation with MRI detection of synovitis and more accurately predicted radiographic progression after 1 year than DAS28 and SDAI. <h3>Objectives</h3> To evaluate the performance of new composite disease activity scores (M-DAS28, M-SDAI and M-CDAI]) compared to conventional measures (DAS28, SDAI and CDAI) to predict radiographic progression in patients with early arthritis. <h3>Methods</h3> This study was conducted on the French multicentric ESPOIR cohort including patients with early (&lt;6 months) unclassified arthritis. The M-DAS28, M-SDAI, and M-CDAI were respectively compared to the DAS28, CDAI and SDAI with regard to associations of radiographic progression (estimated after 1 year by The Sharp/van der Heidje [SHS] scoring system) using t-Student or Mann-Whitney test and receiver operating characteristic analysis. <h3>Results</h3> A total of 664 patients (women 77%, median age 48.6 years, median symptom duration 16 weeks) were included. The mean SJC was 7, the mean tender joint count was 8, the mean ESR was 29 mm/h, the mean CRP level was 21 mg/L. Radiographic progression (ΔSHS ≥1) was present in 60.1% after 1 year. A total of 568 patients (85%) fulfilled the ACR 1987 criteria for RA. The baseline M-DAS28-ESR and the DAS28-ESR both correlated to the same extent with the radiographic progression of joint damage at 1 year (respective area under the curve [AUC] of 0.55 [0.50-0.59] and 0.55 [0.51-0.60]). The baseline M-DAS28CRP also correlated with radiographic progression at 1 year (AUC 0.55 [0.51-0.60]) not the DAS-28-CRP (AUC 0.54 [0.49-0.58]). SDAI and M-SDAI had similar capacity to predict X-ray progression (AUC 0.53 [0.49-0.58] and 0.54 [0.50-0.59] respectively) and did not yeld statistical significance. The same was true for the CDAI versus the M-CDAI (AUC 0.53 [0.49-0.58] for both). A subgroup analysis on patients fulfilling the ACR 1987 criteria for RA has been performed without difference between the conventional and modified scores. <h3>Conclusions</h3> We did not find significant differences between M-DAS28 vs. DAS28, M-CDAI vs. CDAI, and M-SDAI vs. SDAI to predict radiographic progression after 1 year in patients with early arthritis. <h3>References</h3> Baker JF, Conaghan PG, Smolen JS, Aletaha D, Shults J, Emery P, et al. Development and validation of modified disease activity scores in rheumatoid arthritis: Superior correlation with MRI synovitis and X-ray progression. Arthritis Rheum. 2014;66:794-802 <h3>Disclosure of Interest</h3> None declared