What is DAS28 score?


DAS28 is a scoring system which is widely used to assess the disease activity in case of rheumatoid arthritis. It has 3 major indications:
  • To assess the disease activity
  • To assess the response to the treatment, and
  • To take the decision whether the biological therapy is indicated or not

What’s the meaning of DAS28?

DAS stands for Disease Activity Score
28 mean total 28 joints of our body are considered to assess the disease activity. The joints are: 
  • Shoulder joints (2)
  • Elbow joints (2)
  • Wrist joints (2)
  • Knee joints (2)
  • MCP(10) and 
  • PIP(10)

[Image from Davidson's principles and practice of medicine 23rd; page 1026]

What are the factors considered to calculate DAS28?

  • Number of swollen joints (0-28)
  • Number of tender joints (0-28)
  • ESR or CRP (if CRP is used it is called DAS28-CRP)
  • VAS disease activity (0-100)

Note: VAS disease activity is patient's own assessment of the activity of arthritis on a visual analogue scale (VAS), where 0 indicates no symptoms and 100 the worst symptom possible.

How to calculate?

We have to use an online calculator to calculate the score. http://www.4s-dawn.com/DAS28/
It is very easy to use. In the following picture, you can see a calculated score.

Interpretation of the score:

  • > 5.1 means High activity of the disease
  • 2.6- 5.1 means Moderate activity
  • <2.6 means Remission

Use of DAS28 score in clinical practice:

[Image from Davidson's principles and practice of medicine 23rd; page 1026]

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