ISSN: 2640-799X
Rheumatica Acta: Open Access
Opinion       Open Access      Peer-Reviewed

Why does the new disease activity score (EgyDAS) of Rheumatoid Arthritis not function?

Muravyev YV1*, Muravyeva LA2, Glukhova SI1 and Litvinova MA1

1VA Nasonova Research Institute of Rheumatology, 34A Kashirskoye highway, Moscow 115522, Russia
2Central Polyclinic Department of MBUZ [Municipal Budgetary Healthcare Institution], Khimki Central Clinical Hospital, 2/21 Chkalova St., Khimki, Moscow region 141401, Russia
*Corresponding author: Yuri Muravyev, VA Nasonova Research Institute of Rheumatology, 34A Kashirskoye highway, Moscow 115522, Russia, E-mail: murawyu@mail.ru
DOI: 10.17352/raoa.000013
ORCID: https://orcid.org/0000-0001-5394-883X
Received: 05 January, 2021 | Accepted: 23 January, 2021 | Published: 25 January, 2021

Cite this as

Muravyev YV, Muravyeva LA, Glukhova SI, Litvinova MA (2021) Why does the new disease activity score (EgyDAS) of Rheumatoid Arthritis not function? Rheumatica Acta: Open Access 5(1): 001-002 DOI: 10.17352/raoa.000013

The analysis of almost a century-long evolution of ideas about the criteria for the activity of Rheumatoid Arthritis showed that the developed complex indices for determination there of are far from perfect, in particular the Disease Activity Score 28 (DAS28), widely used in clinical practice [1]. Therefore, the recently developed new Disease Activity Score (EgyDAS) of Rheumatoid Arthritis [2] has attracted interest because it includes four laboratory markers of Rheumatoid Arthritis (RA) activity, as opposed to DAS28, which assesses only one laboratory marker. It is the authors’ opinion that EgyDAS is not only more accurate and easy to apply, but also “has both diagnostic/prognostic values in patient with RA”. Because “a subject has a low Egyscore <−0.79, he/she can be considered to not have RA disease “.

Therefore, we decided to put the new disease activity score into practice. For this purpose, a pilot study of medical documents of 9 women with RA, aged 28 to 67 years, was carried out, fulfilled the American College of Rheumatology (ACR) criteria for RA and observed in the V. A. Nasonova Research Institute of Rheumatology.

Having applied the EgyDAS offered by the authors, we have calculated the RA activity (Table 1).

• Remission ≤ −0.15;

• Low disease activity > −0.15–0.15;

• Moderate disease activity > 0.15–1.1;

• High disease activity > 1.1.

The assessment of the same RA patients in the same sequence, but according to DAS28, completed within the same period of time is represented in Table 2.

• Remission ≤ 2.6;

• Low disease activity> 2.6–3.2;

• Moderate disease activity > 3.2–5.1;

• High disease activity > 5.1

It is very unfortunate that the comparison of the results represented in Tables 1,2 allows us speaking about the impossibility of using the published EgyDAS formula in clinical practice.

Therefore, we limited the number of cases.

Hopefully, this is due to a typo in the final release of the article.

Table 1: RA patients’activity according to EgyDAS.
Laboratory activity markers EgyDAS RA activity classification*****
ESR* CRP** PDW*** MPV***
  22 30.2 10.8 9.5 -0.09251 Remission
  9 6.3 11.9 10.3 -1.48257 ?
  11 0.5 11.6 10.1 -2.25683 ?
  106 119 12.7 10.7 1.159325 High
  16 9.3 15.4 12.1 -1.20025 ?
  5 1.5 11.2 9.9 -2.33987 ?
  31 1.7 14.9 11.3 -1.21942 ?
  16 5.7 11.9 10.3 -1.14561 ?
  18 1.1 12.1 10.3 -1.65979 ?
*Erythrocyte sedimentation rate (Westegren), mm/hr; **: C-reactive protein,mg/l; ***: Platelet distribution width, % ; ****: Mean platelet volume, f; *****: Using the same criterion of DAS28 to measure the disease activity of a patient EgyDAS limits as follows [1].
Table 2: RA patients’ activity according to DAS28.
Test characteristic DAS28 RA activity classification****
TJC* SJC** ESR GH***
  12 0 22 60 4.94 Moderate
  3 3 9 60 3.84 Moderate
  14 2 11 60 5.01 Moderate
  15 5 106 90 7.33 High
  16 2 16 67 5.51 High
  6 2 5 45 3.53 Moderate
  10 6 31 60 5.71 High
  6 6 16 80 5.13 High
  2 2 18 30 3.64 Moderate
*:Tender joint count(0-28); **: Swollen joint count(0-28); ***: VAS general health patient(mm); ****: Disease activity was categorized according to DAS28 score into one of the following [3].
  1. Muraviov YuV , Muraviova LA (2020) Saga of the Rheumatoid Arthritis Activity Criteria. EC Orthopaedics 11: 118-126. Link: https://bit.ly/3peW4vU
  2. Khaled SAA, NasrEldin E, Makarem YS, Mahmoud HFF (2020) Value of Platelet Distribution Width and Mean Platelet Volume in Disease Activity Score of Rheumatoid Arthritis. J Inflamm Res 13: 595-606. Link: https://bit.ly/2Np7D5n
  3. Aletaha D, Nell VP, Stamm T, Uffmann M, Pflugbeil S, et al. (2005) Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: validation of a clinical activity score. Arthritis Res Ther 7: R796- R806. Link: https://bit.ly/365Eum
© 2021 Muravyev YV, et al. This is an open-access Case Report distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

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