Full Papers
DAS28(3)CRP is a reliable measure of disease activity in pregnant women with rheumatoid arthritis
C. Raine1, C. Ciurtin2, E.C. Jury3, D.J. Williams4, D. Bennett5, J.J. Manson6, I. Giles7
- Centre for Rheumatology, Department of Inflammation, Division of Medicine, University College London, and Department of Rheumatology, University College London Hospitals NHS Trust, London, UK. c.raine@ucl.ac.uk
- Centre for Rheumatology, Department of Inflammation, Division of Medicine, University College London, and Department of Rheumatology, University College London Hospitals NHS Trust, London, UK.
- Centre for Rheumatology, Department of Inflammation, Division of Medicine, University College London, UK.
- Department of Obstetrics, University College London Hospitals NHS Trust, London, UK; 4UCL EGA Institute for Women’s Health, University College London, UK.
- Nuffield Department of Population Health, University of Oxford, UK.
- Department of Population Health, and Medical Research Council Population Health Research Unit, University of Oxford, UK.
- Centre for Rheumatology, Department of Inflammation, Division of Medicine, University College London, and Department of Rheumatology, University College London Hospitals NHS Trust, London, UK.
CER16555
2023 Vol.41, N°11
PI 2224, PF 2229
Full Papers
PMID: 37223935 [PubMed]
Received: 01/02/2023
Accepted : 17/04/2023
In Press: 18/05/2023
Published: 14/11/2023
Abstract
OBJECTIVES:
The disease activity of rheumatoid arthritis (RA) in pregnancy is most commonly assessed with the modified Disease Activity Score (DAS)-28, the DAS28(3)CRP. However, the performance of the DAS28(3)CRP in pregnancy has not been compared to musculoskeletal ultrasound (MSK-US) as a gold standard. We performed a prospective pilot study to test the hypothesis that pregnancy-related factors limit the reliability of the DAS28(3)CRP.
METHODS:
Pregnant women with RA were recruited from an Obstetric Rheumatology clinic and assessed during pregnancy (second (T2) and third (T3) trimesters) and postpartum with DAS28(3)CRP and MSK-US scores, with quantification of power Doppler (PD) signal in small joints (hands and feet). Age-matched non-pregnant women with RA underwent equivalent assessments. PD scores were calculated as mean scores of all joints scanned.
RESULTS:
We recruited 27 pregnant and 20 non-pregnant women with RA. DAS28(3)CRP was sensitive and specific for active RA in pregnancy and postpartum as defined by positive PD signal, but not in non-pregnancy. There were significant correlations between DAS28(3)CRP and PD scores throughout pregnancy (T2, r=0.82 (95% CI [0.42, 0.95], p<0.01); T3, r=0.68 (95% CI [0.38, 0.86], p<0.01)) and postpartum, r=0.84 (95% CI [0.60, 0.94], p<0.01), while this correlation in non-pregnancy was weaker (r=0.47 (95% CI [0, 0.77], p<0.05).
CONCLUSIONS:
This pilot study found that DAS28(3)CRP is a reliable measure of disease activity in pregnant women with RA. Based on these data, pregnancy does not appear to confound clinical evaluation of the tender and/or swollen joint counts.
