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The management of rheumatoid arthritis (RA) has changed radically over the last 15 years, with the introduction of new drugs and treatment strategies and with the emergence of new concepts of disease severity, treatment targets, and means of evaluating treatment effects.In particular, the necessity to evaluate disease activity using an objective and accurate instrument has been demonstrated. In clinical practice, the 28-joint Disease Activity Score (DAS28) has gained widespread use in the monitoring of disease activity of patients with RA treated with synthetic and biological disease modifying anti-rheumatic drugs1. There is, however, no consensus on the optimal DAS version to be used. DAS28-CRP (C-reactive protein) was developed as a modification of DAS28-ESR (erythrocyte sedimentation rate), which had also previously been developed as a modification of the original DAS2.Using CRP for calculation of the DAS28 is an attractive alternative to ESR for several reasons. First, CRP is very sensitive to short-term changes in inflammation3. Second, CRP is more accurate as an indicator of inflammation than ESR, the latter being influenced by a number of unrelated factors, such as age, sex, anemia, fibrinogen levels, hypergammaglobulinemia, and rheumatoid factor3. Third, CRP measurements are routinely used in clinical practice, and measurements can be standardized in a central laboratory for … Address correspondence to Dr. Gaujoux-Viala; E-mail: cecilegaujouxviala{at}yahoo.fr

C-reactive Protein Versus Erythrocyte Sedimentation Rate in Estimating the 28-joint Disease Activity Score