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Rheumatology 2000; 39: 1154-1155
© 2000 British Society for Rheumatology

Letters to the Editor

Re: Bingham and Emery. Resistant rheumatoid arthritis clinics—a necessary development?

D. Porter

Gartnavel General Hospital, 1053 Great Western Road, Glasgow G12 0YN, UK

SIR, There is an important error in the article by Bingham and Emery [1], and I would urge the journal to print a correction at the earliest opportunity. The authors report using the Disease Activity Score (DAS) to assess response to DMARDs. They state that they use the modified DAS that uses 28 joint counts (DAS28); their Table 2 gives the correct formula for calculating the DAS28, but gives the response criteria for use with the original DAS (44 joint swelling count and Ritchie articular index). These counts are not inter-changeable, and have different response definitions [2]. The correct definitions of response, using the DAS28 are shown in Table 1Go.


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  		TABLE 1. Definitions of response to DMARDs

 
If the authors have been using the response criteria as printed in the editorial, they have been significantly underestimating patients' responses, and may have unnecessarily escalated treatment in patients who have made a good response to therapy.

Accepted 17 March 2000

References

  1. Bingham S, Emery P. Resistant rheumatoid arthritis clinics—a necessary development? Rheumatology2000;39:2–5.[Free Full Text]
  2. van Gestel A, Haagsma C, van Riel P. Validation of rheumatoid arthritis improvement criteria that include simplified joint counts. Arthritis Rheum1998;41:845–50.[Medline]
 

Reply

S. Bingham and P. Emery

Rheumatology and Rehabilitation Research Unit, School of Medicine, University of Leeds, 36 Clarendon Road, Leeds LS2 9JT, UK

We would like to thank Dr Porter for his comments regarding the use of the DAS28 score and calculation of the EULAR response [1]. Inadvertently the incorrect table was published. We can assure Dr Porter that patients have not been over-treated as we use computer software that accurately calculates the DAS and EULAR response. The difficulties of using complex scores are illustrated by the fact that even Dr Porter's corrected table as originally submitted was incorrect in detail (< and > used instead of <= or >=).

Notes

Correspondence to: S. Bingham. Back

References

  1. Porter D. Re: Bingham and Emery. Resistant rheumatoid arthritis clinics—a necessary development. Rheumatology2000;39:1154–5.[Free Full Text]
Accepted 17 March 2000


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D. Porter, S. Bingham, and P. Emery
Re: Bingham and Emery. Resistant rheumatoid arthritis clinics--a necessary development?
Rheumatology, October 1, 2000; 39(10): 1154 - 1155.
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