Disease activity scores in RA differ with pain perception and sex

The Disease Activity Score 28 (DAS28) values for patients with rheumatoid arthritis (RA) vary considerably with their perception of pain and their sex. There are only marginally significant relationships between DAS28 values and the patient’s age and duration of disease.

Leeb and associates enrolled 557 outpatients with RA (432 women and 125 men) consecutively into a cross-sectional study. DAS28 measures were assessed, including tender and swollen joint counts, erythrocyte sedimentation rate, and patient's assessment of disease activity. In addition, physician’s global assessment of disease activity, patient’s assessment of pain, and C-reactive protein level were recorded. T-tests were applied for comparisons of DAS28 values.

The mean DAS28 was 3.66 in women and 3.01 in men; men and women had median 3 and 0 tender joints and median 2 and 1 swollen joints, respectively. DAS28 values were significantly different in patients with early RA and long-lasting RA (3.62 vs 3.37). Regression analysis showed a highly significant relationship between DAS28 score and patient’s pain rating. Pain exerted a prominent influence on patient’s assessment of general health.

The authors noted that pain is predominant in rheumatologic diseases in both women and men and the primary reason leading to a consultation with a physician.