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The rheumatology nurse or rheumatologist will enter the results of the 4 components (total number of tender and swollen joints, ESR or CRP value and the VAS-score) in a calculator. The score is a number between 0 and 10: the higher the number the higher the disease activity. Based on the DAS28 score we are able to categorize your disease activity into 4 categories:
Remission: Your DAS27 score is lower than 2.6. In general, this means that the signs and symptoms of your rheumatoid arthritis are (nearly) completely absent.
Low disease activity: Your DAS28 score is in between 2.6 and 3.2
Moderate disease activity: Your DAS28 score is above 3.2, and High disease activity: your score is above 5.1. In general, adjusting the anti-rheumatic medication should be discussed in these cases (see figure 3). Adjusting the medication may include: increasing the dosage of your medication; adding another antirheumatic drug; or switching of your antirheumatic medication.
DAS28 = 0.56 * sqrt(tender28) + 0.28 * sqrt(swollen28) + 0.70 * ln(ESR) + 0.014 * GH
Figure 4 is an example of the DAS28 course in a patient. At the arrows the medication has been adjusted. At these points the DAS28 score was higher than 3.2, and after adjusting the medication, the disease activity as expressed in the DAS28 went down.