If your Disease Activity Score (DAS) is under 5.1 and... - NRAS
If your Disease Activity Score (DAS) is under 5.1 and you do not meet the criteria to move on to biologics, please say which of the following statements best applies to you.
184 VotersPlease select one:
I don't know my DAS. This method of assessing/ scoring has never been mentioned to me by anyone on my rheumatology team (NHS Orkney and Grampian).
I don't know my DAS either. It's never been mentioned to me. NHS big teaching hospital in London.
Mine has always been well above 5.1 so not able to vote :/
I dont know my DAS either, never been told!
I have always been aware of my DAS score right from the start. It has been 21 months since my diagnosis and in that time I only had one DAS score below 5.1, mostly it has been above 6.0
Why do we (The royal we I know this does not apply to many) have to become disabled and suffer deformities + the indignity of not being able to self care before being moved on to the biological therapies strikes me its just cost driven. However in my opinion this is misguided it must cost a lot more in benefits than these drugs would cost to keep up tip top and working.
The number of people I hear in general say their consultant says they are well controlled! How the heck does the consultant know do they feel your pain and constant tiredness???? I think not the consultants do not have the indignity of having to rely on others to do simple tasks for you wouldn't it be nick to be treat with humanity instead of being a number that costs money!!
I asked for a DAS score and was told I can't have one. I am not sick enough. But I feel rubbish!
I don't know what DAS is as its never been told to me by anyone........
I also do not know what DAS is - but I am off to google it now!
If any of you have had your DAS measured regularly and fall into the 'moderate' active disease category then do please get in touch with me. I would be keen to get your views.
Just to clarify, 'moderate' means a DAS of between 3.2 and 5.1
I've just replied to the request from Emma on the NRAS blog, as I fall into the supposed moderate group even tho' I think my DAS underplays my disease activity. let me know if there are specific areas you want views on, happy to provide them!
Yes, I'm in this category officially. Agree very strongly with joylin above about the iniquity of delaying anti-tnfs until disease is entrenched. And also, like Polly don't feel that my DAS is an accurate reflection of disease activity in my case. I know from experience that my pattern is joints starting to 'grumble', intermittently, in different ways for years before suddenly succumbing to detectable damage during a major flare. So whilst only those joints that are swollen / tender affect the DAS score, I can say with some confidence that the invisible aches, pains & odd sensations are the ones to watch if prevention is really on the agenda. But it isn't.
Hi Jamie I have had regular DAS 28 in the whole time of my treatment for last 20 months. Mine fall into moderate range. On my last consultant appt my consultant said my RA is grumbling as have had ever more new joints flaring, although he said I am still early stage RA. He made me an appt with the biologic nurse and I have just gone through 2 DAS28 for a biologic drug one month apart. On my first DAS 28 for this I could hardly walk as had 3 joints in my feet flare, also 3 joints in both hands, this was within 2 weeks of seeing my consultant and the appt with biologic nurse. My first DAS score was 4.71 and my second was 4.85 so as you can see I failed the NICE criteria. My biologic nurse was shaking her head, as although I had 3 or 4 swollen joints and up to 11 tender ones I never show a high esr or crp. She said I can see in front of my own eyes your swollen joints and the redness from the tender flaring joints. She said some of her patients come in with horrendous joints and low levels of esr whilst others whose joints look ok can have high esr. The long and short of this is that my biologic nurse said if it was up to her she would have put me on Enbral that day as she saw the physical evidence in front of her. She was will be discussing me with my consultant in the New Year as she is recommending me for Enbral and I believe my consultant wants me on it too otherwise why would he have sent me for an appt with her. The nurse also said the NICE criteria is a recommendation and from what I have read I believe that if a DR feels that it would be detrimental for a patients health not to have this treatment they can over rule as such. Still it will all come down to the pcp funding. Jeanette
My consultant mention my DAS score for the first time in my last visit in January. My ESR and CRP levels were raised and I'd been flaring and mini-flaring since my flu jab in November. My score was 2.68 - apparently anything below 2.6 is in remission so because I was slightly over that my MTX was increased. I have to also add though that I'd seen the SHO before I saw my consultant and when he asked if I was in any pain that day and I said my shoulder was painful, he said that was NOT a typical joint to be affected by RA - despite the fact I later found out it is included on the DAS diagramme... So when I then talked to the consultant I left this fact out of our conversation so I think my score should have actually been higher than it was so I'm pleased the drugs were increased as this seems to have settled everything down.
I have been told my DAS but I feel that it is very subjective as it depends partly on you saying how bad you consider your RA to be at a particular point - it's very hard to say reliably how bad it is compared to eg six months before.
Absolutely. Its a really bad subjective test. And often the only way to get yourself on efgfective treatment is to lie about how much it hurts when each joint is pressed - doctors suggest this when patients don't meet the strict criteria to go onto biologicals and yet they know the patient needs them
I have never been told my DAS score or had it mentioned to
Have still not been told mine I have just had it done as medication has failed 3rd dmard ( have tried three now including mtx) and was told it depended on some blood results too that are being done or rather blood being taken today. my score will be repeated in one month. then theu might give me a result??. think rheum like the power/ secrecy bit and we all know cost comes into the equation.. suscpect due to the fact i have steroid injection and oral steroids ( still taking!!) mine will appear low- moderate this time????!!!!
Yes, steroids should be factored out! They completely skew the picture.
I've never discussed DAS at any of my appointments so if it is measured I don't know anything about it.
I was diagnosed in 2008 and never knew about this!
The primary source for DAS is this website! I only just found about my score. Feet arent included in DAS. This (for me) invalidates my score. I am 2.6 but would be much higher if feet were included. Is my treatment informed by this scoring system?? .
Similar answer from myself. Dumfries does not mention nor even hint about my DAS. In door quick assessment and off you go. weemikec
