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ORIGINAL ARTICLE
Year : 2007  |  Volume : 2  |  Issue : 3  |  Page : 91-94

CDAI (clinical disease activity index) in rheumatoid arthritis: cut-off values for classification into different grades of disease activity


1 Department of Medicine, JIPMER, Pondicherry, India
2 A&R Clinic for Arthritis and Rheumatism' and ISIC Superspecialty Hospital, Vasant Kunj, New Delhi, India

Correspondence Address:
A N Malaviya
A&R Clinic for Arthritis and Rheumatism' and ISIC Superspecialty Hospital, Vasant Kunj, New Delhi
India
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Source of Support: None, Conflict of Interest: None


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Background: CDAI is a composite index for quantifying disease activity in RA. It utilises 4 clinical parameters namely, swollen and tender joints out of 28 (the set designated for DAS28) and global assessment of the patient and assessor on a visual analogue scale. No laboratory parameter is needed. Objective: To determine cut-off values for CDAI (clinical disease activity index) in Indian patients with rheumatoid arthritis (RA) for classification into different grades of disease activity. Methods: CDAI and DAS28 (disease activity score on 28 joints) were measured at the first and again at the last clinic visit on 100 adult patients with RA seen over a period of 1½ years. Using recommended DAS28 values as a comparator for classifying patients into the following 4 categories of disease activity namely 'remission', 'low disease activity', 'moderate disease activity, and 'high disease activity', the corresponding CDAI cut-off values were derived statistically. Results: Among Indian patients CDAI cut-off values for the classification of patients into 4 categories of disease activity were: remission ≤ 2.2, low disease activity > 2.2 to ≤ 5, moderate disease activity > 5 to ≤ 21 and high disease activity > 21. Conclusions: CDAI, a simple tool that is based on clinical parameters alone, was applied to the Indian patients with RA. The cut-off values derived in this study by a standardised assessment methodology could be useful in routine monitoring and therapeutic decisions in RA.


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