Second Department of Medicine, Hietzing Hospital, Vienna, Austria.
Ann Rheum Dis. 2010 Aug;69(8):1441-7. doi: 10.1136/ard.2009.122259. Epub 2010 Jun 4.
Instruments for measuring disease activity in psoriatic arthritis (PsA) are not yet firmly established, and most of the currently employed ones have been derived for rheumatoid arthritis. Some of these instruments are based on 28 joint counts, which do not capture joints frequently affected in PsA. Therefore, the reliability and validity of DAREA (for 'Disease Activity index for REactive Arthritis'), which was originally developed for reactive arthritis and employs a 66/68 joint count, was tested in patients with PsA.
Trial data from the Infliximab Multinational Psoriatic Arthritis Controlled Trial were analysed. Results were then independently validated using an observational data set. DAREA was compared to other composite indices regarding correlations with core set variables, sensitivity to change and criterion validity.
Good correlation of the DAREA with single items of disease activity, other composite scores (r=0.6-0.9) and physical function (Health Assessment Questionnaire; r=0.5) was found. Likewise, DAREA was at least as sensitive to change as the other indices and more so in patients with distal interphalangeal joint involvement. Additionally, DAREA correlated well with radiographic changes.
The analyses of this study provide evidence of the utility and validity of the DAREA for PsA disease activity assessment. A second name should therefore be assigned to this score: DAPSA (for 'Disease Activity index for PSoriatic Arthritis').
用于测量银屑病关节炎（PsA）疾病活动度的工具尚未确定，目前使用的大多数工具都是根据类风湿关节炎衍生而来的。其中一些工具基于 28 个关节计数，但无法捕捉到 PsA 中经常受影响的关节。因此，最初为反应性关节炎开发的、采用 66/68 个关节计数的 DAREA（代表“反应性关节炎疾病活动指数”）的可靠性和有效性在 PsA 患者中进行了测试。
分析英夫利昔单抗治疗多发性银屑病关节炎的多国临床试验数据。然后使用观察性数据集对结果进行独立验证。将 DAREA 与其他综合指标进行比较，评估其与核心指标变量的相关性、对变化的敏感性和标准效度。
DAREA 与疾病活动的单个项目、其他综合评分（r=0.6-0.9）和身体功能（健康评估问卷；r=0.5）具有良好的相关性。同样，DAREA 对变化的敏感性至少与其他指标一样，在涉及远侧指间关节受累的患者中更为明显。此外，DAREA 与放射学变化也有很好的相关性。
本研究的分析结果提供了 DAREA 用于评估 PsA 疾病活动度的有效性和有效性的证据。因此，应该给这个评分起一个新的名字：DAPSA（代表“银屑病关节炎疾病活动指数”）。
