Management of Rheumatoid Arthritis

Annex 1:

Annex 2:

Clinical Disease Activity Index (CDAI) for Rheumatoid Arthritis

When to Use

●       All patients with rheumatoid arthritis.

●       Re-assessing patients after starting a new medication for RA

Pearls and pitfalls

●       Assessment of disease activity in rheumatoid arthritis (RA) should be viewed as a dynamic, on-going process; many experts recommend assessing the Clinical Disease Activity Index (CDAI) at every patient visit.

●       Early treatment is important for optimal RA outcomes, and the CDAI can help give a gestalt view of a patient’s disease severity and activity

Why Use

●       The CDAI provides an excellent overview of a patient's disease severity (it correlates closely with the SDAI which requires laboratory data) and the DAS-28 (which is a much longer, 28-joint assessment).

●       CDAI can also help guide therapy based on severity of disease

FORMULA

CDAI = Tender Joint Count + Swollen Joint Count + Patient Global Activity + Provider Global Activity

Score interpretation:

CDAI Score Range                    Disease Severity

≤ 2.8                                                   Remission

> 2.8 - 10.0                                       Low

> 10.0 - 22.0                                    Moderate

> 22.0                                                High