ENLACES ÚTILES EN PATOLOGÍA INMUNORREUMATOLÓGICA (diagnóstico y actividad)

ARTRITIS REUMATOIDE

 

Criterios diagnósticos 

 https://www.rheumakit.com/en/calculators/acr_eular2010 Clinical Disease Activity Index

 https://www.mdcalc.com/clinical-disease-activity-index-cdai-rheumatoid-arthritis (va unido a algoritmo terapéutico)

 https://www.merckmanuals.com/medical-calculators/RheumatoidArthritisCDAI.htm DAS-28

https://www.rheumakit.com/en/calculators/das28_crp

Criterios de respuesta de EULAR

• Good response: > 1.2-point improvement in DAS28, with present score of <= 3.2 points
• Moderate response: > 1.2-point improvement in DAS28, with present score > 3.2 points, or improvement in DAS28 >0.6 to ≤1.2 points, with present score of <= 5.1 points. 
• No response: Improvement in DAS28 of >0.6 to ≤1.2 points, with present score > 5.1 points, or an improvement in DAS28 of <=0.6 points, regardless of present score. 

Health Assessment Questionnarie 

https://www.ser.es/wp-content/uploads/2016/07/HAQ-SER-SPANISH-QUESTIONNAIRE.pdf

ACR 20/50/70 Definition: At least a 20%, 50%, or 70% improvement in the number of tender and swollen joints, and at least a 20%, 50%, or 70% improvement in three of the following five criteria: patient global VAS; patient pain VAS; physician global VAS; HAQ score; acute-phase reactant value (ESR or CRP).

ESPONDILOARTROPATÍA

 BASDAI

https://qxmd.com/calculate/basdai

http://basdai.com/BASDAI.php

PSORIASIS 

CASPAR criteria

The CASPAR study concluded that a patient with an inflammatory musculoskeletal disease (peripheral arthritis, spondylitis, or enthesitis) can be classified as having PsA if a total of at least 3 points is accumulated from the presence of the following list of features (each of which is assigned a certain number of points):

1. Skin psoriasis that is: -Present – two points, OR -Previously present by history – one point, OR -A family history of psoriasis, if the patient is not affected – one point 
2. Nail lesions (onycholysis, pitting) – one point •Dactylitis (present or past, documented by a rheumatologist) – one point 
3. Negative rheumatoid factor (RF) – one point 
4. Juxtaarticular bone formation on radiographs (distinct from osteophytes) – one point

MDA 

Associated with reduced progression of damage both in an observational cohort and in drug trials

A patient is classified as achieving MDA when meeting 5 of the 7 following criteria:

tender joint count < or =1
swollen joint count < or =1
Psoriasis Area and Severity Index < or =1 or body surface area < or =3 percent
patient pain visual analogue score (VAS) < or =15
patient global disease activity VAS < or =20
health assessment questionnaire < or =0.5
tender entheseal points < or =1"

Patients can be further classified as achieving very low disease activity (VLDA) when they meet all seven of the criteria. Further study is required to determine the utility of these definitions of MDA and VLDA as targets for treatment.

DAPSA 

Another composite index for PsA disease activity, which is limited to the assessment of peripheral arthritis, is the DAPSA [

This score is the sum of the swollen joint count of 66 joints, the tender joint count of 68 joints, the patient global assessment on a 10 cm VAS (in cm), pain score on a 10 cm VAS (in cm), and the CRP (mg/dL). 

Disease activity states are defined as follows: 

remission, ≤4; 

low disease activity, >4 and ≤14; 

moderate disease activity, >14 and ≤28; 

high disease activity, >28

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