Number Of Tender Research Articles

Soluble urokinase plasminogen activator receptor (suPAR) in the assessment of inflammatory activity of rheumatoid arthritis patients in remission

Soluble urokinase plasminogen activator receptor (suPAR) is a biomarker increasingly used for the assessment of systemic inflammation. We aimed to evaluate suPAR for the assessment of inflammatory activity in rheumatoid arthritis (RA) patients in remission. In our cross-sectional study we measured plasma suPAR and C-reactive protein (CRP) levels as well as erythrocyte sedimentation rate (ESR) in 120 RA patients at various stages of disease activity and 29 healthy age-matched controls. suPAR, CRP and ESR values were higher in RA patients compared to healthy individuals. When suPAR levels were analyzed according to DAS28 scores of RA patients, suPAR level in the subgroup with DAS28≤2.6 was lower than in the subgroup with DAS28>2.6, but still higher than in controls [4.45 (3.33-5.56) ng/mL vs. 3.66 (3.10-4.67) ng/mL vs. 2.80 (2.06-3.42) ng/mL, p<0.0001, median (interquartile range)]. In contrast, CRP and ESR values were comparable in the subgroup with DAS28≤2.6 and in healthy individuals. We further analyzed the correlation between the number of tender and/or swollen joints and suPAR levels in RA patients in remission. suPAR values were significantly higher in patients with four tender and/or swollen joints than in patients with 2-3 or 0-1 tender and/or swollen joints. While CRP and ESR values indicate remission of the chronic inflammatory process in RA, suPAR values are still elevated compared to healthy individuals. suPAR might be particularly valuable in the recognition of inflammatory activity in patients who are in remission according to DAS28 scores but have symptoms of tender and/or swollen joints.

Relationship between CDT and disease activity in rheumatoid arthritis

The aim of this study was to estimate the serum concentration of carbohydrate-deficient transferrin (CDT) in patients with rheumatoid arthritis (RA) and the relationship between the CDT level and disease activity in RA patients. Studies were carried out in 47female patients with RA and 32healthy women. Disease activity of RA was evaluated using the 28-joint count Disease Activity Score (DAS28). Serum CDT was determined by particle-enhanced immunononephelometry using the N Latex CDT test. Patients with RA had significantly lower serum concentrations of CDT compared with controls. The correlation study showed the significant negative relationship between CDT and DAS28 (r = - 0.483, p = 0.011). There were no correlations between serum CDT level and patient's age, disease duration, number of tender and swollen joints, and degree of disability evaluated by the Health Assessment Questionnaire. The level of CDT in patients with RA was significantly decreased and confirms the changes in transferrin glycosylation which are dependent on the disease activity. Therefore, measurement of CDT in the sera of patients with RA can be useful for the evaluation of disease activity in these patients.

Consistency of assessments and willingness to pay for a reduction in morning symptoms over time in patients with rheumatoid arthritis

Objectives: To determine the variation in morning symptoms and in the corresponding monetary equivalents assigned to their reduction.Methods: The sampled (n = 100) rheumatoid arthritis (RA) patients were interviewed twice by a trained interviewer using the same interview, 2 weeks apart. Patients assessed fatigue, pain, and severity of morning stiffness (MS) on waking up and after maximum improvement on a numeric rating scale (NRS). Patients estimated the duration of MS in minutes and reported the number of tender and swollen joints. Patients were also asked to estimate how much they would be willing to pay on a daily basis if pain, duration of MS, and severity of MS when waking up could be reduced by 25, 50, 75, and 100%. Weighted averages of the monetary assessments for symptom reduction were computed.Results: On average, the NRS values at the first and second assessments were close to each other, except for fatigue and pain, which were significantly lower (p < 0.01) in the second assessment. There was limited within-patient variation, with the majority of symptom assessments within a range of ±10%. Weighted average willingness-to-pay (WTP) estimates were consistent across time points for reduction in pain and MS severity and duration. Changes in symptom assessments were reflected in the WTP estimates.Conclusions: The duration and severity of MS seemed to be more consistent over time than pain and fatigue. WTP estimates and their changes corresponded closely to changes in symptom assessments.

Ultrasound-Defined Remission and Active Disease in Rheumatoid Arthritis: Association with Clinical and Serologic Parameters

To assess the association of clinical and/or serological parameters with ultrasound-defined disease activity in rheumatoid arthritis (RA). Retrospective analysis of 149 consecutive RA patients routinely assessed by sonography of the wrists, metacarpo-phalangeal, and proximal interphalangeal joints. Semiquantitative scoring of synovial hypertrophy/effusion and power Doppler (PD) signals was performed. Sonographic remission was defined by the absence of PD signals. Number of tender and swollen joints, global assessment of disease activity by the physician (VAS-phys) and patient (VAS-pt), C-reactive protein (CRP), erythrocyte sedimentation rate, duration of morning stiffness (MS), simplified disease activity index, disease activity score for 28 joints, clinical disease activity index, and health assessment questionnaires were recorded. PD signals as a sign of active disease were observed in 117 (78.5%) RA patients. CRP, erythrocyte sedimentation rate, and MS were higher in patients with PD signals than in patients in remission. CRP >5.0 mg/L (normal values 0-5.0 mg/L), MS >15 minutes, or the combination of both revealed odds ratios of 5.0, 3.0, or 18.9, respectively, to indicate sonography-defined active disease. The other parameters showed no association with the presence or absence of PD-signals. Sonography-defined disease activity is associated with CRP and MS, whereas current composite scores and its clinical components did not match this definition.

Effects of Anti-Tumor Necrosis Factor Agents for Familial Mediterranean Fever Patients With Chronic Arthritis and/or Sacroiliitis Who Were Resistant to Colchicine Treatment

Effectiveness of anti-tumor necrosis factor (anti-TNF) agents in colchicine-resistant familial Mediterranean fever (FMF) patients has attracted attention in recent years. We analyzed the effect of anti-TNF agents on clinical findings of colchicine-resistant FMF patients with chronic arthritis and/or sacroiliitis. Data from 10 FMF patients (5 male and 5 female patients: mean age, 30.1 [SD, 8.5] years) with chronic arthritis and/or sacroiliitis who were on anti-TNF agents are reviewed. Frequency of FMF attacks before and after treatment with anti-TNF agents was recorded from hospital files. The effects of the anti-TNF treatment were determined by using the number of tender and/or swollen joints, serum acute phase reactant levels, and Bath Ankylosing Spondylitis Disease Activity Index scores. Change in urine protein loss was also evaluated in patients with amyloidosis. In 6 patients, FMF attacks had been considered to be unresponsive to colchicine, and 4 patients were partial responders before treatment with anti-TNF agents. Mean attack frequency of the patients in the 3 months' period before anti-TNF agent treatment was 3.8 (SD, 3.1). After anti-TNF treatment, in 3 patients, FMF attack frequency decreased, and in the remaining 7 patients, no attack occurred. Serum acute phase reactant levels were decreased significantly at 3 and 6 months after anti-TNF treatment (P < 0.05 for all). After anti-TNF treatment Bath Ankylosing Spondylitis Disease Activity Index scores were also decreased significantly (6.2 [SD], 1.7 vs. 2.1 [SD], 1.7; P = 0.012). In all 3 patients with amyloidosis, urine protein loss decreased without any increase in serum creatinine levels. Anti-TNF treatment can have beneficial effects for controlling FMF attacks in FMF patients with chronic arthritis and/or sacroiliitis.

Evaluation of disease activity in a population of Russian JIA patients

Methods During 3-moths cross-sectional study in 30 centers of RUS the data of 1099 consecutive patients were collected. The following key determinants of disease activity were examined: numbers of tender, swollen joints; number of active joint and joints with patient assessment of pain and global health scores (VAS); ESR; DAS 28; JADAS-71, PhGloVAS. Relationship between studied variables was investigated using of a nonparametric method of Spearman’s correlation analysis.

Nutritional Status of Iranian Women with Rheumatoid Arthritis: An Assessment of Dietary Intake and Disease Activity

Long-standing chronic diseases such as rheumatoid arthritis are known to be associated with impairment of nutritional status to some degree. The present study aimed to assess nutritional status of women with rheumatoid arthritis and compare their ingestion of certain micronutrients with dietary reference intakes. In this cross-sectional study, 90 eligible women were recruited. After examination, all patients were evaluated on the basis of disease activity score, calculated using the number of tender and swollen joints, patient global assessment of pain and high sensitivity C-reactive protein (CRP). A three-day 24 h recall was completed and a 10 ml fasting blood sample was obtained to assess the plasma levels of malondialdehyde, total antioxidant and CRP. Despite normal BMI, intake of energy and micronutrients including calcium, folic acid, zinc, magnesium and vitamin B6 were considerably lower compared with the dietary reference intakes. There was no significant relationship between intake of different nutrients or food groups and disease activity score and the biochemical markers including malondialdehyde, CRP and total antioxidant. Intake of energy and some micronutrients were significantly lower than the recommended values. However, no relationship was found between intake of different food groups or nutrients with disease activity or serum antioxidant capacity.

Enthesis erosion in spondyloarthritis is not a persistent structural lesion

ObjectiveTo evaluate the ability of ultrasound (US) to detect the presence and change of Achilles erosions in spondyloarthritis (SpA).MethodsA blind prospective two-dimensional (2D) and three-dimensional (3D) US study of Achilles...

Prevalence of overweight among Moroccan children and adolescents with juvenile idiopathic arthritis

Objective We aimed to estimate the prevalence of overweight among Moroccan children and adolescents with juvenile idiopathic arthritis (JIA). Methods Fifty-eight patients with JIA according to the International League of Association of Rheumatology (ILAR) criteria were included consecutively in this study. The median age of patients was 11 ± 3.3 years (range 2–16). Overweight and obesity were defined by using the Body Mass Index (matched on age and sex and in reference to the French curves. Following data were collected: age, gender, age at onset, disease duration, subtype of JIA, functional disability (determined using the Moroccan version of Childhood Health Assessment Questionnaire [CHAQ]), disease activity (assessed using a 0–10 visual analogical scale, the number of tender and swollen joints and the erythrocyte sedimentation rate); medical treatment and socioeconomic status of patients. Results Twenty-four patients (41.4%) were overweight, 13 (22.4%) were obese and 21(36.2%) have normal. Patients with normal weight, obese and overweight represented successively 16.7%, 33.3% and 50% of systemic forms, 33.3%, 8.3% and 58.3% of seronegative polyarticular forms, 40%, 40% and 20% of seropositive polyarticular forms, 36.4%, 27.3% and 36.4% of persistent oligoarticular forms, 75%, 25% and 0% of extensive oligoarticular forms and 57.1%, 0% and 42.9% of forms with arthritis and enthesitis. In our data, there was no psoriatic arthritis. Overweight and obesity were more prevalent in older patients ( P = 0.01), with significant functional impairment ( P = 0.04) and with active disease (increased VAS) ( P = 0.005). There were no relationships with the subtype of JIA or with corticosteroid treatment ( P = 0.451). Conclusion Approximatively more than 60% of our patients were overweight. Severe functional limitation and active disease are the most correlated parameters with overweight. Better management of the activity and functional status of the disease seems to be of interest to prevent overweight in children with JIA. More studies with a larger number of patients seem to be necessary in order to confirm our results.

Combined Add-on Supplementation of Omega-3 Fatty Acids, Vitamin E, Vitamin A, Copper, and Selenium in Rheumatoid Arthritis

Objectives: The present study evaluated the effects of a combined nutritional supplement, containing omega-3 fatty acids (ω-3 FA) and different antioxidative micronutrients on nutrient status and disease activity in patients with rheumatoid arthritis (RA). Methods: The study was conducted as a double-blind, randomised placebo-controlled trial. A hundred patients with defined RA were allocated to the verum or placebo group. During a period of twelve weeks they were given three capsules of their specific study supplementation every day. The daily dosage of ω-3 FA was 1.35 g (thereof 900 mg eicosapentaenoic acid, EPA), 90 mg vitamin E, 600 μg vitamin A, 3 mg copper, and 75 μg selenium, or soy oil (placebo), respectively. Outcome variables were the changes in DAS 28, the number of tender and swollen joints, morning stiffness, and supply with different nutrients (e.g. serum concentration of EPA, AA and vitamin E), as well as blood lipid levels. Results: Sixty-four participants were included in this analysis: 30 receiving verum and 34 placebo. After twelve weeks of intervention, little but not significant improvements were observed in the DAS 28 and other clinical factors. Subgroup analysis revealed that the effect was much more pronounced in patients who were at least at a moderate activity of illness. Regarding the nutritional status, the serum concentration of EPA (P < 0.001), vitamin E (P < 0.01), SOD (P < 0.05), and GPx (P < 0.001) increased significantly, while AA (P < 0.001) decreased after supplementation. The concentration of triglycerides decreased significantly in the verum group (P < 0.05) but not in the placebo group. Conclusions: A twelve week add-on supplementation of a combined food supplement (ω-3 FA + antioxidants) effected modest but not significant changes in the clinical parameters in RA. Though vitamin E, SOD and GPx improved significantly, equivalent to an increased antioxidant defence. This supplementation was dedicated to enhance the nutritional status of critical nutrients in RA, especially with regard to an increased risk of cardiovascular disease in these patients.

Influence of arthritis and non-arthritis related factors on areal bone mineral density (BMDa) in women with longstanding inflammatory polyarthritis: a primary care based inception cohort

BackgroundThe aim of this analysis was to determine the relative influence of disease and non-disease factors on areal bone mineral density (BMDa) in a primary care based cohort of women with inflammatory polyarthritis.MethodsWomen aged 16 years and over with recent onset inflammatory polyarthritis were recruited to the Norfolk Arthritis Register (NOAR) between 1990 and 1993. Subjects were examined at both baseline and follow up for the presence of tender, swollen and deformed joints. At the 10th anniversary visit, a sub-sample of women were invited to complete a bone health questionnaire and attend for BMDa (Hologic, QDR 4000). Linear regression was used to examine the association between BMDa with both (i) arthritis-related factors assessed at baseline and the 10th anniversary visit and (ii) standard risk factors for osteoporosis. Adjustments were made for age.Results108 women, mean age 58.0 years were studied. Older age, decreasing weight and BMI at follow up were all associated with lower BMDa at both the spine and femoral neck. None of the lifestyle factors were linked. Indices of joint damage including 10th anniversary deformed joint count and erosive joint count were the arthritis-related variables linked with a reduction in BMDa at the femoral neck. By contrast, disease activity as determined by the number of tender and or swollen joints assessed both at baseline and follow up was not linked with BMDa at either site.ConclusionCumulative disease damage was the strongest predictor of reduced femoral bone density. Other disease and lifestyle factors have only a modest influence.

The efficiency and safety of tocilizumab in rheumatoid arthritis(intermediate results of a Russian multicenter study)

Система комплексной поддержки и сопровождения научного журнала Elpub позволяет запустить двуязычный сайт журнала со встроенной системой электронной редакции в соответствии с лучшими издательскими практиками, а так же предусматривает техническую и методическую поддержку со стороны специалистов НЭИКОН.

RHEUMATOID ARTHRITIS IN RHEUMATOLOGICAL CARE OF RUSSIA: THE SEVERITY OF THE DISEASE IN A RUSSIAN PATIENT POPULATION: A CROSS-SECTIONAL EPIDEMIOLOGICAL STUDY (RAISER)

Objective: To study the severity of rheumatoid arthritis in a Russian patient population on the basis of the data of rheumatological care. Methods. Polyclinic and hospital rheumatologists from 27 cities and towns of Russia (a total of 30 centers) participated in the cross-sectional epidemiological study. The study included all patients with valid rheumatoid arthritis, who had consecutively turned to a polyclinic rheumatologist or who had been treated at hospital during the established 3-month period. The demographic and social characteristics of a patient, his/her occupation, comorbidity, the onset and duration of rheumatoid arthritis, clinicofunctional status at the study and antirheumatic therapy were recorded. Results. A total of 1504 patients, including 1271 women, were enrolled; their mean age at the study was 53 years; the mean duration of the disease (after the onset of its first symptoms) was 10.5 years. Most (66%) patients had a family. More than half of the examinees were professionals and specialists. More than 64% of patients were unemployed at the study. Mean disease activity scores were high: morning stiffness [Ме, range 25-75%] for mean 60.0 (30.0-180) min; number of tender (mean [SD] - 26.1±15.8), and swollen (13.4±11.4) joints; ESR, 29.45±15.5 mm/hr; pain, 58.1±22.6 mm (VAS); general health status, 57.4±20.6 mm (VAS). The mean DAS28 score (mean [SD]) was 5.44±1.18. The absolute majority (94%) of patients had erosive arthritis (Steinbrocker stages II-IV). Severe extraarticular manifestations were identified in 10%. The distribution of the patients by the ACR functional classes was as follows: Class I, 8%; Class II, 29%; Class III, 52%, and Class IV, 11%. Comorbidity was as high as 75%, there was a preponderance of cardiovascular diseases, diabetes mellitus, and chronic lung disease. The mean HAQ score in the examined patient cohort was 1.81±0.8. At the study, 89 and 43% of the patients received nonsteroidal anti-inflammatory drugs and systemic glucocorticoids, respectively. Methotrexate (62%) headed the list of basic anti-inflammatory drugs, sulfasalazine (8%), leflunomide (7%), and aminoquinolines (6%) were much less frequently used. Biologicals were given to 9% of the patients. Conclusion. The examined cohort of Russian patients with rheumatoid arthritis, which reflects experience in real clinical practice, is generally characterized by the severe course of the disease in both clinical and functional parameters.

Standardization of Joint Examination Technique Leads to a Significant Decrease in Variability Among Different Examiners

To reduce the amount of variability among assessors, we conducted joint examination standardization seminars in conjunction with multicenter clinical trials for patients with rheumatoid arthritis (RA). The examination techniques used were based on the recommendations of the European League Against Rheumatism (EULAR). To evaluate the effect of standardization, participants at the seminars examined a given patient with RA before and after they were made familiar with the EULAR examination technique. The number of tender and swollen joints as well as the variance among the examiners before and after the training were compared. Joints were rated positive or negative for tenderness and swelling without grading. Overall, 553 individuals from a variety of countries in Europe, North America, Asia, and Australia participated. Examiners included different kinds of health professionals, mainly physicians and nurses. We found a substantial variance among examiners before the training in the standardized method. This variance could be significantly reduced by the training. We also found that the number of joints considered active was markedly reduced after the training. Standardized joint examination training significantly reduces variability among different assessors.

Fibromyalgia Is Common and Adversely Affects Pain and Fatigue Perception in North Indian Patients with Rheumatoid Arthritis

Fibromyalgia (FM) has been shown to be common in patients with rheumatoid arthritis (RA), but studies on Asian patients are lacking. It remains unclear whether FM has an adverse influence on pain, fatigue, quality of life, and mood in these patients, and what its relationship is with disease activity. We studied prevalence and effects of FM in North Indian patients with RA and associations of RA with disease activity. This cross-sectional study included 200 RA patients and an equal number of controls. Presence of FM was defined using the American College of Rheumatology 1990 criteria. Pain and fatigue scores were assessed using a 10 cm visual analog scale. Quality of life and presence of depression/anxiety were determined using validated questionnaires. Disease activity and functional disability in RA patients was assessed using the Disease Activity Score 28-3 and Health Assessment Questionnaire, respectively. FM was present in 15% of patients with RA compared to 2.5% of controls in the North Indian population. RA patients with FM did not differ from those without FM in terms of age, gender, current disease-modifying agents, or steroid use. RA patients with FM had higher disease activity and worse functional disability. The number of tender and swollen joints was higher in patients with FM, but correlated poorly with each other. RA patients with FM had higher pain and fatigue scores but were not different in the quality of life or mood. FM is more common in North Indian patients with RA compared to controls. It adversely affects the pain and fatigue felt by RA patients. Disease activity and FM influence each other.

Adiponectin and leptin serum concentrations in patients with rheumatoid arthritis

Adipose tissue is regarded as an active metabolic and endocrine organ producing adipokines. The purpose of the study was to evaluate adiponectin and leptin concentrations in rheumatoid arthritis (RA) patients (pts) in relation to disease duration and activity. The study group consisted of 80 RA pts. Serum adiponectin and leptin concentrations remained within normal ranges. Adiponectin concentration correlated positively both with the age and disease duration. Both adipokines levels correlated negatively with glomerular filtration rate. There were significant positive correlations between adipokines' concentrations and lipid profile components (between adiponectin and HDL-cholesterol, leptin and total cholesterol and LDL-cholesterol). In pts with long-standing RA, there was a negative correlation between adiponectin and numbers of tender, swollen joints and a positive relationship between leptin level and DAS28. The results confirm adipokines' involvement in the process of inflammation and atherosclerosis: protective and antiinflammatory adiponectin effect and proatherogenic and proinflammatory leptin function.

RESULTS OF AN OPEN CLINICAL STUDY OF THE EFFICACY OF LEFLUNOMIDE IN RHEUMATOID ARTHRITIS

Objective: To evaluate the efficacy of leflunomide versus methotrexate in patients with rheumatoid arthritis. Subjects and methods. The study included 24 patients receiving leflunomide who underwent the determination of changes in the articular syndrome: the Ritchie index, the number of tender and swollen joints, pain, and the total activity of the disease, by using the visual analogue scale, morning stiffness in minutes. Therapeutic efficiency was evaluated by the EULAR criteria on the basis of changes in the Disease Activity Score (DAS) 4 and by using the criteria for a response to therapy ACR 20/ACR 50/ACR 70. Results. A rapid development of a clinical effect was noted in the use of leflunomide: the parameters of the articular syndrome improved at 3-month follow-up. According to the EULAR criteria, just after 1-month leflunomide treatment; good and satisfactory effects were achieved in 12,5 and 28% of the patients, respectively; and according to the ACR, there was a 50% improvement in 51% of the patients and 20% improvement in 22%. The patients treated with leflunomide showed a significantly reduced increment in the number of new erosions whereas those who took methotrexate caused only a reduction in the rate of increment. Conclusion. The new basic drug leflunomide is as effective as the gold standard methotrexate, at the same time it allows clinical improvement to be more rapidly achieved. Leflunomide also slows down the rate of progression of erosive arthritis and it is well tolerated.

USE OF REMICADE® IN PATIENTS WITH CHRONIC TOPHACEOUS GOUT: THEORETICAL RATIONALE AND ASSESSMENT OFOWN EXPERIENCE

The paper deals with the clinical experience in using Remicade®, a tumor necrosis factor-a (TNF-а) inhibitor, in patients with chronic tophaceous gout resistant to therapy with glucocorticoids and nonsteroidal anti-inflammatory drugs. The agent is noted to have a good long-acting clinical effect in reducing the number of tender and swollen joints, as confirmed by the theoretical rationale for the use of anticytokine agents, TNF- а inhibitors in particular, in gouty patients.

Therapy for psoriatic arthritis with infliximab

Objective: to study the efficacy and tolerability of infliximab (Remicade) in the major syndromes of psoriatic arthritis (PA). Subjects and methods. The study was based on Remicade therapy in 22 patients with severe and moderate PA with polyarthritic, osteolytic and spondyloarthritic types of the joint syndrome, generalized psoriasis vulgar and erythrodermata, and pustular psoriasis. Inflammatory activity was determined by DAS 4 and the efficiency of therapy was evaluated by the ACR and EULAR criteria. The severity of psoriasis was judged from the PASI index. Inefficiency or intolerability of essential anti-inflammatory drugs (EAIDs) was observed in all the patients. Therapy with Remicade in combination with methotrexate was performed in 7 patients; the other patients took Remicade without EAIDs. The drug was intravenously injected in a dose of 5 mg/kg by the generally accepted scheme. The efficacy of the first 5 Remicade infusions was evaluated. Results. Just after the first infliximab infusion, there was a significant reduction in the intensity of joint pains and in the duration of morning stiffness, as well as in the number of tender and inflamed joints. The improvement was associated with the duration of treatment. Remicade therapy resulted in diminished inflammatory activity. Before treatment the high activity of PA, estimated from the DAS 4 index, was determined in 71,4% of the patients; and after the second infusion it was seen only in 5%. After three infusions or more, there were a larger number of patients with 70ACR scores, i.e. those with a very good effect of therapy; and after 5 infusions; the number of such patients was as high as 91%. According with the EULAR criteria, a good therapeutic effect was observed in 89% of cases. The course of psoriasis was less pronounced. PA remission occurred in every 6 and every 3 patients after the second and fifth infusions, respectively. Conclusion. Remicade is the most effective drug among the available anti-inflammatory ones for the treatment of PA. It strongly affects the major syndromes of this disease.

Simplified Disease Activity Index as an index of disease activity in patients with rheumatoid arthritis: a comparison with DAS28

Introduction Various factors are known to determine the disease activity in patients with rheumatoid arthritis (RA). The main objective of this study was to establish the validity of the new tool of measurement of disease activity, Simplified Disease Activity Index (SDAI), in patients with RA in Indian population. Methods All patients with RA fulfilling the ACR classification criteria attending the rheumatology clinic at Nizam's Institute of Medical Sciences, Hyderabad over a period of 3 months were included in the study. A detailed assessment of each patient including their demographic characteristics, duration of the disease, number of tender and swollen joint counts, Westergren's ESR and C-reactive protein (mg/dL), patient's and physician's global assessment by VAS (0–10) were recorded. DAS28 and SDAI were calculated for each patient. Statistical analysis was done. Results Two hundred and sixteen patients were included in the study comprising 184 women and 32 men. Mean age of the patients was 42.94 ± 11.23 years and mean duration of disease was 4.10 ± 4.02 years. Mean DAS28 and SDAI were 5.19 ± 1.48 and 24.2 ± 16.06 respectively. ROC curve revealed that discriminative ability of SDAI was better than that of DAS28. The optimal cut-off points for treatment changes were 4.46 for DAS28 (sensitivity 88%, specificity 87.5%) and 12.6 for SDAI (sensitivity 92%, specificity 83%). Conclusion SDAI is a valid tool for measurement of disease activity in RA in Indian population and is as good as DAS28 in its ability to assess the patient's status.