What joints are counted in the DAS28?

The 28 joints assessed are: both shoulders (2), both elbows (2), both wrists (2), all 10 metacarpophalangeal joints (MCP 1–5 bilateral), all 8 proximal interphalangeal joints (PIP 1–4 bilateral), and both knees (2). Hips, ankles, and feet are not included in the DAS28 assessment.

What is the DAS28 cut-off for remission?

According to EULAR criteria, DAS28 3.2 and ≤ 5.1 defines moderate activity, and DAS28 > 5.1 defines high disease activity. These thresholds apply to both the ESR and CRP variants.

What is the difference between DAS28-ESR and DAS28-CRP?

DAS28-ESR uses erythrocyte sedimentation rate (mm/hr) and applies the formula: 0.56×√TJC + 0.28×√SJC + 0.70×ln(ESR) + 0.014×PGA. DAS28-CRP uses C-reactive protein (mg/L) with the formula: 0.56×√TJC + 0.28×√SJC + 0.36×ln(CRP+1) + 0.014×PGA + 0.96. DAS28-CRP scores tend to be slightly lower than DAS28-ESR for the same patient.

How is the Patient Global Assessment scored?

The Patient Global Assessment (PGA) is recorded on a 0–100 mm visual analog scale (VAS). The patient marks a point on a 100 mm line where 0 = no disease activity at all and 100 = maximum possible disease activity. The numeric value (0–100) is entered directly into the formula.

Can DAS28 be used for conditions other than RA?

DAS28 was developed and validated specifically for rheumatoid arthritis. It is sometimes used off-label for psoriatic arthritis and other inflammatory arthritides, but it is not the preferred tool for those conditions. ACR and EULAR recommend DAS28 primarily for RA assessment.

Is this calculator a substitute for clinical judgment?

No. DAS28 is a clinical decision-support tool. Scores should always be interpreted in the context of a full clinical assessment, imaging findings, functional status, and individual patient factors. Treatment decisions should be made by a qualified rheumatologist.

DAS28 Rheumatoid Arthritis Score

Name: DAS28 Rheumatoid Arthritis Score
Availability: InStock
Author: Nham Vu

Calculate DAS28-ESR or DAS28-CRP to assess rheumatoid arthritis disease activity and determine remission, low, moderate, or high activity status.

DAS28 Inputs

Inflammatory Marker

Tender Joint Count (TJC28) 0 – 28

Swollen Joint Count (SJC28) 0 – 28

ESR (mm/hr)

Patient Global Assessment (PGA) 0 – 100 mm VAS

0 = no activity, 100 = maximum activity

Enter values on the left and click Calculate DAS28 to see the score.

DAS28 Score

ESR

—

EULAR disease activity

0 2.6 3.2 5.1 9.4

Clinical Interpretation

Formula Breakdown

√TJC28

√SJC28

ln(ESR)

PGA term

EULAR Activity Thresholds

Category	DAS28 Range	Typical Guidance
Remission	< 2.6	Maintain therapy; consider tapering
Low Activity	2.6 – 3.2	Consider maintaining or cautious taper
Moderate Activity	3.2 – 5.1	Optimize DMARDs; consider step-up
High Activity	> 5.1	Escalate therapy; consider biologics

Summary

Calculate DAS28-ESR or DAS28-CRP to assess rheumatoid arthritis disease activity and determine remission, low, moderate, or high activity status.

How it works

Select the variant: DAS28-ESR (uses erythrocyte sedimentation rate) or DAS28-CRP (uses C-reactive protein).
Enter the 28 Tender Joint Count (TJC28) — the number of joints that are painful on pressure or passive movement.
Enter the 28 Swollen Joint Count (SJC28) — the number of joints with soft-tissue swelling.
Enter the ESR (mm/hr) or CRP (mg/L) laboratory value for the inflammatory marker.
Enter the Patient Global Assessment (PGA) on a 0–100 mm visual analog scale (0 = no activity, 100 = maximum activity).
Click Calculate to see the DAS28 score and EULAR disease activity category.

Use cases

Monitor disease activity at each clinic visit for patients with rheumatoid arthritis.
Define remission (DAS28 < 2.6) as a treatment target in treat-to-target strategies.
Assess response to biologic or DMARD therapy using EULAR response criteria.
Document disease burden for insurance authorization of biologic agents.
Compare pre- and post-treatment scores to quantify therapeutic benefit.
Support clinical trial enrollment and outcome reporting.
Educate patients on their current disease activity level in a standardized way.
Differentiate low, moderate, and high activity states to guide escalation decisions.

Frequently Asked Questions

Last updated: 2026-06-14 · Reviewed by Nham Vu