Introduction
The SDAI is a simple to use scoring system that focuses on the main symptoms of rheumatoid arthritis and that has been validated for both research and clinical use. Therapeutic areas for the SDAI include skin and connective tissue diseases, musculoskeletal disease and immune system diseases.
The SDAI score helps clinicians determine the severity of rheumatoid arthritis based on clinical and laboratory data, so consists of the sum of the components: SJC + TJC + CRP + PGA + EGA
Where:
- SJC – Swollen Joint Count
- TJC – Tender Joint Count
- CRP – C-reactive protein in mg/dL
- PGA – Patient Global Assessment of Disease Activity
- EGA – Evaluator Global Assessment of Disease Activity
Patients with high scores should receive early and aggressive medication and be closely monitored. It is considered that attaining low or remission levels may prevent disease progression and further disability.
Use the following EVALUATION FORM to evaluate your patient and PRINT THE FORM when the evaluation is completed.
Interpretation
Compared to other scores, the SDAI has shown the highest sensitivity and specificity in predicting physicians’ therapeutic decisions.
Remission is considered when SDAI is up to 3.3 whilst response to therapy is considered moderate if SDAI decreases by more than 7 points and major if the decrease is of more than 17 points.
| DAI Score | Disease Severity |
| ≤3.3 | Remission |
| >3.3-11.0 | Low |
| >11.0-26.0 | Moderate |
| >26.0 | High |
In the original study by Smolen et al., the SDAI was shown to provide a valid and sensitive assessment of disease activity and treatment response, one that for rheumatoid arthritis, is comparable with the DAS 28 response criteria.
References
Original reference
Smolen JS, et al. A simplified disease activity index for rheumatoid arthritis for use in clinical practice. Rheumatology. 2003; 42 (2): 244-257.
Validation
Aletaha D, Smolen JS. The Simplified Disease Activity Index (SDAI) and Clinical Disease Activity Index (CDAI) to monitor patients in standard clinical care. Best Pract Res Clin Rheumatol. 2007; 21(4):663-675.
Other references
Soubrier M, Zerkak D, Gossec L, Ayral X, Roux C, Dougados M. Which variables best predict change in rheumatoid arthritis therapy in daily clinical practice? J Rheumatol. 2006; 33(7):1243-6.