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Disease activity score for still’s disease

  • ORIGINAL ARTICLE
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Abstract

Objective

To develop the Still’s Disease Activity Score (SDAS).

Methods

We used data from the prospective adult-onset Still’s disease cohort study and evaluated the disease activity. An expert group selected the most frequent, reproducible, and objective variables significantly modified in statistical analysis when comparing patients in the active group and in the remission group. These criteria were weighted to design the Still’s Disease Activity Score (SDAS). The Delphi method was used to appreciate the level of disease activity. Total SDAS was calculated for each patient and compared to final consensus experts.

Results

At the diagnosis, all patients had an active disease (n = 80), while 48 patients were in remission at 6 months. The SDAS criteria were weighted as follows: fever ≥ 38.5 °C (1 point), rash (1 point), joint involvement (arthralgia: 1 point, swollen joints count “SJC”: 1–3 SJC: 2 points, ≥ 4 SJC: 3 points), physician global assessment VAS ≥ 5/10 or a raise in physician VAS ≥ 2/10 (3 points), patient VAS ≥ 5 or a raise in patient VAS ≥ 2/10 (1 point), and CRP (> 10 mg/l: 1 point, ≥ 100 mg/l: 2 points). At 6 months, the consensus was achieved for 76 (95%) patients with 40 in remission (0–1 point), 8 in low disease activity (2–3 points), 16 in moderate disease activity (4–7 points), and 12 in severe disease activity (≥ 8 points).

Conclusion

The Still’s Disease Activity Score is a valid and sensitive assessment of the disease activity and the therapeutic response in Still’s disease, despite its heterogeneous manifestations and patterns with systemic and articular forms.

Key Points

• The Still’s Disease Activity Score (SDAS) is a good simple tool to assess the activity of the disease in a stable state for a week.

• The SDAS is developed specifically for Still’s disease without the need for an application or a calculator to calculate SDAS in routine clinical practice.

• SDAS is a composite score classifying the disease activity in remission, low disease activity, moderate disease activity, and severe disease activity despite its heterogeneous patterns (systemic and articular forms).

• The SDAS is a valid, reliable, and sensitive score and can be useful to guide the therapeutic strategy in clinical practice and in research.

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Acknowledgements

We thank all internists, rheumatologists, and all physicians who collaborated in the realization of this study.

Author information

Authors and Affiliations

  1. Internal Medicine Department, Faculty of Medicine, University of Algiers 1, Bab El Oued University Hospital Center, Said Touati Street, 16000, Bab El Oued, Algiers, Algeria

    Karima Daghor-Abbaci, Nazim Laraba & Abdelkrim Berrah

  2. Rheumatology Department, Bab El Oued University Hospital Center,, Algiers, Algeria

    Chafia Dahou-Makhloufi & Farida Mechid

  3. Department of Epidemiology, Bab El Oued University Hospital Center, Bab El Oued City, Algiers, Algeria

    Nadia Ait-Hamadouche

  4. Biochemistry Hemotology and Genetics Laboratory of Research, Faculty of Medicine, University of Algiers 1, Bab El Oued University Hospital Center, Algiers, Algeria

    Karima Daghor-Abbaci, Mohamed Makrelouf & Amel Otmane

  5. Internal Medicine Department, Mustapha Bacha University Hospital Center, Algiers, Algeria

    Fifi Otmani

  6. Department of Epidemiology, Mustapha Bacha University Hospital Center, 1St May City, Algiers, Algeria

    Nourredine Smail

  7. Internal Medicine Department, Kouba University Hospital Center, Kouba City, Algiers, Algeria

    Malika Boucelma

  8. Rheumatology Department, Benimessous University Hospital Center, Algiers, Algeria

    Salima Lefkir-Teffiani & Bilal Bengana

  9. Internal Medicine Department, Ibn Sina University Hospital Center, Annaba City, Algeria

    Nadia Boukhris & Samia Boughandjioua

  10. Internal Medicine Department, Bouloughine University Hospital Center, Algiers, Algeria

    Baya Taharbouchet

  11. Internal Medicine Department, Benimessous University Hospital Center, Benimessous City, Algiers, Algeria

    Soraya Ayoub

  12. Internal Medicine Department, Zmirli University Hospital Center, Algiers, Algeria

    Nadia Oumnia

  13. Rheumatology Department, Douera University Hospital Center, Blida City, Algeria

    Chafika Haouichet

  14. Rheumatology Department, Benaknoun University Hospital Center, Algiers, Algeria

    Fella Hanni

  15. Internal Medicine Department, Rouiba University Hospital Center, Algiers, Algeria

    Nacera Benfenatki

Authors
  1. Karima Daghor-Abbaci
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  2. Nazim Laraba
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  7. Amel Otmane
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  11. Salima Lefkir-Teffiani
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  12. Bilal Bengana
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  13. Nadia Boukhris
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  15. Baya Taharbouchet
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  16. Soraya Ayoub
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  17. Nadia Oumnia
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  18. Chafika Haouichet
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  19. Fella Hanni
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  20. Nacera Benfenatki
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  21. Abdelkrim Berrah
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Corresponding author

Correspondence to Karima Daghor-Abbaci.

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Daghor-Abbaci, K., Laraba, N., Dahou-Makhloufi, C. et al. Disease activity score for still’s disease. Clin Rheumatol (2024). https://doi.org/10.1007/s10067-024-07127-8

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