Response to: ‘Is there a need for new thresholds to define remission and low disease activity by Disease Activity Score 28 calculated with C reactive protein? Real life data from a local registry’ by Favalli et al
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* Roy Fleischmann
* Eustratios Bananis

*   Adult Onset Still's Disease
*   Amyloidosis
*   Analgesics

We are delighted that the new cut-offs proposed for Disease Activity Score in 28 joints using CRP method (DAS28(CRP))1 have been tested and validated in another cohort.2 We hope that these validations change how DAS28(CRP) is currently being used in daily clinical practice and in clinical trials to determine low disease activity and remission. Furthermore, in our publication,1 we also proposed new cut-offs for Disease Activity Score in 28 joints using ESR method (DAS28(ESR)) that correspond to Simplified Disease Activity Index (SDAI) because we found that DAS28(ESR) underestimates the disease activity compared with SDAI.1 We hope that these new DAS28(ESR) cut-offs can also be tested in other cohorts as well.

## Footnotes

*   Competing interests None.

*   Provenance and peer review Commissioned; internally peer reviewed.

## References

1.  Fleischmann R, van der Heijde D, Koenig AS, et al. How much does Disease Activity Score in 28 joints ESR and CRP calculations underestimate disease activity compared with the Simplified Disease Activity Index? Ann Rheum Dis Published Online First: 20 Aug 2014. doi:[10.1136/annrheumdis-2013-204920](http://dx.doi.org/10.1136/annrheumdis-2013-204920)
    
    

2.  Favalli EG, Becciolini A, Biggioggero M, et al. Is there a need for new thresholds to define remission and low disease activity by Disease Activity Score 28 calculated with C-Reactive Protein? Real-life data from a local registry. *Ann Rheum Dis* 2015; 74:e5.