Cardiovascular risk assessment using the DAS28-GGT score in rheumatoid arthritis patients initiating JAK inhibitors: Results from the MAJIK-SFR registry
Abstract
Objectives: Cardiovascular disease is the leading cause of death in rheumatoid arthritis (RA). By replacing C-reactive protein (CRP) with gamma-glutamyl transferase (GGT), the DAS28-GGT was developed to integrate both inflammatory disease activity and cardiovascular (CV) risk into a single score. We evaluated its ability to classify CV risk in RA patients initiating Janus kinase inhibitors (JAKi) and compared its performance with DAS28-CRP. Methods: This cross-sectional study used data from the MAJIK-SFR observational registry. RA patients initiating a JAKi with available GGT were included. CV risk was estimated using the SCORE2 and Framingham equations. The discriminative performance of the DAS28-GGT was assessed using ROC curves and compared with the DeLong test. DAS28-GGT discrimination across DAS28-CRP disease activity categories was assessed. Results: We included 185 RA patients (72% women, mean age 58±13years). Mean DAS28-CRP was 4.07±1.27 and mean DAS28-GGT 8.88±1.83. According to SCORE2, 54.3% patients were at low, 38.9% at moderate, and 6.8% at high CV risk and 34.8%, 44.7%, and 20.5%, according to Framingham, respectively. DAS28-GGT better discriminated patients with at least moderate CV risk than DAS28-CRP (SCORE2 AUC 0.59 vs 0.52, P<0.05; Framingham AUC 0.63 vs 0.53, P<0.01). DAS28-GGT significantly discriminated DAS28-CRP remission, low, and high disease activity (AUCs 0.91, 0.70, and 0.83 respectively). Conclusion: This study supports the DAS28-GGT as a simple and practical tool to capture both cardiovascular risk and inflammatory activity in RA patients initiating JAKi. Prospective studies are needed to confirm its value for predicting cardiovascular events.
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BibTeX
@article{perrot2026cardiovascular,
title = {{Cardiovascular risk assessment using the DAS28-GGT score in rheumatoid arthritis patients initiating JAK inhibitors: Results from the MAJIK-SFR registry}},
author = {Léa Perrot and Jerôme Avouac and Marie-Elise Truchetet and Clément Prati and Jean Hugues Salmon and René Marc Flipo and Christian Roux and André Basch and Emmanuelle Dernis and Carine Salliot and Fabienne Coury and Claire Immediato Daien and Philipe Goupille and Thierry Thomas and Béatrice Banneville and Claire Martin and Adeline Ruyssen-Witrand and Roch Giorgi and Thao Pham},
journal = {Joint Bone Spine},
year = {2026},
month = nov,
doi = {10.1016/j.jbspin.2026.106113},
url = {https://inserm.hal.science/inserm-05848819v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Cardiovascular risk assessment using the DAS28-GGT score in rheumatoid arthritis patients initiating JAK inhibitors: Results from the MAJIK-SFR registry
AU - Léa Perrot
AU - Jerôme Avouac
AU - Marie-Elise Truchetet
AU - Clément Prati
AU - Jean Hugues Salmon
AU - René Marc Flipo
AU - Christian Roux
AU - André Basch
AU - Emmanuelle Dernis
AU - Carine Salliot
AU - Fabienne Coury
AU - Claire Immediato Daien
AU - Philipe Goupille
AU - Thierry Thomas
AU - Béatrice Banneville
AU - Claire Martin
AU - Adeline Ruyssen-Witrand
AU - Roch Giorgi
AU - Thao Pham
PY - 2026
DA - 2026/11/02
JO - Joint Bone Spine
DO - 10.1016/j.jbspin.2026.106113
UR - https://inserm.hal.science/inserm-05848819v1
AB - Objectives: Cardiovascular disease is the leading cause of death in rheumatoid arthritis (RA). By replacing C-reactive protein (CRP) with gamma-glutamyl transferase (GGT), the DAS28-GGT was developed to integrate both inflammatory disease activity and cardiovascular (CV) risk into a single score. We evaluated its ability to classify CV risk in RA patients initiating Janus kinase inhibitors (JAKi) and compared its performance with DAS28-CRP. Methods: This cross-sectional study used data from the MAJIK-SFR observational registry. RA patients initiating a JAKi with available GGT were included. CV risk was estimated using the SCORE2 and Framingham equations. The discriminative performance of the DAS28-GGT was assessed using ROC curves and compared with the DeLong test. DAS28-GGT discrimination across DAS28-CRP disease activity categories was assessed. Results: We included 185 RA patients (72% women, mean age 58±13years). Mean DAS28-CRP was 4.07±1.27 and mean DAS28-GGT 8.88±1.83. According to SCORE2, 54.3% patients were at low, 38.9% at moderate, and 6.8% at high CV risk and 34.8%, 44.7%, and 20.5%, according to Framingham, respectively. DAS28-GGT better discriminated patients with at least moderate CV risk than DAS28-CRP (SCORE2 AUC 0.59 vs 0.52, P<0.05; Framingham AUC 0.63 vs 0.53, P<0.01). DAS28-GGT significantly discriminated DAS28-CRP remission, low, and high disease activity (AUCs 0.91, 0.70, and 0.83 respectively). Conclusion: This study supports the DAS28-GGT as a simple and practical tool to capture both cardiovascular risk and inflammatory activity in RA patients initiating JAKi. Prospective studies are needed to confirm its value for predicting cardiovascular events.
SN - 1297-319X
ER -