A model for the development and implementation of a national plan for the optimal management of early spondyloarthritis: the Esperanza Program

Abstract

It is possible to implement a large-scale programme that is measurable.

Validity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) in patients with early spondyloarthritis from the Esperanza programme

“…The study is based on a sample of patients diagnosed with early SpA by their rheumatologist and treated and recruited at the Esperanza programme between April 2008 and June 2011 (for a description of the programme see Muñoz-Fernández et al 4). The programme had the following referral criteria: (1) age <45 years; (2) symptom duration 3–24 months and (3) at least one of the following: (a) inflammatory back pain (defined as two of the following: insidious onset, spinal morning stiffness for ≥30 min, improvement with exercise but not with rest); (b) asymmetrical arthritis, especially in the lower limbs; (c) the presence of spinal or joint pain plus at least one of the following: psoriasis, inflammatory bowel disease, anterior uveitis, radiographic sacroiliitis, human leucocyte antigen B27 (HLA-B27) positivity, or a family history of spondylitis, psoriasis, inflammatory bowel disease or anterior uveitis.…”

“…These inconsistencies illustrate the need to test ASDAS validity in other disease subgroups such as patients with early SpA, who remain to be evaluated. Our objective was to fill this gap with an in-depth study of the validity and discriminant ability of ASDAS in a cohort of patients diagnosed with early SpA 4 5…”

Enthesis erosion in spondyloarthritis is not a persistent structural lesion

“…Previously published referral criteria were used 14 15. All patients were characterised using the Spanish version of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and measurements employing the Bath Ankylosing Spondylitis Radiology Index (BASRI) and a peripheral joint count were also completed on the day of the visit (see additional data in online supplement).…”

Disease Activity As a Major Determinant of Quality of Life and Physical Function in Patients With Early Axial Spondyloarthritis

“…The present study was a cross‐sectional investigation drawing upon baseline data from the ESPERANZA Program, a Spanish prospective national health initiative intended to facilitate the early diagnosis and followup of patients with SpA through the implementation of a referral strategy and the creation of early SpA clinics. Details of this program have been previously published . In summary, the referral criteria were ages 18–45 years, symptom duration between 3 and 24 months, and experiencing inflammatory back pain, asymmetrical arthritis, or spinal or joint pain plus 1 SpA feature.…”