A Possible Correlation Among Different Disease Activity Parameters and Functional Status in Patients with Ankylosing Spondylitis

Demir, Saliha Eroglu; Aytekin, Ebru; Özgönenel, Levent; Rezvanı, Aylin; Doğan, Yasemin; Caglar, Nil Sayiner; Ozaras, Nihal; Okur, Sibel Çağlar; Aydın, Teoman; Tutun, Sule; Güler, Mustafa

doi:10.5606/tjr.2013.2916

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…Our cohort revealed higher mean ASDAS-CRP than mean ASDAS-ESR at both baseline and followup, which is consistent with a previous smaller study (12), although other studies have demonstrated lower ASDAS-CRP than ASDAS-ESR (9)(10)(11). In previous studies, the absolute difference between mean ASDAS-CRP and mean ASDAS-ESR ranged from zero (6)(7)(8) to one unit or above(9,10), while we found corresponding differences close to zero.…”

Section: Discussionsupporting

confidence: 91%

“…However, ASDAS-ESR showed a trend to classify higher numbers of patients in lower disease activity states compared to ASDAS-CRP and lower numbers of patients in higher disease activity states(4). Thereafter, some studies have reported equal mean ASDAS scores(6-8), whereas others have observed differences (9)(10)(11)(12). Hence, there may be clinically relevant discrepancies between the two versions and consequently between their cut-off values for disease activity states, which could impact on treatment decisions in a treat-to-target regimen.…”

Section: Introductionmentioning

confidence: 99%

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Cut-Offs for Disease Activity States in Axial Spondyloarthritis With Ankylosing Spondylitis Disease Activity Score (ASDAS) Based on C-Reactive Protein and ASDAS Based on Erythrocyte Sedimentation Rate: Are They Interchangeable?

Georgiadis,

Ørnbjerg,

Michelsen

et al. 2024

J Rheumatol

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ObjectiveAnkylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS-CRP) is recommended over erythrocyte sedimentation rate (ASDAS-ESR) to assess disease activity in axial spondyloarthritis (axSpA). Although ASDAS-CRP and ASDAS-ESR are not interchangeable, the same disease activity cut-offs are used for both. We aimed to estimate optimal ASDAS-ESR values corresponding to the established ASDAS-CRP cut-offs (1.3, 2.1 and 3.5) and investigate the potential improvement of level of agreement between ASDAS-ESR and ASDAS-CRP disease activity states when applying these estimated cut-offs.MethodsWe used data from axSpA patients initiating a tumour necrosis factor inhibitor from nine European registries. ASDAS-ESR cut-offs were estimated using the Youden index. Level of agreement between ASDAS-ESR and ASDAS-CRP disease activity states was compared against each other.ResultsIn 3,664 patients, mean ASDAS-CRP was higher than ASDAS-ESR at both baseline (3.6 and 3.4, respectively) and aggregated follow-up at 6, 12, or 24 months (1.9 and 1.8, respectively). The estimated ASDAS-ESR values corresponding to the established ASDAS-CRP cut-offs were 1.4, 1.9 and 3.3. By applying these cut-offs, the proportion of discordance between disease activity states according to ASDAS-ESR and ASDAS-CRP decreased from 22.93% to 19.81% in baseline data but increased from 27.17% to 28.94% in follow-up data.ConclusionWe estimated the optimal ASDAS-ESR values corresponding to the established ASDAS-CRP cut-off values. However, applying the estimated cut-offs did not increase the level of agreement between ASDAS-ESR and ASDAS-CRP disease activity states to a relevant degree. Our findings did not provide evidence to reject the established cut-off values for ASDAS-ESR.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Cut-Offs for Disease Activity States in Axial Spondyloarthritis With Ankylosing Spondylitis Disease Activity Score (ASDAS) Based on C-Reactive Protein and ASDAS Based on Erythrocyte Sedimentation Rate: Are They Interchangeable?

Georgiadis,

Ørnbjerg,

Michelsen

et al. 2024

J Rheumatol

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Accelerated kynurenine pathway downregulates immune activation in patients with axial spondyloarthritis

et al. 2023

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Reviewing Disease Activity Indices in Spondyloarthritis From the Sex Perspective: A Systematic Review and Metaanalysis

et al. 2021

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Objective To determine whether the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS) exhibited differences between women and men. Methods We systematically searched MEDLINE, Embase, Web of Science and other sources in English or Spanish from 01 January 1995 to 31 July 2020, to assess the differences according to sex in BASDAI and ASDAS. We performed a comparative analysis by sex using t-student test and mean difference by sex meta-analyses for BASDAI and ASDAS, using a random-effects model via the inverse-variance method. Results Forty-one studies included BASDAI (6,785 women/12,929 men) and 16 of them included ASDAS (2,046 women/4,403 men). Disease activity detected through BASDAI was significantly higher in women than in men (mean: 4.9 vs. 4.2, p=0.02), whereas ASDAS did not detect differences between sexes (mean: 2.8 women vs. 2.8 men). In the meta-analyses, BASDAI detected significant differences between women and men [mean difference= 0.55 (95% confidence intervals (95%CI): 0.46, 0.65), p<0.00001], but ASDAS did not identify significant mean difference between sexes [0.04 (95%CI: -0.05, 0.12), p=0.38]. Conclusion The two most widely used indexes of disease activity in spondyloarthritis discriminate differently according to sex by their different evaluation of peripheral disease. Their different components and weights influence BASDAI and ASDAS values. BASDAI may be influenced by fatigue, but in predominantly peripheral manifestations like enthesitis, ASDAS may not be sensitive enough to detect activity. This may represent a gender bias unfavourable to women, because peripheral spondyloarthritis is more common in women than in men.

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A Possible Correlation Among Different Disease Activity Parameters and Functional Status in Patients with Ankylosing Spondylitis

Cited by 3 publications

References 22 publications

Cut-Offs for Disease Activity States in Axial Spondyloarthritis With Ankylosing Spondylitis Disease Activity Score (ASDAS) Based on C-Reactive Protein and ASDAS Based on Erythrocyte Sedimentation Rate: Are They Interchangeable?

Cut-Offs for Disease Activity States in Axial Spondyloarthritis With Ankylosing Spondylitis Disease Activity Score (ASDAS) Based on C-Reactive Protein and ASDAS Based on Erythrocyte Sedimentation Rate: Are They Interchangeable?

Accelerated kynurenine pathway downregulates immune activation in patients with axial spondyloarthritis

Reviewing Disease Activity Indices in Spondyloarthritis From the Sex Perspective: A Systematic Review and Metaanalysis

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