A prospective study of novel disease activity indices for ankylosing spondylitis

Sundaram, TG; Muhammed, Hafis; Aggarwal, Amita; Gupta, Latika

doi:10.1007/s00296-020-04662-w

Cited by 5 publications

(4 citation statements)

References 28 publications

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“…The present study has some limitations. First, we only focused ASDAS-CRP although there are available novel activity indices for AS such as the BASDAS formula, similar to the ASDAS-CRP but uses only the BASDAI and CRP, and simplified ASDAS [30,31]. Measuring ASDAS-CRP is not yet routine in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Low BASDAI score alone is not a good predictor of anti-tumor necrosis factor treatment efficacy in ankylosing spondylitis: a retrospective cohort study

Nam

Koo

Lee

et al. 2021

BMC Musculoskelet Disord

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Background The purpose of this study was to determine the prevalence of high disease activity as measured using the Ankylosing Spondylitis Disease Activity Score (ASDAS) in ankylosing spondylitis (AS) patients who nonetheless have low Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores after anti-tumor necrosis factor (TNF) treatment. Its clinical impact on anti-TNF survival was also investigated. Methods We conducted a single-centre retrospective cohort study of AS patients having low BASDAI scores (< 4) and available ASDAS-C-reactive protein (CRP) data after 3 months of first-line anti-TNF treatment. Patients were grouped into high-ASDAS (≥ 2.1) and low-ASDAS (< 2.1) groups according to the ASDAS-CRP after 3 months of anti-TNF treatment. Their characteristics were compared. And survival analyses were carried out using Kaplan–Meier curves and log-rank test with the event being discontinuation of anti-TNF treatment due to lack/loss of efficacy. Results Among 116 AS patients with low BASDAI scores after 3 months of anti-TNF treatment, 38.8% were grouped into the high-ASDAS group. The high-ASDAS group tended to have greater disease activity after 9 months of treatment (BASDAI 2.9 ± 1.1 vs. 2.3 ± 1.4, p=0.007; ASDAS-CRP 1.8 ± 0.6 vs. 1.5 ± 0.7, p=0.079; proportion of high ASDAS-CRP 27.8% vs. 13.8%, p=0.094) and greater risk of discontinuing anti-TNF treatment due to lack/loss of efficacy than the low-ASDAS group (p=0.011). Conclusions A relatively high proportion of AS patients with low BASDAI scores had high ASDAS-CRP. These low-BASDAI/high-ASDAS-CRP patients also had a greater risk for discontinuation of anti-TNF treatment due to low/lack of efficacy than the low-ASDAS group. The use of the ASDAS-CRP alone or in addition to the BASDAI may improve the assessment of AS patients treated with anti-TNF agents.

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Section: Discussionmentioning

confidence: 99%

“…We found a benefit of assessing the ASDAS-CRP with respect to prognosis and drug survival during treatment with anti-TNF agents. Although the applicability of ASDAS-CRP might vary across different regions since the measuring ASDAS-CRP needs laboratory tests and the calculator of digital system [31].…”

Section: Discussionmentioning

confidence: 99%

Low BASDAI score alone is not a good predictor of anti-tumor necrosis factor treatment efficacy in ankylosing spondylitis: a retrospective cohort study

Nam

Koo

Lee

et al. 2021

BMC Musculoskelet Disord

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“…The Ankylosing Spondylitis Disease Activity Score (ASDAS) was developed as a composite index. This tool is characterized by integrating patient reports and acute phase reactants [ 43 , 44 ]. The ASAS encourages the implementation of ASDAS-CRP in clinical settings and research activities.…”

Section: Monitoringmentioning

confidence: 99%

Diagnosis, monitoring, and management of axial spondyloarthritis

Zimba,

Kocyigit,

Korkosz

2024

Rheumatol Int

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Axial spondyloarthritis (axSpA) is a chronic condition predominantly affecting the spine and sacroiliac joints. This article provides an in-depth overview of the current approaches to diagnosing, monitoring, and managing axSpA, including insights into developing terminology and diagnostic difficulties. A substantial portion of the debate focuses on the challenging diagnostic procedure, noting the difficulty of detecting axSpA early, particularly before the appearance of radiologic structural changes. Despite normal laboratory parameters, more than half of axSpA patients experience symptoms. X-ray and magnetic resonance imaging (MRI) are essential for evaluating structural damage and inflammation. MRI can be beneficial when there is no visible structural damage on X-ray as it can help unravel bone marrow edema (BME) as a sign of ongoing inflammation. The management covers both non-pharmacological and pharmacological approaches. Lifestyle modifications, physical activity, and patient education are essential components of the management. Pharmacological therapy, including nonsteroidal anti-inflammatory drugs (NSAIDs) and biologic disease-modifying anti-rheumatic drugs (bDMARDs), are explored, emphasizing individualized treatment. To effectively manage axSpA, a comprehensive and well-coordinated approach is necessary, emphasizing the significance of a multidisciplinary team. Telehealth applications play a growing role in axSpA management, notably in reducing diagnostic delays and facilitating remote monitoring. In conclusion, this article underlines diagnostic complexities and emphasizes the changing strategy of axSpA treatment. The nuanced understanding offered here is designed to guide clinicians, researchers, and healthcare providers toward a more comprehensive approach to axSpA diagnosis and care.

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“…The use of the SASDAS has been validated against the ASDAS and/or other standard assessments in previously published manuscripts. [7][8][9][10][11] Current daily practice involves using CRP to evaluate the magnitude of biological inflammation, as it is considered a more specific biomarker than ESR, and high CRP levels better predict radiographic progression, response to nonsteroidal antiinflammatory drugs (NSAIDs), and TNF-α inhibition. [12][13][14][15][16] This post hoc analysis of data from the EMBARK trial compares the CRP versions of the ASDAS and SASDAS for measuring and categorizing disease activity at baseline and after treatment.…”

mentioning

confidence: 99%

Simplified Ankylosing Spondylitis Disease Activity Score (SASDAS) Versus ASDAS: A Post Hoc Analysis of a Randomized Controlled Trial

et al. 2022

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Objective To compare the Simplified Ankylosing Spondylitis Disease Activity Score (SASDAS) against the Ankylosing Spondylitis Disease Activity Score (ASDAS) for measuring and categorizing disease activity using data from the EMBARK trial (ClinicalTrials.gov: NCT01258738), a randomized controlled trial of etanercept (ETN) for axial spondyloarthritis (axSpA). Methods Patients with early active axSpA received ETN 50 mg once weekly (n = 106) or placebo (PBO; n = 109) for 12 weeks in a double-blind manner; they then received open-label ETN for 92 weeks. For this analysis, ASDAS–C-reactive protein (CRP) and SASDAS-CRP were calculated at baseline, week 12, and week 24. The SASDAS was calculated by the linear addition of the ASDAS components without adjustment. Results A very strong correlation, as determined by the Spearman correlation coefficient, was observed between the ASDAS and SASDAS for continuous variables at baseline and during treatment. For pooled categorical data at baseline, the SASDAS placed 69.9% of patients in the same disease categories as the ASDAS but overestimated for 17.8% of patients and underestimated for 12.2% of patients. A similar pattern was seen postbaseline. Cohen weighted κ statistics for all individual and pooled treatments and timepoints (0.54-0.73) reflected moderate to substantial agreement. The capacity to differentiate between treatments (ie, ETN and PBO/ETN) was higher with the ASDAS (effect size –0.74, 95% CI –1.03 to –0.46) compared with the SASDAS (effect size –0.51, 95% CI –0.79 to –0.23), but sensitivity to change was generally similar. Conclusion A very strong correlation between the SASDAS and ASDAS was observed when considering continuous variables; however, moderate to substantial agreement was observed for categorical data, and the SASDAS classified a lower proportion of patients as being in the inactive and low disease activity categories.

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A prospective study of novel disease activity indices for ankylosing spondylitis

Cited by 5 publications

References 28 publications

Low BASDAI score alone is not a good predictor of anti-tumor necrosis factor treatment efficacy in ankylosing spondylitis: a retrospective cohort study

Low BASDAI score alone is not a good predictor of anti-tumor necrosis factor treatment efficacy in ankylosing spondylitis: a retrospective cohort study

Diagnosis, monitoring, and management of axial spondyloarthritis

Simplified Ankylosing Spondylitis Disease Activity Score (SASDAS) Versus ASDAS: A Post Hoc Analysis of a Randomized Controlled Trial

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