Performance of various criteria sets in patients with inflammatory back pain of short duration; the Maastricht early spondyloarthritis clinic

Abstract

Among our selected cohort of patients with early IBP, the prevalence of SpA according to three different criteria sets is high. The ESSG criteria were the most sensitive, followed by the Amor criteria and the Berlin criteria. The modified New York criteria for ankylosing spondylitis appeared to be the most specific. In this cohort, the contribution of MRI and human leucocyte antigen B27 to purely clinical criteria in making a diagnosis of axial SpA was limited.

From Retrospective Analysis of Patients with Undifferentiated Spondyloarthritis (SpA) to Analysis of Prospective Cohorts and Detection of Axial and Peripheral SpA

“…It is noteworthy that a significant proportion of patients in the above studies were diagnosed with AS in less than 2 42,45 or 5 44 years of disease. These findings suggest that diagnosis of AS in some patients made early in the disease course is at a time when the effect of TNF-α blockers may be significant.…”

“…Heuft-Dorenbosch, et al 42 found that in patients with IBP for less than 2 years, ESSG 3 was the best instrument for classification of SpA, followed by criteria of Amor 2 , and lastly Rudwaleit, et al 41 . Of note, Heuft-Dorenbosch, et al 42 concluded that the contribution of HLA-B27 and MRI to the criteria by Amor 2 and ESSG 3 in diagnosing axial SpA was limited.…”

“…Heuft-Dorenbosch, et al 42 found that in patients with IBP for less than 2 years, ESSG 3 was the best instrument for classification of SpA, followed by criteria of Amor 2 , and lastly Rudwaleit, et al 41 . Of note, Heuft-Dorenbosch, et al 42 concluded that the contribution of HLA-B27 and MRI to the criteria by Amor 2 and ESSG 3 in diagnosing axial SpA was limited. More recently, in patients referred by orthopedists and primary care physicians because of back pain longer than 3 months and age at onset younger than 45 years, Brandt, et al 43 showed that IBP, HLA-B27, and MRI-observed sacroiliitis performed well in detecting axial SpA (SpA in that study included AS and axial USpA).…”

“…The Maastricht early SpA clinic (ESPAC) study of 68 patients with IBP with < 2 years of symptoms referred from various clinical departments 42 showed that 14 patients developed AS within 2 years of symptoms and 36 developed SpA according to Amor 2 , ESSG 3 , and Berlin 41 criteria. PsA accounted for 24% and IBD and uveitis for 15% each.…”

Do patients with non‐radiographic axial spondylarthritis differ from patients with ankylosing spondylitis?

“…Nevertheless, a subgroup of patients in a Dutch cohort developed structural changes rather early in the disease course; 20% of the patients with a history of inflammatory back pain of Ͻ2 years in duration had chronic structural changes in the SI joints (27). Although low-grade radiographic sacroiliitis has been proposed as a prognostic factor for the development of AS in patients originally classified as having undifferentiated SpA, only a minority of patients with nr-axSpA seem to develop definitive AS (28).…”