Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activity states and improvement scores

Abstract

Cut-off values for disease activity states and improvement using the ASDAS have been developed. They proved to have external validity and a good performance compared to existing criteria.

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

“…In addition, the Ankylosing Spondylitis Disease Activity Score (ASDAS) was calculated (12). The published cutoffs between disease activity states are Ͻ1.3 for inactive disease, Ͻ2.1 for moderate disease activity, Ͻ3.5 for high disease activity, and Ն3.5 for very high disease activity (13).…”

Challenges and Advances in Targeting Remission in Axial Spondyloarthritis

“…ASDAS offers a more objective assessment of disease activity because it includes C-reactive protein (CRP), which is a marker of inflammation, and may predict structural progression 28 . ASDAS disease activity "states" (inactive disease: ASDAS < 1.3; moderate disease activity: ASDAS < 2.1) have been validated in a routine care population and a clinical trial population 18 , although further validation in relation to structural damage progression and quality of life is still required. The current lack of consensus on the optimal index of disease activity and cutoffs for disease activity states represents a major hurdle in the development of a treat-to-target approach in axSpA.…”

“…In 2001, the Assessment of Spondyloarthritis international Society (ASAS) developed a preliminary definition of clinical remission-ASAS partial remission (ASAS PR), which includes assessment of 4 domains: patient global, spinal pain, physical function, and "inflammation" (a proxy for true inflammation, based on morning stiffness) 5 . In clinical trials, 12-15% 5,6 of patients with ankylosing spondylitis (AS) receiving nonsteroidal antiinflammatory drugs (NSAID) achieve partial remission; a ceiling of ~15-40% at 6 months also exists with biologic therapies, including tumor necrosis factor (TNF) inhibitors and secukinumab 7,8 (Table 1 [9][10][11][12][13][14][15][16][17][18][19][20] ). Treating patients with short symptom duration may increase the proportion of patients reaching clinical remission to ~50% 9,21,22 .…”

Is Spinal Mobility in Patients With Spondylitis Determined By Age, Structural Damage, and Inflammation?

“…Interestingly, the BASDAI, despite being a subjective measure, performs better than acute-phase reactants (19). The ASAS introduced the Ankylosing Spondylitis Disease Activity Score (ASDAS) to evaluate disease activity by combining several BASDAI items plus an objective measure, CRP level or ESR (20,21). The ASDAS demonstrated high responsiveness during treatment with tumor necrosis factor ␣ inhibitors in patients with spondyloarthritis in several studies (22,23).…”