ASDAS, a highly discriminatory ASAS-endorsed disease activity score in patients with ankylosing spondylitis

Heijde, Desirée van der; Lie, Elisabeth; Kvien, Tore K; Sieper, Joachim; Bosch, Filip Van den; Listing, Joachim; Braun, J.; Landewé, Robert

doi:10.1136/ard.2008.100826

Cited by 538 publications

(404 citation statements)

References 8 publications

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“…Other secondary end points included efficacy as evaluated by measuring the change in the BASDAI, the AS Disease Activity Score (ASDAS) 23 using the CRP level, the Bath Ankylosing Spondylitis Functional Index (BASFI) 24, the Bath Ankylosing Spondylitis Metrology Index (BASMI) 25, total back pain (as measured using a 10‐cm VAS), the CRP level, the swollen joint count (SJC) and tender joint count (TJC), and the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) 26. Several patient‐reported QoL outcomes were also evaluated, including the Short Form 36 (SF‐36) 27, the AS Quality of Life (ASQoL) questionnaire 28, and the EuroQol 5‐domain (EQ‐5D) questionnaire 29.…”

Section: Methodsmentioning

confidence: 99%

A Randomized, Double‐Blind, Placebo‐Controlled, Sixteen‐Week Study of Subcutaneous Golimumab in Patients With Active Nonradiographic Axial Spondyloarthritis

Sieper

Heijde

Dougados

et al. 2015

Arthritis & Rheumatology

189

120

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ObjectiveAxial spondyloarthritis (SpA) is a chronic inflammatory disease characterized by back pain and stiffness. The objective of this study was to determine whether golimumab is superior to placebo in patients with nonradiographic axial SpA.MethodsThis phase III, double‐blind, randomized, placebo‐controlled trial was performed to evaluate subcutaneous golimumab (50 mg) versus placebo in patients ages ≥18 years to ≤45 years who had active nonradiographic axial SpA according to the Assessment of SpondyloArthritis international Society (ASAS) criteria for ≤5 years since diagnosis, high disease activity, and an inadequate response to or intolerance of nonsteroidal antiinflammatory drugs. Patients were randomized 1:1 to receive golimumab or placebo subcutaneously every 4 weeks. The primary end point was 20% improvement according to the ASAS criteria (ASAS20) at week 16. Key secondary end points were an ASAS40 response, ASAS partial remission, 50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and change in the Spondyloarthritis Research Consortium of Canada (SPARCC) magnetic resonance imaging (MRI) index for sacroiliac (SI) joint inflammation (SPARCC score).ResultsOf the 198 patients randomized, 197 were treated (97 received golimumab, and 100 received placebo). The mean age of the patients was 31 years, and 57.1% were male. At baseline, the mean ± SD BASDAI was 6.5 ± 1.5, the mean ± SD ASDAS was 3.5 ± 0.9, and the mean ± SD SPARCC score was 11.3 ± 14.0. The primary end point, an ASAS20 response, was achieved by significantly more patients in the golimumab group compared with the placebo group (71.1% versus 40.0%; P < 0.0001). An ASAS40 response was also achieved by significantly more patients in the golimumab group compared with the placebo group (56.7% versus 23.0%; P < 0.0001). The incidence of adverse events did not differ meaningfully between groups.ConclusionPatients with active nonradiographic axial SpA treated with golimumab had significantly greater improvement in symptoms compared with patients treated with placebo. Golimumab was well tolerated and had a favorable risk/benefit profile.

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Section: Methodsmentioning

confidence: 99%

A Randomized, Double‐Blind, Placebo‐Controlled, Sixteen‐Week Study of Subcutaneous Golimumab in Patients With Active Nonradiographic Axial Spondyloarthritis

Sieper

Heijde

Dougados

et al. 2015

Arthritis & Rheumatology

189

120

View full text Add to dashboard Cite

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“…It is likely that the PtGA could contribute to a composite measure of disease activity in GPA, as it has for other diseases (13,14), and could provide unique information complementary to standard physician assessments. In the absence of tools better than those currently available for assessment of disease activity in GPA, data obtained through the use of this highly feasible patient-reported outcome should be collected in all longitudinal studies of GPA, especially in randomized controlled trials of therapies in GPA.…”

Section: Discussionmentioning

confidence: 99%

Brief Report: The Value of a Patient Global Assessment of Disease Activity in Granulomatosis With Polyangiitis (Wegener's)

Tómasson

Davis²,

Hoffman

et al. 2014

Arthritis & Rheumatology

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Objective. To 1) describe the distribution of patient global assessment (PtGA) scores of disease activity in patients with granulomatosis with polyangiitis (GPA; Wegener's), 2) explore the discordance between PtGA scores and physician global assessment (PhGA) scores of disease activity, and 3) explore whether PtGA scores during disease remission are associated with future disease relapse.Methods. Data from the Wegener's Granulomatosis Etanercept Trial (WGET) were used. PtGA and PhGA scores were assessed on 100-mm visual analog scales (VAS). Presence of active disease was determined using the Birmingham Vasculitis Activity Score for WG (BVAS/WG), and remission was defined as a BVAS/WG score of 0. Disease relapse was defined as a BVAS/WG score of >0 after remission had been achieved. Discordance between PtGA and PhGA scores was defined as a difference of >20 points between the two measures.Mixed linear models were used in longitudinal analysis of PtGA scores.Results. Data were obtained from 180 patients in the WGET cohort, seen at a total of 1,719 study visits. The mean ؎ SD PtGA and PhGA disease activity scores (on 100-mm VAS) at baseline were 64.2 ؎ 27.4 and 55.5 ؎ 23.4, respectively. PtGA-PhGA discordance occurred in 53% of patients at baseline, and this was inversely associated with newly diagnosed disease (as opposed to relapsing disease) at baseline (odds ratio 0.37, 95% confidence interval [95% CI] 0.20-0.68) but not with age, sex, or presence of renal or pulmonary disease. Patients were in disease remission during 62% of the study visits. The mean PtGA score during visits immediately prior to relapse was 4.52 points higher (95% CI 0.66-8.4) than that at other remission visits (P ‫؍‬ 0.03).

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“…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).…”

Section: Introductionmentioning

confidence: 99%

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

Calvo‐Gutiérrez

Garrido-Castro

Gil-Cabezas

et al. 2014

Arthritis Care & Research

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Objective. To explore the association between mobility, inflammation, and structural damage in ankylosing spondylitis (AS). Methods. Patients with AS were included in a cross-sectional study in which spinal mobility was measured by the Bath Ankylosing Spondylitis Metrology Index (BASMI) and by the University of Có rdoba Ankylosing Spondylitis Metrology Index (UCOASMI), based on an automated motion analysis. Structural damage was measured by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), and activity by the Ankylosing Spondylitis Disease Activity Score (ASDAS) and the Bath Ankylosing Spondylitis Disease Activity (BASDAI). We analyzed the correlations between variables, as well as interaction by multiple linear regression models to reach a predictive equation. Results. Fifty AS patients, mainly men in their mid-40s and with moderate levels of disease activity and structural damage, were included in the study. BASMI and UCOASMI scores showed a strong correlation (r ‫؍‬ 0.89). UCOASMI scores correlated stronger than BASMI with structural damage (r ‫؍‬ 0.72 versus r ‫؍‬ 0.67) and patient's age (r ‫؍‬ 0.68 versus r ‫؍‬ 0.56). Correlations of mobility were weaker with disease activity by the ASDAS (r ‫؍‬ 0.38) and BASDAI (r ‫؍‬ 0.49), and disease duration (r ‫؍‬ 0.40). Multiple linear regression showed that factors associated to mobility by UCOASMI were age, the BASDAI, mSASSS, ASDAS (0:<2.1, 1:>2.1), and disease duration >15 years. The largest weight in the equation corresponded to the mSASSS. The association between the ASDAS and UCOASMI is dependent on disease duration. Conclusion. Mobility in AS is influenced by both structural damage and activity, but definitely also by age and disease duration. Improved mobility should be a relevant target in AS, even more prominently than activity, given its closer relation to structural damage.

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ASDAS, a highly discriminatory ASAS-endorsed disease activity score in patients with ankylosing spondylitis

Abstract: The ASDAS is a validated, highly discriminatory instrument for assessing disease activity in AS, including patient-reported outcomes and CRP levels.

Cited by 538 publications

References 8 publications

A Randomized, Double‐Blind, Placebo‐Controlled, Sixteen‐Week Study of Subcutaneous Golimumab in Patients With Active Nonradiographic Axial Spondyloarthritis

A Randomized, Double‐Blind, Placebo‐Controlled, Sixteen‐Week Study of Subcutaneous Golimumab in Patients With Active Nonradiographic Axial Spondyloarthritis

Brief Report: The Value of a Patient Global Assessment of Disease Activity in Granulomatosis With Polyangiitis (Wegener's)

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

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