Role of Metrology in Axial Spondyloarthritis: Does It Provide Unique Information in Assessing Patients and Predicting Outcome? Results From the British Society for Rheumatology Biologic Register for Ankylosing Spondylitis

Biallas, Renke L; Dean, Linda E; Davidson, Lesley; Hollick, Rosemary J; Pathan, Ejaz; Robertson, Lindsay; Jones, Gareth T; Macfarlane, Gary J.; Rotariu, Ovidiu

doi:10.1002/acr.24500

Cited by 4 publications

(1 citation statement)

References 41 publications

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“…Bath Ankylosing Spondylitis Metrology Index (BASMI) is a commonly used clinical tool for assessing spinal mobility. It includes examinations of movement in the spine and hips [ 52 ]. BASMI is a quantitative assessment tool used to quantify the course of spinal progression, explicitly focusing on non-imaging aspects.…”

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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Section: Monitoringmentioning

confidence: 99%

Diagnosis, monitoring, and management of axial spondyloarthritis

Zimba,

Kocyigit,

Korkosz

2024

Rheumatol Int

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Worse scores but similar patterns of disease activity: interpreting outcomes in women with axial spondyloarthropathy

Maguire

Wilson

Gallagher

et al. 2022

Scandinavian Journal of Rheumatology

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The occurrence of multiple treatment switches in axial spondyloarthritis. Results from five Nordic rheumatology registries

et al. 2021

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Objectives In axial spondyloarthritis (axSpA), switching between multiple biologic or targeted synthetic (b/ts-) DMARDs might indicate difficult-to-treat disease. We aimed to explore the occurrence of multiple switching in routine care axSpA patients using various definitions, and to identify associated clinical characteristics upon start of first b/tsDMARD (baseline). Methods Observational cohort study including patients with axSpA starting a first-ever b/tsDMARD 2009–2018 based on data from five biologic registries (Denmark/Sweden/Finland/Norway/Iceland). Comorbidities and extra-articular manifestations were identified through linkage to national registries. Multi-switching was defined in overlapping categories according to b/tsDMARD treatment history: treatment with ≥3 b/tsDMARDs, ≥4 or ≥ 5 b/tsDMARDs during follow-up. We explored the cumulative incidence of patients becoming multi-switchers with ≥3 b/tsDMARDs stratified by calendar-period (2009–11/2012–13/2014–15/2016–2018). In the subgroup of patients starting a first b/tsDMARD 2009–2015, baseline characteristics associated with multi-switching (within 3 years’ follow-up) were explored using multiple logistic regression analyses. Results Among 8,398 patients included, 6,056 patients (63% male, median age 42 years) started a first b/tsDMARD 2009–2015, whereof proportions treated with ≥3, ≥4 or ≥ 5 b/tsDMARDs within 3 years’ follow-up were 8%, 3%, 1%, respectively. Calendar-period did not affect the cumulative incidence of multi-switching. Baseline characteristics associated with multi-switching (≥3 b/tsDMARDs) were female gender, shorter disease duration, higher patient global score, comorbidities, and having psoriasis but not uveitis. Conclusion In this large Nordic observational cohort of axSpA patients, multiple switching was frequent with no apparent time-trend. Clinical associated factors included gender, but also previous comorbidities and extraarticular manifestations illustrating the ongoing challenge of treating this patient group.

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Role of Metrology in Axial Spondyloarthritis: Does It Provide Unique Information in Assessing Patients and Predicting Outcome? Results From the British Society for Rheumatology Biologic Register for Ankylosing Spondylitis

Cited by 4 publications

References 41 publications

Diagnosis, monitoring, and management of axial spondyloarthritis

Diagnosis, monitoring, and management of axial spondyloarthritis

Worse scores but similar patterns of disease activity: interpreting outcomes in women with axial spondyloarthropathy

The occurrence of multiple treatment switches in axial spondyloarthritis. Results from five Nordic rheumatology registries

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