Percentage of patients with spondyloarthritis in patients referred because of chronic back pain and performance of classification criteria: experience from the Spondyloarthritis Caught Early (SPACE) cohort
Rosaline van den Berg,Manouk de Hooge,Floris A. van Gaalen,Monique Reijnierse,Tom W J Huizinga,Désirée van der Heijde +5 more
TLDR
The inclusion criteria of the SPACE cohort yield the same high numbers of SpA patients compared with referral strategies like inflammatory back pain, HLA-B27+ or sacroiliitis, yet are easier to apply.Abstract:
Objectives. The objectives of the study are to describe the Spondyloarthritis Caught Early (SPACE) cohort, present the performance of various SpA classification criteria and compare patients fulfilling the imaging arm with patients fulfilling the clinical arm of the Assessment of Spondyloarthritis international Society (ASAS) axSpA criteria on demographics, presence of SpA features and level of disease activity. Methods. Patients with back pain (53 months but 42 years, onset <45 years) visiting the rheumatology outpatient clinic of the Leiden University Medical Center were included in the SPACE cohort. Patients were classified according to the modified New York (mNY), ESSG, Amor and ASAS axSpA criteria. The sensitivity and specificity of criteria were tested against a rheumatologist’s diagnosis. Results. In total, 157 patients were included; 92 patients fulfilled any criteria, 11 fulfilled the mNY (sensitivity 16.9%, specificity 100%), 68 the ESSG (sensitivity 64.6%, specificity 71.7%), 48 the Amor (sensitivity 47.7%, specificity 81.5%) and 60 the ASAS axSpA criteria (sensitivity 84.6%, specificity 94.6%). Of those 60 patients, 30 fulfilled the imaging arm and 30 the clinical arm. Patients in the imaging arm are statistically significantly more often male, have a longer symptom duration and less often a positive family history for SpA than patients fulfilling the clinical arm. Patients in both arms are very similar regarding all other SpA features and level of disease activity. Conclusion. The inclusion criteria of the SPACE cohort yield the same high numbers of SpA patients compared with referral strategies like inflammatory back pain, HLA-B27+ or sacroiliitis, yet are easier to apply. The ASAS axSpA criteria outperformed the other criteria; 38.2% fulfilled the ASAS axSpA criteria. Patients fulfilling the clinical arm of the ASAS axSpA reflect a group of patients similar to those fulfilling the imaging arm.read more
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Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group
Robert G. W. Lambert,P. Bakker,Désirée van der Heijde,Ulrich Weber,Martin Rudwaleit,Kay-Geert A. Hermann,Joachim Sieper,Xenofon Baraliakos,Alexander N. Bennett,Jürgen Braun,Ruben Burgos-Vargas,Maxime Dougados,Susanne Juhl Pedersen,Anne Grethe Jurik,Walter P. Maksymowych,Helena Marzo-Ortega,Mikkel Østergaard,Denis Poddubnyy,Monique Reijnierse,Filip Van den Bosch,Irene E. van der Horst-Bruinsma,Robert Landewé +21 more
TL;DR: The definition of a positive MRI for classification of axial SpA should continue to primarily depend on the imaging features of ‘active sacroiliitis’ until more data are available regarding MRI features of structural damage in the sacrosiliac joint and MRI features in the spine and their utility when used for classification purposes.
Journal ArticleDOI
Prevalence of peripheral and extra-articular disease in ankylosing spondylitis versus non-radiographic axial spondyloarthritis: a meta-analysis
Janneke J. de Winter,Leonieke J J van Mens,Désirée van der Heijde,Robert Landewé,Dominique Baeten +4 more
TL;DR: Peripheral and extra-articular manifestations are equally prevalent in ankylosing spondylitis and nr-axSpA, except for uveitis, which is slightly more prevalent in AS, providing evidence for the largely equal nature of disease manifestations.
Journal ArticleDOI
Magnetic Resonance Imaging of the Sacroiliac Joints Indicating Sacroiliitis According to the Assessment of SpondyloArthritis international Society Definition in Healthy Individuals, Runners, and Women With Postpartum Back Pain.
Janneke J. de Winter,Manouk de Hooge,Marleen G H van de Sande,Henriëtte M. de Jong,Lonneke van Hoeven,Anoek de Koning,Inger Jorid Berg,Roberta Ramonda,Dominique Baeten,Désirée van der Heijde,Angelique E. A. M. Weel,Robert Landewé +11 more
TL;DR: To compare magnetic resonance images of the sacroiliac (SI) joints of healthy subjects and individuals with known mechanical strain acting upon the SI joints to those of patients with axial spondyloarthritis and patients with chronic back pain, MRI images are compared.
Journal ArticleDOI
The burden of non-radiographic axial spondyloarthritis
Annelies Boonen,Joachim Sieper,Désirée van der Heijde,Maxime Dougados,Jack F. Bukowski,Satish Valluri,Bonnie Vlahos,Sameer Kotak +7 more
TL;DR: Although patients with non-radiographic axSpA have shorter disease duration and lack radiological changes, they demonstrate a substantial burden of illness, with self-reported disease activity and functional impairments comparable to those found in patients with radiographic disease.
Journal ArticleDOI
Development of an ASAS-endorsed recommendation for the early referral of patients with a suspicion of axial spondyloarthritis
TL;DR: A consensual ASAS-endorsed referral recommendation for patients suspected of having axial spondyloarthritis was developed as a flexible and universal strategy to be used in clinical practice by primary care physicians or non-rheumatology specialists.
References
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TL;DR: The study showed the clinical history screening test for AS to be moderately sensitive, but it might be better in clinical practice, and substitution of the Rome pain criterion for the New York pain criterion is proposed.
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The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection
Martin Rudwaleit,D. van der Heijde,Robert Landewé,Joachim Listing,Nurullah Akkoc,J Brandt,Jürgen Braun,C.T. Chou,Eduardo Collantes-Estevez,Maxime Dougados,Feng Huang,Jieruo Gu,Muhammad Asim Khan,Yesim Kirazli,Walter P. Maksymowych,Herman Mielants,Inge Juul Sørensen,Salih Ozgocmen,Euthalia Roussou,R. Valle-Oñate,Ulrich Weber,James Cheng-Chung Wei,Joachim Sieper +22 more
TL;DR: The new ASAS classification criteria for axial SpA can reliably classify patients for clinical studies and may help rheumatologists in clinical practice in diagnosing axial spondyloarthritis in those with chronic back pain.
Journal ArticleDOI
The European spondylarthropathy study group preliminary criteria for the classification of spondylarthropathy
Maxime Dougados,van der Linden S,Juhlin R,Huitfeldt B,Bernard Amor,Andrei Calin,A. Cats,Ben A. C. Dijkmans,Ignazio Olivieri,Pasero G +9 more
TL;DR: The proposed classification criteria for spondylarthropathy are easy to apply in clinical practice and performed well in all 7 participating centers and are regarded as preliminary until they have been further evaluated in other settings.
Journal Article
A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index.
TL;DR: The Bath Ankylosing Spondylitis Functional Index satisfies the criteria required of a functional index: it is quick and easy to complete, is reliable and is sensitive to change across the whole spectrum of disease.
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