Performance of referral recommendations in patients with chronic back pain and suspected axial spondyloarthritis
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TLDR
The proposed referral parameters have proven useful when applied in primary care in identifying patients with AS/pre-radiographic axial SpA among young to middle-aged patients with chronic low back pain.Abstract:
Background: Ankylosing spondylitis (AS) and its early form account for up to 5% of all patients with chronic back pain. Interest has recently focused on shortening the delay of 5–10 years between the appearance of first symptoms and the diagnosis of AS, particularly because effective treatments have now become available. Referral parameters that are easy for doctors in primary care to apply to patients presenting with possible AS could contribute to earlier diagnosis. Methods: Orthopaedists and primary-care doctors were requested to refer patients with (1) chronic low back pain (duration >3 months) and (2) onset of back pain before Results: In total, 350 referred cases were analysed. A diagnosis of definite axial spondyloarthritis (axial SpA), comprising established AS and pre-radiographic axial SpA, could be made in 45.4% of all referred patients (of which 50.3% were classified as AS and 49.7% as preradiographic axial SpA), whereas 45.4% were classified as non-SpA and 9.1% as possible SpA. A diagnosis of definite axial SpA could be made in 34.2% if only one referral parameter was positive, and in 62.6% if there was >1 positive referral parameter. Conclusions: The proposed referral parameters have proven useful when applied in primary care in identifying patients with AS/pre-radiographic axial SpA among young to middle-aged patients with chronic low back pain.read more
Citations
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Journal ArticleDOI
The early disease stage in axial spondylarthritis: results from the German Spondyloarthritis Inception Cohort.
Martin Rudwaleit,Hildrun Haibel,Xenofon Baraliakos,Joachim Listing,Elisabeth Märker-Hermann,Henning Zeidler,Jürgen Braun,Joachim Sieper +7 more
TL;DR: Clinical manifestations and disease activity measures are highly comparable between patients with early nonradiographic axial SpA and those with early AS, suggesting that these 2 entities are part of the same disease.
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New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS)
Joachim Sieper,D. van der Heijde,Robert Landewé,J Brandt,R. Burgos-Vagas,Eduardo Collantes-Estevez,Ben A. C. Dijkmans,Maxime Dougados,M.M. Khan,Marjatta Leirisalo-Repo,S. Van der. Linden,Walter P. Maksymowych,Herman Mielants,I. Olivieri,Martin Rudwaleit +14 more
TL;DR: A new approach with real patients defines a set of IBP definition criteria using overall expert judgement on IBP as the gold standard, which are robust, easy to apply and have good face validity.
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Efficacy and safety of adalimumab in patients with non-radiographic axial spondyloarthritis : results of a randomised placebo-controlled trial (ABILITY-1)
Joachim Sieper,Désirée van der Heijde,Maxime Dougados,Philip J. Mease,Walter P. Maksymowych,Matthew A. Brown,Vipin Arora,Aileen L. Pangan +7 more
TL;DR: Results from ABILITY-1 suggest that adalimumab has a positive benefit–risk profile in active nr-axSpA patients with inadequate response to NSAIDs and the safety profile was consistent with what is known for ad alimumab in ankylosing spondylitis and other diseases.
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Maxime Dougados,Dominique Baeten +1 more
TL;DR: The major challenges with direct relevance for clinical practice for the next decade are the development of techniques for early diagnosis, therapeutic modulation of structural damage, and, ultimately, induction of long-term, drug-free remission.
Journal ArticleDOI
Efficacy of adalimumab in the treatment of axial spondylarthritis without radiographically defined sacroiliitis: Results of a twelve-week randomized, double-blind, placebo-controlled trial followed by an open-label extension up to week fifty-two†
Hildrun Haibel,Martin Rudwaleit,Joachim Listing,Frank Heldmann,Robert L. Wong,Hartmut Kupper,Jürgen Braun,Joachim Sieper +7 more
TL;DR: Adalimumab is the first TNF antagonist to demonstrate good clinical efficacy and safety in patients with axial SpA without radiographically defined sacroiliitis refractory to conventional treatment.
References
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Journal ArticleDOI
Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria.
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.
Journal ArticleDOI
Treatment of active ankylosing spondylitis with infliximab: a randomised controlled multicentre trial
Jürgen Braun,J. Brandt,Joachim Listing,A. Zink,Rieke Alten,W. Golder,E Gromnica-lhle,Herbert Kellner,A Krause,Matthias Schneider,H Sörensen,Henning Zeidler,W Thriene,Joachim Sieper +13 more
TL;DR: The results show that treatment with infliximab is effective in patients with active ankylosing spondylitis, and since there are some potentially serious adverse effects, it is recommended that this treatment mainly be used in co-operation with rheumatological centres.
Journal ArticleDOI
Prevalence of spondylarthropathies in HLA‐B27 positive and negative blood donors
Jürgen Braun,Mathias Bollow,Gerold Remlinger,U. Eggens,Martin Rudwaleit,Armin Distler,Joachim Sieper +6 more
TL;DR: With a calculated prevalence of 1.9%, spondylarthropathies are among the most frequent rheumatic diseases in the white population and HLA-B27 positive persons carry a 20-fold increased risk of developing SpA.
Journal ArticleDOI
Efficacy and safety of adalimumab in patients with ankylosing spondylitis: results of a multicenter, randomized, double-blind, placebo-controlled trial.
Désirée van der Heijde,Alan Kivitz,Michael Schiff,Joachim Sieper,Ben A. C. Dijkmans,Jürgen Braun,Maxime Dougados,John D. Reveille,Robert L. Wong,H Kupper,John C. Davis +10 more
TL;DR: Adalimumab was well-tolerated during the 24-week study period and was associated with a significant and sustained reduction in the signs and symptoms of active ankylosing spondylitis.
Journal ArticleDOI
Age at disease onset and diagnosis delay in HLA-B27 negative vs. positive patients with ankylosing spondylitis
Ernst Feldtkeller,Muhammad Asim Khan,Désirée van der Heijde,Sjef van der Linden,Jürgen Braun +4 more
TL;DR: This study of a much larger number of B27– AS patients than have been studied previously confirms earlier reports indicating a significantly older average age at disease onset and a less frequent prevalence of acute anterior uveitis in B 27– than in B27+ AS.
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