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
TLDR
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.Abstract:
Objective: To validate and refine two sets of candidate criteria for the classification/diagnosis of axial spondyloarthritis (SpA). Methods: All Assessment of SpondyloArthritis international Society (ASAS) members were invited to include consecutively new patients with chronic (⩾3 months) back pain of unknown origin that began before 45 years of age. The candidate criteria were first tested in the entire cohort of 649 patients from 25 centres, and then refined in a random selection of 40% of cases and thereafter validated in the remaining 60%. Results: Upon diagnostic work-up, axial SpA was diagnosed in 60.2% of the cohort. Of these, 70% did not fulfil modified New York criteria and, therefore, were classified as having “non-radiographic” axial SpA. Refinement of the candidate criteria resulted in new ASAS classification criteria that are defined as: the presence of sacroiliitis by radiography or by magnetic resonance imaging (MRI) plus at least one SpA feature (“imaging arm”) or the presence of HLA-B27 plus at least two SpA features (“clinical arm”). The sensitivity and specificity of the entire set of the new criteria were 82.9% and 84.4%, and for the imaging arm alone 66.2% and 97.3%, respectively. The specificity of the new criteria was much better than that of the European Spondylarthropathy Study Group criteria modified for MRI (sensitivity 85.1%, specificity 65.1%) and slightly better than that of the modified Amor criteria (sensitivity 82.9, specificity 77.5%). Conclusion: 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 SpA in those with chronic back pain. Trial registration number: NCT00328068.read more
Citations
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What low back pain is and why we need to pay attention
Jan Hartvigsen,Mark J. Hancock,Alice Kongsted,Quinette Louw,Manuela L Ferreira,Stéphane Genevay,Damian G Hoy,Jaro Karppinen,Glenn Pransky,Joachim Sieper,Rob J. E. M. Smeets,Martin Underwood,Rachelle Buchbinder,Dan Cherkin,Nadine E. Foster,Christopher G. Maher,Maurits W. van Tulder,Johannes R. Anema,Roger Chou,Steven P. Cohen,Lucíola da Cunha Menezes Costa,Peter Croft,Manuela L. Ferreira,Paulo H. Ferreira,Julie M. Fritz,Douglas P. Gross,Bart W. Koes,Birgitta Öberg,Wilco C. Peul,Mark L. Schoene,Judith A. Turner,Anthony D. Woolf +31 more
TL;DR: Intensified research efforts and global initiatives are clearly needed to address the burden of low back pain as a public health problem, where health and other systems are often fragile and not equipped to cope with this growing burden.
Journal ArticleDOI
The Assessment of SpondyloArthritis international Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general
Martin Rudwaleit,D. van der Heijde,Robert Landewé,Nurullah Akkoc,J Brandt,C.T. Chou,Maxime Dougados,Feng Huang,Jieruo Gu,Yesim Kirazli,F. Van den Bosch,Ivana Olivieri,Euthalia Roussou,Salvatore Scarpato,Inge Juul Sørensen,R. Valle-Oñate,Ulrich Weber,James Cheng-Chung Wei,J. Sieper +18 more
TL;DR: The new ASAS classification criteria for peripheral SpA performed well in patients presenting with peripheral arthritis, enthesitis and/or dactylitis, particularly regarding sensitivity.
Journal ArticleDOI
The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis
Joachim Sieper,M. Rudwaleit,Xenofon Baraliakos,J Brandt,Jürgen Braun,Ruben Burgos-Vargas,Maxime Dougados,K.-G. Hermann,Robert Landewé,Walter P. Maksymowych,D. van der Heijde +10 more
TL;DR: A comprehensive handbook on the most relevant aspects for the assessments of spondyloarthritis, covering classification criteria, MRI and x rays for sacroiliac joints and the spine, a complete set of all measurements relevant for clinical trials and international recommendations for the management of SpA are provided.
Journal ArticleDOI
2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis
Désirée van der Heijde,Sofia Ramiro,Robert Landewé,Xenofon Baraliakos,Filip Van den Bosch,Alexandre Sepriano,Alexandre Sepriano,Andrea Regel,Adrian Ciurea,Hanne Dagfinrud,Maxime Dougados,Maxime Dougados,Floris A. van Gaalen,Pál Géher,Irene E. van der Horst-Bruinsma,Robert D. Inman,Merryn Jongkees,Uta Kiltz,Tore K Kvien,Pedro Machado,Helena Marzo-Ortega,Anna Molto,Anna Molto,Victoria Navarro-Compán,Salih Ozgocmen,Fernando Pimentel-Santos,John D. Reveille,Martin Rudwaleit,Martin Rudwaleit,J. Sieper,Percival D. Sampaio-Barros,Dieter Wiek,Jürgen Braun +32 more
TL;DR: The 2016 Assessment of SpondyloArthritis international Society-EULAR recommendations provide up-to-date guidance on the management of patients with axSpA and three overarching principles and 13 recommendations deal with surgery and spinal fractures.
Journal ArticleDOI
2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis
Jürgen Braun,R. van den Berg,Xenofon Baraliakos,H. Boehm,Ruben Burgos-Vargas,Eduardo Collantes-Estevez,B. Dijkmans,Paul Emery,Muhammad Asim Khan,Karel Pavelka +9 more
TL;DR: The ASAS/EULAR recommendations on the management of ankylo sing spondylitis (AS) are based on the original paper, a systematic review of existing recommendations and the literature since 2005 and the discussion and agreement among 21 international experts, 2 patients and 2 physiotherapists in a meeting in February 2010 as mentioned in this paper.
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
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 ArticleDOI
The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part I): classification of paper patients by expert opinion including uncertainty appraisal
Martin Rudwaleit,Robert Landewé,D. van der Heijde,Joachim Listing,J Brandt,Jürgen Braun,Rubén Burgos-Vargas,Eduardo Collantes-Estevez,John A. Davis,Ben A. C. Dijkmans,Maxime Dougados,Paul Emery,I E van der Horst-Bruinsma,Robert D. Inman,M A Khan,Marjatta Leirisalo-Repo,S van der Linden,Walter P. Maksymowych,Herman Mielants,I. Olivieri,Roger D. Sturrock,K. de Vlam,Joachim Sieper +22 more
TL;DR: The ASAS group has developed candidate criteria for the classification of axial SpA that include patients without radiographic sacroiliitis, and the candidate criteria need to be validated in an independent international study.
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.
Journal ArticleDOI
How to diagnose axial spondyloarthritis early
TL;DR: This approach can help clinicians to diagnose with a high degree of confidence axial SpA at an early stage in patients with IBP who lack radiographic sacroiliitis.
Related Papers (5)
Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria.
The Assessment of SpondyloArthritis international Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general
The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part I): classification of paper patients by expert opinion including uncertainty appraisal
Martin Rudwaleit,Robert Landewé,D. van der Heijde,Joachim Listing,J Brandt,Jürgen Braun,Rubén Burgos-Vargas,Eduardo Collantes-Estevez,John A. Davis,Ben A. C. Dijkmans,Maxime Dougados,Paul Emery,I E van der Horst-Bruinsma,Robert D. Inman,M A Khan,Marjatta Leirisalo-Repo,S van der Linden,Walter P. Maksymowych,Herman Mielants,I. Olivieri,Roger D. Sturrock,K. de Vlam,Joachim Sieper +22 more