Abstract

BackgroundThe Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is the patient-reported outcome (PRO) that is routinely used in clinical practice to monitor and measure disease activity in axial spondyloarthropathy (axSpA). BASDAI scores greater than four are thought to indicate active disease and require better control. Magnetic resonance imaging (MRI) is the most objective measure of disease activity in axSpA with its ability to pick up active inflammation both in the spine and sacroiliac joints. Previous studies have shown conflicting correlations between BASDAI and MRI, and therefore, there is the question of whether BASDAI is the best tool to monitor disease activity when it is subjective and potentially influenced by other patient factors. We, therefore, conducted a retrospective study to investigate the correlation between BASDAI and MRI in axSpA patients.MethodologyData were collected by retrospective analysis of axSpA patients attending University of Leicester (UHL) axSpA services. BASDAI scores were done within a year and closest to the time of MRI spine + sacroiliac joints were collected. The results prior to the initiation of biologic therapy were used. Data of one hundred and forty-nine patients were collected on their MRI results and BASDAI scores. Data were analysed using Statistical Package for the Social Sciences (SPSS) software and Pearson’s chi-squared applied to assess the correlation between BASDAI and MRI findings.ResultsOut of one hundred and forty-nine patients, 61.7% had active sacroiliitis on their MRI, 57.7% had chronic sacroiliitis, 53% had active spinal inflammation, and 17.4% had other MRI findings of active disease. There was a significant correlation between active sacroiliitis and BASDAI (p=0.014), but similar results were not found with other radiological features. A significant correlation was also found with males having higher BASDAI scores compared to females (p=0.027).ConclusionThis study demonstrates a statistically significant correlation between BASDAI and active sacroiliitis with those having higher scores more likely to have active disease on their MRI.

Highlights

  • Axial spondyloarthritis is an umbrella term that entails a chronic rheumatological inflammatory condition, predominantly affecting the axial skeleton

  • There was a significant correlation between active sacroiliitis and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (p=0.014), but similar results were not found with other radiological features

  • A significant correlation was found with males having higher BASDAI scores compared to females (p=0.027)

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Summary

Introduction

Axial spondyloarthritis (axSpA) is an umbrella term that entails a chronic rheumatological inflammatory condition, predominantly affecting the axial skeleton. It encompasses both radiological axSpA known as ankylosing spondylitis (AS), where evidence of disease is present on x-ray, and non-radiological where it is not. How to cite this article Byravan S, Jain N, Stairs J, et al (November 16, 2021) Is There a Correlation Between Patient-Reported Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) Score and MRI Findings in Axial Spondyloarthropathy in Routine Clinical Practice?. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is the patient-reported outcome (PRO) that is routinely used in clinical practice to monitor and measure disease activity in axial spondyloarthropathy (axSpA). We conducted a retrospective study to investigate the correlation between BASDAI and MRI in axSpA patients

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