Outcome-Parameter bei der ankylosierenden Spondylitis

Abstract

Ankylosing spondylitis (AS) is a frequent inflammatory rheumatic disease and prototype of the Spondyloarthitides (SpA). During the last years outcome parameters have been developed to evaluate different aspects of the disease. Among these are the Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASMI), numeric rating scales for general pain, night pain, patients and physicians global assessment, as well as questionnaires to evaluate quality of life as the short Form (SF)- 36, Euroquol 5 Dimensions (EQ-5D), or the AS specific the ASQuol. These outcome parameters are the basis to conduct clinical trials. The ASessements in AS (ASAS) improvement criteria were developed to evaluate the short term efficacy of Non-Steroidal Antirheumatic Drugs (NSAIDs) and adjusted for the measurement of the high efficacy of the TNF-alpha blocking agents. To examine the x-rays of sacroiliac joints (SIG), the radiological criteria as part of the modified New York criteria are mostly used. For the x-rays of the spine the Bath AS Radiology Index (BASRI) is valuable in daily practice, but the modified Stokes AS Spine Score (mSASSS) is more sensitive for clinical trials. To examine Magnetic Resonance Images (MRI) of SIG and spine also scores are currently developed. Altogether, using the new outcome parameters it was possible to demonstrate the strikingly high efficacy of theTNF-alpha blocking agents. However, it could also be shown that conventional disease modifying antirheumatic drugs (DMARDs) are not effective in the treatment of the axial forms of SpA.