Classification Criteria For Axial Spondyloarthritis Research Articles

OP0171 A data driven approach to the definition of a positive MRI of the sacroiliac joints in spondyloarthritis

BackgroundInflammation on magnetic resonance imaging (MRI) of the sacroiliac joints (SIJ) in patients with spondyloarthritis (SpA) is a major criterion in the Assessment of SpondyloArthritis (ASAS) classification criteria for axial...

FRI0285 Depression is associated with higher BASDAI and BASFI but not ASDAS

BackgroundThe Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Index using C-reactive protein/Erythrocyte sedimentation rate base (ASDAS-CRP/ASDAS-ESR) are validated instruments for measuring disease activity in...

FRI0288 Baseline characteristics of newly diagnosed patients with axial spondyloarthritis: First results from the giant cohort

BackgroundRecently, the field of spondyloarthritis (SpA) has experienced major developments, among them the possibility of earlier diagnosis, particularly by the introduction of MRI of the sacroiliac joints. The application of...

THU0359 Smoking was not Associated with Response to Adalimumab Therapy in Patients with Non-Radiographic Axial Spondyloarthritis

BackgroundCigarette smoking has been reported as a risk factor for early disease onset, higher disease activity, and poor function in patients (pts) with axial spondyloarthritis (SpA). Adalimumab (ADA), approved for...

AB0561 Differences between men and women in ankylosing spondylitis patients

BackgroundAnkylosing spondylitis (AS), a chronic rheumatic disease of young adults, is the prototype of the inflammatory arthropathies. Spinal inflammation, the hallmark of AS, causes pain and stiffness leading to progressive...

OP0273 Does Spinal MRI Add Incremental Diagnostic Value to MRI of the Sacroiliac Joints Alone in Non-Radiographic Axial Spondyloarthritis?

BackgroundThe definition of a positive MRI as major criterion in the Assessment of SpondyloArthritis classification criteria for axial spondyloarthritis (SpA) is based on MRI of the sacroiliac joints (SIJ) alone....

SP0040 Diagnosis of Rheumatoid Arthritis and Spondyloarthritis Using Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) has over the last few years achieved a key position in the diagnosis of rheumatoid arthritis (RA) as well as spondyloarthritis (SpA).In the 2010 ACR/EULAR criteria...

SAT0259 ASAS Classification Criteria for Axial Spa Were Superior to ESSG and Amor Criteria in Distinguishing Spa Patients Among Patients with Chronic Back Pain: Results of a Two-Year Follow-Up Study From China

BackgroundIn 2009 the Assessment of SpondyloArthritis international Society (ASAS) developed the new classification criteria for axial spondyloarthritis in a large cohort of patients with recent-onset low back pain.ObjectivesTo evaluated the...

SAT0224 Anti-Tnf Drug Survival in Axial Spondylarthritis is not Related to the New Asas Classification Criteria

BackgroundSeveral sets of diagnostic and classification criteria for axial spondyloarthritis (SpA) are currently in use. Some, such as the ESSG criteria cover the entire spectrum of spondyloarthropathies, but may be...

AB0891 Correlation of ASDAS and BASDAI with disease activity in axial spondyloarthritis

BackgroundThe Spondyloarthritis International Society (ASAS) published a new measurement tool to help in the assessment of disease activity in Ankylosing Spondylitis (AS) patients and as an instrument to assess treatment...

FRI0442 Commonalities and differences in subsets of axial spondyloarthritis: analysis of a longitudinal observational cohort

BackgroundPatients with axial spondyloarthritis (axSpA) can be classified has having ankylosing spondylitis (AS) or non-radiographic axial spondyloarthritis (nr-axSpA) according to recently described criteria (1). Data are still emerging with regard...

SAT0234 Confirmed High Prevalence of Axial Spondyloarthritis in a Validation Study of Primary Care Patients with Chronic Low Back Pain (Cafaspa-2)

BackgroundIn 2010 we presented a prevalence of 21% fulfilling the ASAS classification criteria for axial spondyloarthritis (aSpA) in primary care patients with chronic low back pain (CLBP) (CaFaSpA 1 study)1....

THU0277 Absence of radiographic progression at two years in a cohort of patients with non- radiographic axial spondyloarthritis treated with TNFA blockers

BackgroundAn inhibitory effect of TNFa blockers on radiographic progression at two years has not been demonstrated until now in patients with Ankylosing Spondylitis. Moreover, in studies evaluating the structural progression...

SAT0275 Almost 40% of patients with chronic back pain starting before the age of 45 fulfill the asas axial spondyloarthritis criteria

BackgroundChronic back pain is a very prevalent complaint in the general population but only a small proportion of these patients suffer from spondyloarthritis (SpA). Unfortunately, it is not clear when...

Assessment of SpondyloArthritis International Society criteria for axial spondyloarthritis in chronic back pain patients with a high prevalence of HLA–B27

The Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial spondyloarthritis (SpA) allow SpA classification of HLA-B27-positive patients if ≥2 specific clinical SpA features are present. We investigated the performance of these clinical ASAS criteria in a population with a high prevalence of HLA-B27. A total of 807 persons reporting chronic back pain (CBP) lasting for >4 weeks during a population survey underwent a clinical, laboratory, and radiologic evaluation. The ASAS criteria for axial SpA were then used to determine classification status. Only 332 patients (41% of all CBP patients) fulfilled the prerequisite ASAS definitions for CBP (duration of ≥3 months and onset at age <45 years). In this ASAS-defined CBP cohort (51% women, CBP onset at age 27.2 years, 17% HLA-B27 positive), ASAS classification criteria for axial SpA were met by 8.4% of patients. Radiographic SpA by the modified New York criteria was present in 2.4%, while 6% fulfilled the clinical arm of the ASAS SpA criteria only. One-fifth of patients with clinical SpA developed radiographic evidence of SpA after a median of 8 years. Application of the clinical ASAS classification criteria in an area with a high prevalence of HLA-B27 leads to significant increases in the prevalence of axial SpA compared to radiologic SpA among CBP patients. This increase in the prevalence of disease is likely to have significant ramifications for patient management and health care systems.

A conundrum: classifying patients with SpA in daily practice

The emphasis placed on HLA-B27 positivity in classification criteria for axial spondyloarthritis has generated some concern over potential misclassification of patients with chronic back pain. The results of a recent study suggest that these worries could have some foundation, at least in regions with high HLA-B27 prevalence.

High frequency of inflammatory back pain and other features of spondyloarthritis in patients with rheumatoid arthritis

The aim of this study was to investigate the frequency of patients with rheumatoid arthritis (RA) who have inflammatory back pain (IBP) and meet the existing classification criteria for ankylosing spondylitis (AS) and spondyloarthritis (SpA). We included 167 patients fulfilling the ACR 1987 revised criteria for RA. After obtaining a medical history and performing a physical examination, standard pelvic X-rays for examination of the sacroiliac joints (SIJ) were ordered in all patients. A computed tomography (CT) or magnetic resonance imaging (MRI) of SIJ was performed in patients with suspected radiographic sacroiliitis and MRI of SIJ in those who have IBP but no radiographic sacroiliitis. IBP was defined according to both Calin and experts' criteria. The modified New York (mNY) criteria were used to classify AS, both ESSG and Amor criteria for SpA and ASAS classification criteria for axial SpA. There were 135 female and 32 male patients with a mean age of 54.8 years. The mean disease duration was 9.8 years. RF was positive in 128 patients (79.2 %) and anti-CCP in 120 patients (81.1 %). Twenty-eight patients with RA (16.8 %) had IBP (Calin criteria), and four (2.4 %) had radiographic sacroiliitis of bilateral grade 3. Three patients (1.8 %) fulfilled the mNY criteria for AS, 31 (18.6 %) ESSG and 26 (15.6 %) Amor criteria for SpA. Nine patients (five with MRI sacroiliitis) (5.3 %) were classified as having axial SpA according to new ASAS classification criteria. This study suggests that the prevalence of SpA features in patients with RA may be much higher than expected.

Axial spondyloarthritis: a new disease entity, not necessarily early ankylosing spondylitis

New classification criteria for axial spondyloarthritis have been developed with the goal of increasing sensitivity of criteria for early inflammatory spondyloarthritis. However these criteria substantially increase heterogeneity of the resulting...

The impact of MRI on the clinical management of inflammatory arthritides

In the past two decades, MRI has gained a major role in research and clinical management of patients with inflammatory arthritides, particularly in spondyloarthritis (SpA), rheumatoid arthritis (RA), and osteoarthritis (OA). MRI is regarded as the most sensitive imaging modality for detecting early SpA in young patients with inflammatory back pain and normal radiographs of the sacroiliac joints. The recently published Assessment of SpondyloArthritis International Society classification criteria for axial SpA include for the first time a positive MRI demonstrating sacroiliitis as an imaging criterion indicative of SpA together with at least one clinical feature of SpA. Recent data show that systematic assessment of sacroiliitis displayed on MRI has much greater diagnostic utility than previously reported and highlight the diagnostic relevance of structural lesions. In RA, MRI has predictive value for the development of disease in new onset undifferentiated arthritis, and MR pathology at disease onset is a highly significant predictor of radiographic erosions. Consequently MRI has been credited with an important role in the new ACR/EULAR 2010 classification criteria for RA. In OA, bone marrow edema (BME) and synovitis may serve as biomarkers in interventional trials. Treatment interventions targeting BME and synovitis observed on MRI in inflammatory arthritides may have a disease-modifying effect as these lesions are potentially reversible and have been shown to be associated with structural progression. Research should focus on the prognostic significance of MRI lesions in larger cohorts and whether adding MRI to routine care improves clinical and radiographic outcome in patients with inflammatory arthritides.

HLA-B27 positive patients differ from HLA-B27 negative patients in clinical presentation and imaging: results from the DESIR cohort of patients with recent onset axial spondyloarthritis

ObjectiveTo clarify the influence of human leucocyte antigen B27 (HLA-B27) status on the phenotype of early axial spondyloarthritis (SpA).Methods708 patients with inflammatory back pain (IBP) defined by Calin or Berlin...