ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1362

Evaluation of Spondyloarthritis activity  by the Patients and the Physicians: ASDAS, Basdai, PASS and Flare

Marie Godfrin-Valnet1, Clément Prati2, Marc Puyraveau3, Eric Toussirot4, Helene Letho-Gyselinck5 and Daniel Wendling5, 1Rheumatology, CHU, Besançon, France, 2Service de Rhumatologie, CHU J Minjoz, Besancon, France, 3Clinical Methodology Center, CHU, Besançon, France, 4Université de Franche Comté , CHRU, CIC Biotherapy 506 and Rheumatology and EA 4266 Pathogens and Inflammation, Besançon, France, 5Service de Rhumatologie, Minjoz University Hospital, Besancon, France

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Spondylarthropathies and Psoriatic Arthritis: Clinical Aspects and Treatment

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Objectives: to define thresholds of the ASDAS corresponding to the PASS (Pateint Acceptable Symptomatic State) and to the thresholds of activity of the disease through what the patients feel. Correlate these levels of activity to the presence of a depressive syndrome and determine a threshold ASDAS and BASDAI corresponding to a flare in spondyloarthritis (SpA).

Methods:

A prospective study of SpA patients (ASAS criteria) from February 2011 until February 2012. Various scores (BASDAI, ASDAS, BASFI) as well as the evaluation of the PASS and the depressive syndrome were measured. Determination of ASDAS thresholds corresponding to the PASS, to the various thresholds of activity according to the patients, and to flare was performed using ROC curves. The Kappa coefficient was calculated to estimate the correlation between the physician’s and the patient’s evaluation of the flare.

Results:

200 SpA patients, mean age 44.4 ± 12.5 years (duration 12.9 ± 10.5 years) were included. The average scores were respectively 4.1 ± 2.2 for the BASDAI and of 2.4 ± 1 for the ASDAS-CRP and of 3.3 ± 2.7 for the BASFI. 58.9 % of the patients were considered in PASS. The PASS corresponded to a BASDAI ≤ 4.1 and to an ASDAS-CRP ≤2.3. Concerning the impression of the disease by the patients: a weakly active disease corresponded to a BASDAI ≤3.8 and to an ASDAS-CRP ≤2.3, and a strongly active disease in a BASDAI >5.2 and an ASDAS-CRP > 3.1. When the disease was considered as strongly active, 64.5 % of patients had a score of severe depressive syndrome on Beck’s scale. A flare was considered by 36.9 % of the patients versus 28.3 % of the physicians. The threshold BASDAI “flare” was ≥5.2 and the threshold ASDAS-CRP “flare” was ≥2.3. The concordance between the evaluation of the flare according to the physician and the patient was good (Kappa: 0.61).

Conclusion:

Our results report a significant link between the level of activity of the disease and the severity of the depressive syndrome. Our study confirms a good concordance between the BASDAI and the ASDAS. Thresholds of BASDAI and ASDAS are proposed for PASS and flare in SpA.

Disclosure:

M. Godfrin-Valnet,
None;

C. Prati,
None;

M. Puyraveau,
None;

E. Toussirot,
None;

H. Letho-Gyselinck,
None;

D. Wendling,
None.

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