Background/Purpose: To evaluate the performances at diagnosis (sensitivity [Se], specificity [Spe], positive and negative predictive values) and study visit (classification purpose) of the ASAS criteria in axial spondyloarthritis (SpA) in patients visiting their rheumatologist for chronic back pain (CBP). Secondary objectives: identifying the most contributive item to diagnosis/classification of SpA, evaluating the performances of each arm of the ASAS criteria and other SpA criteria’s performances.

Methods: Multi-centric, cross-sectional. Patients: history of CBP before the age of 40 visiting a rheumatologist in France. Data: a) items of the different sets of criteria, checking if present at diagnosis or at study visit; b) diagnosis of the rheumatologist at study visit. Statistical analysis: description of the population. Rheumatologist’s diagnosis was considered as the “gold standard” for the estimation of all psychometric properties.  

Results: 1210 patients were included for our analysis. At diagnosis, Se was 0.76 and Spe 0.94 for ASAS axial criteria and Se 0.87 and Spe 0.92 for classification. LR+ of the ASAS axial criteria was 13.6 for diagnosis and 10.30 for classification. The most contributive item to diagnosis and classification was X-ray sacroiliitis, followed by MRI sacroiliitis for diagnosis and history of uveitis for classification. MRI+ imaging ASAS criteria were more sensitive for diagnosis and classification, but as specific as ASAS clinical criteria.

Conclusion: we confirm the validity of the ASAS criteria in diagnosis and classification, in a clinical rheumatological setting of patients with CBP, with good performances compared to the other axial SpA criteria, and for any of their arms.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/performances-of-the-asas-axial-spondyloarthritis-criteria-for-diagnosis-and-classification-purposes-in-patients-visiting-a-rheumatologist-because-of-chronic-back-pain-the-declic-study/