ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 596

Clinical Value of ASDAS Index in Spanish Patients with Ankylosing Spondylitis

Agusti Sellas-Fernandez1, Jose Luis Guerra Vázquez2, Jose Luis Casals3, Carlos Gonzalez Fernandez4, Roberto Miguelez5, José Rosas6, Antonio Fernandez-Nebro7, Cilia Peralta Ginés8, Carlos Montilla-Morales9, Xavier Juanola10, Miguel Ángel Abad11, Alberto Alonso12, Azucena Hernández-Sanz13, Luis Francisco Linares14, Julio Medina15, Joana Rovira16, Juan Carlos Torre-Alonso17, Alfredo Willisch18, Eduardo Collantes-Estevez19 and Ana Ruiz-Zorrilla20, 1H. Vall d'Hebron, Barcelona, Spain, 2H. Arquitecto Marcide, La Coruña, Spain, 3H. Virgen de la Victoria, Málaga, Spain, 4Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain, 5H. de Móstoles, Madrid, Spain, 6Rheumatology, Hospital Marina Baixa, Villajoyosa, Valencia, Alicante, Spain, 7Rheumatology, Hospital Regional Universitario Carlos Haya, Málaga, Spain, 8H. Clínico Lozano Blesa, Zaragoza, Spain, 9H. de Salamanca, Salamanca, Spain, 10Rheumatology, University Hospital Bellvitge, Barcelona, Spain, 11Hospital Virgen del Puerto, Cáceres, Spain, 12Hospital de Cruces, Bilbao, Spain, 13H. Virgen de la Salud, Toledo, Spain, 14Hospital Virgen de la Arrixaca., Murcia, Spain, 15Hospital Clínico, Valladolid, Spain, 16Mutua Terrasa, Barcelona, Spain, 17Rheumatology Department, H. Monte Naranco, Oviedo, Spain, 18Complexo Hospitalario de Ourense, Ourense, Spain, 19Hospital Reina Sofía, Córdoba, Spain, 20Abbvie, Madrid, Spain

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Spondyloarthropathies and Psoriatic Arthritis - Clinical Aspects and Treatment I

Session Type: Abstract Submissions (ACR)

Background/Purpose

The ASDAS (ankylosing spondylitis disease activity score) was developed to overcome some of the deficiencies of BASDAI (Bath Ankylosing Disease Activity Spondyltis Index). In this prospective study merits of both scores are compared.

Methods

Patients with AS according to mNY criteria and BASDAI≥4 were enrolled at 23 Spanish centers and followed during 1 year. Follow-up visits were scheduled every 4 months. Physical examination, CRP and ESR, Patient Global disease activity visual analogue scale (PG-VAS), pain due to AS (VAS), BASDAI, BASMI, BASFI, ASDAS, patient acceptable symptom state (PASS), SF-36, ASQoL, work productivity and activity impairment (WPAI) questionnaire data were recorded at each visit.

Results

A total of 127 evaluable patients, 75.6% men, with median age of 48 years and median time from diagnosis of 10 years, were recruited. Criterion validity: across follow-up correlations between ASDAS and PG-VAS ranged from 0.560 to 0.736, and from 0.758 to 0.840 between BASDAI and PG-VAS. Convergent validity: ASDAS correlation with BASDAI (0.733 to 0.781), BASMI (0.275 to 0.552), BASFI (0.476 to 0.591), lumbar pain VAS, (0.691 to 0.702) and lumbar night pain VAS (0.648 to 0.702) were found. Discriminant validity: mean ASDAS and mean BASDAI were significantly higher in patients with non-acceptable PASS than in patients with acceptable PASS. Patients below median PG-VAS showed significantly lower mean ASDAS and BASDAI than patients above median PG-VAS. ASDAS, but not BASDAI, distinguishes between patients below and above median CRP. Patients in different ASDAS categories showed significant differences in CRP, PG-VAS, BASMI, BASDAI, BASFI and pain VAS across follow-up, but significant differences in TJC and SJC were not found at any visit. Sensitivity to change: significant reductions in mean ASDAS and BASDAI were observed in patients changing from non acceptable PASS at baseline to acceptable PASS across the follow-up, and a significant proportion of patients had a reduction in disease activity level according to their ASDAS categories. ASDAS was sensitive to patients achieving a 50% reduction in BASDAI. Concerning treatments, ASDAS and BASDAI were sensitive to changes in PASS in patients treated with biological therapies, but only BASDAI was sensitive to changes in patients treated with DMARDs. An inverse relationship was detected between ASDAS and physical and mental subscales of SF36, and changes in ASDAS were significantly related with changes in ASQoL. Concerning WPAI, the work time missed increased as ASDAS score increased.

Conclusion

ASDAS has shown good metric properties in patients with AS, performing as well as BASDAI, but with higher sensitivity to inflammatory signs. Patients’ quality of life and impairment of productive activity are associated with  ASDAS scores.

Disclosure:

A. Sellas-Fernandez,
None;

J. L. Guerra Vázquez,
None;

J. L. Casals,
None;

C. Gonzalez Fernandez,
None;

R. Miguelez,
None;

J. Rosas,
None;

A. Fernandez-Nebro,
None;

C. Peralta Ginés,
None;

C. Montilla-Morales,
None;

X. Juanola,
None;

M. Abad,
None;

A. Alonso,
None;

A. Hernández-Sanz,
None;

L. F. Linares,
None;

J. Medina,
None;

J. Rovira,
None;

J. C. Torre-Alonso,
None;

A. Willisch,
None;

E. Collantes-Estevez,
None;

A. Ruiz-Zorrilla,

Abbvie,

3.

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