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Abstract Number: 555

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

Anna Moltó1, Simon Paternotte2, Denis Comet3, Cécile Hacquard-Bouder4, Martin Rudwaleit5, Pascal Claudepierre6, Désirée van der Heijde7 and Maxime Dougados1, 1Rheumatology B Department, Paris-Descartes University, APHP, Cochin Hospital, Paris, France, 2Rheumatology Department, Paris- Descartes University, Cochin hospital, Paris, France, 3Axonal, Nanterre, France, 4Abbott France, Rungis, France, 5Endokrinologikum Berlin, Berlin, Germany, 6Rheumatology, Henri Mondor Teaching Hospital, AP-HP, Créteil, France, 7Rheumatology, Leiden University Medical Center, Leiden, Netherlands

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: classification criteria, Diagnostic criteria, Outcome measures and spondylarthropathy

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Session Information

Title: Spondylarthropathies and Psoriatic Arthritis: Clinical Aspects and Treatment

Session Type: Abstract Submissions (ACR)

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.


Disclosure:

A. Moltó,
None;

S. Paternotte,
None;

D. Comet,
None;

C. Hacquard-Bouder,

Abbott Immunology Pharmaceuticals,

3;

M. Rudwaleit,
None;

P. Claudepierre,
None;

D. van der Heijde,

Abbott Laboratories; Amgen; AstraZeneca; BMS; Centocor: Chugai; Eli-Lilly; GSK; Merck; Novartis; Pfizer; Roche; Sanofi-Aventis; Schering-Plough; UCB; Wyeth,

5,

Imaging Rheumatology,

4;

M. Dougados,
None.

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