Skip to main content
Top
Published in: Current Rheumatology Reports 6/2015

01-06-2015 | Spondyloarthritis (MA Khan, Section Editor)

Looking Into the New ASAS Classification Criteria for Axial Spondyloarthritis Through the Other Side of the Glass

Authors: Nurullah Akkoc, Muhammad A. Khan

Published in: Current Rheumatology Reports | Issue 6/2015

Login to get access

Abstract

The new concept of axial spondylitis (axSpA) and the Assessment of Spondyloarthritis International Society (ASAS) classification criteria for axSpA have induced new clinical research that has broadened our understanding of spondyloarthritis (SpA) and has had indeed a positive impact on earlier diagnosis and treatment of patients with axSpA who have not yet developed radiographic sacroiliitis. The primary goal of any valid classification criteria for any disease is to provide a homogeneous study population with a common etiopathogenesis, similar prognosis, and similar response to identical treatment. Without such a homogeneous study population, robust clinical and basic science research in any subtype of SpA is not possible. All criteria are dynamic concepts that need updating as our knowledge advances and our review of the ASAS classification criteria of axSpA indicates that complex multi-selection design and unclear (not mutually exclusive) definitions of the imaging and clinical arms of the criteria results in patient heterogeneity across study populations. Therefore, there is a need to improve the validity of the ASAS criteria for axSpA. It is our opinion that in the meantime, the clinically well-established entity of AS, as defined by the modified New York (mNY) criteria, should be preserved for the most accurate comparison of the new research studies with those conducted over the last three decades, and that the use of the ASAS criteria should be restricted to patients with nr-axSpA, who are not recognized by the mNY criteria.
Literature
2.
3.
go back to reference Khan MA, van der Linden SM, Kushner I, Valkenburg HA, Cats A. Spondylitic disease without radiologic evidence of sacroiliitis in relatives of HLA-B27 positive ankylosing spondylitis patients. Arthritis Rheum. 1985;28(1):40–3.CrossRefPubMed Khan MA, van der Linden SM, Kushner I, Valkenburg HA, Cats A. Spondylitic disease without radiologic evidence of sacroiliitis in relatives of HLA-B27 positive ankylosing spondylitis patients. Arthritis Rheum. 1985;28(1):40–3.CrossRefPubMed
4.
go back to reference Rudwaleit M, van der Heijde D, Landewe R, Listing J, Akkoc N, Brandt J, et al. The development of Assessment of Spondyloarthritis International Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68(6):777–83. doi:10.1136/ard.2009.108233. This study proposes new classification criteria for axial SpA that include radiographic and non-radiographic stages of the disease.CrossRefPubMed Rudwaleit M, van der Heijde D, Landewe R, Listing J, Akkoc N, Brandt J, et al. The development of Assessment of Spondyloarthritis International Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68(6):777–83. doi:10.​1136/​ard.​2009.​108233. This study proposes new classification criteria for axial SpA that include radiographic and non-radiographic stages of the disease.CrossRefPubMed
5.•
go back to reference Rudwaleit M, van der Heijde D, Landewe R, Akkoc N, Brandt J, Chou CT, et al. The Assessment of Spondyloarthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis. 2011;70(1):25–31. doi:10.1136/ard.2010.133645. This study proposes new classification criteria for SpA that have peripheral manifestations. The performance of the combined use of the axial and peripheral SpA are assessed, also relative to the ESSG and Amor Criteria.CrossRefPubMed Rudwaleit M, van der Heijde D, Landewe R, Akkoc N, Brandt J, Chou CT, et al. The Assessment of Spondyloarthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis. 2011;70(1):25–31. doi:10.​1136/​ard.​2010.​133645. This study proposes new classification criteria for SpA that have peripheral manifestations. The performance of the combined use of the axial and peripheral SpA are assessed, also relative to the ESSG and Amor Criteria.CrossRefPubMed
6.••
go back to reference Deodhar A, Reveille JD, van den Bosch F, Braun J, Burgos-Vargas R, Caplan L, et al. The concept of axial spondyloarthritis: joint statement of the spondyloarthritis research and treatment network and the Assessment of Spondyloarthritis International Society in response to the US Food and Drug Administration’s comments and concerns. Arthritis Rheum. 2014;66(10):2649–56. doi:10.1002/art.38776. This special article summarises the discussions that took place at the meeting between SPARTAN and ASAS leadership, which was held to explore the consensus and also the differences regarding the concept of axial SpA after the FDA’s rebuttal of approving TNF inhibitors for the treatment of nonradiographic axial SpA.CrossRef Deodhar A, Reveille JD, van den Bosch F, Braun J, Burgos-Vargas R, Caplan L, et al. The concept of axial spondyloarthritis: joint statement of the spondyloarthritis research and treatment network and the Assessment of Spondyloarthritis International Society in response to the US Food and Drug Administration’s comments and concerns. Arthritis Rheum. 2014;66(10):2649–56. doi:10.​1002/​art.​38776. This special article summarises the discussions that took place at the meeting between SPARTAN and ASAS leadership, which was held to explore the consensus and also the differences regarding the concept of axial SpA after the FDA’s rebuttal of approving TNF inhibitors for the treatment of nonradiographic axial SpA.CrossRef
7.••
go back to reference Robinson PC, Wordsworth BP, Reveille JD, Brown MA. Axial spondyloarthritis: a new disease entity, not necessarily early ankylosing spondylitis. Ann Rheum Dis. 2012;72(2):162–4. doi:10.1136/annrheumdis-2012-202073. This point of view article discusses the differences between the radiographic and non-radiographic subgroups of axial SpA and suggests that the modified New York criteria for ankylosing spondylitis should remain for clinical use and research studies.CrossRefPubMed Robinson PC, Wordsworth BP, Reveille JD, Brown MA. Axial spondyloarthritis: a new disease entity, not necessarily early ankylosing spondylitis. Ann Rheum Dis. 2012;72(2):162–4. doi:10.​1136/​annrheumdis-2012-202073. This point of view article discusses the differences between the radiographic and non-radiographic subgroups of axial SpA and suggests that the modified New York criteria for ankylosing spondylitis should remain for clinical use and research studies.CrossRefPubMed
8.
go back to reference Zeidler H, Amor B. The Assessment in Spondyloarthritis International Society (ASAS) classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general: the spondyloarthritis concept in progress. Ann Rheum Dis. 2011;70(1):1–3. doi:10.1136/ard.2010.135889.CrossRefPubMed Zeidler H, Amor B. The Assessment in Spondyloarthritis International Society (ASAS) classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general: the spondyloarthritis concept in progress. Ann Rheum Dis. 2011;70(1):1–3. doi:10.​1136/​ard.​2010.​135889.CrossRefPubMed
9.•
go back to reference Taylor WJ, Robinson PC. Classification Criteria: Peripheral Spondyloarthropathy and Psoriatic Arthritis. Current Rheumatology Reports. 2013;15(4). This critical review of the implications of the ASAS classification criteria, with particular reference to psoriatic arthritis, suggest that there are more advantages in distinguishing particular subsets of SpA than there are in unifying them into a single disorder. Taylor WJ, Robinson PC. Classification Criteria: Peripheral Spondyloarthropathy and Psoriatic Arthritis. Current Rheumatology Reports. 2013;15(4). This critical review of the implications of the ASAS classification criteria, with particular reference to psoriatic arthritis, suggest that there are more advantages in distinguishing particular subsets of SpA than there are in unifying them into a single disorder.
10.•
go back to reference Akkoc N, Khan MA. ASAS classification criteria for axial spondyloarthritis: a look at the unfilled part of the glass. Clin Exp Rheumatol. 2014;32(Suppl 87(6)):14–5. This brief letter points out the differences between the clinical and imaging arms of axial SpA and concludes that complex multi-arm structure of the ASAS classification criteria is a potential source of heterogeneity. Akkoc N, Khan MA. ASAS classification criteria for axial spondyloarthritis: a look at the unfilled part of the glass. Clin Exp Rheumatol. 2014;32(Suppl 87(6)):14–5. This brief letter points out the differences between the clinical and imaging arms of axial SpA and concludes that complex multi-arm structure of the ASAS classification criteria is a potential source of heterogeneity.
11.
go back to reference van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 1984;27(4):361–8.CrossRefPubMed van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 1984;27(4):361–8.CrossRefPubMed
13.
go back to reference Dougados M, van der Linden S, Juhlin R, Huitfeldt B, Amor B, Calin A, et al. The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum. 1991;34(10):1218–27.CrossRefPubMed Dougados M, van der Linden S, Juhlin R, Huitfeldt B, Amor B, Calin A, et al. The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum. 1991;34(10):1218–27.CrossRefPubMed
14.
go back to reference Amor B, Dougados M, Mijiyawa M. Criteria of the classification of spondylarthropathies. Rev Rhum Mal Osteoartic. 1990;57(2):85–9.PubMed Amor B, Dougados M, Mijiyawa M. Criteria of the classification of spondylarthropathies. Rev Rhum Mal Osteoartic. 1990;57(2):85–9.PubMed
15.•
go back to reference Sieper J, van der Heijde D. Review: nonradiographic axial spondyloarthritis: new definition of an old disease? Arthritis Rheum. 2013;65(3):543–51. doi:10.1002/art.37803. This review addresses the several questions that have been raised regarding the new definition of nonradiographic axial SpA as part of the axial SpA.CrossRefPubMed Sieper J, van der Heijde D. Review: nonradiographic axial spondyloarthritis: new definition of an old disease? Arthritis Rheum. 2013;65(3):543–51. doi:10.​1002/​art.​37803. This review addresses the several questions that have been raised regarding the new definition of nonradiographic axial SpA as part of the axial SpA.CrossRefPubMed
16.
go back to reference van den Berg R, van Gaalen F, van der Helm-van Mil A, Huizinga T, van der Heijde D. Performance of classification criteria for peripheral spondyloarthritis and psoriatic arthritis in the Leiden Early Arthritis cohort. Ann Rheum Dis. 2012;71(8):1366–9. doi:10.1136/annrheumdis-2011-201081.CrossRefPubMed van den Berg R, van Gaalen F, van der Helm-van Mil A, Huizinga T, van der Heijde D. Performance of classification criteria for peripheral spondyloarthritis and psoriatic arthritis in the Leiden Early Arthritis cohort. Ann Rheum Dis. 2012;71(8):1366–9. doi:10.​1136/​annrheumdis-2011-201081.CrossRefPubMed
18.
go back to reference Ginsburg WW, Cohen MD. Peripheral arthritis in ankylosing spondylitis. A review of 209 patients followed up for more than 20 years. Mayo Clin Proc. 1983;58(9):593–6.PubMed Ginsburg WW, Cohen MD. Peripheral arthritis in ankylosing spondylitis. A review of 209 patients followed up for more than 20 years. Mayo Clin Proc. 1983;58(9):593–6.PubMed
19.
go back to reference Schattenkirchner M, Kruger K. Natural course and prognosis of HLA-B27-positive oligoarthritis. Clin Rheumatol. 1987;6(Suppl 2):83–6. Schattenkirchner M, Kruger K. Natural course and prognosis of HLA-B27-positive oligoarthritis. Clin Rheumatol. 1987;6(Suppl 2):83–6.
20.
go back to reference Helliwell PS, Hickling P, Wright V. Do the radiological changes of classic ankylosing spondylitis differ from the changes found in the spondylitis associated with inflammatory bowel disease, psoriasis, and reactive arthritis? Ann Rheum Dis. 1998;57(3):135–40.CrossRefPubMedCentralPubMed Helliwell PS, Hickling P, Wright V. Do the radiological changes of classic ankylosing spondylitis differ from the changes found in the spondylitis associated with inflammatory bowel disease, psoriasis, and reactive arthritis? Ann Rheum Dis. 1998;57(3):135–40.CrossRefPubMedCentralPubMed
21.
go back to reference Perez Alamino R, Maldonado Cocco JA, Citera G, Arturi P, Vazquez-Mellado J, Sampaio-Barros PD, et al. Differential features between primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease. J Rheumatol. 2011;38(8):1656–60. doi:10.3899/jrheum.101049.CrossRefPubMed Perez Alamino R, Maldonado Cocco JA, Citera G, Arturi P, Vazquez-Mellado J, Sampaio-Barros PD, et al. Differential features between primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease. J Rheumatol. 2011;38(8):1656–60. doi:10.​3899/​jrheum.​101049.CrossRefPubMed
22.•
go back to reference Lubrano E, Spadaro A. Axial psoriatic arthritis: an intriguing clinical entity or a subset of an intriguing disease? Clin Rheumatol. 2012;31(7):1027–32. doi:10.1007/s10067-012-1990-8. A comprehenesive review on the diagnosis and treatment of axial psoriatic arthritis.CrossRefPubMed Lubrano E, Spadaro A. Axial psoriatic arthritis: an intriguing clinical entity or a subset of an intriguing disease? Clin Rheumatol. 2012;31(7):1027–32. doi:10.​1007/​s10067-012-1990-8. A comprehenesive review on the diagnosis and treatment of axial psoriatic arthritis.CrossRefPubMed
23.
go back to reference Queiro R, Belzunegui J, Gonzalez C, De DJ, Sarasqueta C, Torre JC, et al. Clinically asymptomatic axial disease in psoriatic spondyloarthropathy. A retrospective study. Clin Rheumatol. 2002;21(1):10–3.CrossRefPubMed Queiro R, Belzunegui J, Gonzalez C, De DJ, Sarasqueta C, Torre JC, et al. Clinically asymptomatic axial disease in psoriatic spondyloarthropathy. A retrospective study. Clin Rheumatol. 2002;21(1):10–3.CrossRefPubMed
24.
25.
go back to reference Thom N, Ritchlin CT, Zhang X, Reveille J, Weisman MH. Prevalence of chronic axial pain, inflammatory back pain and spondyloarthritis in diagnosed psoriasis. Arthritis Care Res (Hoboken). 2014. doi:10.1002/acr.22528. Thom N, Ritchlin CT, Zhang X, Reveille J, Weisman MH. Prevalence of chronic axial pain, inflammatory back pain and spondyloarthritis in diagnosed psoriasis. Arthritis Care Res (Hoboken). 2014. doi:10.​1002/​acr.​22528.
27.
go back to reference Williamson L, Dockerty JL, Dalbeth N, McNally E, Ostlere S, Wordsworth BP. Clinical assessment of sacroiliitis and HLA-B27 are poor predictors of sacroiliitis diagnosed by magnetic resonance imaging in psoriatic arthritis. Rheumatology (Oxford). 2004;43(1):85–8. doi:10.1093/rheumatology/keg475.CrossRef Williamson L, Dockerty JL, Dalbeth N, McNally E, Ostlere S, Wordsworth BP. Clinical assessment of sacroiliitis and HLA-B27 are poor predictors of sacroiliitis diagnosed by magnetic resonance imaging in psoriatic arthritis. Rheumatology (Oxford). 2004;43(1):85–8. doi:10.​1093/​rheumatology/​keg475.CrossRef
28.
go back to reference Queiro R, Maiz O, Intxausti J, de Dios JR, Belzunegui J, Gonzalez C, et al. Subclinical sacroiliitis in inflammatory bowel disease: a clinical and follow-up study. Clin Rheumatol. 2000;19(6):445–9.CrossRefPubMed Queiro R, Maiz O, Intxausti J, de Dios JR, Belzunegui J, Gonzalez C, et al. Subclinical sacroiliitis in inflammatory bowel disease: a clinical and follow-up study. Clin Rheumatol. 2000;19(6):445–9.CrossRefPubMed
29.
go back to reference Leclerc-Jacob S, Lux G, Rat AC, Laurent V, Blum A, Chary-Valckenaere I, et al. The prevalence of inflammatory sacroiliitis assessed on magnetic resonance imaging of inflammatory bowel disease: a retrospective study performed on 186 patients. Aliment Pharmacol Ther. 2014;39(9):957–62. doi:10.1111/apt.12680.CrossRefPubMed Leclerc-Jacob S, Lux G, Rat AC, Laurent V, Blum A, Chary-Valckenaere I, et al. The prevalence of inflammatory sacroiliitis assessed on magnetic resonance imaging of inflammatory bowel disease: a retrospective study performed on 186 patients. Aliment Pharmacol Ther. 2014;39(9):957–62. doi:10.​1111/​apt.​12680.CrossRefPubMed
30.
go back to reference Sany J, Rosenberg F, Panis G, Serre H. Unclassified HLA-B27 inflammatory rheumatic diseases: follow up of 23 patients. Arthritis Rheum. 1980;23(2):258–9.CrossRefPubMed Sany J, Rosenberg F, Panis G, Serre H. Unclassified HLA-B27 inflammatory rheumatic diseases: follow up of 23 patients. Arthritis Rheum. 1980;23(2):258–9.CrossRefPubMed
31.
go back to reference Mau W, Zeidler H, Mau R, Majewski A, Freyschmidt J, Stangel W, et al. Clinical features and prognosis of patients with possible ankylosing spondylitis. Results of a 10-year follow up. J Rheumatol. 1988;15(7):1109–14.PubMed Mau W, Zeidler H, Mau R, Majewski A, Freyschmidt J, Stangel W, et al. Clinical features and prognosis of patients with possible ankylosing spondylitis. Results of a 10-year follow up. J Rheumatol. 1988;15(7):1109–14.PubMed
32.
go back to reference Oostveen J, Prevo R, den Boer J, van de Laar M. Early detection of sacroiliitis on magnetic resonance imaging and subsequent development of sacroiliitis on plain radiography. A prospective, longitudinal study. J Rheumatol. 1999;26(9):1953–8.PubMed Oostveen J, Prevo R, den Boer J, van de Laar M. Early detection of sacroiliitis on magnetic resonance imaging and subsequent development of sacroiliitis on plain radiography. A prospective, longitudinal study. J Rheumatol. 1999;26(9):1953–8.PubMed
33.
go back to reference Kumar A, Bansal M, Srivastava DN, Pandhi A, Menon A, Mehra NK, et al. Long-term outcome of undifferentiated spondylarthropathy. Rheumatol Int. 2001;20(6):221–4.CrossRefPubMed Kumar A, Bansal M, Srivastava DN, Pandhi A, Menon A, Mehra NK, et al. Long-term outcome of undifferentiated spondylarthropathy. Rheumatol Int. 2001;20(6):221–4.CrossRefPubMed
34.
go back to reference Sampaio-Barros PD, Bertolo MB, Kraemer MH, Marques-Neto JF, Samara AM. Undifferentiated spondyloarthropathies: a 2-year follow-up study. Clin Rheumatol. 2001;20(3):201–6.CrossRefPubMed Sampaio-Barros PD, Bertolo MB, Kraemer MH, Marques-Neto JF, Samara AM. Undifferentiated spondyloarthropathies: a 2-year follow-up study. Clin Rheumatol. 2001;20(3):201–6.CrossRefPubMed
35.
go back to reference Huerta-Sil G, Casasola-Vargas JC, Londono JD, Rivas-Ruiz R, Chavez J, Pacheco-Tena C, et al. Low grade radiographic sacroiliitis as prognostic factor in patients with undifferentiated spondyloarthritis fulfilling diagnostic criteria for ankylosing spondylitis throughout follow up. Ann Rheum Dis. 2006;65(5):642–6. doi:10.1136/ard.2005.043471.CrossRefPubMedCentralPubMed Huerta-Sil G, Casasola-Vargas JC, Londono JD, Rivas-Ruiz R, Chavez J, Pacheco-Tena C, et al. Low grade radiographic sacroiliitis as prognostic factor in patients with undifferentiated spondyloarthritis fulfilling diagnostic criteria for ankylosing spondylitis throughout follow up. Ann Rheum Dis. 2006;65(5):642–6. doi:10.​1136/​ard.​2005.​043471.CrossRefPubMedCentralPubMed
36.
go back to reference Bennett AN, McGonagle D, O’Connor P, Hensor EM, Sivera F, Coates LC, et al. Severity of baseline magnetic resonance imaging-evident sacroiliitis and HLA-B27 status in early inflammatory back pain predict radiographically evident ankylosing spondylitis at eight years. Arthritis Rheum. 2008;58(11):3413–8. doi:10.1002/art.24024.CrossRefPubMed Bennett AN, McGonagle D, O’Connor P, Hensor EM, Sivera F, Coates LC, et al. Severity of baseline magnetic resonance imaging-evident sacroiliitis and HLA-B27 status in early inflammatory back pain predict radiographically evident ankylosing spondylitis at eight years. Arthritis Rheum. 2008;58(11):3413–8. doi:10.​1002/​art.​24024.CrossRefPubMed
38.•
go back to reference Poddubnyy D, Rudwaleit M, Haibel H, Listing J, Marker-Hermann E, Zeidler H, et al. Rates and predictors of radiographic sacroiliitis progression over 2 years in patients with axial spondyloarthritis. Ann Rheum Dis. 2011;70(8):1369–74. doi:10.1136/ard.2010.145995. This study reported that progression of radiographic sacroiliitis by at least one grade over 2 years only in a small percentage of patients with early axial spondyloarthritis and that elevated level of CRP, was found to be a strong positive predictor of progression.CrossRefPubMed Poddubnyy D, Rudwaleit M, Haibel H, Listing J, Marker-Hermann E, Zeidler H, et al. Rates and predictors of radiographic sacroiliitis progression over 2 years in patients with axial spondyloarthritis. Ann Rheum Dis. 2011;70(8):1369–74. doi:10.​1136/​ard.​2010.​145995. This study reported that progression of radiographic sacroiliitis by at least one grade over 2 years only in a small percentage of patients with early axial spondyloarthritis and that elevated level of CRP, was found to be a strong positive predictor of progression.CrossRefPubMed
39.•
go back to reference Aydin SZ, Maksymowych WP, Bennett AN, McGonagle D, Emery P, Marzo-Ortega H. Validation of the ASAS criteria and definition of a positive MRI of the sacroiliac joint in an inception cohort of axial spondyloarthritis followed up for 8 years. Ann Rheum Dis. 2012;71(1):56–60. doi:10.1136/ard.2011.153064. This study reported that a positive baseline MRI had 100 % sensitivity but a low specificity for subsequent radiographic sacroiliitis, both with global assessment or ASAS definition of a positive MRI. This study estimated the progression rate to radiographic sacroilitiis in the Leeds cohort as 14.2 % over eight years, after excluding the patients, who fulfilled the modified New York criteria at baseline.CrossRefPubMed Aydin SZ, Maksymowych WP, Bennett AN, McGonagle D, Emery P, Marzo-Ortega H. Validation of the ASAS criteria and definition of a positive MRI of the sacroiliac joint in an inception cohort of axial spondyloarthritis followed up for 8 years. Ann Rheum Dis. 2012;71(1):56–60. doi:10.​1136/​ard.​2011.​153064. This study reported that a positive baseline MRI had 100 % sensitivity but a low specificity for subsequent radiographic sacroiliitis, both with global assessment or ASAS definition of a positive MRI. This study estimated the progression rate to radiographic sacroilitiis in the Leeds cohort as 14.2 % over eight years, after excluding the patients, who fulfilled the modified New York criteria at baseline.CrossRefPubMed
40.
go back to reference Rudwaleit M, Haibel H, Baraliakos X, Listing J, Marker-Hermann E, Zeidler H, et al. The early disease stage in axial spondylarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis Rheum. 2009;60(3):717–27. doi:10.1002/art.24483.CrossRefPubMed Rudwaleit M, Haibel H, Baraliakos X, Listing J, Marker-Hermann E, Zeidler H, et al. The early disease stage in axial spondylarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis Rheum. 2009;60(3):717–27. doi:10.​1002/​art.​24483.CrossRefPubMed
41.•
go back to reference Gong Y, Zheng N, Chen SB, Xiao ZY, Wu MY, Liu Y, et al. Ten years’ experience with needle biopsy in the early diagnosis of sacroiliitis. Arthritis Rheum. 2012;64(5):1399–406. doi:10.1002/art.33453. This study evaluated the usefulness of needle biopsy in the diagnosis of early sacroiliitis and showed that MRI, though of low sensitivity, is specific for the diagnosis of early sacroiliitis and that evidence of MRI sacroiliitis is associtaed with future progression of sacroiliitis detected by computerized tomography.CrossRefPubMed Gong Y, Zheng N, Chen SB, Xiao ZY, Wu MY, Liu Y, et al. Ten years’ experience with needle biopsy in the early diagnosis of sacroiliitis. Arthritis Rheum. 2012;64(5):1399–406. doi:10.​1002/​art.​33453. This study evaluated the usefulness of needle biopsy in the diagnosis of early sacroiliitis and showed that MRI, though of low sensitivity, is specific for the diagnosis of early sacroiliitis and that evidence of MRI sacroiliitis is associtaed with future progression of sacroiliitis detected by computerized tomography.CrossRefPubMed
42.
go back to reference van den Berg R, de Hooge M, van Gaalen F, Reijnierse M, Huizinga T, van der Heijde D. Percentage of patients with spondyloarthritis in patients referred because of chronic back pain and performance of classification criteria: experience from the Spondyloarthritis Caught Early (SPACE) cohort. Rheumatology (Oxford). 2013. doi:10.1093/rheumatology/ket164. van den Berg R, de Hooge M, van Gaalen F, Reijnierse M, Huizinga T, van der Heijde D. Percentage of patients with spondyloarthritis in patients referred because of chronic back pain and performance of classification criteria: experience from the Spondyloarthritis Caught Early (SPACE) cohort. Rheumatology (Oxford). 2013. doi:10.​1093/​rheumatology/​ket164.
43.••
go back to reference Molto A, Paternotte S, van der Heijde D, Claudepierre P, Rudwaleit M, Dougados M. Evaluation of the validity of the different arms of the ASAS set of criteria for axial spondyloarthritis and description of the different imaging abnormalities suggestive of spondyloarthritis: data from the DESIR cohort. Ann Rheum Dis. 2014. doi:10.1136/annrheumdis-2013-204262. This study compares the patient characteristics between the patients fulfilling the imaging and clinical arms of the patients with axial SpA in the DESIR cohort and also report on the prevalence of the different imaging abnormalities in the two arms.PubMed Molto A, Paternotte S, van der Heijde D, Claudepierre P, Rudwaleit M, Dougados M. Evaluation of the validity of the different arms of the ASAS set of criteria for axial spondyloarthritis and description of the different imaging abnormalities suggestive of spondyloarthritis: data from the DESIR cohort. Ann Rheum Dis. 2014. doi:10.​1136/​annrheumdis-2013-204262. This study compares the patient characteristics between the patients fulfilling the imaging and clinical arms of the patients with axial SpA in the DESIR cohort and also report on the prevalence of the different imaging abnormalities in the two arms.PubMed
44.
go back to reference Dougados M, D’Agostino MA, Benessiano J, Berenbaum F, Breban M, Claudepierre P, et al. The DESIR cohort: a 10-year follow-up of early inflammatory back pain in France: study design and baseline characteristics of the 708 recruited patients. Joint Bone Spine: Rev Rhum. 2011;78(6):598–603. doi:10.1016/j.jbspin.2011.01.013.CrossRef Dougados M, D’Agostino MA, Benessiano J, Berenbaum F, Breban M, Claudepierre P, et al. The DESIR cohort: a 10-year follow-up of early inflammatory back pain in France: study design and baseline characteristics of the 708 recruited patients. Joint Bone Spine: Rev Rhum. 2011;78(6):598–603. doi:10.​1016/​j.​jbspin.​2011.​01.​013.CrossRef
45.
go back to reference Tournadre A, Pereira B, Lhoste A, Dubost JJ, Ristori JM, Claudepierre P, et al. Differences between women and men with recent-onset axial spondyloarthritis: results from a prospective multicenter French cohort. Arthritis Care Res (Hoboken). 2013;65(9):1482–9. doi:10.1002/acr.22001.CrossRef Tournadre A, Pereira B, Lhoste A, Dubost JJ, Ristori JM, Claudepierre P, et al. Differences between women and men with recent-onset axial spondyloarthritis: results from a prospective multicenter French cohort. Arthritis Care Res (Hoboken). 2013;65(9):1482–9. doi:10.​1002/​acr.​22001.CrossRef
46.
go back to reference de Hooge M, van den Berg R, Navarro-Compan V, Reijnierse M, van Gaalen F, Fagerli K, et al. Prevalence of structural lesions seen on MRI-spine in patients with (possible) axial spondyloarthritis (axSpA) included in the SPACE-cohort. Arthritis Rheum. 2013;65:S1237–S. de Hooge M, van den Berg R, Navarro-Compan V, Reijnierse M, van Gaalen F, Fagerli K, et al. Prevalence of structural lesions seen on MRI-spine in patients with (possible) axial spondyloarthritis (axSpA) included in the SPACE-cohort. Arthritis Rheum. 2013;65:S1237–S.
47.
go back to reference van den Berg R, de Hooge M, Navarro-Compan V, Reijnierse M, van Gaalen F, Fagerli K, et al. Prevalence of structural lesions on MRI of the sacroiliac joints in patients with early axial spondyloarthritis and patients with back pain. Arthritis Rheum. 2013;65:S1238–S. van den Berg R, de Hooge M, Navarro-Compan V, Reijnierse M, van Gaalen F, Fagerli K, et al. Prevalence of structural lesions on MRI of the sacroiliac joints in patients with early axial spondyloarthritis and patients with back pain. Arthritis Rheum. 2013;65:S1238–S.
48.
go back to reference Davis Jr JC, Van Der Heijde D, Braun J, Dougados M, Cush J, Clegg DO, et al. Recombinant human tumor necrosis factor receptor (etanercept) for treating ankylosing spondylitis: a randomized, controlled trial. Arthritis Rheum. 2003;48(11):3230–6. doi:10.1002/art.11325.CrossRefPubMed Davis Jr JC, Van Der Heijde D, Braun J, Dougados M, Cush J, Clegg DO, et al. Recombinant human tumor necrosis factor receptor (etanercept) for treating ankylosing spondylitis: a randomized, controlled trial. Arthritis Rheum. 2003;48(11):3230–6. doi:10.​1002/​art.​11325.CrossRefPubMed
49.
go back to reference van der Heijde D, Dijkmans B, Geusens P, Sieper J, DeWoody K, Williamson P, et al. Efficacy and safety of infliximab in patients with ankylosing spondylitis: results of a randomized, placebo-controlled trial (ASSERT). Arthritis Rheum. 2005;52(2):582–91. doi:10.1002/art.20852.CrossRefPubMed van der Heijde D, Dijkmans B, Geusens P, Sieper J, DeWoody K, Williamson P, et al. Efficacy and safety of infliximab in patients with ankylosing spondylitis: results of a randomized, placebo-controlled trial (ASSERT). Arthritis Rheum. 2005;52(2):582–91. doi:10.​1002/​art.​20852.CrossRefPubMed
50.
go back to reference van der Heijde D, Kivitz A, Schiff MH, Sieper J, Dijkmans BA, Braun J, et al. Efficacy and safety of adalimumab in patients with ankylosing spondylitis: results of a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2006;54(7):2136–46. doi:10.1002/art.21913.CrossRefPubMed van der Heijde D, Kivitz A, Schiff MH, Sieper J, Dijkmans BA, Braun J, et al. Efficacy and safety of adalimumab in patients with ankylosing spondylitis: results of a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2006;54(7):2136–46. doi:10.​1002/​art.​21913.CrossRefPubMed
51.
go back to reference Inman RD, Davis Jr JC, Heijde D, Diekman L, Sieper J, Kim SI, et al. Efficacy and safety of golimumab in patients with ankylosing spondylitis: results of a randomized, double-blind, placebo-controlled, phase III trial. Arthritis Rheum. 2008;58(11):3402–12. doi:10.1002/art.23969.CrossRefPubMed Inman RD, Davis Jr JC, Heijde D, Diekman L, Sieper J, Kim SI, et al. Efficacy and safety of golimumab in patients with ankylosing spondylitis: results of a randomized, double-blind, placebo-controlled, phase III trial. Arthritis Rheum. 2008;58(11):3402–12. doi:10.​1002/​art.​23969.CrossRefPubMed
52.•
go back to reference Landewe R, Braun J, Deodhar A, Dougados M, Maksymowych WP, Mease PJ, et al. Efficacy of certolizumab pegol on signs and symptoms of axial spondyloarthritis including ankylosing spondylitis: 24-week results of a double-blind randomised placebo-controlled phase 3 study. Ann Rheum Dis. 2014;73(1):39–47. doi:10.1136/annrheumdis-2013-204231. This is the first trial of a TNF inhibitor that included patients with ankylosing spondylitis and non-radiographic axSpA in one single study, which reported that certolizumab is effective in treating the signs and symptoms of axial SpA.CrossRefPubMedCentralPubMed Landewe R, Braun J, Deodhar A, Dougados M, Maksymowych WP, Mease PJ, et al. Efficacy of certolizumab pegol on signs and symptoms of axial spondyloarthritis including ankylosing spondylitis: 24-week results of a double-blind randomised placebo-controlled phase 3 study. Ann Rheum Dis. 2014;73(1):39–47. doi:10.​1136/​annrheumdis-2013-204231. This is the first trial of a TNF inhibitor that included patients with ankylosing spondylitis and non-radiographic axSpA in one single study, which reported that certolizumab is effective in treating the signs and symptoms of axial SpA.CrossRefPubMedCentralPubMed
53.•
go back to reference Sieper J, van der Heijde D, Dougados M, Mease PJ, Maksymowych WP, Brown MA, et al. Efficacy and safety of adalimumab in patients with non-radiographic axial spondyloarthritis: results of a randomised placebo-controlled trial (ABILITY-1). Ann Rheum Dis. 2013;72(6):815–22. doi:10.1136/annrheumdis-2012-201766. The first clinical trial that utilized the ASAS axial SpA criteria in classifying nr-axSpA patients which showed that adalimumab has a positive benefit–risk profile in active nr-axSpA patients with inadequate response to NSAIDs.CrossRefPubMedCentralPubMed Sieper J, van der Heijde D, Dougados M, Mease PJ, Maksymowych WP, Brown MA, et al. Efficacy and safety of adalimumab in patients with non-radiographic axial spondyloarthritis: results of a randomised placebo-controlled trial (ABILITY-1). Ann Rheum Dis. 2013;72(6):815–22. doi:10.​1136/​annrheumdis-2012-201766. The first clinical trial that utilized the ASAS axial SpA criteria in classifying nr-axSpA patients which showed that adalimumab has a positive benefit–risk profile in active nr-axSpA patients with inadequate response to NSAIDs.CrossRefPubMedCentralPubMed
54.•
go back to reference Dougados M, van der Heijde D, Sieper J, Braun J, Maksymowych WP, Citera G, et al. Symptomatic efficacy of etanercept and its effects on objective signs of inflammation in early nonradiographic axial spondyloarthritis: a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheumatol. 2014;66(8):2091–102. doi:10.1002/art.38721. In this randomized controlled trial etanercept showed good efficacy in patients with nonradiographic axial SpA over 12 weeks with clinical/functional improvement continuing through 24 weeks.CrossRefPubMed Dougados M, van der Heijde D, Sieper J, Braun J, Maksymowych WP, Citera G, et al. Symptomatic efficacy of etanercept and its effects on objective signs of inflammation in early nonradiographic axial spondyloarthritis: a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheumatol. 2014;66(8):2091–102. doi:10.​1002/​art.​38721. In this randomized controlled trial etanercept showed good efficacy in patients with nonradiographic axial SpA over 12 weeks with clinical/functional improvement continuing through 24 weeks.CrossRefPubMed
55.
go back to reference Sieper J, van der Heijde D, Dougados M, Maksymowych WP, Boice J, Bergan G, et al. A randomized, double-blind, placebo-controlled, 16-week study of subcutaneous golimumab in patients with active nonradiographic axial spondyloarthritis. Arthritis Rheum. 2014;66(11):S1283–4. Sieper J, van der Heijde D, Dougados M, Maksymowych WP, Boice J, Bergan G, et al. A randomized, double-blind, placebo-controlled, 16-week study of subcutaneous golimumab in patients with active nonradiographic axial spondyloarthritis. Arthritis Rheum. 2014;66(11):S1283–4.
57.••
go back to reference Ciurea A, Scherer A, Exer P, Bernhard J, Dudler J, Beyeler B, et al. Tumor necrosis factor alpha inhibition in radiographic and nonradiographic axial spondyloarthritis: results from a large observational cohort. Arthritis Rheum. 2013;65(12):3096–106. doi:10.1002/art.38140. This study from the Swiss Clinical Quality Management (SCQM) Cohort showed that response to anti-TNF treatment is better in the group of patients with radiographic axial SpA than in the group with nonradiographic axial SpA, with the exception of patients with elevated CRP levels at baseline.CrossRefPubMed Ciurea A, Scherer A, Exer P, Bernhard J, Dudler J, Beyeler B, et al. Tumor necrosis factor alpha inhibition in radiographic and nonradiographic axial spondyloarthritis: results from a large observational cohort. Arthritis Rheum. 2013;65(12):3096–106. doi:10.​1002/​art.​38140. This study from the Swiss Clinical Quality Management (SCQM) Cohort showed that response to anti-TNF treatment is better in the group of patients with radiographic axial SpA than in the group with nonradiographic axial SpA, with the exception of patients with elevated CRP levels at baseline.CrossRefPubMed
59.
go back to reference Davis Jr JC, Van der Heijde DM, Dougados M, Braun J, Cush JJ, Clegg DO, et al. Baseline factors that influence ASAS 20 response in patients with ankylosing spondylitis treated with etanercept. J Rheumatol. 2005;32(9):1751–4.PubMed Davis Jr JC, Van der Heijde DM, Dougados M, Braun J, Cush JJ, Clegg DO, et al. Baseline factors that influence ASAS 20 response in patients with ankylosing spondylitis treated with etanercept. J Rheumatol. 2005;32(9):1751–4.PubMed
60.
go back to reference Lord PA, Farragher TM, Lunt M, Watson KD, Symmons DP, Hyrich KL, et al. Predictors of response to anti-TNF therapy in ankylosing spondylitis: results from the British Society for Rheumatology Biologics Register. Rheumatology (Oxford). 2010;49(3):563–70. doi:10.1093/rheumatology/kep422.CrossRef Lord PA, Farragher TM, Lunt M, Watson KD, Symmons DP, Hyrich KL, et al. Predictors of response to anti-TNF therapy in ankylosing spondylitis: results from the British Society for Rheumatology Biologics Register. Rheumatology (Oxford). 2010;49(3):563–70. doi:10.​1093/​rheumatology/​kep422.CrossRef
62.
go back to reference van Hoeven L, Luime J, Han H, Vergouwe Y, Weel A. Identifying axial spondyloarthritis in Dutch primary care patients, ages 20–45 years, with chronic low back pain. Arthritis Care Res (Hoboken). 2014;66(3):446–53. doi:10.1002/acr.22180.CrossRef van Hoeven L, Luime J, Han H, Vergouwe Y, Weel A. Identifying axial spondyloarthritis in Dutch primary care patients, ages 20–45 years, with chronic low back pain. Arthritis Care Res (Hoboken). 2014;66(3):446–53. doi:10.​1002/​acr.​22180.CrossRef
63.
go back to reference Sieper J, Lenaerts J, Wollenhaupt J, Rudwaleit M, Mazurov VI, Myasoutova L, et al. Efficacy and safety of infliximab plus naproxen versus naproxen alone in patients with early, active axial spondyloarthritis: results from the double-blind, placebo-controlled INFAST study, part 1. Ann Rheum Dis. 2014;73(1):101–7. doi:10.1136/annrheumdis-2012-203201.CrossRefPubMedCentralPubMed Sieper J, Lenaerts J, Wollenhaupt J, Rudwaleit M, Mazurov VI, Myasoutova L, et al. Efficacy and safety of infliximab plus naproxen versus naproxen alone in patients with early, active axial spondyloarthritis: results from the double-blind, placebo-controlled INFAST study, part 1. Ann Rheum Dis. 2014;73(1):101–7. doi:10.​1136/​annrheumdis-2012-203201.CrossRefPubMedCentralPubMed
64.
go back to reference Carette S, Graham D, Little H, Rubenstein J, Rosen P. The natural disease course of ankylosing spondylitis. Arthritis Rheum. 1983;26(2):186–90.CrossRefPubMed Carette S, Graham D, Little H, Rubenstein J, Rosen P. The natural disease course of ankylosing spondylitis. Arthritis Rheum. 1983;26(2):186–90.CrossRefPubMed
65.
go back to reference Poddubnyy D, Haibel H, Listing J, Marker-Hermann E, Zeidler H, Braun J, et al. Baseline radiographic damage, elevated acute-phase reactant levels, and cigarette smoking status predict spinal radiographic progression in early axial spondylarthritis. Arthritis Rheum. 2012;64(5):1388–98. doi:10.1002/art.33465.CrossRefPubMed Poddubnyy D, Haibel H, Listing J, Marker-Hermann E, Zeidler H, Braun J, et al. Baseline radiographic damage, elevated acute-phase reactant levels, and cigarette smoking status predict spinal radiographic progression in early axial spondylarthritis. Arthritis Rheum. 2012;64(5):1388–98. doi:10.​1002/​art.​33465.CrossRefPubMed
66.
go back to reference van Tubergen A, Ramiro S, van der Heijde D, Dougados M, Mielants H, Landewe R. Development of new syndesmophytes and bridges in ankylosing spondylitis and their predictors: a longitudinal study. Ann Rheum Dis. 2012;71(4):518–23. doi:10.1136/annrheumdis-2011-200411.CrossRefPubMed van Tubergen A, Ramiro S, van der Heijde D, Dougados M, Mielants H, Landewe R. Development of new syndesmophytes and bridges in ankylosing spondylitis and their predictors: a longitudinal study. Ann Rheum Dis. 2012;71(4):518–23. doi:10.​1136/​annrheumdis-2011-200411.CrossRefPubMed
67.
go back to reference Ward MM. Health-related quality of life in ankylosing spondylitis: a survey of 175 patients. Arthritis Care Res. 1999;12(4):247–55.CrossRefPubMed Ward MM. Health-related quality of life in ankylosing spondylitis: a survey of 175 patients. Arthritis Care Res. 1999;12(4):247–55.CrossRefPubMed
Metadata
Title
Looking Into the New ASAS Classification Criteria for Axial Spondyloarthritis Through the Other Side of the Glass
Authors
Nurullah Akkoc
Muhammad A. Khan
Publication date
01-06-2015
Publisher
Springer US
Published in
Current Rheumatology Reports / Issue 6/2015
Print ISSN: 1523-3774
Electronic ISSN: 1534-6307
DOI
https://doi.org/10.1007/s11926-015-0515-2

Other articles of this Issue 6/2015

Current Rheumatology Reports 6/2015 Go to the issue

Orphan Diseases (B Manger, Section Editor)

Multicentric Reticulohistiocytosis: a Critical Review

Orphan Diseases (B Manger, Section Editor)

Tumor-Induced Osteomalacia: an Up-to-Date Review

Spondyloarthritis (MA Khan, Section Editor)

Revisiting MHC Genes in Spondyloarthritis

PSORIATIC ARTHRITIS (O FITZGERALD AND P HELLIWELL, SECTION EDITORS)

Treat to Target in Psoriatic Arthritis—Evidence, Target, Research Agenda

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.