Is ASDAS better than BASDAI as a measure of disease activity in axial psoriatic arthritis?

Centre for Prognosis Studies in the Rheumatic Diseases, University of Toronto Psoriatic Arthritis Clinic, Toronto Western Hospital, Toronto, Ontario, Canada.
Annals of the rheumatic diseases (Impact Factor: 8.11). 12/2010; 69(12):2160-4. DOI: 10.1136/ard.2010.129726
Source: PubMed

ABSTRACT To assess the discriminative ability and correlation of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and Bath Ankylosing Spondylitis Activity Disease Activity Index (BASDAI) with disease activity in axial psoriatic arthritis (AxPsA).
Patients with AxPsA were selected from a large prospective cohort study of psoriatic arthritis. Patient and physician global scores were used as constructs of disease activity. Patients were categorised into high and low disease activity states based on patient and physician global assessment scores and physician's decision to change treatment. Statistical analysis included descriptive statistics, linear and logistic regression.
201 patients with AxPsA were included in the study. ASDAS and BASDAI showed good correlation with disease activity as reflected by the patient global score (correlation coefficients (r) for BASDAI 0.84, ASDAS-B 0.77, ASDAS-C 0.81, p < 0.001) and the physician global score (r = 0.53 for BASDAI, r = 0.50 for ASDAS-B, r = 0.55 for ASDAS-C, p < 0.001). Both scores showed good discriminative ability between high and low disease activity states. However, there were no significant differences between areas under the curve for the models that compared ASDAS with BASDAI for each definition of disease activity state.
In patients with AxPsA, ASDAS and BASDAI scores show similar good to moderate discriminative ability and correlation with different constructs of disease activity. ASDAS was not superior to BASDAI in its ability to discriminate between high and low disease activity states in AxPsA.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective. The objective of this study was to determine whether BMI and gender could lead to a different response rate to anti-TNF agents in patients affected by axial SpA.Methods. One hundred and seventy patients with active axial SpA (defined as a BASDAI ≥4) treated with an anti-TNF agent [adalimumab (ADA), etanercept (ETA), infliximab (IFX)] were retrospectively evaluated. Patients were divided according to the baseline BMI as normal weight (BMI < 25), overweight (BMI 25-30) and obese (BMI ≥ 30). After 12 months of treatment a 50% improvement of the initial BASDAI (BASDAI50) was the primary end point and BASDAI ≤1 was the secondary end point.Results. After 12 months of anti-TNF treatment, 67.8% of men and 46.2% of women reached the BASDAI50 (P = 0.01). According to BMI categories, the rate of BASDAI50 achievement decreased from 72.8% in normal weight subjects to 54.5% in overweight and 30.4% in obese subjects (P < 0.001). In the logistic regression analysis, the best independent predictors of failure to obtain a BASDAI50 response at the 12th month of therapy in axial SpA patients were female gender [odds ratio (OR) 3.23 (95% CI 1.52, 7.14)] and a BMI ≥30 [OR 3.57 (95% CI 1.15, 11.11)]. Analysing outcomes based on IFX therapy (the larger subgroup), the BASDAI50 response rate fell from 79.0% in normal weight subjects to 56.7% in overweight and 16.7% in obese subjects (P < 0.001). No significant differences were observed with ADA and ETA.Conclusion. Data suggest that being female, overweight and mostly obese is associated with a lower rate of success in obtaining response status in axial SpA patients treated with anti-TNF drugs. Body weight could represent a modifiable factor to reach the best outcome in axial SpA patients treated with TNF blockers.
    Rheumatology (Oxford, England) 01/2014; · 4.24 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective. To evaluate the involvement of the bursa located next to the head of the 5th metatarsal bone in patients with psoriatic arthritis (PsA) in comparison with the other seronegative spondyloarthritis (SpA). Methods. All patients with PsA seen during a period of 24 months were enrolled. The control group included healthy subjects and patients with the other SpA. All subjects underwent clinical and ultrasound (US) examination of the lateral surface of the 5th metatarsal. Results. 150 PsA patients (88 M; 62 F), 172 SpA (107 M; 65 F), and 95 healthy controls (58 M; 37 F) were evaluated. Based on clinical and US evaluation, bursitis was diagnosed in 17/150 (11.3%) PsA patients but in none of the SpA (P < 0.0001) and healthy (P = 0.0002) controls. In detecting bursitis, US was more sensitive than clinical examination, although the difference did not reach statistical significance (P = 0.09). Conclusion. The bursa of the 5th metatarsophalangeal joint appears to be involved in PsA more frequently than by chance. If confirmed by other studies, this finding could be considered as a distinctive clinical sign of PsA, useful for differential diagnosis with the other SpA. In asymptomatic patients, US proved to be more sensitive in the detection of bursitis.
    BioMed Research International 01/2014; 2014:174841. · 2.88 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Psoriatic arthritis (PsA) is a heterogeneous inflammatory arthritis with a varied clinical phenotype. There has been considerable international collaboration over recent years to develop and prioritise appropriate disease domains and outcome measures to capture all aspects of this complex disease. It has been recognised that patient-reported measures and physician assessments are complementary and, when used together, allow an improved reflection of disease burden. Taking this concept one step further, the experience in rheumatoid arthritis has demonstrated benefits of incorporating the patient perspective in the development of outcome measures. We report a systematic review demonstrating (1) that there has been little incorporation of the patient perspective in the development of outcome measures and domains in PsA, (2) the proceedings from the preliminary patient involvement in outcome measures for PsA (PIOMPSA) meetings, and (3) a proposed roadmap for improving patient involvement.
    Current Rheumatology Reports 05/2014; 16(5):418.


Available from
May 26, 2014