The Definition of Disease Duration in Ankylosing Spondylitis: Reassessing the Concept

John C Davis, Jr. ¹, Maxime Dougados ², Jürgen Braun ³, Joachim Sieper ⁴, DMFM van der Heijde ⁵ and Sjef van der Linden ^5*

¹ UCSF, United States
² Hopital Cochin, France
³ Rheumazentrum Ruhrgebiet, Germany
⁴ University Clinic Benjamin Franklin, Germany
⁵ University Hospital Maastricht, Netherlands

^* To whom correspondence should be addressed. E-mail: sli{at}sint.azm.nl.

Accepted 31 January 2006

Abstract

The concept and definition of disease duration in patients with ankylosing spondylitis (AS) is ambiguous and often results in many years between the onset of symptoms and diagnosis. Members of the ASsessments in Ankylosing Spondylitis (ASAS) International Working Group through consensus recently recommended identifying specific components of the medical history in order to better define and document the concept of disease duration. These include: (1) the time of onset of the first symptom(s) of axial manifestations (including inflammatory back pain), (2) the time of onset of the first symptoms of each individual manifestation that may be an extra-axial sign or symptom of AS such as peripheral arthritis and enthesitis, (3) the time of onset of associated diseases belonging to the spondylarthritides (SpA), in particular acute anterior uveitis (AAU), inflammatory bowel disease (IBD) and psoriasis, and (4) the time since actual diagnosis by a health care provider. Such uniformity in data collection will ensure both comparability across studies and facilitate future research.

Keywords: ankylosing spondylitis, disease duration, recommendations, standardization

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