Abstract
The aim of this study was to compare the discriminative ability of Ankylosing Spondylitis Disease Activity Score (ASDAS) with Bath Ankylosing Spondylitis Activity Disease Activity Index (BASDAI) and other clinical disease activity parameters in patients with axial psoriatic arthritis (axPsA). Patients with axPsA were recruited from Erciyes Spondyloarthritis Cohort (ESPAC) and Anatolian Group for the Assessment in Rheumatic Disease (ANGARD) cohort and were assessed for BASDAI, ASDAS, BASFI (Bath Ankylosing Spondylitis Functional Index), Ankylosing Spondylitis Quality of Life (ASQoL), and visual analog scale (VAS) pain. The discriminant ability of ASDAS-C-reactive protein (−CRP) and ASDAS-erythrocyte sedimentation rate (−ESR) was assessed using standardized mean differences between patients with high and low disease activity. Fifty-four patients with axPsA were included in the study. Both ASDAS scores showed good discriminative ability between high and low disease activity states. Both ASDAS versions and BASDAI had relatively high area under the curve (AUC) according to ASAS partial remission, patient and physician global assessments in receiver operating characteristic (ROC) curve analysis. There was no significant difference between AUC scores for the models that compared ASDAS-CRP and ASDAS-ESR with BASDAI for each individual definition of disease activity states. ASDAS versions and BASDAI showed good similar discriminative ability between high and low disease activity as reflected by the AUC analysis in axPsA. The cutoff values for inactive disease and high disease activity were relatively similar to predefined cutoff values for AS. Further, prospective validation is now required to identify the appropriate assessment tools and cutoff values in axPsA.
Similar content being viewed by others
References
Zink A, Thiele K, Huscher D, Listing J, Sieper J, Krause A, Gromnica-Ihle E, von Hinueber U, Wassenberg S, Genth E, Schneider M, German Collaborative Arthritis C (2006) Healthcare and burden of disease in psoriatic arthritis. A comparison with rheumatoid arthritis and ankylosing spondylitis. J Rheumatol 33(1):86–90
Marsal S, Armadans-Gil L, Martinez M, Gallardo D, Ribera A, Lience E (1999) Clinical, radiographic and HLA associations as markers for different patterns of psoriatic arthritis. Rheumatology 38(4):332–337
Battistone MJ, Manaster BJ, Reda DJ, Clegg DO (1999) The prevalence of sacroilitis in psoriatic arthritis: new perspectives from a large, multicenter cohort. A Department of Veterans Affairs Cooperative Study. Skelet Radiol 28(4):196–201
Gladman DD, Brubacher B, Buskila D, Langevitz P, Farewell VT (1992) Psoriatic spondyloarthropathy in men and women: a clinical, radiographic, and HLA study. Clin Invest Med 15(4):371–375
Hanly JG, Russell ML, Gladman DD (1988) Psoriatic spondyloarthropathy: a long term prospective study. Ann Rheum Dis 47(5):386–393
Nas K, Karkucak M, Durmus B, Ulu MA, Karatay S, Capkin E, Ulusoy H, Gulkesen A, Sula B, Akgol G, Cevik R, Ozgocmen S (2013) The performance of psoriatic arthritis classification criteria in Turkish patients with psoriatic arthritis. Int J Rheum Dis. doi:10.1111/1756-185X.12158
Helliwell PS, Hickling P, Wright V (1998) 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 57(3):135–140
Perez Alamino R, Maldonado Cocco JA, Citera G, Arturi P, Vazquez-Mellado J, Sampaio-Barros PD, Flores D, Burgos-Vargas R, Santos H, Chavez-Corrales JE, Palleiro D, Gutierrez MA, Vieira-Sousa E, Pimentel-Santos FM, Paira S, Berman A, Moreno-Alvarez M, Collantes-Estevez E, Group R (2011) Differential features between primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease. J Rheumatol 38(8):1656–1660. doi:10.3899/jrheum.101049
Mease PJ, Antoni CE, Gladman DD, Taylor WJ (2005) Psoriatic arthritis assessment tools in clinical trials. Ann Rheum Dis 64(2):ii49–54. doi:10.1136/ard.2004.034165
Lubrano E, Marchesoni A, Olivieri I, D’Angelo S, Spadaro A, Parsons WJ, Cauli A, Salvarani C, Mathieu A, Zaccara E, Ferrara N, Helliwell PS (2009) The radiological assessment of axial involvement in psoriatic arthritis: a validation study of the BASRI total and the modified SASSS scoring methods. Clin Exp Rheumatol 27(6):977–980
Chandran V, Barrett J, Schentag CT, Farewell VT, Gladman DD (2009) Axial psoriatic arthritis: update on a longterm prospective study. J Rheumatol 36(12):2744–2750. doi:10.3899/jrheum.090412
Taylor WJ, Harrison AA (2004) Could the bath ankylosing spondylitis disease activity index (BASDAI) be a valid measure of disease activity in patients with psoriatic arthritis? Arthritis Rheum 51(3):311–315. doi:10.1002/art.20421
Fernandez-Sueiro JL, Willisch A, Pertega-Diaz S, Tasende JA, Fernandez-Lopez JC, Villar NO, Galdo F, Blanco FJ (2010) Validity of the bath ankylosing spondylitis disease activity index for the evaluation of disease activity in axial psoriatic arthritis. Arthritis Care Res 62(1):78–85. doi:10.1002/acr.20017
Eder L, Chandran V, Shen H, Cook RJ, Gladman DD (2010) Is ASDAS better than BASDAI as a measure of disease activity in axial psoriatic arthritis? Ann Rheum Dis 69(12):2160–2164. doi:10.1136/ard.2010.129726
Calin A, Garrett S, Whitelock H, Kennedy LG, O’Hea J, Mallorie P, Jenkinson T (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. Arthritis Care Res 21(12):2281–2285
Yanik B, Gursel YK, Kutlay S, Ay S, Elhan AH (2005) Adaptation of the Bath Ankylosing Spondylitis Functional Index to the Turkish population, its reliability and validity: functional assessment in AS. Clin Rheumatol 24(1):41–47. doi:10.1007/s10067-004-0968-6
Doward LC, Spoorenberg A, Cook SA, Whalley D, Helliwell PS, Kay LJ, McKenna SP, Tennant A, van der Heijde D, Chamberlain MA (2003) Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis 62(1):20–26
Duruoz MT, Doward L, Turan Y, Cerrahoglu L, Yurtkuran M, Calis M, Tas N, Ozgocmen S, Yoleri O, Durmaz B, Oncel S, Tuncer T, Sendur O, Birtane M, Tuzun F, Bingol U, Kirnap M, Celik Erturk G, Ardicoglu O, Memis A, Atamaz F, Kizil R, Kacar C, Gurer G, Uzunca K, Sari H (2013) Translation and validation of the Turkish version of the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire. Rheumatol Int 33(11):2717–2722. doi:10.1007/s00296-013-2796-y
Anderson JJ, Baron G, van der Heijde D, Felson DT, Dougados M (2001) Ankylosing spondylitis assessment group preliminary definition of short-term improvement in ankylosing spondylitis. Arthritis Rheum 44(8):1876–1886. doi:10.1002/1529-0131(200108)44:8<1876::AID-ART326>3.0.CO;2-F
DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44(3):837–845
Youden WJ (1950) Index for rating diagnostic tests. Cancer 3(1):32–35
Machado P, Landewe R, Lie E, Kvien TK, Braun J, Baker D, van der Heijde D, Assessment of SpondyloArthritis international S (2011) Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activity states and improvement scores. Ann Rheum Dis 70(1):47–53. doi:10.1136/ard.2010.138594
Queiro R, Belzunegui J, Gonzalez C, De DJ, Sarasqueta C, Torre JC, Figueroa M (2002) Clinically asymptomatic axial disease in psoriatic spondyloarthropathy. A retrospective study. Clin Rheumatol 21(1):10–13
Lukas C, Landewe R, Sieper J, Dougados M, Davis J, Braun J, van der Linden S, van der Heijde D, Assessment of SpondyloArthritis international S (2009) Development of an ASAS-endorsed disease activity score (ASDAS) in patients with ankylosing spondylitis. Ann Rheum Dis 68(1):18–24. doi:10.1136/ard.2008.094870
van der Heijde D, Lie E, Kvien TK, Sieper J, Van den Bosch F, Listing J, Braun J, Landewe R, Assessment of SpondyloArthritis international S (2009) ASDAS, a highly discriminatory ASAS-endorsed disease activity score in patients with ankylosing spondylitis. Ann Rheum Dis 68(12):1811–1818. doi:10.1136/ard.2008.100826
Aydin SZ, Can M, Atagunduz P, Direskeneli H (2010) Active disease requiring TNF-alpha-antagonist therapy can be well discriminated with different ASDAS sets: a prospective, follow-up of disease activity assessment in ankylosing spondylitis. Clin Exp Rheumatol 28(5):752–755
van der Heijde D, Braun J, Dougados M, Sieper J, Pedersen R, Szumski A, Koenig AS (2012) Sensitivity and discriminatory ability of the Ankylosing Spondylitis Disease Activity Score in patients treated with etanercept or sulphasalazine in the ASCEND trial. Rheumatology 51(10):1894–1905. doi:10.1093/rheumatology/kes142
Xu M, Lin Z, Deng X, Li L, Wei Y, Liao Z, Li Q, Wei Q, Hu Z, Zhang Y, Lin Q, Huang J, Li T, Pan Y, Wu Y, Jin O, Yu B, Gu J (2011) The Ankylosing Spondylitis Disease Activity Score is a highly discriminatory measure of disease activity and efficacy following tumour necrosis factor-alpha inhibitor therapies in ankylosing spondylitis and undifferentiated spondyloarthropathies in China. Rheumatology 50(8):1466–1472. doi:10.1093/rheumatology/ker087
Fernandez-Espartero C, de Miguel E, Loza E, Tomero E, Gobbo M, Descalzo MA, Collantes-Estevez E, Mulero J, Munoz-Fernandez S, Zarco P, Carmona L, Group ES (2013) Validity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) in patients with early spondyloarthritis from the Esperanza programme. Ann Rheum Dis. doi:10.1136/annrheumdis-2012-202976
Zweig MH, Campbell G (1993) Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem 39(4):561–577
Disclosures
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kılıç, G., Kılıç, E., Nas, K. et al. Comparison of ASDAS and BASDAI as a measure of disease activity in axial psoriatic arthritis. Clin Rheumatol 34, 515–521 (2015). https://doi.org/10.1007/s10067-014-2734-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-014-2734-8