Article Text

Download PDFPDF
Definition of disease duration in ankylosing spondylitis: reassessing the concept
  1. J C Davis1,
  2. M Dougados2,
  3. J Braun3,
  4. J Sieper4,
  5. D van der Heijde5,
  6. S van der Linden5
  1. 1Division of Rheumatology, University of California San Francisco, San Francisco, California, USA
  2. 2Rheumatology B Department, Hospital Cochin, University of Paris, Paris, France
  3. 3Rheumatology Medical Center Ruhrgebiet, Herne, Germany
  4. 4Department of Medicine I, Charite-Campus Benjamin Franklin, Berlin, Germany
  5. 5Department of Internal Medicine, Division of Rheumatology, University Hospital Maastricht, Maastricht, The Netherlands
  1. Correspondence to:
    S van der Linden
    Department of Internal Medicine, Division of Rheumatology, University of Maastricht, PO Box 5800, NL-6202-AZ Maastricht, The Netherlands; Sli{at}


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

  • AAU, acute anterior uveitis
  • ASAS, Assessment in Ankylosing Spondylitis
  • IBD, inflammatory bowel disease
  • SpA, spondyloarthritides

Statistics from


  • Competing interests: None declared.

  • Published Online First 7 February 2006

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.