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Letter
Ankylosing Spondylitis Disease Activity Score (ASDAS): 2018 update of the nomenclature for disease activity states
  1. Pedro M Machado1,
  2. Robert Landewé2,3,
  3. Désirée van der Heijde4
  4. Assessment of SpondyloArthritis international Society (ASAS)
  1. 1 Centre for Rheumatology and MRC Centre for Neuromuscular Diseases, University College London, London, UK
  2. 2 Department of Rheumatology, Academic Medical Center Amsterdam, Heerlen, The Netherlands
  3. 3 Atrium Medical Center Heerlen, Heerlen, The Netherlands
  4. 4 Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to Dr Pedro M Machado, Centre for Rheumatology and MRC Centre for Neuromuscular Diseases, University College London, London WC1B 5EH, UK; p.machado{at}ucl.ac.uk

https://doi.org/10.1136/annrheumdis-2018-213184

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    The Ankylosing Spondylitis Disease Activity Score (ASDAS) is a measure of axial spondyloarthritis (axSpA) disease activity with validated cut-offs endorsed by the Assessment of SpondyloArthritis international Society (ASAS) and Outcome Measures in Rheumatology (OMERACT).1 2 In the 2016 update of the ASAS-European League Against Rheumatism (EULAR) management recommendations for axSpA, it is recommended that biological disease-modifying antirheumatic drugs should be considered in patients with persistently high disease activity despite conventional treatments, and that the preferred measure to define active disease should be the ASDAS (ASDAS of at least 2.1, ie, high disease activity).3 The 2017 update of treat-to-target recommendations in axial and peripheral SpA recommends that the treatment target should be inactive disease/clinical remission and that low/minimal disease activity may be an alternative treatment target. The same recommendations state that the preferred measure to define the target in axSpA is the ASDAS.4

    ASDAS cut-offs for disease activity states are 1.3, separating ‘inactive disease’ from ‘moderate disease activity’, 2.1, …

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    Footnotes

    • Contributors PMM drafted the manuscript and is the first author of the ASDAS cut-offs manuscript published in 2011. DvdH led the discussion at the ASAS 2018 annual meeting and is the senior author of the ASDAS cut-offs manuscript published in 2011. RL was the president of ASAS at the ASAS 2018 annual meeting and a coauthor of the ASDAS cut-offs manuscript published in 2011. All authors read, commented on, and approved the final manuscript.

    • Funding PMM is supported by the National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre (BRC).

    • Disclaimer The views expressed are those of the authors and not necessarily those of the (UK) National Health Service (NHS), the NIHR or the (UK) Department of Health.

    • Competing interests PMM has received consulting/speaker’s fees from AbbVie, Centocor, Janssen, MSD, Novartis, Pfizer and UCB Pharma. RL has received consulting fees and/or research grants and/or speaker’s bureau from Abbott, Ablynx, Amgen, AstraZeneca, Bristol-Myers Squibb, Centocor, Glaxo-Smith-Kline, Merck, Novartis, Pfizer, Roche, Schering-Plough, UCB Pharma and Wyeth. DvdH has received consulting fees from AbbVie, Amgen, Astellas, AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Daiichi, Eli-Lilly, Galapagos, Gilead, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi and UCB Pharma and is the director of Imaging Rheumatology BV.

    • Provenance and peer review Not commissioned; internally peer reviewed.