Table 2

Clinical assessment of axial spondyloarthritis

 BASDAI 62 Questions Calculation 1. How would you describe the overall level of fatigue/tiredness you have experienced? Assess each question on a numerical rating scale (NRS) of 0 (none) to 10 (very severe), alternatively, a VAS can be used for questions 1–5 (NRS preferred by ASAS) Calculation of BASDAI:Compute the mean of questions 5 and 6Calculate the sum of the values of question 1–4 and add the result to the mean of questions 5 and 6Divide the result by 5 2. How would you describe the overall level of ankylosing spondylitis neck, back or hip pain you have had? 3. How would you describe the overall level of pain/swelling in joints other than neck, back or hips you had? 4. How would you describe the overall level of discomfort you have had from any areas tender to touch or pressure? 5. How would you describe the overall level of morning stiffness you have had from the time you wake up? 6. How long does your morning stiffness last from the time you wake up? ASDAS 84 89 Parameters Calculations 1. Total back pain (BASDAI question 2) ASDAS-CRP: 0.121 x total back pain+0.110 x patient global+0.073 x peripheral pain/swelling+0.058 x duration of morning stiffness+0.579xln(CRP+1); ASDAS-ESR: 0.113xpatient global+0.293x√ESR+0.086 x peripheral pain/swelling+0.069 x duration of morning stiffness+0.079xtotal back pain Assess each question on an NRS of 0 (none) to 10 (very severe) 2. Patient global assessment 3. Peripheral pain/swelling (BASDAI question 3) 4. Duration of morning stiffness (BASDAI question 6) 5. C reactive protein (CRP) in mg/L (or erythrocyte sedimentation rate (ESR)) (the lowest value for CRP can be 2 mg/L) Improvement criteria ASAS 2090 Improvement ≥20% and absolute improvement of ≥1 unit (on a scale of 0–10; or 10 units on a scale of 0–100) in at least three of the four following domains: Patient global assessment Pain Function (BASFI)63 Inflammation (mean of morning stiffness-related BASDAI VAS scores for questions 5 and 6) No worsening of ≥20% and ≥1 unit in the remaining domain ASAS 4091 Improvement ≥40% and absolute improvement of ≥2 unit (on a scale of 0–10; or 10 units on a scale of 0–100) in at least three of the four following domains: Patient global assessment Pain Function (BASFI)63 Inflammation (mean of morning stiffness-related BASDAI VAS scores for questions 5 and 6) No worsening at all in the fourth domain Remission criteria ASAS partial remission90 A value not above two units on a 0–10 scale in each of the four domains: patient global, pain, function, inflammation (mean of morning stiffness-related BASDAI VAS scores for questions 5 and 6)* ASDAS inactive disease84 ASDAS <1.3
• ASAS, Assessments of SpondyloArthritis international Society90; ASDAS, Ankylosing Spondylitis Disease Activity Score; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index62; BASFI, Bath Ankylosing Spondylitis Functional Index; VAS, Visual Analogue Scale.