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The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection.
Ann Rheum Dis 2009; 68(6):777-83AR

Abstract

OBJECTIVE

To validate and refine two sets of candidate criteria for the classification/diagnosis of axial spondyloarthritis (SpA).

METHODS

All Assessment of SpondyloArthritis international Society (ASAS) members were invited to include consecutively new patients with chronic (> or =3 months) back pain of unknown origin that began before 45 years of age. The candidate criteria were first tested in the entire cohort of 649 patients from 25 centres, and then refined in a random selection of 40% of cases and thereafter validated in the remaining 60%.

RESULTS

Upon diagnostic work-up, axial SpA was diagnosed in 60.2% of the cohort. Of these, 70% did not fulfil modified New York criteria and, therefore, were classified as having "non-radiographic" axial SpA. Refinement of the candidate criteria resulted in new ASAS classification criteria that are defined as: the presence of sacroiliitis by radiography or by magnetic resonance imaging (MRI) plus at least one SpA feature ("imaging arm") or the presence of HLA-B27 plus at least two SpA features ("clinical arm"). The sensitivity and specificity of the entire set of the new criteria were 82.9% and 84.4%, and for the imaging arm alone 66.2% and 97.3%, respectively. The specificity of the new criteria was much better than that of the European Spondylarthropathy Study Group criteria modified for MRI (sensitivity 85.1%, specificity 65.1%) and slightly better than that of the modified Amor criteria (sensitivity 82.9, specificity 77.5%).

CONCLUSION

The new ASAS classification criteria for axial SpA can reliably classify patients for clinical studies and may help rheumatologists in clinical practice in diagnosing axial SpA in those with chronic back pain.

TRIAL REGISTRATION NUMBER

NCT00328068.

Authors+Show Affiliations

Med Klinik I, Charité, Campus Benjamin Franklin, Berlin, Germany. martin.rudwaleit@charite.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

19297344

Citation

Rudwaleit, M, et al. "The Development of Assessment of SpondyloArthritis International Society Classification Criteria for Axial Spondyloarthritis (part II): Validation and Final Selection." Annals of the Rheumatic Diseases, vol. 68, no. 6, 2009, pp. 777-83.
Rudwaleit M, van der Heijde D, Landewé R, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68(6):777-83.
Rudwaleit, M., van der Heijde, D., Landewé, R., Listing, J., Akkoc, N., Brandt, J., ... Sieper, J. (2009). The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Annals of the Rheumatic Diseases, 68(6), pp. 777-83. doi:10.1136/ard.2009.108233.
Rudwaleit M, et al. The Development of Assessment of SpondyloArthritis International Society Classification Criteria for Axial Spondyloarthritis (part II): Validation and Final Selection. Ann Rheum Dis. 2009;68(6):777-83. PubMed PMID: 19297344.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. AU - Rudwaleit,M, AU - van der Heijde,D, AU - Landewé,R, AU - Listing,J, AU - Akkoc,N, AU - Brandt,J, AU - Braun,J, AU - Chou,C T, AU - Collantes-Estevez,E, AU - Dougados,M, AU - Huang,F, AU - Gu,J, AU - Khan,M A, AU - Kirazli,Y, AU - Maksymowych,W P, AU - Mielants,H, AU - Sørensen,I J, AU - Ozgocmen,S, AU - Roussou,E, AU - Valle-Oñate,R, AU - Weber,U, AU - Wei,J, AU - Sieper,J, Y1 - 2009/03/17/ PY - 2009/3/20/entrez PY - 2009/3/20/pubmed PY - 2009/6/25/medline SP - 777 EP - 83 JF - Annals of the rheumatic diseases JO - Ann. Rheum. Dis. VL - 68 IS - 6 N2 - OBJECTIVE: To validate and refine two sets of candidate criteria for the classification/diagnosis of axial spondyloarthritis (SpA). METHODS: All Assessment of SpondyloArthritis international Society (ASAS) members were invited to include consecutively new patients with chronic (> or =3 months) back pain of unknown origin that began before 45 years of age. The candidate criteria were first tested in the entire cohort of 649 patients from 25 centres, and then refined in a random selection of 40% of cases and thereafter validated in the remaining 60%. RESULTS: Upon diagnostic work-up, axial SpA was diagnosed in 60.2% of the cohort. Of these, 70% did not fulfil modified New York criteria and, therefore, were classified as having "non-radiographic" axial SpA. Refinement of the candidate criteria resulted in new ASAS classification criteria that are defined as: the presence of sacroiliitis by radiography or by magnetic resonance imaging (MRI) plus at least one SpA feature ("imaging arm") or the presence of HLA-B27 plus at least two SpA features ("clinical arm"). The sensitivity and specificity of the entire set of the new criteria were 82.9% and 84.4%, and for the imaging arm alone 66.2% and 97.3%, respectively. The specificity of the new criteria was much better than that of the European Spondylarthropathy Study Group criteria modified for MRI (sensitivity 85.1%, specificity 65.1%) and slightly better than that of the modified Amor criteria (sensitivity 82.9, specificity 77.5%). CONCLUSION: The new ASAS classification criteria for axial SpA can reliably classify patients for clinical studies and may help rheumatologists in clinical practice in diagnosing axial SpA in those with chronic back pain. TRIAL REGISTRATION NUMBER: NCT00328068. SN - 1468-2060 UR - https://www.unboundmedicine.com/medline/citation/19297344/The_development_of_Assessment_of_SpondyloArthritis_international_Society_classification_criteria_for_axial_spondyloarthritis__part_II_:_validation_and_final_selection_ L2 - https://ard.bmj.com/cgi/pmidlookup?view=long&pmid=19297344 DB - PRIME DP - Unbound Medicine ER -