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Rheumatology & Arthritis Learning NetworkThe Culprit in axSpA: Structural Damage or Disease Activity?

New Study Reveals Disease Activity Metrics More Closely Linked to Global Functioning in Axial Spondyloarthritis Patients

A recent study published in Arthritis Care & Research has shed light on the factors that most influence the global functioning of patients with axial spondyloarthritis (axSpA). Contrary to common belief, the study found that measures of disease activity and physical function are more closely related to patient well-being than structural damage or spinal mobility.

HCN Medical Memo
For rheumatologists treating patients with axSpA, this study underscores the importance of focusing on disease activity and physical function as key indicators of patient well-being. Although structural damage and spinal mobility are often considered critical, they may not be as closely linked to the patient’s global functioning as previously thought. Therefore, a more nuanced approach to treatment and assessment may be warranted.

Key Points
  • Researchers studied 103 consecutive patients with both radiographic and non-radiographic axSpA.
  • Tools used for assessment included BASDAI, BASFI, BASMI, ASAS HI, and Epionics SPINE.
  • ASAS HI scores were significantly associated with BASDAI, BASFI, and back pain scores.
  • No correlation was found between ASAS HI measures and range of motion, range of kinematics, or radiographic damage.
  • David Kiefer, MD, of Ruhr University Bochum, suggests that axSpA patients may find spinal mobility less relevant or may use coping strategies to overcome limitations.

Approximately 1 in 200 adults in the United States is affected by axial spondyloarthritis (axSpA), making it more common than previously thought, according to data from the Centers for Disease Control and Prevention (CDC).

Additional Points

  • Structural damage of the spine and sacroiliac joints was assessed by counting the number of syndesmophytes and by New York criteria for sacroiliitis grading.
  • A weak correlation was found between ASAS HI and BASMI scores.

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