scholarly journals AB0703 WHICH OF THE ASDAS OR BASDAI CORRELATES BETTER WITH PHYSICIAN GLOBAL ASSESSMENT?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1647.4-1647
Author(s):  
K. Maatallah ◽  
W. Triki ◽  
H. Ferjani ◽  
D. Kaffel ◽  
W. Hamdi
Keyword(s):  
New York ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Global Assessment ◽  
Cross Sectional Study ◽  
Face Validity ◽  
Physician Global Assessment ◽  
Cross Sectional ◽  
Asas Criteria ◽  
The Mean

Background:Ankylosing Spondylitis Disease Activity score (ASDAS) was developed because of the limitations of Bath Ankylosing Spondylitis Disease Index (BASDAI) of being totally patient-derived with limited face and construct validity. ASDAS includes inflammatory markers that were aimed to increase its face validity by representing a different ‘objective’ domain of disease activity that was not included in BASDAI.Objectives:The aim of our study was to compare correlation of ASDAS and BASDAI with physician global assessment (PhGA) in order to know which is more reliable.Methods:Cross-sectional study including patients with SpA according to the ASAS criteria of 2009 and/or New York modified criteria. The erythrocyte sedimentation rate (ESR) and the C-reactive protein (crp) were measured. The disease activity was assessed by BASDAI and ASDAS. Physician global assessment (PhGA) was rated by 0–100 numeric score. We correlated disease activity indices with physician global assessment by Pearson coefficient.Results:A total of 110 patients (68 men and 42 women) with a mean age of 43.18 ±12.34 [19-79] years was collected. The mean disease duration was 5.99±2.31 [1-10] years. The mean ESR and CRP were respectively 28.41±21.51 [2-110] and 15.56 ±23.84 [0-153] mg/l. ESR was correlated with PhGA (p=0.06, r=0.300), however CRP was not correlated with PhGA (p=0.134, r=0.165). The mean ASDAS-ESR and ASDAS-CRP were respectively 2.93±1.05 [0.83-5.65] and 2.81±0.97 [0.29-4.77]. The mean BASDAI was 4.42±2.23 [0-9.2]. The mean PhGA was 5.43 ±2.31 [1-10]. The BASDAI correlated with PhGA (p=0.007, r=0.307). In addition, ASDAS-ESR and ASDAS-CRP correlated with PhGA (p=0.001, r=0.372, p=0.001, r=0.391) respectively.Conclusion:In conclusion both BASDAI and ASDAS are equal, with a superiority nonetheless for the ASDAS since it correlated stronger with PhGA.Acknowledgments:NoneDisclosure of Interests:None declared

scholarly journals IL-17 and Disease Activity in Spondyloarthitis

2021 ◽  
Vol 57 (4) ◽  
pp. 289
Author(s):  
Yuliasih Yuliasih ◽  
Yusdeny Lanasakti
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Disease Activity Score ◽  
Cross Sectional Study ◽  
Activity Score ◽  
Strongly Correlated ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Asas Criteria

Highlight:The correlation of IL-17 to disease activity by The Ankylosing Spondylitis Disease Activity Score C-Reactive Protein (ASDAS-CRP) was identified. IL-17 level is strongly correlated to disease activity in SpA patients. Abstract:IL-17 is a new cytokine involved in the pathogenesis of Spondyloarthritis (SpA). Recent studies show that IL-17 level correlates to disease activity, and it is used as a basis in treating SpA patients who do not respond to anti-TNF-α. This study identified the correlation of IL-17 to disease activity measured by The Ankylosing Spondylitis Disease Activity Score C-Reactive Protein (ASDAS-CRP). This study was a cross-sectional study involving SpA patients according to the 2009 ASAS criteria in Dr. Soetomo General Academic Hospital, Surabaya. Disease activity and IL-17 level were analyzed using Spearman correlation test to see the strength of correlation. Forty SpA patients showed mean age of 53.58 ± 9.28 years with a body mass index of 24.36 ± 3.23 kg/m2, ESR of 39.50 ± 18.76 mm/hour, clinically obtained Schober Test of 13.11 ± 1.22 cm, chest extension test of 1.45 ± 0.77 cm, and tragus-to-wall test 13.53 ± 1.99 cm. The median CRP and IL-17 were 0.3 (0.10-5.70) mg/dL and 9.30 (7.70-13.60) pg/dL, respectively. Based on the ASDAS-CRP system, the patients showed disease activities that fall into the category was high (62.5%), moderate (35%), and inactivity (2.5%). IL-17 level is strongly correlated to disease activity in SpA patients (p=0.000, r = 0.711).

scholarly journals AB0725 FACTORS ASSOCIATED WITH RADIOGRAPHIC SPINAL INVOLVEMENT IN SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1657.2-1657
Author(s):  
M. Slouma ◽  
S. Rahmouni ◽  
R. Dhahri ◽  
I. Gharsallah ◽  
N. Boussetta ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Structural Damage ◽  
Disease Duration ◽  
Diagnostic Delay ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Factors Associated ◽  
The Mean

Background:Spondyloarthritis (SpA) is characterized by significant radiographic changes in the spine. The structural spine damage can be assessed using several scorings such as the Bath AS Radiology Index (BASRI) and the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS).Objectives:We aimed to identify factors associated with structural damage in the spine using these scores.Methods:We conducted a cross-sectional study including patients with SpA diagnosed according to the assessment of Spondyloarthritis International Society criteria.To assess the radiographic involvement of the spine, we used the mSASSS, the BASRI-spine (BASRI-S), the BASRI-lumber (BASRI-L) and the BASRI-cervical (BASRI-C).Disease activity was assessed using the BASDAI and ASDAS-CRP.Results:Among the 112 patients, 72.32% were men. The mean age was 43.78 ± 12,91 years. The mean age at diagnosis was 37.8 ± 13.45 years. The diagnostic delay of 37,8 ± 46 months.Forty-nine patients were smockers (43.8%).The mean BASDAI score and ASDAS–CRP score were 4.04 ± 1.99 and 3.30 ± 0.87.The mean ESR and CRP were 36.21 ± 27 (mm/H) and 31.28 ± 47.25 mg/LThe mean BASRI-S was 3,99 ± 21,96 and the mean mSASSS was 10,26 ± 15,41.Twenty-five patients (22.3%) had non-radiographic axial SpA.Men had higher BARSI-L (1.36 vs 0.7, p= 0.045) and BASRI-S (4.3 vs 3.09; p=0.047) than women.Moreover, smokers’ patients had higher mSASSS (14.07 vs 7.02; p=0.031), BASRI-C (1.23 vs 0.62; p=0.031), and BASRI-S (4.82 vs 3.35; p= 0.009) than nonsmokers’ patients.A positive correlation was noted between age and BASRI-C (r= 0.260, p=0.012). There was no correlation between age at the onset of SpA and structural spine damage.We found a positive correlation between disease duration and the following scores: BASRI-C (r=0.245, p=0.018) and BASRI-S (r=0.274, p=0.003).Patients with non-radiographic axial SpA had lower mSASSS (4.05 vs 12.14; p=0.034), BASRI-s (1.2 vs 4.9; p< 10-3), and BASRI-L (0.42 vs 1.4; p=0.003) than patients with radiographic axial SpA.There was no correlation between the radiographic index and BASDAI and ASDAS-CRP.Conclusion:We confirmed previous observations that male gender, smoking and disease duration are associated with structural damage in the spine [1].However, CRP and other inflammatory biomarkers were not associated with radiographic evidence of spine involvement.As observed in previous studies, the radiographic spine damage did not correlate with disease activity (BASDAI) [1].References:[1]Sari I, Haroon N. Radiographic Progression in Ankylosing Spondylitis: From Prognostication to Disease Modification. Curr Rheumatol Rep. 2018 Nov 8;20(12):82.Disclosure of Interests:None declared

scholarly journals Comparative Analysis Between the Basdai and Mini-Basdai Indices in Patients with Ankylosing Spondylitis

2018 ◽  
Vol 15 (5) ◽  
pp. 7-14
Author(s):  
Sandra Burtica ◽  
Adriana Gurghean ◽  
Ion Bruckner
Keyword(s):  
New York ◽  
Ankylosing Spondylitis ◽  
Biological Therapy ◽  
Cross Sectional Study ◽  
Individual Characteristics ◽  
Cross Sectional ◽  
Duration Of Disease ◽  
The Mean ◽  
The Individual ◽  
Spinal Flexion

AbstractObjectives. The aim of this paper is to compare the degree of accuracy between the BASDAI and mini-BASDAI indices in assessing the activity of ankylosing spondylitis (AS), especially in patients without peripheral manifestations.Materials and method. Our cross-sectional study consisted of a group of 124 patients with AS, according to the modified New York criteria. All patients offered their informed consent. All the individual characteristics of the patients were documented, both demographic and disease-related. The activity of the disease was measured using the BASDAI questionnaire, from which we calculated the mini-BASDAI by eliminating the questions about peripheral arthritis and entesitis. The functional impairment of mobility in the spine and sacro-iliac joints was measured by the Schober index, lateral spinal flexion, occiput-wall, menton-sternum and finger-ground index.Results. The mean age of the patients was 43.43 +/− 13.27 years, mean height 174.3 +/− 8.46 cm, weight 78.23 +/− 14.19 kg, duration of disease in years 15.06 +/− 9.19 and number of years from initiation of biological therapy 6.42 +/− 3.08. The BASDAI score was 1.26 +/− 1.93, while the mini-BASDAI score was 1.51 +/− 2.08. In the group of patients without peripheral manifestations, both BASDAI and mini-BASDAI correlated significantly with the occiput-wall index, besides ESR, CRP, ASDAS-CRP and the Schober index.Conclusion. Mini-BASDAI is not superior to BASDAI in evaluating patients with ankylosing spondylitis without peripheral manifestations, but it has shown a better correlation in addition to BASDAI with the indices of flexion of the cervico-dorsal spine.

scholarly journals POS1013 LET’S TAKE A LOOK AT THE SYMPHYSIS PUBIC AREA IN SPONDYLARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 774.3-775
Author(s):  
H. Hajji ◽  
H. Ferjani ◽  
K. Maatallah ◽  
S. Miri ◽  
C. Ines ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Disease Duration ◽  
Activity Index ◽  
Disease Activity Index ◽  
Pubic Symphysis ◽  
Cross Sectional ◽  
Imaging Characteristics ◽  
Asas Criteria ◽  
The Mean

Background:Symphysis pubic (SP) is the frequent site of enthesitis in spondylarthritis (SpA). Radiological changes in SP appear later in the course of the disease. Underdiagnosed, its prevalence varies from 4% to 47% (1), depending on imaging modalities.Objectives:This study aimed to evaluate the prevalence of SP involvement in patients with spondyloarthritis (SpA). We also focused on the relation between radiographical changes and clinical findings.Methods:It was a cross-sectional study, including patients with SpA according to the Assessment of SpondyloArthritis International Society (ASAS) criteria. We collected the following data: age, gender, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS), and Bath Ankylosing Spondylitis Functional Index (BASFI).Pelvic radiographs were examined by 2 experimented rheumatologists. Grading symphysial involvement was made as follow: scores ranged from 0-4 per reading: grade 0 = normal; grade 1 = subtle irregularity and/or subchondral sclerosis, grade 2 = clear erosions, 3 = marked sclerosis, grade 4 = ankylosis.We divided our patients into two groups: G0 patients without SP changes and G1 patients with SP changes.Results:One hundred and thirty-one patients were included, 84 were male, and 48 were female. The sex ratio M/F was 1.72. The mean age was 41.32±12.42 years. The mean disease duration was 12.65 ± 9.49 years. The clinical presentation of SpA was peripheral in 61 cases and axial in 118 cases. The mean disease scores activity was: BASDAI: 3.94±2.046 and ASDASCRP: 2.75±1.05. The mean BASFI was 4.17±2.7SP changes were observed in 31 patients: score 1 (n=14), score 2 (n=8), score 3 (n=8) and score 4 (n=4). Sex ratios M/F were 2.1 and 1.65 in G1 and G0, respectively (p=0.23). No statistically significant differences were reported between the two groups G0 and G1: mean age (40.48 vs. 43.45, p=0.324), mean disease duration (11.19 vs. 14.45, p=0.218), mean BASDAI (3.8 versus 3.9, p=0.850), mean ASDAS-ESR (3.09 vs. 2.55, p=0.113) and mean BASFI (3.76 versus 4.96, p=0.06) respectively. In G1, nine patients had hip involvement (p=0.203). Enthesitis was more common in patients with SP changes (p=0.02).Conclusion:In our study, the presence of enthesitis was associated with SP changes. Surprisingly, age and disease duration did not influence SP changes (1).References:[1]Kang Y, Ahn JM, Lee E, Lee JW, Kang HS. Active inflammatory changes around the pubic symphysis in patients with axial spondyloarthritis: Magnetic resonance imaging characteristics and association with clinical factors. Eur J Radiol. mars 2020;124:108802.Disclosure of Interests:None declared.

scholarly journals Interleukin-37 as an anti-inflammatory cytokine: does its relation to disease activity suggest its potential role in rheumatoid arthritis therapy?

2021 ◽  
Vol 48 (1) ◽  
Author(s):  
Eman A. Baraka ◽  
Mona G. Balata ◽  
Shereen H. Ahmed ◽  
Afaf F. Khamis ◽  
Enas A. Elattar
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Tender Joint ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Significant Difference ◽  
The Mean ◽  
Anti Inflammatory

Abstract Background This study aimed to measure the serum and synovial interleukin (IL)-37 levels in rheumatoid arthritis (RA) patients compared to patients with primary knee osteoarthritis (PKOA) and healthy controls and to detect its relation to RA disease activity. Results This cross-sectional study included 50 RA patients with a mean age of 40.24 ± 8.62 years, 50 patients with PKOA with a mean age of 56.69 ± 4.21, and 40 healthy controls with a mean age of 41.75 ± 7.38 years. The mean serum IL-37 level in the RA patients (382.6 ± 73.97 pg/ml) was statistically significantly (P < 0.001) the highest among the studied groups; however, it showed a non-significant difference between the PKOA patients (70.38 ± 27.49 pg/ml) and the healthy controls (69.97 ± 25.12 pg/ml) (P > 0.94). Both serum and synovial IL-37 levels were significantly positively correlated with disease activity scores (r = 0.92, P< 0.001 and r = 0.85, P < 0.001), tender joint counts (r = 0.83, P < 0.001 and r = 0.82, P < 0.001 ), swollen joint counts (r = 0.72, P < 0.001 and r = 0.60, P < 0.001), visual analog scale (r = 0.82, P < 0.001 and r = 0.82, P < 0.001), erythrocyte sedimentation rate (r = 0.75, P < 0.001 and r = 0.65, P < 0.001), and C-reactive protein (r = 0.93, P < 0.001 and r = 0.79, P < 0.001), respectively. Conclusion Serum and synovial IL-37 were significantly elevated in the RA patients, and they were closely correlated. Being less invasive, the serum IL-37 could be a marker of disease activity and could reflect the effective disease control by drugs. Having an anti-inflammatory effect could not suggest IL-37 as the key player to control inflammation alone, but its combination with other anti-proinflammatory cytokines could be investigated.

scholarly journals Comparison of Novel, Bach Mai Boston Tool (BBT) and the Patient-Generated Subjective Global Assessment (PG-SGA) for Oncology Inpatients

2019 ◽  
Vol 26 (1) ◽  
pp. 107327481986376 ◽  
Author(s):  
Binh Pham Van ◽  
Linh Nguyen Thuy ◽  
Hoa Nguyen Thi Thanh ◽  
Anh Nguyen Le Tuan ◽  
Phuong Duong Thi ◽  
...  
Keyword(s):  
Global Assessment ◽  
Cross Sectional Study ◽  
Subjective Global Assessment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nutrition Screening ◽  
Kappa Value ◽  
Risk Patients ◽  
The Mean ◽  
Sensitivity Specificity

Oncology inpatients are at high risk of malnutrition. Identification of at risk patients by nutrition screening requires a practical and easy to use tool. The aim of this study was to determine the validity of the Bach Mai Boston Tool (BBT) compared to a ‘gold standard’ full nutrition assessment using the Patient-Generated Subjective Global Assessment (PG-SGA). A cross-sectional study was conducted on 270 oncology inpatients from January to December 2016. Cohen’s Kappa, sensitivity, specificity and ROC analyses were performed. 270 inpatients were included in this study with a mean age of 56.3 ± 12.1 years old. Of these patients, 51.8% were male, and 74.1% had gastrointestinal cancer. The mean body mass index of patients was 20.6 ± 3.0 kg/m2. The PG-SGA tool identified 146 (54.1%) malnourished patients, while the BBT identified 105 (39.9%) malnourished patients. The BBT had a medium consistency, with a Kappa value of 0.6. Using a cut-off point of ≥ 4, the BBT had a sensitivity of 87.7% and a specificity of 72.6%. On the other hand, a BBT with a cut-off point ≥ 5 resulted in a sensitivity of 67.1%, a specificity of 94.4%, and an AUC of 0.81. The BBT is a practical, informative and valid tool for detecting malnutrition in hospitalized oncology patients. We recommend using a cut-off point of 4 for screening the risk of malnutrition for oncology inpatients.

scholarly journals Quality of informed consent documents among US. hospitals: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e033299
Author(s):  
Erica S Spatz ◽  
Haikun Bao ◽  
Jeph Herrin ◽  
Vrunda Desai ◽  
Sriram Ramanan ◽  
...  
Keyword(s):  
Informed Consent ◽  
Cross Sectional Study ◽  
Face Validity ◽  
Fee For Service ◽  
Cross Sectional ◽  
Consent Document ◽  
Informed Consent Document ◽  
The Mean ◽  
Quality Threshold

ObjectiveTo determine whether informed consent for surgical procedures performed in US hospitals meet a minimum standard of quality, we developed and tested a quality measure of informed consent documents.DesignRetrospective observational study of informed consent documents.Setting25 US hospitals, diverse in size and geographical region.CohortAmong Medicare fee-for-service patients undergoing elective procedures in participating hospitals, we assessed the informed consent documents associated with these procedures. We aimed to review 100 qualifying procedures per hospital; the selected sample was representative of the procedure types performed at each hospital.Primary outcomeThe outcome was hospital quality of informed consent documents, assessed by two independent raters using an eight-item instrument previously developed for this measure and scored on a scale of 0–20, with 20 representing the highest quality. The outcome was reported as the mean hospital document score and the proportion of documents meeting a quality threshold of 10. Reliability of the hospital score was determined based on subsets of randomly selected documents; face validity was assessed using stakeholder feedback.ResultsAmong 2480 informed consent documents from 25 hospitals, mean hospital scores ranged from 0.6 (95% CI 0.3 to 0.9) to 10.8 (95% CI 10.0 to 11.6). Most hospitals had at least one document score at least 10 out of 20 points, but only two hospitals had >50% of their documents score above a 10-point threshold. The Spearman correlation of the measures score was 0.92. Stakeholders reported that the measure was important, though some felt it did not go far enough to assess informed consent quality.ConclusionAll hospitals performed poorly on a measure of informed consent document quality, though there was some variation across hospitals. Measuring the quality of hospital’s informed consent documents can serve as a first step in driving attention to gaps in quality.

scholarly journals Factors associated with disease-specific quality of life in Taiwanese patients with ankylosing spondylitis: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e028966
Author(s):  
Ming-Chi Lu ◽  
Kuang-Yung Huang ◽  
Chien-Hsueh Tung ◽  
Bao-Bao Hsu ◽  
Cheng-Han Wu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Cross Sectional Study ◽  
Dietary Habit ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Disease Specific

ObjectiveThe aim of this study was to assess the factors associated with disease-specific quality of life in Taiwanese patients with ankylosing spondylitis.DesignA cross-sectional study.SettingA regional teaching hospital in southern Taiwan.ParticipantsAdult patients with ankylosing spondylitis recruited from the outpatient rheumatology clinics of the study hospital.Primary outcome measureDisease-specific quality of life assessed by the Evaluation of Ankylosing Spondylitis Quality of Life (EASi-QoL).ResultsOf the 265 patients, 57% were 20–49 years of age, with a male preponderance (75.5%). Multiple stepwise linear regression analysis indicated that a higher disease activity, assessed by the Ankylosing Spondylitis Disease Activity Score, was significantly and independently associated with a lower quality of life in all four domains (physical function, disease activity, emotional well-being and social participation) of the EASi-QoL. In addition, various independent factors, including educational level, nature of occupation, disease duration, dietary habit and body mass index, were significantly associated with different domains of the EASi-QoL.ConclusionsOur findings indicated that, in addition to disease activity and perceived health status, a number of other factors could significantly impact the different aspects of quality of life in patients with ankylosing spondylitis, which warrant special consideration and support from healthcare providers.

Fibromyalgia in Spondyloarthritis: Effect on Disease Activity Assessment in Clinical Practice

2016 ◽  
Vol 43 (11) ◽  
pp. 2056-2063 ◽  
Author(s):  
Jean Wach ◽  
Marie-Claude Letroublon ◽  
Fabienne Coury ◽  
Jacques Guy Tebib
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Activity Index ◽  
Short Form ◽  
Disease Activity Index ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Moderate Activity ◽  
Cross Sectional ◽  
American College Of Rheumatology

Objective.Spondyloarthritis (SpA) is the second most frequent inflammatory rheumatic disease, characterized by spinal involvement, peripheral arthritis, or enthesitis with marked pain, stiffness, and fatigue. Fibromyalgia (FM) may be associated with SpA, and shares some common symptoms. We aimed to determine how FM influences assessment of SpA disease activity, which is mainly dependent on patient-based outcome measures such as the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) or the Ankylosing Spondylitis Disease Activity Score (ASDAS).Methods.This single-center cross-sectional study included consecutive patients with SpA according to the Assessment of SpondyloArthritis International Society criteria. FM was diagnosed according to the 1990 American College of Rheumatology criteria. Patient characteristics, BASDAI, ASDAS/C-reactive protein (CRP), Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, and the Medical Outcomes Study Short Form-36 questionnaire were recorded and compared.Results.The study included 103 patients with SpA; 81 with axial and 22 with peripheral forms. Eighteen patients presented with concomitant FM, of whom 12 had axial SpA and 6 peripheral SpA. Demographic characteristics did not differ except for sex, with a female predominance in the FM group that was more marked in peripheral forms. BASDAI was higher in patients with FM [median (IQR): 4.2 (4.2) vs 2.2 (3.1); p = 0.0068], whereas ASDAS-CRP was not significantly different [median (IQR): 2.7 (2) vs 2 (1.3); p = 0.1264]. Nevertheless, median ASDAS-CRP corresponded to high disease activity in patients with SpA or FM compared with moderate activity in non-FM patients.Conclusion.FM is a frequent comorbidity in patients with SpA, especially in peripheral forms. In patients with SpA-FM, disease activity may be overestimated when measured by BASDAI and to a lesser extent by ASDAS-CRP, and this overestimation could lead to inappropriate treatment escalation.

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