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“A Common Language for Spondyloarthritis”

Gretchen Henkel  |  Issue: December 2010  |  December 1, 2010

Because the criteria are relatively new, the task of disseminating them will take some time and present challenges, Dr. Landewé notes. “Apparently, we still have to educate physicians seeing patients with low back pain or with other signs of spondyloarthritis in order to get those patients referred to where they belong—and that is to the rheumatologist.”

Educating colleagues, both in primary care and in rheumatology, is one of the future challenges. Dr. Rudwaleit thinks that ASAS will face challenges to define scientific projects that are attractive and interesting enough to the ASAS community to keep them “motivated and contributing. I think that the first 10 years were probably a little bit easier since we had many unfilled gaps,” he says. “Still, there are many unanswered questions such as that of the stimuli of bone formation in AS, the relationship of inflammation and bone formation, and the potential of modifying this process.”

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Dr. Reveille believes there’s still plenty of work for ASAS and its methods in several other domains in AS. “Biomarkers, genetics, refinements in imaging—all of these elements will continue to develop, will need vetting, and will need to be incorporated into revisions of disease criteria,” Dr. Reveille asserts. “I also think we’re still struggling with some of the early disease definitions, not just in spondyloarthritis, and ASAS is extremely well suited to do that. They have, even at this point, no rivals.”

References

  1. van der Heijde D, Bellamy N, Calin A, et al. Preliminary core sets for endpoints in ankylosing spondylitis. J Rheumatol. 1997;24:2225-2229.
  2. van der Heijde D, Calin A, Dougados M, et al. Selection of instruments in the core set for DC-ART, SMARD, physical therapy, and clinical recordkeeping in ankylosing spondylitis. J Rheumatol. 1999;26:951-954.
  3. Anderson JJ, Baron G, van der Heijde D, et al. Ankylosing Spondylitis Assessment Group preliminary definition of short-term improvement in ankylosing spondylitis. Arthritis Rheum. 2001;44:1876-1886.
  4. van Tubergen A, van der Heijde D, Anderson J, et al. Comparison of statistically derived ASAS improvement criteria for ankylosing spondylitis with clinically relevant improvement according to an expert panel. Ann Rheum Dis. 2003;62:215-221.
  5. van der Heijde D, Dougados M, Davis J, et al. Assessment in Ankylosing Spondylitis International Working Group/Spondylitis Association of America recommendations for conducting clinical trials in ankylosing spondylitis. Arthritis Rheum. 2005;52:386-394.
  6. Rudwaleit M, Landewé R, van der Heijde D, et al. The development of Assessment of SpondyloArthritis International Society classification criteria for axial spondyloarthritis (part I): Classification of paper patients by expert opinion including uncertainty appraisal. Ann Rheum Dis. 2009;68:770-776.
  7. 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;68:777-783.
  8. Braun J, Pham T, Sieper J, et al. International ASAS consensus statement for the use of anti-tumour necrosis factor agents in patients with ankylosing spondylitis. Ann Rheum Dis. 2003;62:817-824.
  9. Brandt J, Listing J, Sieper J, et al. Development and preselection of criteria for short-term improvement after anti-TNF (alpha) therapy in ankylosing spondylitis. Ann Rheum Dis. 2004;63:1438-1444.
  10. Zochling J, van der Heijde D, Burgos-Vargas R, et al. ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis. 2006; 65:442-452.
  11. van der Heijde D, Landewé R, Hermann KG, et al. ASAS/OMERACT MRI in AS Working Group. Is there a preferred method for scoring activity of the spine by magnetic resonance imaging in ankylosing spondylitis? J Rheumatol. 2007; 34:871-873.
  12. Sieper J, Rudwaleit M, Baraliakos X, Brandt J, et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: A guide to assess spondyloarthritis. Ann Rheum Dis. 2009; 68:ii1-ii44.
  13. Lukas C, Landewé R, Sieper J, et al. Development of an ASAS-endorsed disease activity score (ASDAS) in patients with ankylosing spondylitis. Ann Rheum Dis. 2009;68:18-24.
  14. van der Heijde D, Lie E, Kvien TK, et al. The ASDAS is a highly discriminatory ASAS-endorsed disease activity score in patients with ankylosing spondylitis. Ann Rheum Dis. 2009; 68:1811-1818.

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Filed under:Axial SpondyloarthritisConditionsPractice SupportResearch Rheum Tagged with:Ankylosing SpondylitisClassification CriteriaEducationResearch

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