WASHINGTON, D.C.—The methods used to classify ankylosing spondylitis (AS) have changed dramatically in recent years, giving rise to a more nuanced view of the disease—a valuable clinical tool and a benefit to the patient, an expert said here at the 2012 ACR/ARHP Annual Meeting, held November 9–14 in Washington, D.C. [Editor’s Note: This session was recorded and is available via ACR SessionSelect at www.rheumatology.org.]
Désirée van der Heijde, MD, PhD, professor of rheumatology at Leiden University in the Netherlands, reviewed the new Assessment of SpondyloArthritis International Society (ASAS) classification criteria for axial spondylarthritis (SpA), which expanded the lens through which the disease is seen.1 Dr. Van der Heijde also offered her thoughts on the best current treatment for AS, which continues to rely heavily on a combination of nonpharmacological and pharmacological (nonsteroidal antiinflammatory drugs [NSAIDs] and tumor necrosis factor [TNF] inhibitors) treatment.
Researchers are hoping for a way to identify AS patients earlier; on average, nine years pass from the time the first symptoms are felt to the time of diagnosis.
New Tools for Early Identification
When it comes to identifying AS, until 2009, the focus was mainly on the modified New York criteria. “When we used the modified New York criteria, we can only try to treat these patients when they have sacroilitis on the radiographs,” Dr. van der Heijde said. “But that’s not the way it starts. It starts earlier with back pain.”