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Clinical utility of the ASDAS index in comparison with BASDAI in patients with ankylosing spondylitis (Axis Study)

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Abstract

The objective of the study was to study the clinical utility of the Ankylosing Spondylitis Disease Activity Score (ASDAS) for the assessment of disease activity in ankylosing spondylitis (AS) patients, compared to the Bath Ankylosing Spondylitis Activity Index (BASDAI). This was a prospective longitudinal observational study in patients with AS (NY-modified criteria) from 23 Spanish centers. Physical and analytical data; global, lumbar, and nocturnal pain; ASDAS, BASDAI and minimally acceptable clinical status (PASS) were collected. Psychometric characteristics of both indexes were analyzed: construct validity (convergent and divergent), discriminant capacity, criterion validity (global physician and patient assessment), and sensitivity to change. The study involved 127 patients (19.7% attrition). Both BASDAI and ASDAS showed a higher correlation with patient’s global assessment (r = 0.76 and 0.70, respectively) than with physician’s global assessment (r = 0.67 and 0.57). Both scores allowed discriminating patients with an acceptable clinical status, although BASDAI to a greater extent than ASDAS (Cohen δ 1.72 vs 0.88 for the medical PASS). Both scores showed sensitivity to change in patients who changed from an unacceptable symptomatic state to acceptable according to PASS criteria (physician and patient) and by BASDAI 50 response criteria (Cohen δ > 0.80). BASDAI showed better criterion validity than ASDAS, both for the patient PASS (AUC 0.85 vs 0.79) and for the physician’s (AUC 0.90 vs 0.79). ASDAS shows adequate performance for disease activity in patients with AS; however, in this study, its psychometric properties do not present advantages over BASDAI in terms of criterion validity, sensitivity to change or discriminative capacity; replacement of BASDAI by ASDAS is not supported by the data.

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Acknowledgements

The authors wish to thank María Jesús García de Yebenes and Teresa Otón, from InMusc, Madrid, for providing medical writing and editing services in the development of this manuscript, and Jesús Garrido for his statistical support. Abbvie Spain sponsored the study; contributed to its design; participated in the collection, analysis, and interpretation of the data, and in the writing, reviewing, and approval of the final manuscript.

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Authors and Affiliations

  1. Hospital Vall d’Hebron, Barcelona, Spain

    Agustí Sellas i Fernandez

  2. Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

    Xavier Juanola Roura

  3. Hospital de Cruces, Baracaldo, Vizcaya, Spain

    Alberto Alonso Ruiz

  4. Hospital Marina Baixa Villajoyosa, Alicante, Spain

    José Rosas

  5. Hospital Clínico Universitario de Valladolid, Valladolid, Spain

    Julio Medina Luezas

  6. Hospital Universitario Reina Sofía/IMIBIC, Universidad de Córdoba, Córdoba, Spain

    Eduardo Collantes Estevez

  7. Hospital Virgen del Puerto, Plasencia, Cáceres, Spain

    Miguel Ángel Abad Hernández

  8. Medical Department, Abbvie Spain, Avenida de Burgos, 91, 28050, Madrid, Spain

    Virginia Carrasco Benitez & Cesar Fisac

Authors
  1. Agustí Sellas i Fernandez
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  2. Xavier Juanola Roura
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  3. Alberto Alonso Ruiz
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  4. José Rosas
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  5. Julio Medina Luezas
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  6. Eduardo Collantes Estevez
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  7. Miguel Ángel Abad Hernández
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  8. Virginia Carrasco Benitez
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  9. Cesar Fisac
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Corresponding author

Correspondence to Cesar Fisac.

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Conflict of interest

External author disclosures: A. Sellas-Fernández has received research grant from AbbVie; X. Juanola-Roura has received research grant from AbbVie; A. Alonso-Ruiz A has received research grant from AbbVie; J. Rosas has received research grant from AbbVie; J. Medina-Luezas has received research grant from AbbVie; E. Collantes- Estevez E has received research grant from AbbVie; M. A. Abad-Hernandez has received research grant from AbbVie. Internal author disclosures: VC and CF are full-time employees of AbbVie.

Funding

Funding Study funded by Abbvie Spain (Grant number SCI-SPAI-2009-06).

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Sellas i Fernandez, A., Juanola Roura, X., Alonso Ruiz, A. et al. Clinical utility of the ASDAS index in comparison with BASDAI in patients with ankylosing spondylitis (Axis Study). Rheumatol Int 37, 1817–1823 (2017). https://doi.org/10.1007/s00296-017-3814-2

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  • DOI: https://doi.org/10.1007/s00296-017-3814-2

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