Rheumatology Department, Hospital Universitario de Móstoles, Madrid, Spain.
Rheumatology Department, Hospital Universitario de la Paz, Madrid, Spain.
Ann Rheum Dis. 2014 Jul;73(7):1350-5. doi: 10.1136/annrheumdis-2012-202976. Epub 2013 May 24.
To evaluate the validity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) in early spondyloarthritis (SpA) in comparison with conventional clinical measures of disease activity.
Six hundred and seventy-six incident cases of early SpA from the Esperanza programme were included. Patients were categorised into high and low disease activity states based on patient and physician global assessment scores and on the physician's decision to start treatment with a disease-modifying antirheumatic drug or tumour necrosis factor blocker. The discriminant ability of ASDAS-C-reactive protein (CRP) and ASDAS-erythrocyte sedimentation rate (ESR) was tested using standardised mean differences between patients with high and low disease activity. Convergent validity was tested by Pearson correlation between ASDAS versions and other measures of disease activity.
ASDAS-ESR and ASDAS-CRP showed good correlation with BASDAI (r=0.79 and 0.74, respectively). Both indices correlated well with the patient global assessment (r=0.70 in both indices) and moderately with the physician global score (r=0.46 and 0.47, respectively). CRP and ESR showed poor correlation with patient- and physician-derived measures. ASDAS performed similarly across the global SpA sample, ankylosing spondylitis (AS), non-radiographic axial SpA and peripheral SpA.
ASDAS performed as a valid activity score even being slightly better than the Bath Ankylosing Spondylitis Disease Activity Index in its ability to discriminate between high and low disease activity in early SpA. ASDAS performed similarly in AS, early forms of SpA, non-radiographic axial SpA and peripheral SpA.
评估强直性脊柱炎疾病活动评分（ASDAS）在早期脊柱关节炎（SpA）中的有效性，并与疾病活动的常规临床指标进行比较。
纳入 Esperanza 项目中的 676 例早期 SpA 新发病例。根据患者和医生的总体评估评分以及医生决定开始使用疾病修饰抗风湿药物或肿瘤坏死因子阻滞剂治疗，将患者分为高疾病活动状态和低疾病活动状态。使用高疾病活动和低疾病活动患者之间的标准化均数差值来测试 ASDAS-C 反应蛋白（CRP）和 ASDAS-红细胞沉降率（ESR）的判别能力。通过 ASDAS 版本与其他疾病活动测量之间的 Pearson 相关性来测试其收敛有效性。
ASDAS-ESR 和 ASDAS-CRP 与 BASDAI 具有良好的相关性（分别为 r=0.79 和 0.74）。这两个指数与患者的总体评估高度相关（两个指数均为 r=0.70），与医生的总体评分中度相关（分别为 r=0.46 和 0.47）。CRP 和 ESR 与患者和医生得出的测量结果相关性较差。ASDAS 在整个 SpA 样本、强直性脊柱炎（AS）、非放射学轴向 SpA 和外周 SpA 中表现出相似的性能。
ASDAS 作为一种有效的活动评分，即使在区分早期 SpA 中的高疾病活动和低疾病活动方面，其性能也略优于 Bath 强直性脊柱炎疾病活动指数。ASDAS 在 AS、早期 SpA、非放射学轴向 SpA 和外周 SpA 中的表现相似。
