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Rheumatology for general practitioners
Published in Maneesh Bhatia, Tim Jennings, An Orthopaedics Guide for Today's GP, 2017
Biologic therapies can be introduced in secondary care. There is emerging evidence that the early use of biologics may be particularly helpful in patients with AS. Selection is based on the level of disease activity as assessed by two commonly used clinical measurement tools – the BASDAI (Bath Ankylosing Spondylitis Disease Activity) and BASFI (Bath Ankylosing Spondylitis Functional Index). Traditional DMARDs may be helpful in patients with peripheral synovitis (Figures 11.6 through 11.9).
Criteria and Outcome Assessment of Ankylosing Spondylitis
Published in Barend J. van Royen, Ben A. C. Dijkmans, Ankylosing Spondylitis Diagnosis and Management, 2006
Désirée van der Heijde, Sjef van der Linden
For the ASAS core set, only single variables have been selected. However, in recent years several combined instruments became available, especially from the Bath group in the United Kingdom. These are pooled instruments developed to assess the various aspects of the disease process. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is a measure to assess signs and symptoms of disease activity such as morning stiffness (duration and severity), several aspects of pain, and fatigue (11). The BASDAI is used to assess disease activity when starting and monitoring patients on tumor necrosis factor (TNF)-blocking agents (12).
Anticytokine therapies in rheumatic diseases: an update
Published in Rajan Madhok, Hilary Capell, The Year in Rheumatic Disorders Volume 4, 2004
(n = 16) for 6 weeks; all patients received etanercept in the subsequent observational phase, lasting 24 weeks. DMARDs and steroids were withdrawn prior to the study. The primary outcome measure was a 50% improvement in the Bath AS Disease Activity Index (BASDAI), an index of disease activity that evaluates fatigue, pain and stiffness. Ancillary outcome measures included the Bath AS Functional Index (BASFI), which evaluates the impact of disability on different activities of daily living, the Bath AS Metrology Index (an index of spinal mobility), pain level on a numeric rating scale, quality of life (using the Short Form 36), and C-reactive protein levels. Fifty-seven per cent of the etanercept-treated patients but only 6% of patients receiving placebo (P = 0.004) had a 50% improvement in the BASDAI at week 6 (Fig. 3.4); when the placebo-treated patients switched to etanercept, 56% improved. Similarly, the other outcome variables improved significantly with etanercept but not with placebo at week 6. Disease relapses occurred on average 6 weeks after cessation of etanercept therapy. No severe adverse events were observed.
IL-23 inhibition for the treatment of psoriatic arthritis
Published in Expert Opinion on Biological Therapy, 2022
Raagav Mohanakrishnan, Secia Beier, Atul Deodhar
Axial involvement in PsA is common and is reported to vary from 5% at baseline to 70% in advanced disease [42] The DISCOVER-1 and 2 studies assessed guselkumab’s efficacy in axial PsA patients by pooling patients from both studies who had axial symptoms and x-ray evidence of sacroiliitis. Fifty percent change in Bath ankylosing spondylitis disease activity score (BASDAI 50) was used as an outcome. Results from this pooled analysis showed that patients in guselkumab treatment groups had a significantly higher percentage achieving BASDAI50 scores (40.5% in q8wk, 37.9% in q4wk, vs 19.1% in placebo, p < 0.01), regardless of HLA-B27 status [43]. This result was especially interesting, since IL-23 inhibitors Ustekinumab and Risankizumab did not show efficacy in clinical trials of axial spondylarthritis (axSpA) [44,45] and hence IL-23 inhibitors were initially thought to be not effective on the axial skeleton. These results raise the issue whether axial PsA is a distinct entity, different from axial spondyloarthritis with skin psoriasis.
Real-world effectiveness and safety of adalimumab for treatment of ankylosing spondylitis in Japan
Published in Modern Rheumatology, 2019
Shigeto Kobayashi, Tomoko Kashiwagi, Junko Kimura
Patient demographics and baseline characteristics, including HLA-B27 status, concomitant medications, comorbid conditions, and extra-articular manifestations, were recorded in the case report form. Overall improvement (remarkably improved, improved, or not improved) was evaluated by physician judgment at weeks 12 and 24 or at discontinuation. Overall Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, from its symptom component (fatigue, spinal pain, joint pain, localized tenderness, and morning stiffness), were evaluated at baseline, week 12, and week 24. Change in BASDAI score from baseline and change in BASDAI score of ≥50% (BASDAI50 response) from baseline to week 12 and week 24 were evaluated. Extra-articular manifestations of AS were deemed ‘improved,’ ‘worsened,’ ‘remained undeterminable,’ or ‘no change in disease status’ at week 12 and week 24, again based on physician judgment.
Assessment of arterial stiffness and epicardial adipose tissue thickness in predicting the subclinical atherosclerosis in patients with ankylosing spondylitis
Published in Clinical and Experimental Hypertension, 2021
Kenan Demir, Ahmet Avcı, Serpil Ergulu Esmen, Abdullah Tuncez, Muhammed Ulvi Yalcın, Ahmet Yılmaz, Sema Yılmaz, Bülent Behlül Altunkeser
Blood specimens were collected after 12 h of fasting in both groups. Total cholesterol, HDL-C, LDL-C, triglyceride, urea, glucose, hemoglobin, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured. Arterial blood pressure measurements were performed from both arms after 10 min of rest in all subjects. Height and weight measurements of all subjects were performed. Body mass index (BMI) was calculated as weight divided by height squared (kg/m2). In addition, disease duration (duration since symptom onset), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the Bath Ankylosing Spondylitis Functional Index (BASFI) scores were calculated.