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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).
Ankylosing spondylitis
Published in John M. Saxton, Exercise and Chronic Disease, 2011
Hanne Dagfinrud, Silje Halvorsen, Nina K. Vøllestad
The ASessment in Ankylosing Spondylitis (ASAS) working group defined a core set of domains and instruments for assessing the most important aspects of disease assessments in AS, including pain, spinal mobility, physical function and patient global assessment of disease (van der Heijde et al., 1999). Measures of aerobic capacity or physical fitness are not included in the core set, reflecting the main treatment goal of improving or maintaining spinal mobility and reducing pain. Accordingly, the outcome measures selected in this review were the Bath Ankylosing Spondylitis (BAS) Metrology Index (BASMI) (Jenkinson et al., 1994) or a separate spinal mobility measure (Schober test or fingertip-to-floor distance, FFD), BAS Functioning Index (BASFI) (Calin et al., 1994), BAS Disease Activity Index (BASDAI) (Garrett et al., 1994) or a single pain scale and global assessment of well-being (BAS-G) (Jones et al., 1996). Additionally, three studies had cardiorespiratory fitness as an outcome measure.
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 DMARDs and steroids were withdrawn prior to the study.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.
Comparison of the effects of aerobic training alone versus aerobic training combined with clinical Pilates exercises on the functional and psychosocial status of patients with ankylosing spondylitis: A randomized controlled trial
Published in Physiotherapy Theory and Practice, 2023
Power analysis was performed to determine the number of patients. The Bath Ankylosing Spondylitis Functional Index (BASFI) was used for functional status assessment. The study by Roşu, Topa, Chirieac, and Ancuta (2014) was used as a reference for conducting the power analysis; the mean pre – and post-treatment BASFI values in their study were 3.56 ± 1.83 and 1.50 ± 1.11, respectively. The effect size of the treatment method was calculated as d = 1.376 (95% CI, 1.076–1.675). We compared the pre – and post-treatment BASFI values in our study using the Wilcoxon paired-samples tests as double-tailed, assuming α = 0.05 and statistical power (1 – β) = 0.80. The required sample size was calculated as 10 patients. We compared the results between the groups using the two-tailed Mann–Whitney U test, and because the patients were divided in a 1:1 ratio in both groups, the sample size was calculated as 13 for each group, and the total sample size for both groups was 26.
Validity, reliability, and factor structure of the Istanbul Low Back Pain Disability Index in axial spondyloarthritis
Published in Modern Rheumatology, 2021
Mehmet Tuncay Duruöz, Sevtap Acer Kasman, Nilay Şahin, İlhan Sezer, Hatice Bodur, Ayşegül Ketenci, Sami Hizmetli, Didem Erdem Gürsoy, Ali Nail Demir, Ahmet Kıvanç Menekşeoğlu, Ahmet Karadağ, Hatice Şule Baklacıoğlu
Regarding the convergent part of construct validity, all patients were asked to fill the BASFI, DFI, and HAQ questionnaires to evaluate the functional status. BASFI is a self-report questionnaire to define and monitor the functional ability of patients with AS [14]. It contains ten items (bending, reaching, standing, changing position, turning, and climbing steps) assessing the patients’ function by using visual analog scales. The score ranges between 0 and 10, with 0 indicating no functional impairments and 10 reflecting maximal impairment. DFI was developed to evaluate the functional abilities of persons with AS and covers 20 items about activities of daily living including dressing, bathing, standing, running, changing positions, climbing stairs, doing housework or usual job, coughing or sneezing, and breathing using three-point-Likert scale expressions [15]. The total score ranges from 0 to 40, with higher values reflecting worse physical functioning. HAQ has eight groups of questions regarding activities of daily living [16]. Responses are 0: able to do with no difficulty; 1: able to do with some difficulty; 2: able to do with much difficulty; and 3: unable to do. The final score may range from 0 to 3.
Certolizumab pegol for the treatment of psoriatic arthritis and plaque psoriasis
Published in Expert Review of Clinical Immunology, 2020
Maria Esposito, Francesco Carubbi, Alessandro Giunta, Alessia Alunno, Roberto Giacomelli, Maria Concetta Fargnoli
Unlike the RAPID-PsA, whose inclusion criteria was a peripheral articular disease, registries, and real-life cohorts also included patients with axial involvement. Both our study and the BIOPURE reported a significant decrease of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) at weeks 24 and 12, respectively [44,45]. However, we also observed a reduction of the Bath Ankylosing Spondylitis Functional Index (BASFI) from week 12. Finally, a significant reduction of HAQ at 12 weeks was observed in the BIOPURE and in our cohort [44,45]. The BIOPURE reported a treatment persistence of 62.8% in 94 PsA patients treated with CZP, which was similar to that of rheumatoid arthritis and spondyloarthritis [44]. Conversely, persistence was higher in rheumatoid arthritis vs PsA in biologic-naïve patients and mean survival time was longer in rheumatoid arthritis compared to PsA. Data from Canadian databases report that CZP has the lowest proportion of adherent patients across all rheumatologic indications compared to other subcutaneous TNFi [46].