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Axial, peripheral SpA ASAS criteria predicted SpA diagnosis
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Researchers of this study used the positive predictive value of the Assessment of Spondyloarthritis International Society Spondyloarthritis classification criteria to predict diagnosis of the condition by a rheumatologist after 4-year follow-up.
To determine the predictive validity of the Assessment of Spondyloarthritis International Society (ASAS) Spondyloarthritis (SpA) classification criteria, Alexandre Sepriano, MD, from the Department of Rheumatology at Leiden University Medical Center in The Netherlands, and colleagues contacted 909 patients (either in person or by telephone) from 22 centers who attended follow-up visits for a mean of 4.4 years, according to the abstract. The patients were included in the study if their age of onset was younger than 45 years and if they had chronic back for more than 3 months (658 patients), or had a peripheral arthritis and/or enthesitis and/or dactylitis (251 patients). Researchers used rheumatologists’ diagnoses at follow-up as an external standard to determine the positive predictive value (PPV) of the ASAS classification criteria.
Alexandre Sepriano
Sepriano and colleagues found that of 564 patients who received follow-up visits, 70.2% were diagnosed with SpA by a rheumatologist. Of these, 335 patients met axial SpA (axSpA) or peripheral SpA (pSpA) criteria at baseline, according to the abstract. Of the patients who met axSpA or pSpA criteria, 309 patients were diagnosed with SpA after the follow-up period (PPV SpA criteria = 92.2%).
“The long-term follow-up of the original ASAS cohort provided an excellent predictive validity for the ASAS axSpA and pSpA classification criteria and or the combined set,” Sepriano and colleagues wrote. “In addition, patients fulfilling the ‘clinical arm’ had disease characteristics in accordance with the rheumatologists’ perception of what ‘SpA looks like’ (‘gestalt’) resulting in a good predictive validity similar to that of the ‘imaging arm.’”
Specifically, researchers determined the PPV of axSpA was 93.3% and the PPV of pSpA was 89.5%. Within the clinical arm only, the PPV was 88%, while the clinical arm ± imaging arm PPV was 96%. Similarly, the imaging arm only had a PPV of 86.2%, while the imaging arm ± clinical arm had a PPV of 94.7%, according to the abstract. – by Jeff Craven
Disclosure: The researchers report no relevant financial disclosures.
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