Is the new ASDAS nomenclature in agreement with therapeutic decision making in patients with axial spondyloarthritis?

OBJECTIVES

To evaluate the association between low disease activity according to the new ASDAS nomenclature and the physician therapeutic decisions in patients with axial spondyloarthritis (axSpA).

MATERIAL AND

METHODS

Longitudinal retrospective study including patients diagnosed with axSpA receiving a tumor necrosis factor-inhibitor between January 2014 and June 2019 as a first treatment. For each visit, disease activity was determined afterwards according to the new ASDAS nomenclature (inactive, low, high and very high activity), and the physician's therapeutic decision was recorded. The association between disease activity and the physician's decision was evaluated through descriptive statistics.

RESULTS

A total of 304 visits of 104 patients with axSpA were analyzed. For those visits where a low activity ASDAS score was obtained, the physician's therapeutic decision was no escalation of treatment in 98.2% of cases. However, for those visits with a high or very high disease activity ASDAS score, the physician's therapeutic decision was to escalate treatment in 33.7% and 82.8% of cases respectively.

CONCLUSIONS

The state measured by the ASDAS index formerly defined as 'moderated disease activity' is considered in clinical practice as 'low disease activity' because of the physician's choice in these situations to not-escalate the treatment. Our data substantiate the recent updating in ASDAS nomenclature.