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or dactylitis. A patient with peripheral manifestations can fulfil pSpA criteria if at least one of the following SpA feature is present in addition: uveitis, psoriasis, IBD, preceding infection, HLA-B27 positivity or sacroiliitis on imaging; or if at least two of the following additional SpA features are
present: arthritis, enthesitis, dactylitis, IBP or a positive family history for SpA.
The ASAS/OMERACT core set
In an attempt to bring homogeneity in outcome assessment in AS, the Assessment of SpondyloArthritis international Society (ASAS) has selected a core set of variables that have been endorsed by the Outcome Measures in Rheumatology Clinical Trials (OMERACT) group. This core set is intended to be used as standardised end-points in clinical trials and in clinical practice. Three scenarios for core sets have been defined: (1) disease controlling anti-rheumatic therapy (DC-ART), (2) symptom modifying anti-rheumatic drugs (SMARDs) and physical therapy and (3) clinical record keeping. The domains selected for all three core sets include ‘physical function’, ‘pain’, ‘spinal mobility’, ‘spinal stiffness’, ‘fatigue’ and ‘patient’s global assessment’. The DC-ART core sets and clinical record keeping further include ‘peripheral joints/entheses’ and ‘acute phase reactants’, and the core set for DC-ART includes ‘radiographs of the spine’. Specific instruments to assess the domains for all three core set have been selected (Table).
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