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Table ASAS/OMERACT core set for SMARD, DC-ART and specific instruments Domains Instruments
Function BASFI
Pain
Spinal mobility
Spinal stiffness
Patient global
Peripheral joint, entheses
Acute phase reactants Radiograph spine Fatigue
NRS/VAS (last week/spine/night/due to AS)
NRS/VAS (last week/spine/due to AS)
Chest expansion, modified Schober, occiput to wall, cervical rotation, (lateral spinal flexion or BASMI)
NRS/VAS (duration of morning stiffness, spine, last week) NRS/VAS (global disease activity last week)
Number of swollen joints (44 joint count) MASES,
San Francisco or Berlin
CRP or ESR
mSASSS on lateral lumbar spine / lateral cervical spine
Fatigue question BASDAI
ASAS, Assessment of SpondyloArthritis international Society; OMERACT, Outcome Measures in Rheumatology Clinical Trials; DC-ART, disease controlling anti-rheumatic therapy; SMARD, symptom modifying anti-rheumatic drugs; BASDAI, Bath Ankylosing Spondylitis Functional Index; NRS, Numerical Rating Scale; VAS, Visual Analogue Scale; BASMI, Bath Ankylosing Spondylitis Metrology Index; MASES, Maastricht Ankylosing Spondylitis Enthesis Score; CRP, C-reactive protein; ESR, Erythrocyte Sedimentation Rate; mSASSS, modified Stoke Ankylosing Spondylitis Spinal Score; BASRI, Bath Ankylosing Spondylitis Radiology Index; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index
Assessment and monitoring is important in systemic diseases that may present with a variety of symptoms and signs, such as SpA. Each of these symptoms can be assessed in clinical practice using different instruments. Disease monitoring should include patient history (patient oriented questionnaires), clinical parameters including spinal mobility, laboratory tests and imaging, all according to clinical presentation, as well as the ASAS core set12. In this regard, instruments for the assessment and monitoring of the disease have been validated for use in clinical practice as well as in clinical trials13. Disease activity indices are relevant for monitoring disease activity in patients with SpA. The Bath AS Disease Activity Index (BASDAI) and recently the AS Disease Activity Score (ASDAS) are the most important indices available for clinical practice. The ASDAS-CRP is recommended by ASAS and validated cut-off levels for levels of disease activity as well as improvement in disease activity have been defined14.
Clinical assessment and monitoring
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