ASAS consensus definition of early axial spondyloarthritis

Victoria Navarro-Compán; Diego Benavent; Dafne Capelusnik; Désirée van der Heijde; Robert Bm Landewé; Denis Poddubnyy; Astrid van Tubergen; Xenofon Baraliakos; Filip E Van den Bosch; Floris A van Gaalen; Lianne Gensler; Clementina López-Medina; Helena Marzo-Ortega; Anna Molto; Rodolfo Pérez-Alamino; Martin Rudwaleit; Marleen van de Sande; Raj Sengupta; Ulrich Weber; Sofia Ramiro

doi:10.1136/ard-2023-224232

ASAS consensus definition of early axial spondyloarthritis

Victoria Navarro-Compán^*, Diego Benavent, Dafne Capelusnik, Désirée van der Heijde, Robert Bm Landewé, Denis Poddubnyy, Astrid van Tubergen, Xenofon Baraliakos, Filip E Van den Bosch, Floris A van Gaalen, Lianne Gensler, Clementina López-Medina, Helena Marzo-Ortega, Anna Molto, Rodolfo Pérez-Alamino, Martin Rudwaleit, Marleen van de Sande, Raj Sengupta, Ulrich Weber, Sofia Ramiro

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVES: To develop a consensual definition for the term 'early axial spondyloarthritis-axSpA'-and 'early peripheral spondyloarthritis-pSpA'.

METHODS: The ASAS (Assessment of SpondyloArthritis international Society-Spondyloarthritis EARly definition) steering committee convened an international working group (WG). Five consecutive steps were followed: (1) systematic literature review (SLR); (2) discussion of SLR results within the WG and ASAS community; (3) a three-round Delphi survey inviting all ASAS members to select the items that should be considered for the definition; (4) presentation of Delphi results to the WG and ASAS community and (5) ASAS voting and endorsement (2023 annual meeting).

RESULTS: Following the SLR, consensus was to proceed with an expert-based definition for early axSpA (81% in favour) but not for pSpA (54% against). Importantly, early axSpA should be based on symptom duration taking solely axial symptoms into account. 151-164 ASAS members participated in the Delphi surveys. Consensus was achieved for considering the following items within early axSpA definition: duration of symptoms ≤2 years; axial symptoms defined as cervical/thoracic/back/buttock pain or morning stiffness; regardless of the presence/absence of radiographic damage. The WG agreed that in patients with a diagnosis of axSpA 'early axSpA' should be defined as a duration of ≤2 years of axial symptoms. Axial symptoms should include spinal/buttock pain or morning stiffness and should be considered by a rheumatologist as related to axSpA. The ASAS community endorsed this proposal (88% in favour).

CONCLUSIONS: Early axSpA has newly been defined, based on expert consensus. This ASAS definition should be adopted in research studies addressing early axSpA.

Original language	English
Pages (from-to)	1093-1099
Number of pages	7
Journal	Annals of the Rheumatic Diseases
Volume	83
Issue number	9
Early online date	15 Jun 2023
DOIs	https://doi.org/10.1136/ard-2023-224232
Publication status	Published - 27 Aug 2024

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Navarro-Compán, V., Benavent, D., Capelusnik, D., van der Heijde, D., Landewé, R. B., Poddubnyy, D., van Tubergen, A., Baraliakos, X., Van den Bosch, F. E., van Gaalen, F. A., Gensler, L., López-Medina, C., Marzo-Ortega, H., Molto, A., Pérez-Alamino, R., Rudwaleit, M., van de Sande, M., Sengupta, R., Weber, U., & Ramiro, S. (2024). ASAS consensus definition of early axial spondyloarthritis. Annals of the Rheumatic Diseases, 83(9), 1093-1099. https://doi.org/10.1136/ard-2023-224232

@article{8b6ae8d48b2e4f9398e0344fe0998833,

title = "ASAS consensus definition of early axial spondyloarthritis",

abstract = "OBJECTIVES: To develop a consensual definition for the term 'early axial spondyloarthritis-axSpA'-and 'early peripheral spondyloarthritis-pSpA'.METHODS: The ASAS (Assessment of SpondyloArthritis international Society-Spondyloarthritis EARly definition) steering committee convened an international working group (WG). Five consecutive steps were followed: (1) systematic literature review (SLR); (2) discussion of SLR results within the WG and ASAS community; (3) a three-round Delphi survey inviting all ASAS members to select the items that should be considered for the definition; (4) presentation of Delphi results to the WG and ASAS community and (5) ASAS voting and endorsement (2023 annual meeting).RESULTS: Following the SLR, consensus was to proceed with an expert-based definition for early axSpA (81% in favour) but not for pSpA (54% against). Importantly, early axSpA should be based on symptom duration taking solely axial symptoms into account. 151-164 ASAS members participated in the Delphi surveys. Consensus was achieved for considering the following items within early axSpA definition: duration of symptoms ≤2 years; axial symptoms defined as cervical/thoracic/back/buttock pain or morning stiffness; regardless of the presence/absence of radiographic damage. The WG agreed that in patients with a diagnosis of axSpA 'early axSpA' should be defined as a duration of ≤2 years of axial symptoms. Axial symptoms should include spinal/buttock pain or morning stiffness and should be considered by a rheumatologist as related to axSpA. The ASAS community endorsed this proposal (88% in favour).CONCLUSIONS: Early axSpA has newly been defined, based on expert consensus. This ASAS definition should be adopted in research studies addressing early axSpA.",

author = "Victoria Navarro-Comp{\'a}n and Diego Benavent and Dafne Capelusnik and {van der Heijde}, D{\'e}sir{\'e}e and Landew{\'e}, {Robert Bm} and Denis Poddubnyy and {van Tubergen}, Astrid and Xenofon Baraliakos and {Van den Bosch}, {Filip E} and {van Gaalen}, {Floris A} and Lianne Gensler and Clementina L{\'o}pez-Medina and Helena Marzo-Ortega and Anna Molto and Rodolfo P{\'e}rez-Alamino and Martin Rudwaleit and {van de Sande}, Marleen and Raj Sengupta and Ulrich Weber and Sofia Ramiro",

note = "{\textcopyright} Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2024",

month = aug,

day = "27",

doi = "10.1136/ard-2023-224232",

language = "English",

volume = "83",

pages = "1093--1099",

journal = "Annals of the Rheumatic Diseases",

issn = "0003-4967",

publisher = "Elsevier BV",

number = "9",

}

Navarro-Compán, V, Benavent, D, Capelusnik, D, van der Heijde, D, Landewé, RB, Poddubnyy, D, van Tubergen, A, Baraliakos, X, Van den Bosch, FE, van Gaalen, FA, Gensler, L, López-Medina, C, Marzo-Ortega, H, Molto, A, Pérez-Alamino, R, Rudwaleit, M, van de Sande, M, Sengupta, R, Weber, U & Ramiro, S 2024, 'ASAS consensus definition of early axial spondyloarthritis', Annals of the Rheumatic Diseases, vol. 83, no. 9, pp. 1093-1099. https://doi.org/10.1136/ard-2023-224232

TY - JOUR

T1 - ASAS consensus definition of early axial spondyloarthritis

AU - Navarro-Compán, Victoria

AU - Benavent, Diego

AU - Capelusnik, Dafne

AU - van der Heijde, Désirée

AU - Landewé, Robert Bm

AU - Poddubnyy, Denis

AU - van Tubergen, Astrid

AU - Baraliakos, Xenofon

AU - Van den Bosch, Filip E

AU - van Gaalen, Floris A

AU - Gensler, Lianne

AU - López-Medina, Clementina

AU - Marzo-Ortega, Helena

AU - Molto, Anna

AU - Pérez-Alamino, Rodolfo

AU - Rudwaleit, Martin

AU - van de Sande, Marleen

AU - Sengupta, Raj

AU - Weber, Ulrich

AU - Ramiro, Sofia

PY - 2024/8/27

Y1 - 2024/8/27

N2 - OBJECTIVES: To develop a consensual definition for the term 'early axial spondyloarthritis-axSpA'-and 'early peripheral spondyloarthritis-pSpA'.METHODS: The ASAS (Assessment of SpondyloArthritis international Society-Spondyloarthritis EARly definition) steering committee convened an international working group (WG). Five consecutive steps were followed: (1) systematic literature review (SLR); (2) discussion of SLR results within the WG and ASAS community; (3) a three-round Delphi survey inviting all ASAS members to select the items that should be considered for the definition; (4) presentation of Delphi results to the WG and ASAS community and (5) ASAS voting and endorsement (2023 annual meeting).RESULTS: Following the SLR, consensus was to proceed with an expert-based definition for early axSpA (81% in favour) but not for pSpA (54% against). Importantly, early axSpA should be based on symptom duration taking solely axial symptoms into account. 151-164 ASAS members participated in the Delphi surveys. Consensus was achieved for considering the following items within early axSpA definition: duration of symptoms ≤2 years; axial symptoms defined as cervical/thoracic/back/buttock pain or morning stiffness; regardless of the presence/absence of radiographic damage. The WG agreed that in patients with a diagnosis of axSpA 'early axSpA' should be defined as a duration of ≤2 years of axial symptoms. Axial symptoms should include spinal/buttock pain or morning stiffness and should be considered by a rheumatologist as related to axSpA. The ASAS community endorsed this proposal (88% in favour).CONCLUSIONS: Early axSpA has newly been defined, based on expert consensus. This ASAS definition should be adopted in research studies addressing early axSpA.

AB - OBJECTIVES: To develop a consensual definition for the term 'early axial spondyloarthritis-axSpA'-and 'early peripheral spondyloarthritis-pSpA'.METHODS: The ASAS (Assessment of SpondyloArthritis international Society-Spondyloarthritis EARly definition) steering committee convened an international working group (WG). Five consecutive steps were followed: (1) systematic literature review (SLR); (2) discussion of SLR results within the WG and ASAS community; (3) a three-round Delphi survey inviting all ASAS members to select the items that should be considered for the definition; (4) presentation of Delphi results to the WG and ASAS community and (5) ASAS voting and endorsement (2023 annual meeting).RESULTS: Following the SLR, consensus was to proceed with an expert-based definition for early axSpA (81% in favour) but not for pSpA (54% against). Importantly, early axSpA should be based on symptom duration taking solely axial symptoms into account. 151-164 ASAS members participated in the Delphi surveys. Consensus was achieved for considering the following items within early axSpA definition: duration of symptoms ≤2 years; axial symptoms defined as cervical/thoracic/back/buttock pain or morning stiffness; regardless of the presence/absence of radiographic damage. The WG agreed that in patients with a diagnosis of axSpA 'early axSpA' should be defined as a duration of ≤2 years of axial symptoms. Axial symptoms should include spinal/buttock pain or morning stiffness and should be considered by a rheumatologist as related to axSpA. The ASAS community endorsed this proposal (88% in favour).CONCLUSIONS: Early axSpA has newly been defined, based on expert consensus. This ASAS definition should be adopted in research studies addressing early axSpA.

U2 - 10.1136/ard-2023-224232

DO - 10.1136/ard-2023-224232

M3 - Article

C2 - 37321799

SN - 0003-4967

VL - 83

SP - 1093

EP - 1099

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

IS - 9

ER -

ASAS consensus definition of early axial spondyloarthritis

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