Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Cut-Offs for Disease Activity States in Axial Spondyloarthritis With Ankylosing Spondylitis Disease Activity Score (ASDAS) Based on C-Reactive Protein and ASDAS Based on Erythrocyte Sedimentation Rate : Are They Interchangeable?

Georgiadis, Stylianos ; Ørnbjerg, Lykke Midtbøll ; Michelsen, Brigitte ; Kvien, Tore K. ; Giuseppe, Daniela Di ; Wallman, Johan K. LU ; Závada, Jakub ; Provan, Sella A. ; Kristianslund, Eirik Klami and Rodrigues, Ana Maria , et al. (2024) In Journal of Rheumatology 51(7). p.673-677
Abstract

Objective. Ankylosing Spondylitis Disease Activity Score based on C-reactive protein (ASDAS-CRP) is recommended over ASDAS based on erythrocyte sedimentation rate (ASDAS-ESR) to assess disease activity in axial spondyloarthritis (axSpA). Although ASDAS-CRP and ASDAS-ESR are not interchangeable, the same disease activity cut-offs are used for both. We aimed to estimate optimal ASDAS-ESR values corresponding to the established ASDAS-CRP cut-offs (1.3, 2.1, and 3.5) and investigate the potential improvement of level of agreement between ASDAS-ESR and ASDAS-CRP disease activity states when applying these estimated cut-offs. Methods. We used data from patients with axSpA from 9 European registries initiating a tumor necrosis factor... (More)

Objective. Ankylosing Spondylitis Disease Activity Score based on C-reactive protein (ASDAS-CRP) is recommended over ASDAS based on erythrocyte sedimentation rate (ASDAS-ESR) to assess disease activity in axial spondyloarthritis (axSpA). Although ASDAS-CRP and ASDAS-ESR are not interchangeable, the same disease activity cut-offs are used for both. We aimed to estimate optimal ASDAS-ESR values corresponding to the established ASDAS-CRP cut-offs (1.3, 2.1, and 3.5) and investigate the potential improvement of level of agreement between ASDAS-ESR and ASDAS-CRP disease activity states when applying these estimated cut-offs. Methods. We used data from patients with axSpA from 9 European registries initiating a tumor necrosis factor inhibitor. ASDAS-ESR cut-offs were estimated using the Youden index. The level of agreement between ASDAS-ESR and ASDAS-CRP disease activity states was compared against each other. Results. In 3664 patients, mean ASDAS-CRP was higher than ASDAS-ESR at both baseline (3.6 and 3.4, respectively) and aggregated follow-up at 6, 12, or 24 months (1.9 and 1.8, respectively). The estimated ASDAS-ESR values corresponding to the established ASDAS-CRP cut-offs were 1.4, 1.9, and 3.3. By applying these cut-offs, the proportion of discordance between disease activity states according to ASDAS-ESR and ASDAS-CRP decreased from 22.93% to 19.81% in baseline data but increased from 27.17% to 28.94% in follow-up data. Conclusion. We estimated the optimal ASDAS-ESR values corresponding to the established ASDAS-CRP cut-off values. However, applying the estimated cut-offs did not increase the level of agreement between ASDAS-ESR and ASDAS-CRP disease activity states to a relevant degree. Our findings did not provide evidence to reject the established cut-off values for ASDAS-ESR.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
axial spondyloarthritis, patient outcome assessment, registry data, validation study
in
Journal of Rheumatology
volume
51
issue
7
pages
5 pages
publisher
Journal of Rheumatology
external identifiers
  • pmid:38621792
  • scopus:85197769490
ISSN
0315-162X
DOI
10.3899/jrheum.2023-1217
language
English
LU publication?
yes
id
581b177d-d339-4ded-b338-907fadceb0eb
date added to LUP
2024-12-12 11:50:14
date last changed
2025-06-13 02:02:20
@article{581b177d-d339-4ded-b338-907fadceb0eb,
  abstract     = {{<p>Objective. Ankylosing Spondylitis Disease Activity Score based on C-reactive protein (ASDAS-CRP) is recommended over ASDAS based on erythrocyte sedimentation rate (ASDAS-ESR) to assess disease activity in axial spondyloarthritis (axSpA). Although ASDAS-CRP and ASDAS-ESR are not interchangeable, the same disease activity cut-offs are used for both. We aimed to estimate optimal ASDAS-ESR values corresponding to the established ASDAS-CRP cut-offs (1.3, 2.1, and 3.5) and investigate the potential improvement of level of agreement between ASDAS-ESR and ASDAS-CRP disease activity states when applying these estimated cut-offs. Methods. We used data from patients with axSpA from 9 European registries initiating a tumor necrosis factor inhibitor. ASDAS-ESR cut-offs were estimated using the Youden index. The level of agreement between ASDAS-ESR and ASDAS-CRP disease activity states was compared against each other. Results. In 3664 patients, mean ASDAS-CRP was higher than ASDAS-ESR at both baseline (3.6 and 3.4, respectively) and aggregated follow-up at 6, 12, or 24 months (1.9 and 1.8, respectively). The estimated ASDAS-ESR values corresponding to the established ASDAS-CRP cut-offs were 1.4, 1.9, and 3.3. By applying these cut-offs, the proportion of discordance between disease activity states according to ASDAS-ESR and ASDAS-CRP decreased from 22.93% to 19.81% in baseline data but increased from 27.17% to 28.94% in follow-up data. Conclusion. We estimated the optimal ASDAS-ESR values corresponding to the established ASDAS-CRP cut-off values. However, applying the estimated cut-offs did not increase the level of agreement between ASDAS-ESR and ASDAS-CRP disease activity states to a relevant degree. Our findings did not provide evidence to reject the established cut-off values for ASDAS-ESR.</p>}},
  author       = {{Georgiadis, Stylianos and Ørnbjerg, Lykke Midtbøll and Michelsen, Brigitte and Kvien, Tore K. and Giuseppe, Daniela Di and Wallman, Johan K. and Závada, Jakub and Provan, Sella A. and Kristianslund, Eirik Klami and Rodrigues, Ana Maria and Santos, Maria José and Rotar, Žiga and Pirkmajer, Katja Perdan and Nordström, Dan and Macfarlane, Gary J. and Jones, Gareth T. and van der Horst-Bruinsma, Irene and Hellamand, Pasoon and Østergaard, Mikkel and Hetland, Merete Lund}},
  issn         = {{0315-162X}},
  keywords     = {{axial spondyloarthritis; patient outcome assessment; registry data; validation study}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{673--677}},
  publisher    = {{Journal of Rheumatology}},
  series       = {{Journal of Rheumatology}},
  title        = {{Cut-Offs for Disease Activity States in Axial Spondyloarthritis With Ankylosing Spondylitis Disease Activity Score (ASDAS) Based on C-Reactive Protein and ASDAS Based on Erythrocyte Sedimentation Rate : Are They Interchangeable?}},
  url          = {{http://dx.doi.org/10.3899/jrheum.2023-1217}},
  doi          = {{10.3899/jrheum.2023-1217}},
  volume       = {{51}},
  year         = {{2024}},
}