Defining Bath Ankylosing Spondylitis Disease Activity Index Cut-off Values for Disease Activity States in a Multinational European Cohort of Patients With Axial Spondyloarthritis
(2025) In ACR Open Rheumatology 7(12).- Abstract
OBJECTIVE: The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is widely used for assessing disease activity in patients with axial spondyloarthritis (axSpA), particularly in settings where markers of inflammation are unavailable. As no consensus on BASDAI cut-off values exists for disease activity states in axSpA, we aimed to develop and validate such cut-offs against external criteria.
METHODS: Routine care patients with axSpA initiating a biologic disease-modifying antirheumatic drug in eight European registries were included. Receiver operating characteristic analyses against external criteria were performed to determine optimal BASDAI values for separating remission, low disease activity (LDA), high disease... (More)
OBJECTIVE: The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is widely used for assessing disease activity in patients with axial spondyloarthritis (axSpA), particularly in settings where markers of inflammation are unavailable. As no consensus on BASDAI cut-off values exists for disease activity states in axSpA, we aimed to develop and validate such cut-offs against external criteria.
METHODS: Routine care patients with axSpA initiating a biologic disease-modifying antirheumatic drug in eight European registries were included. Receiver operating characteristic analyses against external criteria were performed to determine optimal BASDAI values for separating remission, low disease activity (LDA), high disease activity (HDA), and very high disease activity (VHDA). Follow-up data at 6 months were used to select BASDAI cut-off values between remission and LDA and between LDA and HDA, whereas baseline data were used to select the cut-off for VHDA. The level of agreement between disease activity states based on BASDAI and Axial Spondyloarthritis Disease Activity Score (ASDAS) cut-off values was assessed using the proportion of discordance and weighted kappa.
RESULTS: In this cohort of 4,633 patients, the optimal BASDAI cut-off values between remission, LDA, HDA and VHDA were estimated to be <1.3, <2.5, and >5.3. The proportions of discordance between BASDAI and ASDAS disease activity states were 27.6% (weighted κ = 0.48) in baseline data and 37.6% (weighted κ = 0.28) in 6-month data.
CONCLUSION: BASDAI cut-off values for separating remission, LDA, HDA and VHDA were estimated in >4,600 patients. These cut-off values can be used for assessing disease activity and monitoring patients with axSpA, particularly when laboratory markers are unavailable.
(Less)
- author
- Georgiadis, Stylianos
; Ørnbjerg, Lykke Midtbøll
; Michelsen, Brigitte
; Kvien, Tore K
; Shoae Kazemi, Mehrdad
; Závada, Jakub
; Pavelka, Karel
; Glintborg, Bente
; Loft, Anne Gitte
; Reich, Andreas
; Regierer, Anne C
; Rodrigues, Ana Maria
; Santos, Maria José
; Rutanen, Jarno
; Kuusalo, Laura
; Ciurea, Adrian
; Nissen, Michael J
; Gudbjornsson, Bjorn
; Pálsson, Ólafur
LU
; Rotar, Žiga
; Perdan Pirkmajer, Katja
; Di Giuseppe, Daniela
; Østergaard, Mikkel
and Hetland, Merete Lund
(Less) - organization
- publishing date
- 2025-12
- type
- Contribution to journal
- publication status
- published
- subject
- in
- ACR Open Rheumatology
- volume
- 7
- issue
- 12
- article number
- e70125
- publisher
- Wiley
- external identifiers
-
- pmid:41328490
- ISSN
- 2578-5745
- DOI
- 10.1002/acr2.70125
- language
- English
- LU publication?
- yes
- additional info
- © 2025 The Author(s). ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.
- id
- 6653bca2-2269-46a6-abbf-e27c2f2eb2a8
- date added to LUP
- 2025-12-03 10:50:59
- date last changed
- 2025-12-03 12:37:32
@article{6653bca2-2269-46a6-abbf-e27c2f2eb2a8,
abstract = {{<p>OBJECTIVE: The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is widely used for assessing disease activity in patients with axial spondyloarthritis (axSpA), particularly in settings where markers of inflammation are unavailable. As no consensus on BASDAI cut-off values exists for disease activity states in axSpA, we aimed to develop and validate such cut-offs against external criteria.</p><p>METHODS: Routine care patients with axSpA initiating a biologic disease-modifying antirheumatic drug in eight European registries were included. Receiver operating characteristic analyses against external criteria were performed to determine optimal BASDAI values for separating remission, low disease activity (LDA), high disease activity (HDA), and very high disease activity (VHDA). Follow-up data at 6 months were used to select BASDAI cut-off values between remission and LDA and between LDA and HDA, whereas baseline data were used to select the cut-off for VHDA. The level of agreement between disease activity states based on BASDAI and Axial Spondyloarthritis Disease Activity Score (ASDAS) cut-off values was assessed using the proportion of discordance and weighted kappa.</p><p>RESULTS: In this cohort of 4,633 patients, the optimal BASDAI cut-off values between remission, LDA, HDA and VHDA were estimated to be <1.3, <2.5, and >5.3. The proportions of discordance between BASDAI and ASDAS disease activity states were 27.6% (weighted κ = 0.48) in baseline data and 37.6% (weighted κ = 0.28) in 6-month data.</p><p>CONCLUSION: BASDAI cut-off values for separating remission, LDA, HDA and VHDA were estimated in >4,600 patients. These cut-off values can be used for assessing disease activity and monitoring patients with axSpA, particularly when laboratory markers are unavailable.</p>}},
author = {{Georgiadis, Stylianos and Ørnbjerg, Lykke Midtbøll and Michelsen, Brigitte and Kvien, Tore K and Shoae Kazemi, Mehrdad and Závada, Jakub and Pavelka, Karel and Glintborg, Bente and Loft, Anne Gitte and Reich, Andreas and Regierer, Anne C and Rodrigues, Ana Maria and Santos, Maria José and Rutanen, Jarno and Kuusalo, Laura and Ciurea, Adrian and Nissen, Michael J and Gudbjornsson, Bjorn and Pálsson, Ólafur and Rotar, Žiga and Perdan Pirkmajer, Katja and Di Giuseppe, Daniela and Østergaard, Mikkel and Hetland, Merete Lund}},
issn = {{2578-5745}},
language = {{eng}},
number = {{12}},
publisher = {{Wiley}},
series = {{ACR Open Rheumatology}},
title = {{Defining Bath Ankylosing Spondylitis Disease Activity Index Cut-off Values for Disease Activity States in a Multinational European Cohort of Patients With Axial Spondyloarthritis}},
url = {{http://dx.doi.org/10.1002/acr2.70125}},
doi = {{10.1002/acr2.70125}},
volume = {{7}},
year = {{2025}},
}