ASAS classification criteria for axial spondyloarthritis: time to modify.
The relationship between ankylosing spondylitis and the recently proposed entity called axial spondyloarthritis with its radiographic and non-radiographic forms that have been defined by the Assessment of Spondyloarthritis International Society (ASAS) criteria for axial spondyloarthritis (axSpA), is currently being debated. The Food and Drug Agency (FDA) had criticized the ASAS criteria and the studies which used these criteria to enroll patients in a clinical trial of certolizumab and adalimumab for the treatment of non-radiographic axial spondyloarthritis. The primary aim of classification criteria is to create homogenous patient populations for basic and clinical research. But the multi-arm construct of the ASAS criteria is a potential source of heterogeneity reducing their utility. Criteria sets should be regarded as dynamic concepts open to modifications or updates as our knowledge advances. We provide evidence to conclude that it is time to modify the ASAS Criteria for axSpA, and we propose some of the steps that can be taken to start moving forward in improving the validity of these criteria.
Department of Rheumatology, Faculty of Medicine, Dokuz Eylul University, Balcova, 35340, Izmir, Turkey.
Nurullah
N
Akkoc
Case Western Reserve University, Cleveland, OH, USA. mkhan@metrohealth.org.|MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA. mkhan@metrohealth.org.
Muhammad A
MA
Khan
D000068879:Adalimumab / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D000068582:Certolizumab Pegol / Q000627:therapeutic use; D015796:HLA-B27 Antigen / Q000235:genetics*; D006801:Humans; D008279:Magnetic Resonance Imaging; D016032:Randomized Controlled Trials as Topic; D058566:Sacroiliitis / Q000000981:diagnostic imaging*; D012955:Societies, Medical; D025241:Spondylarthritis / Q000145:classification* / Q000175:diagnosis* / Q000188:drug therapy
D018501:Antirheumatic Agents; D015796:HLA-B27 Antigen; D000068879:Adalimumab; D000068582:Certolizumab Pegol
Axial spondyloarthritis; Classification criteria; HLA-B27; Non-radiographic axial spondyloarthritis ankylosing spondylitis; Sacroiliitis; Spondyloarthritis