PMID- 19821259
OWN - NLM
STAT- MEDLINE
DCOM- 20100721
LR  - 20100427
IS  - 1557-0681 (Electronic)
IS  - 1478-2189 (Linking)
VI  - 8
IP  - 1
DP  - 2010 Mar
TI  - Outcome of active disease in ankylosing spondylitis: a prospective study.
PG  - 10-7
LID - 10.1002/msc.161 [doi]
AB  - BACKGROUND: People with ankylosing spondylitis (AS) typically experience episodic 
      exacerbations, but the extent to which they subsequently experience a sustained 
      reduction in disease markers below recognized thresholds for active disease is 
      unclear. OBJECTIVE: To investigate changes in, and associations between, disease 
      markers over 18 months in people with active AS. METHODS: Within a cohort of 89 
      participants with AS, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 
      scores of 4 or higher were used to identify those with active disease. Standard 
      assessment tools were used to monitor participants prospectively at four 
      consecutive six-monthly intervals. Participants received standard treatments but 
      none received anti-tumor necrosis factor-alpha (TNFalpha) medication during the 
      study. RESULTS: The median age of the cohort was 50 years (inter-quartile range 
      [IQR] 38.5-55.5), the median age of disease onset was 25 years (IQR 18-33) and 
      the median disease duration was 18 years (IQR 13-27). Forty-seven (53%) 
      participants had a BASDAI score of 4 or higher on the first assessment, of whom 
      45 (51%) scored 4 or higher on all subsequent assessments. Furthermore, 38 (43%) 
      and 16 (18%) participants scored BASDAI 5 or 6, respectively, or higher, 
      throughout. BASDAI scores correlated strongly with Bath Ankylosing Spondylitis 
      Functional Index (BASFI) scores. Compared with 19 (21%) participants whose BASDAI 
      scores were consistently below 4 throughout, participants with persistently high 
      BASDAI scores showed higher scores for anxiety and depression, and some evidence 
      of functional deterioration during the study period. CONCLUSIONS: In this cohort, 
      disease markers in most people with active AS were sustained above the standard 
      threshold for active disease. This has important implications for planning care 
      pathways and for optimal utilization of anti-TNFalpha treatment.
FAU - Martindale, J
AU  - Martindale J
AD  - Wrightington, Wigan and Leigh NHS Foundation Trust, Lancashire, UK.
FAU - Smith, J
AU  - Smith J
FAU - Grennan, D
AU  - Grennan D
FAU - Goodacre, L
AU  - Goodacre L
FAU - Goodacre, J A
AU  - Goodacre JA
LA  - eng
PT  - Journal Article
PL  - England
TA  - Musculoskeletal Care
JT  - Musculoskeletal care
JID - 101181344
RN  - 0 (Tumor Necrosis Factor-alpha)
SB  - IM
MH  - Adult
MH  - Anxiety
MH  - Depression/economics
MH  - Female
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Mental Disorders/drug therapy/economics
MH  - Middle Aged
MH  - Prospective Studies
MH  - Spondylitis, Ankylosing/drug therapy/*economics/*physiopathology
MH  - Treatment Outcome
MH  - Tumor Necrosis Factor-alpha/therapeutic use
EDAT- 2009/10/13 06:00
MHDA- 2010/07/22 06:00
CRDT- 2009/10/13 06:00
PHST- 2009/10/13 06:00 [entrez]
PHST- 2009/10/13 06:00 [pubmed]
PHST- 2010/07/22 06:00 [medline]
AID - 10.1002/msc.161 [doi]
PST - ppublish
SO  - Musculoskeletal Care. 2010 Mar;8(1):10-7. doi: 10.1002/msc.161.