Testing the ASAS criteria in a large Colombian cohort: What do we have to learn from Colombia?-Reference-Cited by-同舟云学术

Testing the ASAS criteria in a large Colombian cohort: What do we have to learn from Colombia?

Published:2024-09-04 Issue: Volume: Page:
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Author:

Rueda Igor¹,Rodriguez Gustavo José²,Santos Ana María¹,Devia Juan Camilo Santacruz²,Arias-Correal Sofía¹,Uribe Keisy Orduz¹,Quintero-Munoz Elias¹,Pedraza Cristian Mesa¹,Rueda Juan Camilo²,Bello Juan Manuel³,Ballesteros Giovanny³,Calvo Enrique⁴,Londono John¹

Affiliation:

1. Universidad de La Sabana

2. Grupo de Estudio de las eSPondiloArtritis (GESPA), Universidad de La Sabana

3. Hospital Militar Central

4. Universidad Nacional de Colombia

Abstract

Background: Spondyloarthritis (SpA) can be classified by clinical presentation using Assessment of SpondyloArthritis international Society (ASAS) criteria. Though useful in many cohorts, their usefulness in Colombia needs to be clarified. The study aimed to describe a large Colombian group of SpA patients, evaluate ASAS criteria's sensitivity in the GESPA cohort, and propose axSpA criteria modification. Methods: This was a cohort study. A structured survey was conducted, followed by a physical examination and laboratory samples. Patients were classified according to ASAS, ESSG, and mNY criteria, and clinical presentations were compared. Finally, ASAS sensitivity was contrasted to mNY, ESSG, and rheumatologist's criteria. Patients who had less than three months of back pain duration at the time of evaluation and radiographic sacroiliitis were allowed to be classified as axial patients if they met the other characteristics proposed by ASAS (axSpA-w/oCBP). Findings: A total of 461 SpA patients (58·1% pSpA) were analyzed. There were differences between axSpA and pSpA patients in disease onset, initial symptoms, gluteal pain, history of infection, Schober test, sacroiliitis, and alleles HLA. The axSpA-w/oCBP allowed the reclassification of 88 (32·8%) pSpA to axSpA patients. This modification showed additional differences in diagnosis delay, and spinal mobility assessment. The sensitivity of the ASAS classification criteria was 90·8% compared to the rheumatology criteria. Interpretation: The GESPA cohort is one of the largest in LatAm, with a predominance of pSpA patients, with clinical, and imaging differences between the axSpA and pSpA. The ASAS criteria have good sensitivity compared to the rheumatologist's criteria. However, the mandatory criterial of chronic back pain by ASAS misclassified axSpA as pSpA. The proposed axSpA-w/oCBP modification allowed better identification of axSpA patients, reducing the number of pSpA with radiographic sacroiliitis and achieving more coherence with the authentic clinical presentation.

Publisher

Springer Science and Business Media LLC

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