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Clinical diagnosis of ankylosing spondylitis or axial spondyloarthritis is in concordance with ASAS criteria for axial spondyloarthritis: results from a single tertiary referral centre in Croatia

The Assessment of SpondyloArthritis International Society (ASAS) group has recently developed criteria to classify patients with axial spondyloarthritis (axSpA). Objectives were to evaluate concordance of ASAS criteria for axSpA with clinically established diagnoses of ankylosing spondylitis (AS) or axSpA in a single tertiary referral centre for spondyloarthropathies in Croatia. 383 patients diagnosed with AS (214 patients) or axSpA (169 patients) at the Department of Rheumatology, Physical Medicine and Rehabilitation, University Hospital Center Sestre Milosrdnice in Zagreb in the 2010-2012 period. Data from the original charts were collected and all the variables of the ASAS criteria for axSpA were searched for: chronic low-back pain, evidence of radiographic sacroileitis, HLA B27 positivity, inflammatory back pain (IBP), presence of arthritis, enthesitis, uveitis, dactylitis, psoriasis, inflammatory bowel disease (IBD), positive effect of NSAIDs, family history, elevated serum C-reactive protein and presence of all SpA features was confirmed by rheumatologist. Average disease duration of AS was 138.4±107.4 months and of axSpA 175.5±136.5 months. Radiographic sacroileitis was observed in 91.1 % of patients in AS group and in all patients with axSpA. HLA-B27 positive antigen was found in 31.1.% patients with AS and 22.0% patients with axSpA. In both AS and axial SpA groups with radiographic sacroileitis as entry criterion only 2.5% and 1.4% patients did not meet ASAS criteria. Among those with no radiographic sacroileitis only 1.9% and 2.9% patients had less than 2 SpA features, respectively. Furthermore, in AS group of patients who were HLA-B27 positive only 1.7% did not fulfill ASAS criteria, whereas all HLA-B27 positive patients in axial SpA group met the criteria. Among HLA-B27 negative patients in AS and axial SpA group 3.3% and 1.8% of patients did not fulfill ASAS criteria, respectively. ASAS criteria for diagnosing axial SpA are routinely followed and used in everyday clinical practice.

ankylosing spondylitis ; axial spondyloarthritis ; diagnosis ; criteria ; ASAS ; Croatia

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