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Active nonradiographic axial SpA was defined as a total back pain score of ≥4 cm on a 0 10-cm visual analog scale (VAS) and a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (14) score of ≥4 cm on a 0 10-cm visual
All patients had active disease at screening and baseline, defined as a total back pain evaluation of ≥40 mm (visual analogue scale (VAS) of 0 100 mm) and a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of ≥4 cm (0 10 cm VAS).
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Overall assessment of health score in AS patients was determined from a visual analogue scale (VAS), recording from 0 cm (none) to 10 cm (very severe); the pain score by visual analogue scale (VAS, 0 to 10 cm), included nocturnal pain (last week/spine/at night due to AS) and total back pain (last week/spine/due to AS).
Baseline disease activity was significantly lower in the OASIS cohort compared with the adalimumab cohort, as assessed by the Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), total back pain, inflammation, C-reactive protein, and the Patient's Global Assessment of disease activity.
Patients included in the study were men and women between the ages of 18 and 75 years, had had active AS for at least 3 months, and Bath AS Disease Activity Index BASDAII) 21 and total back pain score ≥4 at screening and baseline, without complete fusion of the spine, and did not respond adequately to, or were intolerant of, ≥2 NSAIDs (each taken for ≥2 weeks).
The individual domains contributing to the ASAS are (i) the spinal inflammation, defined as mean of items 5 (overall level of morning stiffness) and 6 (duration of morning stiffness) of the BASDAI; (ii) back pain, defined as mean of total back pain and nocturnal back pain; (iii) patient's global assessment; and (iiii) the physical function, defined as BASFI.
Despite the absence of radiographic sacroiliitis and the above differences in demographics compared with AS patients, patients with nr-axSpA who continued to have symptoms of active disease despite NSAIDs had comparable levels of disease activity to that of patients with AS according to BASDAI, ASDAS and total back pain.
We showed that among patients with active nonradiographic axial SpA as defined by BASDAI and total back pain scores, spinal inflammation on MRI may be observed in half of those without MRI evidence of SI joint inflammation.
Patients eligible for enrolment must have had 'definite' AS according to the modified New York criteria 9 and symptoms of active disease (Bath AS Disease Activity Index (BASDAI) 10≥4 and total back pain visual analogue scale score ≥4, each on a scale of 0 10 cm); patients with complete ankylosis were excluded.
In a cross-sectional survey with 9267 respondents, average total back pain costs per patient per year in Germany have been reported as €1322 [ 2].
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com