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  • Goodbye to the term ‘ankylosing spondylitis’, hello ‘axial spondyloarthritis’: time to embrace the ASAS-defined nomenclature

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Goodbye to the term ‘ankylosing spondylitis’, hello ‘axial spondyloarthritis’: time to embrace the ASAS-defined nomenclature
  1. Désirée van der Heijde1,
  2. Anna Molto2,3,
  3. Sofia Ramiro1,4,
  4. Jürgen Braun5,
  5. Maxime Dougados6,
  6. Floris A van Gaalen1,
  7. Lianne S Gensler7,
  8. Robert D Inman8,
  9. Robert B M Landewé4,9,
  10. Helena Marzo-Ortega10,
  11. Victoria Navarro-Compán11,
  12. Andri Phoka12,
  13. Denis Poddubnyy13,
  14. Mikhail Protopopov13,
  15. John Reveille14,
  16. Martin Rudwaleit15,
  17. Percival Sampaio-Barros16,
  18. Alexandre Sepriano1,17,
  19. Joachim Sieper13,
  20. Filip E Van den Bosch18,19,
  21. Irene van der Horst-Bruinsma20,
  22. Pedro M Machado21,22,23,
  23. Xenofon Baraliakos5
  1. 1 Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  2. 2 Rheumatology, Hospital Cochin, Paris, France
  3. 3 Université Paris-Cité, INSERM U1153, Paris, France
  4. 4 Rheumatology, Zuyderland Medical Centre, Heerlen, The Netherlands
  5. 5 Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany
  6. 6 Hopital Cochin, Rheumatology, Université Paris Descartes Faculté de Médecine, Paris, France
  7. 7 Medicine/Rheumatology, University of California, San Francisco, California, USA
  8. 8 Schroeder Arthritis Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
  9. 9 Rheumatology, Amsterdam University Medical Center, Amsterdam, The Netherlands
  10. 10 NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
  11. 11 Rheumatology, University Hospital La Paz, IdiPaz, Madrid, Spain
  12. 12 ASIF, London, UK
  13. 13 Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine), Charité Universitätsmedizin Berlin, Berlin, Germany
  14. 14 Rheumatology, University of Texas McGovern Medical School, Houston, Texas, USA
  15. 15 Internal Medicine and Rheumatology, Klinikum Bielefeld Rosenhöhe, Bielefeld, Germany
  16. 16 Rheumatology, Faculdade de Medicina da Universidade de São Paulo e Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
  17. 17 Nova Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
  18. 18 Rheumatology, Ghent University Hospital, Gent, Belgium
  19. 19 Internal Medicine and Pediatrics, VIB-UGent Center for Inflammation Research, Ghent University, Gent, Belgium
  20. 20 Department of Rheumatology, Radboud University Medical Centre, Nijmegen, The Netherlands
  21. 21 Rheumatology and Neuromuscular Diseases, University College London, National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, London, UK
  22. 22 NHS Foundation Trust, London, UK
  23. 23 Rheumatology, Norhwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
  1. Correspondence to Professor Désirée van der Heijde, Rheumatology, Leiden University Medical Center, Leiden 2300 RC, Netherlands; mail{at}dvanderheijde.nl

Abstract

Ankylosing spondylitis (AS) is the historic term used for decades for the HLA-B27-associated inflammatory disease affecting mainly the sacroiliac joints (SIJ) and spine. Classification criteria for AS have radiographic sacroiliitis as a dominant characteristic. However, with the availability of MRI of SIJ, it could be demonstrated that the disease starts long before definite SIJ changes become visible on radiographs. The Assessment of SpondyloArthritis international Society, representing a worldwide group of experts reached consensus on changes in the nomenclature pertaining to axial spondyloarthritis (axSpA), such as the terminology of diagnosis and of assessment of disease activity tools. These are important changes in the field, as experts in axSpA are now in agreement that the term axSpA is the overall term for the disease. A further differentiation, of which radiographic versus non-radiographic is only one aspect, may be relevant for research purposes. Another important decision was that the terms AS and radiographic axSpA (r-axSpA) can be used interchangeably, but that the preferred term is r-axSpA. Based on the decision that axSpA is the correct terminology, a proposal was made to officially change the meaning of the ASDAS acronym to ‘Axial Spondyloarthritis Disease Activity Score’. In addition, for simplification it was proposed that the term ASDAS (instead of ASDAS-CRP) should be preferred and applied to the ASDAS calculated with C reactive protein (CRP). It is hoped that these changes will be used consequently for education, in textbooks, manuscripts and presentations.

  • spondylitis, ankylosing
  • low back pain
  • outcome assessment, health care

https://doi.org/10.1136/ard-2023-225185

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    Footnotes

    • Handling editor Josef S Smolen

    • X @annamolto, @sofiaramiro82, @MProtopopov, @AlexSepriano

    • Contributors DvdH, AM, SR and PMM drafted the manuscript. All authors reviewed and approved the manuscript before submission.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests DvdH has received consulting fees from AbbVie, Argenx, Bayer, BMS, Galapagos, Gilead, GlaxoSmithKline, Janssen, Lilly, Novartis, Pfizer, Takeda, UCB Pharma. She is Director of Imaging Rheumatology bv, associate editor of ARD, editorial board member of J Rheumatol and RMD Open, advisor of ASAS. AM has received consulting fees from AbbVie, Amgen, BMS, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, UCB Pharma and Viatris. SR has received research grants and/or consulting fees from AbbVie, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Pfizer, UCB, Sanofi. MD has received consulting fees from Pfizer, AbbVie, UCB, Amgen, BMS, Galapagos, Lilly, Novartis, Merck. FAvG has received consultation fees from Novartis, BMS, AbbVie, MSD, Janssen, Lily, UCB. LG has received research grants and/or consulting fees from AbbVie, Acelyrin, Eli Lilly, Fresenius Kabi, Janssen, Novartis, Pfizer, UCB. RDI has received consulting fees from Abbvie, Janssen, Novartis, UCB. RBML has received consulting fees from AbbVie, BMS, Galapagos, Eli-Lilly, Novartis, Jansen, Pfizer and UCB, is director of Rheumatology Consultancy BV and past-president and executive member of ASAS. HM-O has received grant support from Janssen, Novartis and UCB. Honoraria and/or speaker fees from AbbVie, Biogen, Eli-Lilly, Janssen, Moonlake, Novartis, Pfizer, Takeda and UCB. VN-C has received consultancy/speaker/research grants from Abbvie, BMS, Fresenius Kabi, Galapagos, Janssen, Lilly, Moonlake, MSD, Novartis, Pfizer, Roche, UCB. AP, Patient with AxSpa, Eupati Fellow, Patient Expert, Advocator, President of Cyprus League of People with Rheumatism, President of AGORA Federation, Secretary of Axial Spondylarthritis International Federation (ASIF), EULAR-Advocacy Committee Member-Pare Committee Member. DP has received research support from AbbVie, Eli Lilly, MSD, Novartis, Pfizer, consulting fees from AbbVie, Biocad, Bristol-Myers Squibb, Eli Lilly, Janssen, Moonlake, Novartis, Pfizer and UCB, and speaker fees from AbbVie, Canon, DKSH, Eli Lilly, Janssen, MSD, Medscape, Novartis, Peervoice, Pfizer and UCB. MP has received consulting fees from Novartis as well as support for attending meetings and/or travel from Abbvie, Jannsen, Novartis and UCB. MR has receieved consulting/speaker fees from Abbvie, Chugai, Boehringer, Eli-Lilly, Janssen, Novartis, UCB. PDS-B has received consulting/ speaker's fees from AbbVie, Celltrion, Eli Lilly, GSK, Janssen, Novartis, Pfizer and UCB. AS has received speaking and/or consulting fees from Abbvie, Novartis, UCB and Lilly. JS has received gees for consultancies and for being a member of speakers’ bureau from Abbvie, Merck, Novartis and UCB. FEVdB has received consulting fees from Abbvie, Amgen, Eli Lilly, Galapagos, Janssen, Moonlake, Novartis and UCB. IvdH-B has received consulting/speaker’s fees from UCB, Lilly, AbbVie, MSD, BMS, Novartis. PMM has received consulting/speaker’s fees from Abbvie, BMS, Celgene, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Orphazyme, Pfizer, Roche and UCB. XB has received consulting/speaker’s fees Abbvie, Amgen, BMS, Chugai, Galapagos, Gilead, Lilly, MSD, Novartis, Pfizer, Roche, Sandoz, UCB, Zuellig Pharma and is Member of the Editorial Board of ARD, ASAS President and EULAR President Elect.

    • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.