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Research ArticleSpondyloarthritis

Performance of 3 Composite Measures for Disease Activity in Peripheral Spondyloarthritis

Esther Beckers, Marin Been, Casper Webers, Annelies Boonen, Peter M. ten Klooster, Harald E. Vonkeman and Astrid van Tubergen
The Journal of Rheumatology March 2022, 49 (3) 256-264; DOI: https://doi.org/10.3899/jrheum.210075
Esther Beckers
1E. Beckers, MSc, M. Been, MD, C. Webers, MD, PhD, A. Boonen, MD, PhD, Professor, A. van Tubergen, MD, PhD, Professor, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht;
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  • For correspondence: esther.beckers@mumc.nl
Marin Been
1E. Beckers, MSc, M. Been, MD, C. Webers, MD, PhD, A. Boonen, MD, PhD, Professor, A. van Tubergen, MD, PhD, Professor, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht;
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Casper Webers
1E. Beckers, MSc, M. Been, MD, C. Webers, MD, PhD, A. Boonen, MD, PhD, Professor, A. van Tubergen, MD, PhD, Professor, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht;
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Annelies Boonen
1E. Beckers, MSc, M. Been, MD, C. Webers, MD, PhD, A. Boonen, MD, PhD, Professor, A. van Tubergen, MD, PhD, Professor, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht;
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Peter M. ten Klooster
2P.M. ten Klooster, PhD, Department of Psychology, Health & Technology, University of Twente, Enschede;
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Harald E. Vonkeman
3H.E. Vonkeman, MD, PhD, Department of Psychology, Health & Technology, University of Twente, Enschede, and Department of Rheumatology, Medisch Spectrum Twente, Enschede, the Netherlands.
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Astrid van Tubergen
1E. Beckers, MSc, M. Been, MD, C. Webers, MD, PhD, A. Boonen, MD, PhD, Professor, A. van Tubergen, MD, PhD, Professor, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht;
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Abstract

Objective To investigate concurrent validity and discrimination of the Disease Activity Index for Psoriatic Arthritis (DAPSA) score, Psoriatic Arthritis Disease Activity Score (PASDAS), and Ankylosing Spondylitis Disease Activity Score (ASDAS) in peripheral spondyloarthritis (pSpA) in clinical practice.

Methods Data from a Dutch registry for SpA (SpA-Net) were used. Predefined hypotheses on concurrent validity of the composite measures with 15 other outcome measures of disease activity, physical function, and health-related quality of life were tested. Concurrent validity was considered acceptable if ≥ 75% of the hypotheses were confirmed. Discrimination was assessed by stratifying patients in DAPSA, PASDAS, and ASDAS predefined disease activity states and studying mean differences in health outcomes by 1-way ANOVA. Further, the concordance in disease activity states was determined. All analyses were repeated in subgroups with and without psoriasis (PsO).

Results DAPSA, PASDAS, and ASDAS scores were available for 191, 139, and 279 patients with pSpA, respectively. The concurrent validity and discrimination of all composite measures were acceptable, as the strength of correlations were as hypothesized in ≥ 75% of the studied correlations. With increasing disease activity states, scores in nearly all outcome measures worsened significantly. The DAPSA, PASDAS, and ASDAS classified 22%, 56%, and 48% of the patients, respectively, in the 2 highest disease activity states. Stratified analyses for concomitant PsO revealed no relevant subgroup differences.

Conclusion The performance of DAPSA, PASDAS, and ASDAS in pSpA was acceptable, and independent of concomitant PsO. Due to discrepancy in classification, the validity of existing thresholds for disease activity states warrants further study in pSpA.

Key Indexing Terms:
  • disease activity score
  • outcome assessment
  • psoriatic arthritis
  • spondyloarthropathy
  • Accepted for publication August 13, 2021.
  • Copyright © 2022 by the Journal of Rheumatology
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1 Mar 2022
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Performance of 3 Composite Measures for Disease Activity in Peripheral Spondyloarthritis
Esther Beckers, Marin Been, Casper Webers, Annelies Boonen, Peter M. ten Klooster, Harald E. Vonkeman, Astrid van Tubergen
The Journal of Rheumatology Mar 2022, 49 (3) 256-264; DOI: 10.3899/jrheum.210075

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Performance of 3 Composite Measures for Disease Activity in Peripheral Spondyloarthritis
Esther Beckers, Marin Been, Casper Webers, Annelies Boonen, Peter M. ten Klooster, Harald E. Vonkeman, Astrid van Tubergen
The Journal of Rheumatology Mar 2022, 49 (3) 256-264; DOI: 10.3899/jrheum.210075
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Keywords

DISEASE ACTIVITY SCORE
OUTCOME ASSESSMENT
PSORIATIC ARTHRITIS
SPONDYLOARTHROPATHY

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