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

doi:10.3899/jrheum.210075

Performance of 3 Composite Measures for Disease Activity in Peripheral Spondyloarthritis

J Rheumatol. 2022 Mar;49(3):256-264. doi: 10.3899/jrheum.210075. Epub 2021 Sep 1.

Authors

Esther Beckers¹, Marin Been², Casper Webers², Annelies Boonen², Peter M Ten Klooster³, Harald E Vonkeman⁴, Astrid van Tubergen²

Affiliations

¹ E. 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; esther.beckers@mumc.nl.
² E. 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.
³ P.M. ten Klooster, PhD, Department of Psychology, Health & Technology, University of Twente, Enschede.
⁴ H.E. Vonkeman, MD, PhD, Department of Psychology, Health & Technology, University of Twente, Enschede, and Department of Rheumatology, Medisch Spectrum Twente, Enschede, the Netherlands.

PMID: 34470791
DOI: 10.3899/jrheum.210075

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.

Keywords: disease activity score; outcome assessment; psoriatic arthritis; spondyloarthropathy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Arthritis, Psoriatic* / diagnosis
Humans
Outcome Assessment, Health Care
Quality of Life
Severity of Illness Index
Spondylitis, Ankylosing*