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Braun J, Baraliakos X, Kiltz U. Treat-to-target in axial spondyloarthritis - what about physical function and activity? Nat Rev Rheumatol 2021; 17:565-576. [PMID: 34312518 DOI: 10.1038/s41584-021-00656-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 02/07/2023]
Abstract
In patients with axial spondyloarthritis (axSpA), pain, functional and structural impairments, reduced mobility and potential deformity of the axial skeleton are the most prominent health concerns. Limitations in physical function and spinal mobility are caused by both inflammation and structural damage, and therefore restrictions to physical function must be monitored throughout a patient's life. Consequently, the assessment of physical function is recommended as a key domain in the Assessment of Spondyloarthritis International Society-OMERACT Core Outcome Set. However, in comparison with disease activity, physical function seems to be a relatively neglected target of intervention in patients with axSpA, even though physical function is a major contributor to costs and disability in this disease. This Review aims to reacquaint rheumatologists with the targets for physical function, physical activity and performance by giving guidance on determinants of physical function and how physical function can be examined in patients with axSpA.
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Affiliation(s)
- Jürgen Braun
- Rheumazentrum Ruhrgebiet, Herne, Ruhr Universität Bochum, Bochum, Germany.
| | - Xenofon Baraliakos
- Rheumazentrum Ruhrgebiet, Herne, Ruhr Universität Bochum, Bochum, Germany
| | - Uta Kiltz
- Rheumazentrum Ruhrgebiet, Herne, Ruhr Universität Bochum, Bochum, Germany
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Kiefer D, Baraliakos X, Adolf D, Chatzistefanidi V, Schwarze I, Lange U, Brandt-Jürgens J, Stemmler E, Sartingen S, Braun J. Successful evaluation of spinal mobility measurements with the Epionics SPINE device in patients with axial spondyloarthritis compared to controls. J Rheumatol 2021; 49:44-52. [PMID: 34393107 DOI: 10.3899/jrheum.201470] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate ES for quantification of spinal mobility in patients with axSpA. METHODS A total of 153 individuals, 39 females and 114 males, were examined:134 axSpA patients, 40 non-(nr-) and 94 radiographic (r)-axSpA, and 19 healthy controls (HC), respectively. The results were compared using mean ES scores and modeling was performed using multivariable logistic regression models resulting in good validity and high discriminative power. RESULTS ES measurements showed meaningful differences between axSpA patients and HC (all p<0.001) as well as between r- and nr-axSpA (p<0.01). In axSpA patients a negative correlation between ES and BASMI values was found: -0.76≤r≤-0.52 (p<0.05). BASFI scores showed a similar trend (r > -0.39). Patients with r-axSpA had a more limited and slower spinal mobility than those with nr-axSpA. Other patient reported outcomes did almost not correlate. CONCLUSION This study shows that the ES is an objective performance measure and a valid tool to assess spinal mobility in axSpA, also based on OMERACT criteria. RoK and RoM scores provide additional information on physical function of axSpA patients.
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Affiliation(s)
- David Kiefer
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Xenofon Baraliakos
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Daniela Adolf
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Varvara Chatzistefanidi
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Ilka Schwarze
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Uwe Lange
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Jan Brandt-Jürgens
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Edgar Stemmler
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Sabine Sartingen
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Jürgen Braun
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
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Fongen C, Dagfinrud H, Bilberg A, Pedersen E, Johansen MW, van Weely S, Hagen KB, Sveaas SH. Responsiveness and Interpretability of 2 Measures of Physical Function in Patients With Spondyloarthritis. Phys Ther 2020; 100:728-738. [PMID: 31944251 DOI: 10.1093/ptj/pzaa004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/28/2019] [Accepted: 10/06/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Maintenance or improvement of physical function is an important treatment target in the management of patients with axial spondyloarthritis (axSpA); measurement tools that can detect changes in physical function are therefore important. OBJECTIVES The objective of this study was to compare responsiveness and interpretability of the patient-reported Bath Ankylosing Spondylitis Functional Index (BASFI) and the Ankylosing Spondylitis Performed-Based Improvement (ASPI) in measuring change in physical function after exercise in patients with axSpA. DESIGN This was a sub-study of 58 patients nested within a randomized controlled trial comparing the effect of 12 weeks of exercise with usual care. METHODS Responsiveness and interpretability were assessed according to the Consensus-based Standards for the selection of health status Measurement Instrument. Responsiveness was assessed by testing 8 predefined hypotheses for ASPI and BASFI. Interpretability was assessed by: (1) using patients' reported change as an anchor ("a little better" = minimal important change) and (2) by categorizing patients with a 20% improvement as responders. RESULTS For ASPI and BASFI, 5 of 8 (63%) versus 2 of 8 (25%) of the predefined hypotheses for responsiveness were confirmed. The minimal important change values for improvement in physical function were 3.7 seconds in ASPI and 0.8 points (on a scale from 0 to 10) for BASFI. In the intervention group, 21 of 30 (70%) and 13 of 30 (43%) of the patients were categorized as responders measured with ASPI and BASFI, respectively. There was a tendency towards a floor effect in BASFI, as 8 of 58 (14%) patients scored the lowest value at baseline. LIMITATIONS This study was limited by its moderate sample size. CONCLUSIONS Our findings suggest that ASPI is preferable over BASFI when evaluating physical function after exercise interventions in patients with axSpA.
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Affiliation(s)
- Camilla Fongen
- Department of Rheumatology, National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Hanne Dagfinrud
- Department of Rheumatology, National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital
| | - Annelie Bilberg
- Institute of Neuroscience and Physiology, Section of Health and Rehabilitation, Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, and Department of Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Elisabeth Pedersen
- Department of Rheumatology, University Hospital of North Norway, Tromsø, Norway
| | | | - Salima van Weely
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
| | - Kåre Birger Hagen
- Department of Rheumatology, National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital
| | - Silje Halvorsen Sveaas
- Department of Rheumatology, National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, PO Box 23 Vinderen, 0319 Oslo, Norway
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4
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van Bentum RE, Ibáñez Vodnizza SE, Poblete de la Fuente MP, Valenzuela Aldridge F, Navarro-Compán V, Rusman TR, Ter Wee MM, Valenzuela Letelier O, van Weely SFE, van der Horst-Bruinsma IE. The Ankylosing Spondylitis Performance Index: Reliability and Feasibility of an Objective Test for Physical Functioning. J Rheumatol 2020; 47:1475-1482. [PMID: 32007935 DOI: 10.3899/jrheum.191063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Physical function in patients with axial spondyloarthritis (axSpA) is currently evaluated through questionnaires. The Ankylosing Spondylitis Performance Index (ASPI) is a performance-based measure for physical functioning, which has been validated in Dutch patients with radiographic (r-) axSpA. The interrater reliability has not yet been determined. To our knowledge, this study is the first to evaluate the validity, reliability, and feasibility of the ASPI in another patient population, including both r- and nonradiographic (nr-) axSpA patients. METHODS Patients with axSpA were recruited from rheumatology clinics in Santiago, Chile. Dutch instructions were translated to Spanish by a forward-backward procedure. Study visits were performed at baseline and 1-4 weeks later. Four ASPI observers were involved, measuring the performance times of the 3 ASPI tests. Validity was assessed through a patient questionnaire (numeric rating scale 0-10: ≥ 6 sufficient). For reliability, intraclass correlation coefficients (ICC) were calculated (with 95% CI). Correlations between the ASPI and disease variables were tested with regression analyses. RESULTS Sixty-eight patients were included (57% male, 52% r-axSpA). All patients understood the Spanish instructions and considered the ASPI to reach its aim (84%) and representativeness (85%) for physical functioning. The overall interrater (n = 62) and test-retest (n = 39) reliability (ICC) of the 3 tests combined were 0.93 (0.88-0.96) and 0.94 (0.87-0.97), respectively. Eighty-two percent of the patients completed all tests and 94% finished in < 15 min (feasibility). CONCLUSION This study demonstrated a high validity and feasibility in an entirely different population, with both r-axSpA and nr-axSpA. The interrater and test-retest reliability was excellent. The ASPI instructions are now available for Spanish-speaking patients.
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Affiliation(s)
- Rianne E van Bentum
- R.E. van Bentum, MD, T.R. Rusman, MSc, I.E. van der Horst-Bruinsma, MD, PhD, Professor, Department of Rheumatology, Amsterdam University Medical Centre, Vrije Universiteit, Amsterdam, the Netherlands
| | - Sebastian E Ibáñez Vodnizza
- S.E. Ibáñez Vodnizza, MD, M.P. Poblete de la Fuente, MD, F. Valenzuela Aldridge, MD, O. Valenzuela Letelier, MD, Department of Rheumatology, Clínica Alemana - UDD Medicine Faculty, Santiago, Chile
| | - Maria P Poblete de la Fuente
- S.E. Ibáñez Vodnizza, MD, M.P. Poblete de la Fuente, MD, F. Valenzuela Aldridge, MD, O. Valenzuela Letelier, MD, Department of Rheumatology, Clínica Alemana - UDD Medicine Faculty, Santiago, Chile
| | - Francisca Valenzuela Aldridge
- S.E. Ibáñez Vodnizza, MD, M.P. Poblete de la Fuente, MD, F. Valenzuela Aldridge, MD, O. Valenzuela Letelier, MD, Department of Rheumatology, Clínica Alemana - UDD Medicine Faculty, Santiago, Chile
| | - Victoria Navarro-Compán
- V. Navarro-Compán, MD, PhD, Department of Rheumatology, University Hospital La Paz, IdiPaz, Madrid, Spain
| | - Tamara R Rusman
- R.E. van Bentum, MD, T.R. Rusman, MSc, I.E. van der Horst-Bruinsma, MD, PhD, Professor, Department of Rheumatology, Amsterdam University Medical Centre, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marieke M Ter Wee
- M.M. ter Wee, PhD, Department of Rheumatology, Amsterdam University Medical Centre, Vrije Universiteit, and Department of Epidemiology & Biostatistics, Amsterdam Public Health, Amsterdam University Medical Centre, Vrije Universiteit, Amsterdam
| | - Omar Valenzuela Letelier
- S.E. Ibáñez Vodnizza, MD, M.P. Poblete de la Fuente, MD, F. Valenzuela Aldridge, MD, O. Valenzuela Letelier, MD, Department of Rheumatology, Clínica Alemana - UDD Medicine Faculty, Santiago, Chile
| | - Salima F E van Weely
- S.F. van Weely, PhD, Department of Orthopedics, Rehabilitation and Physical Therapy, Leiden University Medical Centre, Leiden, the Netherlands
| | - Irene E van der Horst-Bruinsma
- R.E. van Bentum, MD, T.R. Rusman, MSc, I.E. van der Horst-Bruinsma, MD, PhD, Professor, Department of Rheumatology, Amsterdam University Medical Centre, Vrije Universiteit, Amsterdam, the Netherlands;
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Kiltz U, Braun J. Assessments of Functioning in Patients With Axial Spondyloarthritis. JOURNAL OF RHEUMATIC DISEASES 2020. [DOI: 10.4078/jrd.2020.27.1.22] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Uta Kiltz
- Rheumazentrum Ruhrgebiet and Ruhr-University Bochum, Herne, Germany
| | - Jürgen Braun
- Rheumazentrum Ruhrgebiet and Ruhr-University Bochum, Herne, Germany
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Kiefer D, Baraliakos X, Bühring B, Kiltz U, Braun J. [Epionics SPINE-use of an objective method to examine spinal mobility in patients with axial spondyloarthritis]. Z Rheumatol 2019; 79:143-152. [PMID: 31468167 DOI: 10.1007/s00393-019-00692-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Axial spondylarthritis (axSpA) is a chronic inflammatory disease of the spine that can be associated with loss of physical function, mobility and upright postural impairment. Established tools for the assessment of function that are largely based on subjective perception are semiquantitatively recorded by standardized questionnaires (Bath ankylosing spondylitis functional index, BASFI), while measurement of spinal mobility of patients with axSpA is based on physical examination of various movement regions particularly the axial skeleton (Bath ankylosing spondylitis metrology index, BASMI). Recently, a performance test has been added to assess the range of motion and speed of certain tasks (AS performance-based improved test, ASPI); however, since these tests have limited reliability and reproducibility, more objective tests would be desirable. In this study the spinal mobility of patients with axSpA was quantified using the Epionics SPINE device (ES) and data were evaluated using the outcome measures in rheumatology (OMERACT) criteria. The ES automatically measures various patterns of spinal movements using electronic sensors, which also assess the range and speed of carrying out movements. Patients with back pain from other causes and persons without back pain served as controls. The measurement results obtained with ES differed between the groups and correlated with BASMI values (r = 0.53-0.82, all p = <0.03). Patients with radiographically detectable axSpA had more limited and slower mobility than those with non-radiographically detectable axSpA. Overall, the results presented here suggest that ES measurements represent a valid and objective measurement procedure of spinal mobility for axSpA patients.
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Affiliation(s)
- D Kiefer
- Rheumazentrum Ruhrgebiet, Herne und Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
| | - X Baraliakos
- Rheumazentrum Ruhrgebiet, Herne und Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
| | - B Bühring
- Rheumazentrum Ruhrgebiet, Herne und Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
| | - U Kiltz
- Rheumazentrum Ruhrgebiet, Herne und Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
| | - J Braun
- Rheumazentrum Ruhrgebiet, Herne und Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland.
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Swinnen TW, Milosevic M, Van Huffel S, Dankaerts W, Westhovens R, de Vlam K. Instrumented BASFI (iBASFI) Shows Promising Reliability and Validity in the Assessment of Activity Limitations in Axial Spondyloarthritis. J Rheumatol 2016; 43:1532-40. [PMID: 27307537 DOI: 10.3899/jrheum.150439] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The Bath Ankylosing Spondylitis Functional Index (BASFI) is the most popular method to assess activity capacity in axial spondyloarthritis (axSpA), to our knowledge. It is endorsed by the Assessment of Spondyloarthritis international Society. But it may have recall bias or aberrant self-judgments in individual patients. Therefore, we aimed to (1) develop the instrumented BASFI (iBASFI) by adding a body-worn accelerometer with automated algorithms to performance-based measurements (PBM), (2) study the iBASFI's core psychometric properties, and (3) reduce the number of iBASFI items. METHODS Twenty-eight patients with axSpA wore a 2-axial accelerometer while completing 12 PBM derived from the BASFI. A chronometer and both manual and "automated algorithm-based" acceleration segmentation identified movement time. Test-retest trials and methods (algorithm vs manual segmentation/chronometer/BASFI) were compared with ICC, standard error of measurement [percentage of movement time (SEM%)], and Spearman ρ correlation coefficients. Linear regression identified the optimal set of reliable iBASFI PBM. RESULTS Good to excellent test-retest reliability was found for 8/12 iBASFI items (ICC range 0.812-0.997, SEM range 0.4-30.4%), typically with repeated and fast movements. Automated algorithms excellently mimicked manual segmentation (ICC range 0.900-0.998) and the chronometer (ICC range 0.878-0.998) for 10/12 iBASFI items. Construct validity compared with the BASFI was confirmed for 7/12 iBASFI items (δ range 0.504-0.755). Together, sit-to-stand speed test (stBeta 0.483), cervical rotation (stBeta -0.392), and height (stBeta -0.375) explained 59% of the variance in the BASFI (p < 0.01). CONCLUSION The proof-of-concept iBASFI showed promising reliability and validity in measuring activity capacity. The number of the iBASFI's PBM may be minimized, but further validation in larger axSpA cohorts is needed before its clinical use.
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Affiliation(s)
- Thijs Willem Swinnen
- From the Division of Rheumatology, University Hospitals Leuven; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven; Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven; iMinds, Medical Information Technology, KU Leuven, Leuven, Belgium.T.W. Swinnen, PT, MSc, Doctoral Research Fellow, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, and Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; M. Milosevic, MSc Eng, Doctoral Research Fellow, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven, and iMinds, Medical Information Technology, KU Leuven; S. Van Huffel, MSc Eng, PhD, Full Professor Biomedical Data Processing, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven, and iMinds, Medical Information Technology, KU Leuven; W. Dankaerts, PT, PhD, Professor Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; R. Westhovens, MD, PhD, Full Professor Rheumatology, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven; K. de Vlam, MD, PhD, Principal Investigator Clinical Rheumatology, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven
| | - Milica Milosevic
- From the Division of Rheumatology, University Hospitals Leuven; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven; Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven; iMinds, Medical Information Technology, KU Leuven, Leuven, Belgium.T.W. Swinnen, PT, MSc, Doctoral Research Fellow, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, and Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; M. Milosevic, MSc Eng, Doctoral Research Fellow, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven, and iMinds, Medical Information Technology, KU Leuven; S. Van Huffel, MSc Eng, PhD, Full Professor Biomedical Data Processing, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven, and iMinds, Medical Information Technology, KU Leuven; W. Dankaerts, PT, PhD, Professor Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; R. Westhovens, MD, PhD, Full Professor Rheumatology, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven; K. de Vlam, MD, PhD, Principal Investigator Clinical Rheumatology, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven
| | - Sabine Van Huffel
- From the Division of Rheumatology, University Hospitals Leuven; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven; Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven; iMinds, Medical Information Technology, KU Leuven, Leuven, Belgium.T.W. Swinnen, PT, MSc, Doctoral Research Fellow, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, and Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; M. Milosevic, MSc Eng, Doctoral Research Fellow, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven, and iMinds, Medical Information Technology, KU Leuven; S. Van Huffel, MSc Eng, PhD, Full Professor Biomedical Data Processing, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven, and iMinds, Medical Information Technology, KU Leuven; W. Dankaerts, PT, PhD, Professor Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; R. Westhovens, MD, PhD, Full Professor Rheumatology, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven; K. de Vlam, MD, PhD, Principal Investigator Clinical Rheumatology, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven
| | - Wim Dankaerts
- From the Division of Rheumatology, University Hospitals Leuven; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven; Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven; iMinds, Medical Information Technology, KU Leuven, Leuven, Belgium.T.W. Swinnen, PT, MSc, Doctoral Research Fellow, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, and Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; M. Milosevic, MSc Eng, Doctoral Research Fellow, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven, and iMinds, Medical Information Technology, KU Leuven; S. Van Huffel, MSc Eng, PhD, Full Professor Biomedical Data Processing, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven, and iMinds, Medical Information Technology, KU Leuven; W. Dankaerts, PT, PhD, Professor Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; R. Westhovens, MD, PhD, Full Professor Rheumatology, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven; K. de Vlam, MD, PhD, Principal Investigator Clinical Rheumatology, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven
| | - Rene Westhovens
- From the Division of Rheumatology, University Hospitals Leuven; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven; Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven; iMinds, Medical Information Technology, KU Leuven, Leuven, Belgium.T.W. Swinnen, PT, MSc, Doctoral Research Fellow, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, and Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; M. Milosevic, MSc Eng, Doctoral Research Fellow, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven, and iMinds, Medical Information Technology, KU Leuven; S. Van Huffel, MSc Eng, PhD, Full Professor Biomedical Data Processing, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven, and iMinds, Medical Information Technology, KU Leuven; W. Dankaerts, PT, PhD, Professor Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; R. Westhovens, MD, PhD, Full Professor Rheumatology, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven; K. de Vlam, MD, PhD, Principal Investigator Clinical Rheumatology, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven
| | - Kurt de Vlam
- From the Division of Rheumatology, University Hospitals Leuven; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven; Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven; iMinds, Medical Information Technology, KU Leuven, Leuven, Belgium.T.W. Swinnen, PT, MSc, Doctoral Research Fellow, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, and Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; M. Milosevic, MSc Eng, Doctoral Research Fellow, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven, and iMinds, Medical Information Technology, KU Leuven; S. Van Huffel, MSc Eng, PhD, Full Professor Biomedical Data Processing, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics, Department of Electrical Engineering, KU Leuven, and iMinds, Medical Information Technology, KU Leuven; W. Dankaerts, PT, PhD, Professor Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, KU Leuven; R. Westhovens, MD, PhD, Full Professor Rheumatology, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven; K. de Vlam, MD, PhD, Principal Investigator Clinical Rheumatology, Division of Rheumatology, University Hospitals Leuven, and Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven.
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van Weely SFE, Dekker J, Steultjens MPM, van Denderen JC, Nurmohamed MT, Dijkmans BAC, van der Horst-Bruinsma IE. Objective evaluation of physical functioning after tumor necrosis factor inhibitory therapy in patients with ankylosing spondylitis: a selection of 3 feasible performance-based tests. J Rheumatol 2015; 42:623-9. [PMID: 25593234 DOI: 10.3899/jrheum.140337] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE (1) To select a limited number of performance-based tests that are reliable, show improvement in physical functioning after tumor necrosis factor inhibitor (TNFi) therapy in patients with ankylosing spondylitis (AS), and generate information equivalent to the full set of tests, and (2) are feasible for use in daily clinical practice. METHODS Eight performance-based tests were evaluated. To eliminate redundant testing, the tests that showed adequate reliability, the highest standardized response mean (SRM), and the largest proportion of patients with an improved performance-based physical functioning were selected. The selected tests were combined into a new criterion for improvement in physical functioning (AS Performance-based Improvement; ASPI). The number and percentage of improved patients identified with the ASPI and identified with the full set of performance tests were compared. RESULTS Reliability for all tests was adequate to excellent (ICC 0.73-0.96). The tests for bending, putting on socks, and getting up from the floor had the highest SRM (0.52-0.74) and showed the largest proportion of improved patients after TNFi therapy. The combination of these 3 tests was feasible in daily clinical practice and showed improved physical functioning after TNFi therapy in 67% of the patients. CONCLUSION The 3 selected tests are recommended for use in daily practice because they generate information comparable to the full set. They are reliable and feasible, and the combination of these tests showed improved physical functioning after TNFi therapy in 67% of the patients. Evaluation of physical functioning might be improved by adding these tests to other AS outcome measures.
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Affiliation(s)
- Salima F E van Weely
- From Reade, Centre for Rehabilitation and Rheumatology; Department of Rehabilitation Medicine, and the Department of Rheumatology, and the Department of Psychiatry, EMGO Institute, Vrije Universiteit (VU) University Medical Centre, Amsterdam, the Netherlands; and the Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK.S.F.E. van Weely, MSc; J.C. van Denderen, MD; M.T. Nurmohamed, MD, PhD, Reade, Centre for Rehabilitation and Rheumatology; J. Dekker, PhD, Reade, Centre for Rehabilitation and Rheumatology, and the Department of Rehabilitation Medicine, Department of Psychiatry, EMGO Institute, VU University Medical Centre; B.A.C. Dijkmans, MD, PhD, Reade, Centre for Rehabilitation and Rheumatology, and the Department of Rheumatology, VU University Medical Centre; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Centre; M.P.M. Steultjens, PhD, Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University.
| | - Joost Dekker
- From Reade, Centre for Rehabilitation and Rheumatology; Department of Rehabilitation Medicine, and the Department of Rheumatology, and the Department of Psychiatry, EMGO Institute, Vrije Universiteit (VU) University Medical Centre, Amsterdam, the Netherlands; and the Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK.S.F.E. van Weely, MSc; J.C. van Denderen, MD; M.T. Nurmohamed, MD, PhD, Reade, Centre for Rehabilitation and Rheumatology; J. Dekker, PhD, Reade, Centre for Rehabilitation and Rheumatology, and the Department of Rehabilitation Medicine, Department of Psychiatry, EMGO Institute, VU University Medical Centre; B.A.C. Dijkmans, MD, PhD, Reade, Centre for Rehabilitation and Rheumatology, and the Department of Rheumatology, VU University Medical Centre; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Centre; M.P.M. Steultjens, PhD, Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University
| | - Martijn P M Steultjens
- From Reade, Centre for Rehabilitation and Rheumatology; Department of Rehabilitation Medicine, and the Department of Rheumatology, and the Department of Psychiatry, EMGO Institute, Vrije Universiteit (VU) University Medical Centre, Amsterdam, the Netherlands; and the Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK.S.F.E. van Weely, MSc; J.C. van Denderen, MD; M.T. Nurmohamed, MD, PhD, Reade, Centre for Rehabilitation and Rheumatology; J. Dekker, PhD, Reade, Centre for Rehabilitation and Rheumatology, and the Department of Rehabilitation Medicine, Department of Psychiatry, EMGO Institute, VU University Medical Centre; B.A.C. Dijkmans, MD, PhD, Reade, Centre for Rehabilitation and Rheumatology, and the Department of Rheumatology, VU University Medical Centre; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Centre; M.P.M. Steultjens, PhD, Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University
| | - J Christiaan van Denderen
- From Reade, Centre for Rehabilitation and Rheumatology; Department of Rehabilitation Medicine, and the Department of Rheumatology, and the Department of Psychiatry, EMGO Institute, Vrije Universiteit (VU) University Medical Centre, Amsterdam, the Netherlands; and the Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK.S.F.E. van Weely, MSc; J.C. van Denderen, MD; M.T. Nurmohamed, MD, PhD, Reade, Centre for Rehabilitation and Rheumatology; J. Dekker, PhD, Reade, Centre for Rehabilitation and Rheumatology, and the Department of Rehabilitation Medicine, Department of Psychiatry, EMGO Institute, VU University Medical Centre; B.A.C. Dijkmans, MD, PhD, Reade, Centre for Rehabilitation and Rheumatology, and the Department of Rheumatology, VU University Medical Centre; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Centre; M.P.M. Steultjens, PhD, Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University
| | - Michael T Nurmohamed
- From Reade, Centre for Rehabilitation and Rheumatology; Department of Rehabilitation Medicine, and the Department of Rheumatology, and the Department of Psychiatry, EMGO Institute, Vrije Universiteit (VU) University Medical Centre, Amsterdam, the Netherlands; and the Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK.S.F.E. van Weely, MSc; J.C. van Denderen, MD; M.T. Nurmohamed, MD, PhD, Reade, Centre for Rehabilitation and Rheumatology; J. Dekker, PhD, Reade, Centre for Rehabilitation and Rheumatology, and the Department of Rehabilitation Medicine, Department of Psychiatry, EMGO Institute, VU University Medical Centre; B.A.C. Dijkmans, MD, PhD, Reade, Centre for Rehabilitation and Rheumatology, and the Department of Rheumatology, VU University Medical Centre; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Centre; M.P.M. Steultjens, PhD, Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University
| | - Ben A C Dijkmans
- From Reade, Centre for Rehabilitation and Rheumatology; Department of Rehabilitation Medicine, and the Department of Rheumatology, and the Department of Psychiatry, EMGO Institute, Vrije Universiteit (VU) University Medical Centre, Amsterdam, the Netherlands; and the Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK.S.F.E. van Weely, MSc; J.C. van Denderen, MD; M.T. Nurmohamed, MD, PhD, Reade, Centre for Rehabilitation and Rheumatology; J. Dekker, PhD, Reade, Centre for Rehabilitation and Rheumatology, and the Department of Rehabilitation Medicine, Department of Psychiatry, EMGO Institute, VU University Medical Centre; B.A.C. Dijkmans, MD, PhD, Reade, Centre for Rehabilitation and Rheumatology, and the Department of Rheumatology, VU University Medical Centre; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Centre; M.P.M. Steultjens, PhD, Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University
| | - Irene E van der Horst-Bruinsma
- From Reade, Centre for Rehabilitation and Rheumatology; Department of Rehabilitation Medicine, and the Department of Rheumatology, and the Department of Psychiatry, EMGO Institute, Vrije Universiteit (VU) University Medical Centre, Amsterdam, the Netherlands; and the Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK.S.F.E. van Weely, MSc; J.C. van Denderen, MD; M.T. Nurmohamed, MD, PhD, Reade, Centre for Rehabilitation and Rheumatology; J. Dekker, PhD, Reade, Centre for Rehabilitation and Rheumatology, and the Department of Rehabilitation Medicine, Department of Psychiatry, EMGO Institute, VU University Medical Centre; B.A.C. Dijkmans, MD, PhD, Reade, Centre for Rehabilitation and Rheumatology, and the Department of Rheumatology, VU University Medical Centre; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Centre; M.P.M. Steultjens, PhD, Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University
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Deodhar A, Braun J, Inman RD, van der Heijde D, Zhou Y, Xu S, Han C, Hsu B. Golimumab administered subcutaneously every 4 weeks in ankylosing spondylitis: 5-year results of the GO-RAISE study. Ann Rheum Dis 2014; 74:757-61. [PMID: 25387477 PMCID: PMC4392310 DOI: 10.1136/annrheumdis-2014-205862] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective Assess golimumab efficacy/safety through 5 years in patients with active ankylosing spondylitis (AS). Methods 356 patients with AS were randomly assigned to placebo, golimumab 50 mg or 100 mg every 4 weeks. At week 16, patients with inadequate response early escaped with blinded dose adjustments (placebo to 50 mg, 50 mg to 100 mg). At week 24, all patients receiving placebo crossed over to 50 mg. Blinded active therapy continued through week 104; from week 104 to week 252, the golimumab dose could be adjusted. Intent-to-treat and observed efficacy data were assessed by randomised treatment groups. Results At week 256, and with >4.5 years of golimumab, overall intent-to-treat Assessment in SpondyloArthritis international Society criteria for 20% improvement (ASAS20) and ASAS40 response rates were 66.0% (235/356) and 57.0% (203/356), respectively; Bath AS Disease Activity Index 50% improvement response was 55.9% (199/356). Observed response rates among the 255 (72%) patients who continued golimumab through week 252 were consistent, albeit somewhat higher. Among patients who increased golimumab from 50 to 100 mg, 60.6% (20/33) and 44.7% (17/38) achieved ASAS20/ASAS40 responses, respectively, following ≥2 consecutive doses of golimumab 100 mg. Golimumab safety through week 268 was similar to that through week 24 regardless of dose. Conclusions Clinical improvements observed in patients treated with golimumab through week 24 were sustained through week 256 (5 years). Long-term golimumab safety is consistent with that of other established tumour-necrosis-factor-antagonists. Trial registration number ClinicalTrials.gov: NCT00265083.
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Affiliation(s)
- Atul Deodhar
- Division of Arthritis & Rheumatic Diseases, Oregon Health & Science University, Portland, Oregon, USA
| | - Jürgen Braun
- Department of Rheumatology, Rheumazentrum Ruhrgebiet, Herne, Germany
| | - Robert D Inman
- Departments of Medicine and Immunology, University of Toronto, Toronto, Ontario, Canada
| | | | - Yiying Zhou
- Department of Biostatistics, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Stephen Xu
- Department of Biostatistics, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Chenglong Han
- Patient Reported Outcomes, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Benjamin Hsu
- Department of Immunology, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
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Braun J, Baraliakos X, Heldmann F, Kiltz U. Tumor necrosis factor alpha antagonists in the treatment of axial spondyloarthritis. Expert Opin Investig Drugs 2014; 23:647-59. [DOI: 10.1517/13543784.2014.899351] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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