Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Assessment of Activity in Children with Enthesitis Related Arthritis Using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).

Katsicas2,  Marìa M., Russo1,  Ricardo A. G.

Hospital de Pediatrìa Prof Dr JP Garrahan, Buenos Aires, Argentina
Hospital de Pediatrìa Prof Dr JP Garrahan

Background:

Enthesitis related Arthritis (ERA), as defined by ILAR criteria, is characterized by involvement of entheses and pheripheral joints; axial skeleton is affected in some patients The clinical spectrum of ERA overlaps with that of spondyloarthropathy. Bath Ankylosing Spondyliyis Disease Activity Index (BASDAI) is a score designed to determine the degree of activity in patients with Ankylosing Spondylitis. Its value as an outcome measure in children with ERA has not been tested.

Purpose:

To assess disease activity using BASDAI in children with ERA. To correlate BASDAI score with disease activity markers.

Methods:

Cross Sectional observational-descriptive study. Consecutive patients with ERA were included. Variables recorded were: presence of axial involvement [AI] (spinal pain and reduced spinal mobility or chest expansion), enthesitis, HLA-B27, number of active joints, number of joints with reduced mobility, duration of stiffness, ESR, physician'sglobal evaluation of activity (phy) [0–3], patient's assessment of well-being (p) [0–3] and pain [0–3] meassured on a 10 cm visual analogue scale (VAS), BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI) and CHAQ scores. BASDAI score was administered by a pediatric rheumatologist (MK) and answered by children (> 8 y) or parents (3–8 y). Association between disease activity markers (ESR, number of active joints, phyVAS, pVAS, painVAS) and BASDAI score was analysed (Spearman's correlation). Patients with AI were compared with those with peripheral involvement.

Results:

57 patients were enrolled (50 M,7 F). Age at onset: 9 ± 2.9 (3–15) years. Age at evaluation: 10 ± 2.9 (6–17) years. AI: 47 %. Enthesitis: 57%. Presence of HLA-B27: 42 %; # active joints: 2 (0–14) [median, range]; # joints with reduced mobility: 2 (0–12); duration of stiffness: 15 (0–180) minutes; Schöber test: 4,5 (2–7) cm; ESR= 2 (15–110) mm/h; phy VAS: 0.35 (0–1.9); pVAS: 0.48 (0–2.62); pain VAS: 0.41 (0–2.43). BASDAI >0 was recorded in 43 (86%) patients. Median BASDAI score: 1.90 (0–7.50). BASDAI correlated with: pVAS (r: 0.67; p=0,003), duration of stiffness (r: 0.65; p=0,004), phyVAS (r: 0.63; p=0,005) and ESR (r: 0.56; p=0,01). Patients with AI showed higher BASDAI score than patients with peripheral involvement. (median BASDAI score: 2.6 vs 1.7). BASDAI score corresponding to patients with AI strongly correlated with: duration of stiffness (r: 86%; p=0,006); ESR (r: 86%; p=0,01); phy VAS (r: 82%; p=0,01). Individual BASDAI score items correlations were: fatigue with pVAS (r: 59%; p=0,01) and phy VAS (r: 50%; p=0,03); spinal pain with painVAS (r: 63%; p=0,007); joint pain with pVAS (r: 64%; p=0,006) and phyVAS (r: 53%; p=0,03); areas of localized tenderness with pVAS (r: 64%; p:0,006); morning stiffness with duration of morning stiffness (r: 60%; p=0,01); ESR (r: 58%; p=0,01) and phy VAS (r: 51%; p=0,03).

Conclusion:

BASDAI showed correlation with certain activity disease markers, especially in patients with AI. BASDAI score ranged in the low-medium spectrum of the scale. BASDAI should be included as a useful outcome measure in the asssessment of activity in children with ERA.

To cite this abstract, please use the following information:
Katsicas, Marìa M., Russo, Ricardo A. G.; Assessment of Activity in Children with Enthesitis Related Arthritis Using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). [abstract]. Arthritis Rheum 2010;62 Suppl 10 :212
DOI: 10.1002/art.27981

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