RT Journal Article SR Electronic T1 Eligibility criteria for biologic disease-modifying antirheumatic drugs in axial spondyloarthritis: going beyond BASDAI JF RMD Open JO RMD Open FD EULAR SP e001145 DO 10.1136/rmdopen-2019-001145 VO 6 IS 1 A1 Marona, Jose A1 Sepriano, Alexandre A1 Rodrigues-Manica, Santiago A1 Pimentel-Santos, Fernando A1 Mourão, Ana Filipa A1 Gouveia, Nélia A1 Branco, Jaime Cunha A1 Santos, Helena A1 Vieira-Sousa, Elsa A1 Vinagre, Filipe A1 Tavares-Costa, João A1 Rovisco, João A1 Bernardes, Miguel A1 Madeira, Nathalie A1 Cruz-Machado, Rita A1 Roque, Raquel A1 Silva, Joana Leite A1 Marques, Mary Lucy A1 Ferreira, Raquel Miriam A1 Ramiro, Sofia YR 2020 UL http://rmdopen.bmj.com/content/6/1/e001145.abstract AB Objectives To compare definitions of high disease activity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in selecting patients for treatment with biologic disease-modifying antirheumatic drugs (bDMARDs).Methods Patients from Rheumatic Diseases Portuguese Register (Reuma.pt) with a clinical diagnosis of axial spondyloarthritis (axSpA) were included. Four subgroups (cross-tabulation between ASDAS (≥2.1) and BASDAI (≥4) definitions of high disease activity) were compared regarding baseline characteristics and response to bDMARDs at 3 and 6 months estimated in multivariable regression models.Results Of the 594 patients included, the majority (82%) had both BASDAI≥4 and ASDAS ≥2.1. The frequency of ASDAS ≥2.1, if BASDAI<4 was much larger than the opposite (ie, ASDAS <2.1, if BASDAI≥4): 62% vs 0.8%. Compared to patients fulfilling both definitions, those with ASDAS ≥2.1 only were more likely to be male (77% vs 51%), human leucocyte antigen B27 positive (79% vs 65%) and have a higher C reactive protein (2.9 (SD 3.5) vs 2.1 (2.9)). Among bDMARD-treated patients (n=359), responses across subgroups were globally overlapping, except for the most ‘stringent’ outcomes. Patients captured only by ASDAS responded better compared to patients fulfilling both definitions (eg, ASDAS inactive disease at 3 months: 61% vs 25% and at 6 months: 42% vs 25%).Conclusion The ASDAS definition of high disease activity is more inclusive than the BASDAI definition in selecting patients with axSpA for bDMARD treatment. The additionally ‘captured’ patients respond better and have higher likelihood of predictors thereof. These results support using ASDAS≥2.1 as a criterion for treatment decisions.