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Methods. Patients completed BASDAI and BASFI questionnaires annually from 1996 to 2001. Demographic and clinical data were collected. The mean .rst and last recorded scores were compared. The change per year and area under the curve per year for the BASDAI and BASFI were calculated. Relationships between demographic, clinical and longitudinal BASDAI/ BASFI data were examined. Subgroup analyses were performed using the cross-sectional and longitudinal data. Results. Two hundred and seventy-nine BASDAI and 322 BASFI questionnaires were analysed. The BASFI increased [mean change 6.15, 95% con.dence interval (CI) 1.9, 10.3, P=0.005] but the BASDAI did not (mean change 0.87, 95% CI 3.96, 5.7, P=0.71). First recorded scores were the best predictors of the cumulative scores per year. Patients with peripheral joint (P=0.01) and hip (P<0.001) disease had higher mean BASFI scores. Males (P<0.001) and patients with spinal disease alone (P=0.0014), iritis (P=0.005) and late-onset AS (P=0.002) became more functionally impaired over time.
Do you categorize patients as having mild, moderate, severe disease?
Do you use some other method to categorize patients – early disease, established disease?
How do you currently assess a patient’s likelihood of progression in AS?
Do you believe that earlier intervention with biologics leads to better clinical outcomes?
If treated early and aggressively, do you believe that the natural course of AS can be altered?
Disease Activity and Disability Assessment Instruments
Complete agreement does not exist with regard to the specific instruments that should be used to measure disease activity; however, a questionnaire directed at specialists in the field of AS indicates that many experts prefer the Bath AS Disease Activity Index (BASDAI) and/or the Bath AS Functional Index (BASFI).1,2 The ASsessment in Ankylosing Spondylitis Improvement Criteria (ASAS-IC), a composite of four domains, have also been evaluated recently and were concluded to be strict in defining response and highly specific as well.3 
1. Braun J, Sieper J. Building consensus on nomenclature and disease classification for ankylosing spondylitis: results and discussion of a questionnaire prepared for the International Workshop on New Treatment Strategies in Ankylosing Spondylitis, Berlin, Germany, January 18-19, 2002. Ann Rheum Dis. 2002;61(suppl III):iii61-iii67.
2. Braun J, Pham T, Sieper J, et al for the ASAS Working Group. International ASAS consensus statement for the use of anti-tumor necrosis factor agents in patients with ankylosing spondylitis. Ann Rheum Dis. 2003;62:817-824.
3. van Tubergen A, van der Heijde D, Anderson J, et al for the ASAS Working Group. Comparison of statistically derived ASAS improvement criteria for ankylosing spondylitis with clinically relevant improvement according to an expert panel. Ann Rheum Dis. 2003;62:215-221.
Disease Activity and Disability Assessment Instruments
Complete agreement does not exist with regard to the specific instruments that should be used to measure disease activity; however, a questionnaire directed at specialists in the field of AS indicates that many experts prefer the Bath AS Disease Activity Index (BASDAI) and/or the Bath AS Functional Index (BASFI).1,2 The ASsessment in Ankylosing Spondylitis Improvement Criteria (ASAS-IC), a composite of four domains, have also been evaluated recently and were concluded to be strict in defining response and highly specific as well.3 
1. Braun J, Sieper J. Building consensus on nomenclature and disease classification for ankylosing spondylitis: results and discussion of a questionnaire prepared for the International Workshop on New Treatment Strategies in Ankylosing Spondylitis, Berlin, Germany, January 18-19, 2002. Ann Rheum Dis. 2002;61(suppl III):iii61-iii67.
2. Braun J, Pham T, Sieper J, et al for the ASAS Working Group. International ASAS consensus statement for the use of anti-tumor necrosis factor agents in patients with ankylosing spondylitis. Ann Rheum Dis. 2003;62:817-824.
3. van Tubergen A, van der Heijde D, Anderson J, et al for the ASAS Working Group. Comparison of statistically derived ASAS improvement criteria for ankylosing spondylitis with clinically relevant improvement according to an expert panel. Ann Rheum Dis. 2003;62:215-221.
The domains and the formula for calculating the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) are described above.
Secondary endpoints included the proportion of subjects achieving ASAS partial remission.
Patients will be categorized as in ASAS partial remission if the patient achieves the following:
Value < 20 (0-100 scale) in all 4 domains of ASAS Working Group Criteria for Improvement
Patient global
Spinal pain
Function (BASFI)
Inflammation:
- defined as the average of the last 2 BASDAI questions concerning level and duration of morning stiffness