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Ankylosing Spondylitis — SCE Rheumatology MCQ

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ModerateSpondyloarthropathyAnkylosing SpondylitisSCE Rheumatology

A 35-year-old man with radiographic axial spondyloarthritis has sustained symptom control on a TNF inhibitor. At follow-up, the clinical team wishes to quantify disease activity using a validated composite index that combines patient-reported domains with C-reactive protein and classifies a score below 1.3 as inactive disease. Which measure should be used?

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Correct answer: A — Axial Spondyloarthritis Disease Activity Score (ASDAS)

ASDAS is the composite axSpA disease-activity measure that incorporates patient-reported domains and an acute-phase reactant, preferably CRP. ASDAS below 1.3 denotes inactive disease; 1.3 to below 2.1 denotes low disease activity. BASDAI is a validated, entirely patient-reported disease-activity index and does not incorporate CRP. BASFI measures physical function, BASMI assesses spinal mobility, and ASQoL measures disease-related quality of life. The BSR 2025 response pathway includes both ASDAS and BASDAI rather than stating that ASDAS has replaced BASDAI; therefore, the original wording claiming BSR preference or supersession was too strong.

Reference: Zhao SS et al. Evolution of the axial spondyloarthritis disease activity score and uptake in clinical practice. 2025. https://www.nice.org.uk/guidance/NG65/chapter/Recommendations