ASDAS Scoring — SCE Rheumatology MCQ

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ModerateSpondyloarthropathyASDAS ScoringSCE Rheumatology

A 32-year-old man with axial spondyloarthritis has an ASDAS-CRP score of 3.8. Using the current ASDAS disease activity-state classification adopted in UK specialist practice, which state does this represent?

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Correct answer: A — Very high disease activity

Explanation lettering: E = shown as A · D = shown as B · A = shown as D · B = shown as E

The correct answer is E, very high disease activity. The current ASDAS states are inactive disease at <1.3, low disease activity from 1.3 to <2.1, high disease activity from 2.1 to 3.5, and very high disease activity at >3.5. Therefore, an ASDAS-CRP of 3.8 is unequivocally in the very high category. Option C is incorrect because high disease activity extends only up to and including 3.5. “Moderate disease activity” is legacy terminology: in the 2018 nomenclature update it was renamed low disease activity without changing the established cut-offs. Options A and D require scores below 2.1.

Reference: Machado PM, Landewé R, Lie E, et al. Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activity states and improvement scores. Ann Rheum Dis. 2011;70:47–53. https://pubmed.ncbi.nlm.nih.gov/21068095/