{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T03:33:49Z","timestamp":1789875229394,"version":"4.0.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"UCB Biopharma SRL","award":["UCB Biopharma SRL"],"award-info":[{"award-number":["UCB Biopharma SRL"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Rheumatol Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To investigate which Axial Spondyloarthritis Disease Activity Score (ASDAS) cut-off corresponds best with treatment intensification (TI) in daily practice in patients with axial spondyloarthritis (axSpA). Patients from the prospective SpA-Net registry with axSpA and \u2265\u20091 ASDAS measurement in 2016\u20132022 were included. TI was defined as (1) increasing dose\/frequency of current drug, (2) switching drug(s) or (3) adding drug(s); all due to inefficacy of current treatment and only considering anti-inflammatory drugs. Patients could contribute multiple observations. Receiver operating characteristic analyses assessed the ability of ASDAS to discriminate between TI\/non-TI (Area Under the Curve [AUC]), and identify the ASDAS cut-off that discriminated best. In a random subsample, the rationale for treatment decisions was retrospectively analyzed using patient records. In total, 350 patients with 2,191 ASDAS measurements (243 TI events, 11.1%) were included. Median follow-up was 2.8 years. At inclusion, mean age was 48.2 (SD 14.3) years, 152 (43.4%) were female, and mean ASDAS was 2.4 (SD 1.0). The mean ASDAS was 3.0 (SD 1.0) at TI versus 2.3 (SD 1.0) at non-TI timepoints. TI occurred infrequently at ASDAS\u2009\u2265\u20092.1 observations (203\/1,266 [16.0%]). Using all observations, the AUC was 0.71 (95%CI 0.68\u20130.74) with an optimal ASDAS cut-off of 2.7 (sensitivity 69%, specificity 66%). When stratifying by drug exposure or extra-musculoskeletal manifestations, results were similar (ASDAS cut-off 2.6\u20133.2). The patient record analysis supported the findings. In daily practice, TI is associated with a higher ASDAS cut-off than the recommended one (\u2265\u20092.1). Rheumatologists consider factors beyond disease activity when making treatment decisions.<\/jats:p>","DOI":"10.1007\/s00296-025-06011-1","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T04:54:40Z","timestamp":1761195280000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Which ASDAS cut-off corresponds best to treatment intensification in patients with axial spondyloarthritis in daily practice? A prospective study from a clinical registry"],"prefix":"10.1007","volume":"45","author":[{"given":"Rabab","family":"Nezam El-Din","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8477-0683","authenticated-orcid":false,"given":"Astrid","family":"van Tubergen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3792-7718","authenticated-orcid":false,"given":"Harald E.","family":"Vonkeman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3011-8547","authenticated-orcid":false,"given":"Casper","family":"Webers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"issue":"1","key":"6011_CR1","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1136\/ard-2022-223296","volume":"82","author":"S Ramiro","year":"2023","unstructured":"Ramiro S, Nikiphorou E, Sepriano A, Ortolan A, Webers C, Baraliakos X, Landewe RBM, Van den Bosch FE, Boteva B, Bremander A, Carron P, Ciurea A, van Gaalen FA, Geher P, Gensler L, Hermann J, de Hooge M, Husakova M, Kiltz U, Lopez-Medina C, Machado PM, Marzo-Ortega H, Molto A, Navarro-Compan V, Nissen MJ, Pimentel-Santos FM, Poddubnyy D, Proft F, Rudwaleit M, Telkman M, Zhao SS, Ziade N, van der Heijde D (2023) ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update. 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AvT received unrestricted research grants from Novartis and UCB, received consulting fees from Novartis, Johnson and Johnson and UCB, and received speakers fees from Pfizer and Novartis. HEV received unrestricted grants from Galapagos and Boehringer Ingelheim and speakers fees from AbbVie, Novartis, Pfizer, UCB, Janssen and Lilly, and is a board member of the Dutch Arthritis Society. CW received honorarium from Novartis.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study adhered to the ethical guidelines of the Declaration of Helsinki. The ethics committee of the University Hospital Maastricht\/Maastricht University determined that observational studies involving SpA-Net were not subject to the Medical Research Involving Human Subjects Act as data were collected in routine care, and official approval was not required for this study (METC azM\/UM 15-4-266, date February 23, 2016). All participants provided informed consent for their data to be used for research purposes.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"This work has previously been presented as a poster presentation at the ACR Convergence 2023 congress (San Diego, United States), as an oral presentation at the EULAR 2024 European Congress of Rheumatology (Vienna, Austria) and as a poster presentation at the 14th International Congress on Spondyloarthritides (Ghent, Belgium). Abstracts have been published in Arthritis & Rheumatology (\n                      \n                      , abstract number: 0517), Annals of the Rheumatic Diseases (https:\/\/\n                      \n                      , abstract number: OP0060), and Clinical and Experimental Rheumatology (\n                      \n                      , abstract number: P106).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Note on related Congress abstracts and publications"}}],"article-number":"256"}}