Minimal disease activity in axial spondyloarthritis: The need of the hour and a proposal for development

Atul A. Deodhar, Anand Kumthekar, Maureen Dubreuil

Research output: Contribution to journalReview article

4 Scopus citations

Abstract

Purpose of review Axial spondyloarthritis (axSpA) is a chronic inflammatory condition with articular and extra-articular manifestations. Remission, a state of absence of clinical and imaging signs of disease activity over time, is the goal of management. This review addresses the concept of minimal disease activity (MDA) in axSpA, which is less stringent than remission, and is closer to patient and provider acceptable low disease state. Recent findings Existing axSpA treatments improve physical function and quality of life, and lead to remission in a minority of patients. A consistent MDA state decreases disease progression in rheumatoid arthritis and psoriatic arthritis. We argue a need to develop MDA in axSpA for clinical practice and clinical trials and propose methodology. Considering that MDA will be used in clinical practice, its elements must be easy to collect and cover both musculoskeletal and extra-articular domains. MDA will complement current disease activity measures in axSpA. Summary Defining an MDA target in axSpA would provide an outcome measure that is less stringent than remission, and will likely predict function and quality of life. We propose methods to develop MDA in axSpA and that further research be performed to determine if treating to an MDA target in axSpA improves patient outcomes.

Original languageEnglish (US)
Pages (from-to)293-297
Number of pages5
JournalCurrent opinion in rheumatology
Volume29
Issue number4
DOIs
StatePublished - Jul 1 2017
Externally publishedYes

Keywords

  • axial spondyloarthritis
  • minimal disease activity
  • outcome measure
  • remission

ASJC Scopus subject areas

  • Rheumatology

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