Screening Process Leads to Faster Identification of Axial Spondyloarthritis

A stratified screening process led to a more rapid identification of axial spondyloarthritis (axSpA) in adults with low back pain, according to results from a study published online ahead of print in Arthritis Care & Research.

The study involved 405 patients from primary care low back pain clinics who received a primary standardized clinical screening, reported researchers from the University of Toronto and University Health Network in Toronto. Patients with low back pain lasting more than 3 months and who were younger than 50 years were referred for a more comprehensive second screening with a physical therapist with advanced training in rheumatology.

During the second screening, the physical therapist gauged axSpA risk in patients with inflammatory features. Researchers measured the precision and accuracy of the screening against a rheumatologist with axSpA expertise.

“AxSpA risk assignment by rheumatologist was: 64.9% (none or low-risk axSpA) and 35.1% (medium- or high-risk axSpA),” researchers reported. “The best combination of sensitivity (68%), specificity (90%), positive (80%), and negative (84%) predictive values was evident with the secondary screen.”

The median wait time from the initial primary screening to the secondary screening was 15 days.

According to the study, 15.6% of patients were diagnosed with axSpA, and the median time from onset of low back pain to diagnosis was 2 years for patients with nonradiographic axSpA and 7 years for patients with ankylosing spondylitis.

Reference:
Passalent L, Sundararajan K, Perruccio AV, et al. Bridging the gap between symptom onset and diagnosis in axial spondyloarthritis [published online ahead of print, 2021 Jul 15]. Arthritis Care Res (Hoboken). 2021;10.1002/acr.24751. doi:10.1002/acr.24751