Evaluation of performance of BASDAI (Bath Ankylosing Spondylitis Disease
          Activity Index) in a Brazilian cohort of 1492 patients with spondyloarthritis: data from
          the Brazilian Registry of Spondyloarthritides (RBE)

Costa, Izaias Pereira da; Bortoluzzo, Adriana B.; Gonçalves, Célio R.; Silva, José Antonio Braga da; Ximenes, Antonio Carlos; Bértolo, Manoel B.; Ribeiro, Sandra L.E.; Keiserman, Mauro; Menin, Rita; Skare, Thelma L.; Carneiro, Sueli; Azevedo, Valderílio F.; Vieira, Walber P.; Albuquerque, Elisa N.; Bianchi, Washington A.; Bonfiglioli, Rubens; Campanholo, Cristiano; Carvalho, Hellen M.S.; Duarte, Angela L.B. Pinto; Kohem, Charles L.; Leite, Nocy H.; Lima, Sonia A.L.; Meirelles, Eduardo S.; Pereira, Ivânio A.; Pinheiro, Marcelo M.; Polito, Elizandra; Resende, Gustavo G.; Rocha, Francisco Airton C.; Santiago, Mittermayer B.; Sauma, Maria de Fátima L.C.; Valim, Valéria; Sampaio-Barros, Percival D.

doi:10.1016/j.rbr.2014.05.005

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Original articles • Rev. Bras. Reumatol. 55 (1) • Jan-Feb 2015 • https://doi.org/10.1016/j.rbr.2014.05.005 copy

Evaluation of performance of BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) in a Brazilian cohort of 1492 patients with spondyloarthritis: data from the Brazilian Registry of Spondyloarthritides (RBE)

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

To analyze the results of the application of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in a large series of Brazilian patients with the diagnosis of SpA and establish its correlations with specific variables into the group.

Methods

A common protocol of investigation was prospectively applied to 1492 Brazilian patients classified as SpA according to the European Spondyoarthropathies Study Group (ESSG), attended at 29 referral centers of Rheumatology in Brazil. Clinical and demographic variables, and disease indices (BASDAI, Basfi, Basri, Mases, ASQol) were applied. The total values of BASDAI were compared to the presence of the different variables.

Results

The mean score of BASDAI was 4.20 ± 2.38. The mean scores of BASDAI were higher in patients with the combined (axial + peripheral + entheseal) (4.54 ± 2.38) clinical presentation, compared to the pure axial (3.78 ± 2.27) or pure peripheral (4.00 ± 2.38) clinical presentations (P < 0.001). BASDAI also presented higher scores associated with the female gender (P < 0.001) and patients who did not practice exercises (P < 0.001). Regarding the axial component, higher values of BASDAI were significantly associated with inflammatory low back pain (P < 0.049), alternating buttock pain (P < 0.001), cervical pain (P < 0.001) and hip involvement (P < 0.001). There was also statistical association between BASDAI scores and the peripheral involvement, related to the lower (P = 0.004) and upper limbs (P = 0.025). The presence of enthesitis was also associated to higher scores of BASDAI (P = 0.040). Positive HLA-B27 and the presence of cutaneous psoriasis, inflammatory bowel disease, uveitis and urethritis were not correlated with the mean scores of BASDAI. Lower scores of BASDAI were associated with the use of biologic agents (P < 0.001).

Conclusion

In this heterogeneous Brazilian series of SpA patients, BASDAI was able to demonstrate “disease activity” in patients with axial as well as peripheral disease.

Spondyloarthritis; Disease activity; BASDAI; Epidemiology

BASDAI	Mean	Standard deviation
Total	4.20	2.38
Question 1	4.21	2.99
Question 2	5.05	3.20
Question 3	3.28	3.18
Question 4	4.28	3.34
Question 5	4.59	3.29
Question 6	3.85	3.36

	%	Mean	SD	P
Primary AS	67.6	4.21	2.36
Psoriatic AS	4.6	4.38	2.32
Enteropathic AS	2.6	4.70	2.41
Psoriatic Arthritis	14.2	4.13	2.47	0.305
USpA	6.8	4.35	2.28
Reactive Arthritis	3.4	4.12	2.57
Enteropathic Arthritis	0.8	4.37	3.05

	%	Mean	SD	P
Mixed	48.5	4.50	2.38
Axial	34.5	3.78	2.28	< 0.001
Peripheral	11.0	3.87	2.23
Enthesitic	6.0	4.96	2.22

	%	Mean	SD	P
Gender
Male	72.3	3.97	2.95	< 0.001
Female	27.7	4.84	3.05
Race
White	67.4	4.03	2.38	0.057
Non-white	32.6	4.30	2.40
Exercise
Yes	40.8	3.89	2.35	< 0.001
No	59.2	4.42	2.38
Family history
Yes	18.0	4.32	2.49	0.413
No	82.0	4.18	2.36
HLA-B27
Positive	69.0	4.16	2.33	0.391
Negative	31.0	4.33		2.50

	%	Mean	SD	P
Inflammatory low back pain				0.049
Yes	67.6	4.29	2.31
No	32.4	4.02	2.53
Buttock pain				< 0.001
Yes	33.1	4.59	2.39
No	66.9	4.01	2.36
Neck pain				< 0.001
Yes	30.8	4.64	2.32
No	69.2	4.01	2.39
Hip pain				< 0.001
Yes	25.1	4.63	2.35
No	74.9	4.06	2.38
Arthritis, lower limb				0.004
Yes	48.9	4.38	2.35
No	51.1	4.03	2.30
Arthritis, upper limb
Yes	22.1	4.46	2.40	0.025
No	77.9	4.13		2.37
Enthesitis				0.040
Yes	27.1	4.41	2.41
No	72.9	4.13	2.37
Dactylitis				0.423
Yes	9.1	4.04	2.48
No	90.9	4.22	2.37
Uveitis				0.926
Yes	19.1	4.22	2.53
No	80.9	4.20	2.35
Skin psoriasis				0.849
Yes	17.8	4.23	2.42
No	82.2	4.20	2.38
Inflammatory bowel disease				0.106
Yes	4.7	4.67	2.46
No	95.3	4.18	2.38
Urethritis
Yes	4.4	4.51	2.57	0.326
No	95.6	4.19	2.37

	%	Mean	SD	P
NSAID				0.888
Yes	67.6	4.21	2.35
No	32.4	4.19	2.45
NSAID on-demand				0.713
Yes	24.9	4.16	2.40
No	75.1	4.22	2.38
Corticosteroid				0.297
Yes	35.3	4.29	2.37
No	64.7	4.16	2.39
Methotrexate				0.866
Yes	51.7	4.21	2.32
No	48.3	4.19	2.45
Sulfasalazine				0.934
Yes	44.7	4.21	2.44
No	55.3	4.19	2.34
Biologicals				< 0.001
Yes	20.4	3.73	2.47
No	79.6	4.32	2.35
Infliximab				< 0.001
Yes	15.3	3.58	2.50
No	84.7	4.32	2.35
Etanercept				0.104
Yes	2.8	4.78	2.30
No	97.2	4.19	2.38
Adalimumab
Yes	2.3	3.70	2.06	0.164
No	97.7	4.22	2.39

Sociedade Brasileira de Reumatologia Av Brigadeiro Luiz Antonio, 2466 - Cj 93., 01402-000 São Paulo - SP, Tel./Fax: 55 11 3289 7165 - São Paulo - SP - Brazil
E-mail: sbre@terra.com.br

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