How well are the ASAS/OMERACT core outcome sets for ankylosing spondylitis implemented in randomized clinical trials? A systematic literature review.

This study aims to investigate how well the Assessment of SpondyloArthritis international Society (ASAS)/Outcome Measures in Rheumatology Clinical Trials (OMERACT) core set and response criteria for ankylosing spondylitis (AS) have been implemented in randomized controlled trials (RCTs) testing pharmacological and non-pharmacological interventions. A systematic literature search was performed up to June 2013 looking for RCTs in patients with axial spondyloarthritis (SpA) (AS and non-radiographic axial SpA). The assessed domains and instruments belonging to the core sets for disease-controlling anti-rheumatic therapy (DC-ART) and symptom-modifying anti-rheumatic drugs (SMARDs) were extracted. Results were reported separately for those trials published until 2 years after the publication of the core set (1 April 2001; 'control trials') and those trials published at least 2 years after the publication date ('implementation trials'). One hundred twenty-three articles from 99 RCTs were included in the analysis, comparing 48 'control trials' and 51 'implementation trials'. Regarding DC-ART core set, the following domains were significantly more frequently assessed in the 'implementation group' in comparison to the 'control group': 'physical function' (100 vs 41.7 %; p = 0.001), 'peripheral joints/entheses' (100 vs 33.3 %; p = 0.001) and 'fatigue' (100 vs 0 %; p = 0.001). Three instruments were significantly more used in the 'implementation group': Bath Ankylosing Spondylitis Functional Index (BASFI) (100 vs 8.3 %; p = = 0.001), CRP (92.3 vs 58.3 %; p = 0.01) and Bath Ankylosing Spondylitis Metrology Index (BASMI) (53.8 vs 0 %; p = 0.001). Regarding SMARD core set domains, physical function (92 vs 23 %; p = 0.001) and fatigue (84 vs 17 %; p = 0.001), as well as the instruments BASFI (88 vs 14 %; p = 0.001) and BASMI (52 vs 0 %; p = 0.001), increased significantly in the 'implementation group'. Twenty per cent of trials from the 'implementation group' but none from the 'control group' included all domains of the core set. In conclusion, this study provides evidence for the implementation of the ASAS/OMERACT core set in RCTs of both DC-ART and SMARD. This applies to the use of the domains and, to a lesser extent, to the specific instruments

Aim

This study aims to investigate how well the Assessment of SpondyloArthritis international Society (ASAS)/Outcome Measures in Rheumatology Clinical Trials (OMERACT) core set and response criteria for ankylosing spondylitis (AS) have been implemented in randomized controlled trials (RCTs) testing pharmacological and non-pharmacological interventions.

Contributors

Bautista-Molano W, Navarro-Compán V, Landewé RBM, Boers M, et al

Publication

Journal: Clinical Rheumatology
Volume: 33
Issue: 9
Pages: 1313 - 1322
Year: 2014
DOI: 10.1007/s10067-014-2728-6

Further Study Information

Current Stage: Completed
Date:
Funding source(s): Wilson Bautista-Molano was supported by an ASAS Fellowship. Victoria Navarro-Compán was partially supported by a grant from the Fundación Española de Reumatología.


Health Area

Disease Category: Rheumatology

Disease Name: Ankylosing spondylitis (AS)

Target Population

Age Range: Unknown

Sex: Either

Nature of Intervention: Any

Stakeholders Involved

Study Type

- COS uptake study

Method(s)

- Systematic review

A systematic literature search was performed in PubMed, Medline and Embase electronic library databases to identify target studies using a comprehensive search strategy. The
search was updated last on 18 June 2013, without limitation of years of publication. Articles in English, French, German, Dutch, Portuguese or Spanish were selected for analysis. All of the descriptions and synonyms for AS and SpA were used in the search terms in
order to identify all relevant studies.

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