ToolsCalculators
Ankylosing Spondylitis Disease Activity Score with ESR (ASDAS-ESR)
Composite disease-activity index for axial spondyloarthritis using ESR.
Ankylosing Spondylitis Disease Activity Score with ESR (ASDAS-ESR)
Back pain, last week
0 = none, 10 = worst possible (BASDAI question 2).
/10
Duration of morning stiffness, last week
0 = none, 10 = worst possible (BASDAI question 6).
/10
Patient global assessment of disease activity, last week
0 = not active, 10 = very active.
/10
Peripheral pain/swelling, last week
0 = none, 10 = worst possible (BASDAI question 3).
/10
ESR (Westergren)
mm/hr
Complete the fields above to see the result.
When to use
- Quantifying disease activity in axial spondyloarthritis when CRP is unavailable but ESR is.
- Monitoring response to therapy alongside clinical assessment.
Formula
ASDAS-ESR = 0.08 x back pain + 0.07 x duration of morning stiffness + 0.11 x patient global assessment + 0.09 x peripheral pain/swelling + 0.29 x sqrt(ESR[mm/hr]). Each patient-reported item is scored 0-10 (NRS).
Pearls and pitfalls
- Cut-offs are identical to ASDAS-CRP: <1.3 inactive, 1.3 to <2.1 moderate, 2.1 to <3.5 high, >=3.5 very high disease activity.
- ASAS/EULAR recommend ASDAS-CRP over ASDAS-ESR when both acute-phase markers are available, as CRP was the version validated for treatment-response cut-offs.
References
- Lukas C, Landewé R, Sieper J, et al. Development of an ASAS-endorsed disease activity score (ASDAS) in patients with ankylosing spondylitis. Ann Rheum Dis. 2009;68(1):18-24.
- Machado P, Landewé R, Lie E, et al. Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activity states and improvement scores. Ann Rheum Dis. 2011;70(1):47-53.