Additionally, authors made suggestions regarding pertinent publications for potential inclusion in the review. In brief, a literature search was conducted in PubMed, using the key search terms AS, structural progression and associated terms intended to identify publications relating to radiographic outcome measures, such as the mSASSS, that are used to assesses the impact of treatment on radiographic structural progression in patients with AS. The aim of this scoping review is to describe the validity of the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) as a primary outcome measure in evaluating the efficacy of treatments for AS in terms of structural damage progression a systematic review was not conducted. Thus, drugs that are effective in both treating spinal inflammation and protecting against radiographic progression may have a beneficial impact on long-term physical function. Structural damage can cause permanent limitation in spinal mobility and physical function. Disability (limitation of physical function and spinal mobility) related to disease activity or inflammation may be reversible, and controlling inflammation or disease activity may not only have direct effects on patient-reported outcomes but also prevent further progression of structural damage. Spinal ossification may lead to reduced physical function and quality of life. The hallmark clinical manifestations of AS include inflammatory back pain and stiffness, with syndesmophytes and spinal ankylosis being the most characteristic features. The mSASSS is the most validated and widely used measure for assessing AS radiographic progression.ĪS is a chronic inflammatory disease that typically affects the axial skeleton and the entheses. Scoring systems that reliably assess radiographic structural damage in AS are needed to assess drugs’ effects. In AS, structural damage occurring because of syndesmophyte formation and ankylosis is irreversible. This review of the medical literature confirmed that the mSASSS is the most validated and widely used method for assessing radiographic progression in AS, correlating with worsening measures of disease signs and symptoms, spinal mobility and physical function, with a 2-year interval being required to ensure sufficient sensitivity to change. The mSASSS has not been used, to date, as a primary outcome measure in a prospective randomized controlled clinical trial of biologic therapy in AS. The validity of the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) as a primary outcome measure in evaluating the effect of AS treatments on radiographic progression rates was assessed in this review. Structural damage is currently assessed by conventional radiography and scoring systems that reliably assess radiographic structural damage are needed to capture the differential effects of drugs on structural damage progression. In ankylosing spondylitis (AS), structural damage that occurs as a result of syndesmophyte formation and ankylosis of the vertebral column is irreversible.
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