Because the criteria are relatively new, the task of disseminating them will take some time and present challenges, Dr. Landewé notes. “Apparently, we still have to educate physicians seeing patients with low back pain or with other signs of spondyloarthritis in order to get those patients referred to where they belong—and that is to the rheumatologist.”
Educating colleagues, both in primary care and in rheumatology, is one of the future challenges. Dr. Rudwaleit thinks that ASAS will face challenges to define scientific projects that are attractive and interesting enough to the ASAS community to keep them “motivated and contributing. I think that the first 10 years were probably a little bit easier since we had many unfilled gaps,” he says. “Still, there are many unanswered questions such as that of the stimuli of bone formation in AS, the relationship of inflammation and bone formation, and the potential of modifying this process.”
Dr. Reveille believes there’s still plenty of work for ASAS and its methods in several other domains in AS. “Biomarkers, genetics, refinements in imaging—all of these elements will continue to develop, will need vetting, and will need to be incorporated into revisions of disease criteria,” Dr. Reveille asserts. “I also think we’re still struggling with some of the early disease definitions, not just in spondyloarthritis, and ASAS is extremely well suited to do that. They have, even at this point, no rivals.”
References
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