The identification of axial SpA in the primary-care setting and the introduction of questionnaires that could optimize the pattern of referral to secondary care is one of the most important objectives of the CAFASPA study.
ID
Source
Brief title
Condition
- Autoimmune disorders
- Joint disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
This study will reveal the prevalence of axial SpA among people with chronic
low back pain in primary care.
Secondary outcome
Questionnaires that differentiate between inflammatory and non-inflammatory
back pain in relation to the diagnosis of SpA will be compared with a view to
creating a simple referral model for SpA that can be applied in the
primary-care sector.
Background summary
*Chronic low back pain:
CAse-Finding Axial SPondyloArthropathy in general practice* (CAFASPA)
Recent years have seen a substantial improvement in the prognosis of patients
with axial spondyloarthropathy (SpA) due to the advent of new drugs and the
intensive use of existing drugs. It is important to ensure that the right
medication is instituted early in the disease process. The stumbling block as
far as early recognition is concerned is the absence of specific factors on
which to base the diagnosis. Furthermore, there is a seven-year delay before
abnormalities pathognomonic of sacroiliitis are visible on a conventional
x-ray. Predictive models have recently been developed for early recognition of
SpA, but these are based on patients who had already been referred to secondary
care and closer analysis shows that these patients had also already suffered
from inflammatory back pain for 7.7 years. Therefore, future research should
focus on early detection of SpA.
Study objective
The identification of axial SpA in the primary-care setting and the
introduction of questionnaires that could optimize the pattern of referral to
secondary care is one of the most important objectives of the CAFASPA study.
Study design
This is a cross-sectional trial which will be performed in close cooperation
with GPs.
Prior to inclusion in the study, potential subjects are screened successively
by a GP, research assistant and investigator. Patients who exhibit features of
chronic low back pain will be examined for the presence of axial Spa and, if
necessary, treated in accordance with the guidelines. For patients with chronic
low back pain, in addition to completing questionnaires, the trial consists of
blood testing, x-ray examination and magnetic resonance imaging (MRI) of
sacroiliac (SI) joints. General practice groups will be invited to take part in
the study. It is expected that around 400 patients will be recruited in this
period. This number is considered amply sufficient to answer the questions that
the trial seeks to address.
Study burden and risks
Patients will be fully informed about the aim of the study and also about the
circumstances of the individual examination, the amount of time required and
the potential risks. The burden for the patient consists of the time spent
(questionnaires, physical examination), the provision of 23 ml of blood and the
need to undergo an x-ray and MRI of the SI joints.
mathenesserlaan 264
3021 HR Rotterdam
NL
mathenesserlaan 264
3021 HR Rotterdam
NL
Listed location countries
Age
Inclusion criteria
aspecific low back pain
symptom duration more than 12 weeks
age 20-45
Exclusion criteria
impossible to communicate
low back pain due to trauma
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
CCMO | NL27759.003.09 |