Discrepancies in the assessment of axial spondyloarthritis between patients and rheumatologists: what does this mean?

By
Daniel Wendling
Olivier Fakih
Frank Verhoeven
Clément Prati
May 23, 2026

Clinical Rheumatology

Overview

This report highlights significant discrepancies in disease activity assessments between patients with axial spondyloarthritis (axSpA) and rheumatologists.

Background

Axial spondyloarthritis is a chronic inflammatory disease that significantly affects patients' quality of life. Accurate assessment of disease activity is crucial for effective treatment and management.

Data Highlights

Study	Population	VAS Difference	Significance
Michelsen et al.	9013 axSpA patients	20 (women), 15 (men)	Significant
Godfrin-Valnet et al.	200 patients	37 (patients) vs. 29 (rheumatologists)	p < 0.0001
Wang et al.	298 axSpA patients	Higher discordance with pain scores	Not specified
DANBIO registry	594 axSpA patients	48% discordance	Not specified
DESIR cohort	708 patients	25.5–28.8% discordance over 3 years	Not specified

Key Findings

Discrepancies in VAS scores between patients and rheumatologists can be significant, with differences of up to 20 mm.
Patients often report higher disease activity than rheumatologists.
Factors such as gender, education level, and ongoing biological treatment influence the assessment discordance.
High patient-reported activity scores correlate with markers of depression.
Discordance in assessments is consistently observed across various studies and patient cohorts.

Clinical Implications

Healthcare providers should be aware of the potential discrepancies in disease activity assessments between patients and rheumatologists. Incorporating patient-reported outcomes into clinical evaluations may enhance treatment strategies and improve patient outcomes.

Conclusion

Understanding the variations in disease assessment between patients and rheumatologists is essential for optimizing management of axial spondyloarthritis.