ReviewNature reviews. Rheumatology2012
Referral strategies for early diagnosis of axial spondyloarthritis.
Review in Nature reviews. Rheumatology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it, 124 citations in OpenAlex.
- Efficacy and Safety of Tumor Necrosis Factor Inhibitors, Interleukin-17 Inhibitors, and Janus Kinase Inhibitors in Patients with Non-Radiographic Axial Spondyloarthritis: A Systematic Review and Network Meta-Analysis.International archives of allergy and immunology · 2025Pooled it
- HLA B27 antigen in Middle Eastern and Arab countries: systematic review of the strength of association with axial spondyloarthritis and methodological gaps.BMC musculoskeletal disorders · 2017Pooled it
- Improvement of Functioning and Health With Ixekizumab in the Treatment of Active Nonradiographic Axial Spondyloarthritis in a 52-Week, Randomized, Controlled Trial.Arthritis care & research · 2022Trial
- Is Treatment in Patients With Suspected Nonradiographic Axial Spondyloarthritis Effective? Six-Month Results of a Placebo-Controlled Trial.Arthritis & rheumatology (Hoboken, N.J.) · 2021Trial
- A Fifty-Two-Week, Randomized, Placebo-Controlled Trial of Certolizumab Pegol in Nonradiographic Axial Spondyloarthritis.Arthritis & rheumatology (Hoboken, N.J.) · 2019Trial
- Efficacy of certolizumab pegol on signs and symptoms of axial spondyloarthritis including ankylosing spondylitis: 24-week results of a double-blind randomised placebo-controlled Phase 3 study.Annals of the rheumatic diseases · 2014Trial
- Performance of referral strategies for patients with suspected axial spondyloarthritis: a systematic review with meta-analysis.EClinicalMedicine · 2026Article
- HLA-B27 Testing in Clinical Practice: A Retrospective Analysis of Testing Indications and Rheumatology Referral Patterns.The Journal of rheumatology · 2025Article
- Prevalence of axial spondyloarthritis (axSpA) in patients treated for chronic back pain in chiropractic clinics: the oregon chiropractic axial spondyloarthritis study (ORCAS).Clinical rheumatology · 2025Observational
- Article
- Long-Term Follow-Up of Patients with Axial Spondyloarthritis in Real-Life Setting: Results from Greece of the Multi-Country Registry Proof Study.Mediterranean journal of rheumatology · 2024Article
- Regional Differences in Diagnosis Journey and Healthcare Utilization: Results from the International Map of Axial Spondyloarthritis (IMAS).Rheumatology and therapy · 2024Article
- [The role of HLA-B27 in the pathogenesis and diagnosis of axial spondyloarthritis : 50 years after discovery of the strong genetic association].Zeitschrift fur Rheumatologie · 2024Review
- The Role of Early Treatment in the Management of Axial Spondyloarthritis: Challenges and Opportunities.Rheumatology and therapy · 2024Review
- Progressive improvement in time to diagnosis in axial spondyloarthritis through an integrated referral and education system.Rheumatology advances in practice · 2024Article
- The Development and Validation of an AI Diagnostic Model for Sacroiliitis: A Deep-Learning Approach.Diagnostics (Basel, Switzerland) · 2023Article
- Early identification of axial spondyloarthritis in a multi-ethnic Asian population.Clinical rheumatology · 2022Article
- Expert recommendations on early diagnosis and referral of axial spondyloarthritis in the Kingdom of Saudi Arabia.Clinical rheumatology · 2022Review
- Emerging story of gut dysbiosis in spondyloarthropathy: From gastrointestinal inflammation to spondyloarthritis.Frontiers in cellular and infection microbiology · 2022Review
- Patient perspectives on health care provider practices leading to an axial spondyloarthritis diagnosis: an exploratory qualitative research study.BMC family practice · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The spectrum of HLA-B27-associated inflammatory spine diseases is referred to as axial spondyloarthritis (axSpA). AxSpA encompasses established ankylosing spondylitis (AS) but also nonradiographic axSpA, and can be classified according to the Assessment of SpondyloArthritis international Society classification criteria for axSpA. Specific and effective therapy for axSpA includes education, physiotherapy, NSAIDs and biologic agents, as appropriate. Patients with axSpA, however, are often diagnosed late in the course of the disease. As specific therapy is available, the effective identification of those individuals who are likely to have axSpA among patients with chronic back pain in primary care and their subsequent referral to a rheumatologist for establishing a correct diagnosis is worth pursuing. Candidate referral parameters that can easily be applied to patients with chronic back pain and age at onset ≤ 45 years (the target population) include inflammatory back pain (IBP) and positivity for HLA-B27. Following diagnostic work-up by a rheumatologist, these referral parameters, either alone or in combination, have led to the diagnosis of as many as 33-45% of patients within this target population with axSpA, 41-62% of whom had undiagnosed AS. Thus, educating primary care physicians on the value of IBP and HLA-B27 testing within this target population, and referral to a rheumatologist if one of these parameters is positive, is a promising approach to reduce the long delay in diagnosing patients with axSpA.
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