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Christian Schwedler, Thomas Häupl, Ulrich Kalus, Véronique Blanchard, Gerd-Rüdiger Burmester, Denis Poddubnyy, Berthold Hoppe
BACKGROUND: Galactosylation of immunoglobulin G (IgG) is reduced in rheumatoid arthritis (RA) and assumed to correlate with inflammation and altered humoral immunity. IgG hypogalactosylation also increases with age. To investigate dependencies in more detail, we compared IgG hypogalactosylation between patients with RA, patients with axial spondyloarthritis (axSpA), and healthy control subjects (HC), and we studied it in RA on the background of HLA-DRB1 shared epitope (SE), anticitrullinated protein antibodies (ACPA), and/or rheumatoid factor (RF) status...
March 14, 2018: Arthritis Research & Therapy
Sovira Tan, Michael M Ward
PURPOSE OF REVIEW: Computed tomography (CT) is increasingly being used in ankylosing spondylitis (AS) for imaging the spine and sacroiliac joint (SIJ). We review new insights to diagnosis and evaluation revealed by the use of CT. RECENT FINDINGS: Studies using low-dose CT in AS to detect syndesmophytes can image the entire spine, but semiquantitative scoring of the scans by human readers decreases the reliability and validity of this method. The thoracic spine is the segment most involved with syndesmophytes...
March 13, 2018: Current Opinion in Rheumatology
Rene Y Choi, Mark Asquith, James T Rosenbaum
PURPOSE OF REVIEW: The intestinal microbiome is thought to play a role in the pathogenesis of inflammatory bowel disease (IBD). There are many shared clinical manifestations between IBD and spondyloarthritis (SpA), of which the most common are peripheral arthritis and uveitis. Clinical overlap along with similar genetics between these diseases suggests a possible shared pathogenetic mechanism, which might center on the intestinal microbiota. In this review, we discuss the available evidence that SpA is a microbiome-driven disease and indicate how SpA-associated uveitis could be tied to gut dysbiosis...
March 13, 2018: Current Opinion in Rheumatology
Kwi Young Kang, In Je Kim, Sung-Hwan Park, Yeon Sik Hong
Objectives: To compare trabecular bone scores (TBS) between axial SpA (axSpA) patients with and without vertebral fractures and investigate associations between TBS and vertebral fractures. Methods: Two hundred and fifty-five patients fulfilling the imaging arm of the Assessment of SpondyloArthritis International Society axSpA criteria were enrolled. TBS and BMD were assessed using dual-energy X-ray absorptiometry. Vertebral fracture of the thoracic and lumbar spine was defined according to the Genant criteria...
March 9, 2018: Rheumatology
Filip Van den Bosch, Philip J Mease, Joachim Sieper, Dominique L Baeten, Yinglin Xia, Su Chen, Aileen L Pangan, In-Ho Song
Objectives: Describe efficacy and safety of 3 years of adalimumab treatment in patients with peripheral spondyloarthritis (pSpA) and identify predictors of remission. Methods: Patients with pSpA were randomised to adalimumab 40 mg every other week or placebo for 12 weeks; a 144-week open-label extension followed (NCT01064856). Remission was assessed by the Peripheral SpA Response Criteria (PSpARC) and Ankylosing Spondylitis Disease Activity Score inactive disease (ASDAS ID)...
2018: RMD Open
Mark P Sykes, Louise Hamilton, Colin Jones, Karl Gaffney
Objective: Acute anterior uveitis (AAU) is the most common extra-articular manifestation of axial spondyloarthritis (axSpA). In this study, patients presenting with AAU were evaluated clinically and with MRI in order to estimate the prevalence of axSpA. Methods: Consecutive patients presenting to a university teaching hospital between February 2014 and March 2015 with AAU were invited to participate. Those with a history of chronic back pain (CBP) beginning <45 years were evaluated clinically and with MRI of thoracolumbar spine and sacroiliac joints...
2018: RMD Open
Reyhan Kose, Taskin Senturk, Gokhan Sargin, Songul Cildag, Yasemin Kara
Pustulotic arthro-osteitis (PAO) is a rare chronic inflammatory disease, which has now been classified as a seronegative spondyloarthritis. The sternoclavicular and sternocostal joints, pelvis, vertebra, hip, and long bones are affected. Skin findings of the disease are accepted as a variant of pustular psoriasis, but some authors have suggested that palmoplantar pustulosis (PPP) is a different entity. The synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome should be considered in the differential diagnosis...
February 2018: Eurasian Journal of Medicine
Mohammad H Derakhshan, Himanshu Pathak, Debbie Cook, Sally Dickinson, Stefan Siebert, Karl Gaffney
Objectives: There have been significant advances in axial spondyloarthritis (axSpA), with implications for service delivery. We evaluated the state of axSpA rheumatology services and how people with axSpA perceive their care. Methods: An online patient survey was emailed to all members of the National Ankylosing Spondylitis Society and advertised widely via social media. Separately, a Web-based questionnaire about axSpA services was sent to rheumatologists at all 172 acute hospital trusts in the UK...
February 23, 2018: Rheumatology
Imke Redeker, Falk Hoffmann, Johanna Callhoff, Hildrun Haibel, Joachim Sieper, Angela Zink, Denis Poddubnyy
OBJECTIVES: The aim of this study was to assess the psychological well-being and to analyse factors associated with depressive symptoms in axial spondyloarthritis (axSpA). METHODS: A stratified random sample of subjects with a diagnosis of axSpA (International Classification of Diseases, Tenth Revision, German Modification M45) was drawn from health insurance data in Germany. These persons received a postal questionnaire on disease-related, psychological and lifestyle factors as well as socioeconomic status...
March 10, 2018: Annals of the Rheumatic Diseases
X J Ji, K Sun, Z Y Hu, Y Zhang, Y P Ma, Z Sun, K P Li, J Zhu, J L Zhang, F Huang
Objective: The aim of this study was to set up a large, longitudinal and prospective database to compare the clinical manifestations in human leucocyte antigen (HLA)-B(27) positive and negative patients with ankylosing spondylitis(AS) based on real-world evidence in Chinese population. Methods: A total of 897 outpatients with confirmed AS were recruited consecutively by smart management system for spondyloarthritis (SMSP) from April 13, 2016 to June 6, 2017 in Chinese PLA General Hospital from 30 provinces and autonomous regions...
March 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Praveena Chiowchanwisawakit, Wanruchada Katchamart, Manathip Osiri, Pongthorn Narongroeknawin, Parawee Chevaisrakul, Tasanee Kitumnuaypong, Boonjing Siripaitoon, Worawit Louthrenoo
OBJECTIVE: This study aimed to evaluate the long-term effectiveness and safety of the first anti-tumor necrosis factor α therapy (TNFi) and to identify the associated factors of drug discontinuation in patients with spondyloarthritis. METHODS: This was a retrospective cohort study. Patients with spondyloarthritis who were prescribed the first TNFi between December 2009 and October 2014 in the Rheumatic Disease Prior Authorization registry were enrolled. Baseline clinical data were retrieved...
March 7, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Fernando Rizzello, Ignazio Olivieri, Alessandro Armuzzi, Fabio Ayala, Vincenzo Bettoli, Luca Bianchi, Luca Cimino, Antonio Costanzo, Antonio Cristaudo, Salvatore D'Angelo, Marco Daperno, Anna Chiara Fostini, Mauro Galeazzi, Michele Gilio, Paolo Gionchetti, Paolo Gisondi, Ennio Lubrano, Antonio Marchesoni, Annamaria Offidani, Ambrogio Orlando, Daniela Pugliese, Carlo Salvarani, Raffaele Scarpa, Maurizio Vecchi, Giampiero Girolomoni
INTRODUCTION: Immune-mediated inflammatory diseases (IMIDs) are chronic autoimmune conditions that share common pathophysiologic mechanisms. The optimal management of patients with IMIDs remains challenging because the coexistence of different conditions requires the intervention of several specialists. The aim of this study was to develop a series of statements defining overarching principles that guide the implementation of a multidisciplinary approach for the management of spondyloarthritis (SpA)-related IMIDs including SpA, psoriasis, psoriatic arthritis, Crohn's disease, ulcerative colitis and uveitis...
March 7, 2018: Advances in Therapy
Gergely Bodis, Victoria Toth, Andreas Schwarting
Since the discovery of HLA 60 years ago, it has contributed to the understanding of the immune system as well as of the pathogenesis of several diseases. Aside from its essential role in determining donor-recipient immune compatibility in organ transplantation, HLA genotyping is meanwhile performed routinely as part of the diagnostic work-up of certain autoimmune diseases. Considering the ability of HLA to influence thymic selection as well as peripheral anergy of T cells, its role in the pathogenesis of autoimmunity is understandable...
March 7, 2018: Rheumatology and Therapy
Janneke de Winter, Manouk de Hooge, Marleen van de Sande, Henriëtte de Jong, Lonneke van Hoeven, Anoek de Koning, Inger Jorid Berg, Roberta Ramonda, Dominique Baeten, Désirée van der Heijde, Angelique Weel, Robert Landewé
OBJECTIVE: To compare MRI of the sacroiliac joints (MRI-SI) of healthy, symptomless individuals and those with known mechanical strain acting upon SI joints to axial spondyloarthritis (axSpA) and chronic back pain (CBP) patients. METHODS: Three trained, calibrated and blinded readers randomly scored MRI-SI of 172 subjects: 47 healthy individuals without current/past back pain; 47 axSpA patients from the SPondyloArthritis Caught Early (SPACE) cohort (with a previously confirmed positive MRI-SI); 47 CBP controls (irrespective of MRI-SI results) from the SPACE cohort; 7 women with postpartum back pain; and 24 frequent runners...
March 7, 2018: Arthritis & Rheumatology
Sayam Dubash, Dennis McGonagle, Helena Marzo-Ortega
Axial spondyloarthritis (axSpA) is a chronic inflammatory condition that encompasses ankylosing spondylitis (AS) as well as non-radiographic axial disease (nr-axSpA) and can lead to chronic pain, structural damage and disability. The introduction of tumour necrosis factor inhibitor (TNFi) drugs for AS heralded a new era of drug therapeutics for what was previously a largely untreatable disease. This has now been expanded with the licensing of secukinumab, an interleukin 17A (IL-17A) inhibitor for the treatment of AS...
March 2018: Therapeutic Advances in Chronic Disease
João Eurico Fonseca, José António Pereira da Silva, Miguel Bernardes, Rui Cernadas, José Canas da Silva, Lúcia Costa, Taciana Videira, Luís C Miranda, Anabela Barcelos, Pedro A Laires, Raquel Dezerto, Marília D Pereira, Filomena Vidal, Esmeralda Cunha, Ana Morais, Carla Martins, Rui Mesquita
OBJECTIVES: Early diagnosis and treatment of Rheumatoid Arthritis (RA) and axial Spondylarthritis (axial SpA) can limit the impact of disease outcomes. This study evaluated the effectiveness of a referral program on the identification of patients with RA and axial SpA. METHODS: This was an observational, prospective, randomized (by clusters) study conducted in Portugal to evaluate the impact of the implementation of a set of referral support actions (RSA). The study was divided in two sub-studies, the RA sub-study and the axial SpA sub-study...
March 5, 2018: Acta Reumatológica Portuguesa
Salvatore D'Angelo, Antonio Carriero, Michele Gilio, Francesco Ursini, Pietro Leccese, Carlo Palazzi
Spondyloarthritis (SpA) are chronic inflammatory diseases with overlapping pathogenic mechanisms and clinical features. Treatment armamentarium against SpA includes non-steroidal anti-inflammatory drugs, glucocorticoids, conventional disease-modifying antirheumatic drugs (DMARDs, including sulfasalazine, methotrexate, leflunomide, cyclosporine), targeted synthetic DMARDs (apremilast) and biological DMARDs (TNF inhibitors, anti-IL 12/23 and anti-IL-17 agents). Areas covered: A narrative review of published literature on safety profile of available SpA treatment options was performed...
March 5, 2018: Expert Opinion on Drug Safety
Janneke J de Winter, Marleen G van de Sande, Niklas Baerlecken, Inger Berg, Roberta Ramonda, Désirée van der Heijde, Floris A van Gaalen, Torsten Witte, Dominique L Baeten
BACKGROUND: Anti-CD74 IgG antibodies are reported to be elevated in patients with axial spondyloarthritis (axSpA). This study assessed the diagnostic value of anti-CD74 antibodies in patients with early axSpA. METHODS: Anti-CD74 IgG and IgA antibodies were first measured in an exploratory cohort of patients with radiographic axSpA (138 patients with ankylosing spondyloarthritis (AS)) and 57 healthy controls and then were measured in patients with early axSpA (n = 274) and with non-SpA chronic back pain (CBP) (n = 319), participating in the spondyloarthritis caught early (SPACE) prospective cohort study of patients under 45 years old with early back pain (for ≥ 3 months, but ≤ 2 years)...
March 1, 2018: Arthritis Research & Therapy
Cédric Lukas, Catherine Cyteval, Maxime Dougados, Ulrich Weber
Recognition of axial spondyloarthritis (SpA) remains challenging, as no unique reference standard is available to ascertain diagnosis. Imaging procedures have been used for long in the field, in particular pelvic radiography, to capture structural changes evocative of sacroiliitis, the key feature in SpA. The introduction of MRI of the sacroiliac joints (SIJs) has led to a major shift in recognition of the disorder. MRI has been shown to detect the initial inflammatory processes, in particular osteitis depicted by bone marrow oedema, even in patients having not yet developed structural lesions...
2018: RMD Open
Romain Freund, Benjamin Granger, Cécile Francois, Guislaine Carcelain, Philippe Ravaud, Xavier Mariette, Bruno Fautrel
Several tests have been proposed to detect latent tuberculosis (LTB). OBJECTIVE: To evaluate the cost-effectiveness of different interferon-gamma release assays based strategies used to screen LTB before tumour necrosis factor (TNF) blockers initiation. METHODS: Consecutive patients with rheumatoid arthritis, spondyloarthritis or Crohn's disease for whom TNF-blockers were considered, were recruited in 15 tertiary care centres. All were screened for LTB with tuberculin skin test (TST), QuantiFERON TB Gold® in tube (QFT) and T-SPOT...
February 22, 2018: La Presse Médicale
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