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Takeshi Suzuki, Yuka Hidaka, Yu Seri
The consecutive reports and stored images of ultrasound examinations for 100 symptomatic ankles of 74 patients with rheumatoid arthritis (RA) were reviewed for the presence or absence of retrocalcaneal bursitis (RCB) and Achilles tendon enthesitis (ATE). The ankles were classified into 4 categories based on the presence or absence of RCB or ATE. The number of RCB(-)/ATE(-), RCB(+)/ATE(-), RCB(+)/ATE(+), and RCB(-)/ATE(+) ankles was 62, 16, 12, and 10, respectively. When classifying patients into early RA and established RA, the percentage of RCB(-)/ATE(+) ankles with early RA was significantly lower than that with established RA ( P  = ...
2018: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
Douglas J Veale, Ursula Fearon
Psoriatic arthritis is a chronic, immune-mediated, inflammatory arthropathy that presents with inflammation of the joints and entheses, including those of the axial skeleton, and is associated with increased mortality from cardiovascular disease. Diagnosis is primarily based on clinical phenotype because of the diversity of the associated features, which can include skin and nail disease, dactylitis, uveitis, and osteitis. Improved understanding of the pathogenesis of psoriatic arthritis has led to the development of effective biologics and small-molecular drugs targeting specific cytokines and signalling pathways, which can prevent disease progression and improve quality of life...
June 2, 2018: Lancet
Charlie Bridgewood, Abdulla Watad, Richard J Cuthbert, Dennis McGonagle
PURPOSE OF REVIEW: The spondyloarthopathies (SpA), which encompass related diseases that were originally viewed as autoimmune, are now known to have a strong innate immune or autoinflammatory initiation phase characterized by disease localization to tissue-specific sites based on the nuances and microanatomy and immunology of those sites. This review covers recent translational advances in the field of SpA. RECENT FINDINGS: Imaging studies in SpA continue to add support for the pivotal role of enthesitis in disease initiation and expression...
June 9, 2018: Current Opinion in Rheumatology
Lihi Eder, Sibel Z Aydin, Gurjit S Kaeley, Walter P Maksymowych, Mikkel Østergaard
Psoriatic arthritis (PsA) is a heterogeneous disease with various manifestations of musculoskeletal inflammation. Recent advances in imaging, including ultrasound (US) and magnetic resonance imaging (MRI), allow for the accurate evaluation of the extent of inflammation and damage in the peripheral joints, spine, and entheses. The development and validation of outcome measures are critical steps in creating standardized evaluations of musculoskeletal inflammation and damage in psoriatic patients. At the 2017 meeting of the Group for Research and Assessment of Psoriasis and PsA (GRAPPA), recent work on outcome measures from the GRAPPA US and MRI working groups was summarized...
June 2018: Journal of Rheumatology. Supplement
Elisabeth Gilis, Céline Mortier, Koen Venken, Karlijn Debusschere, Lars Vereecke, Dirk Elewaut
Spondyloarthritis (SpA) encompasses a group of diseases characterized by an inflammatory arthritis involving both joints and entheses. However, extraarticular symptoms constitute a large element of the pathology and should not be underestimated. Microscopic gut inflammation is observed in 50% of patients with SpA and has been linked to disease activity, underscoring the effect of gut inflammation in SpA. In this review, we discuss the influence of gut microbiota on SpA pathogenesis. A change in microbiota composition has been linked to the development of various inflammatory arthritides, and dysbiosis is a potential factor in the pathogenesis of multiple inflammatory diseases...
June 2018: Journal of Rheumatology. Supplement
Jose U Scher
The microbiome is a known and established immunomodulator of many inflammatory disorders, including psoriasis and psoriatic arthritis. Microbes co-evolved with their human hosts and provide them with nutritional, metabolic, and immunologic support. An accumulating body of evidence has revealed that psoriatic diseases are characterized by a state of intestinal dysbiosis, which has been linked to a decrease in beneficial commensals and fatty acids. This has been shown in both animal models and human samples, and multiple studies have addressed the physiological and potentially pathogenic role of intestinal and cutaneous microbes in human health and disease...
June 2018: Journal of Rheumatology. Supplement
Richard Holland, William Tillett, Alexis Ogdie, Ying Y Leung, Dafna D Gladman, Kristina Callis Duffin, Laura C Coates, Philip J Mease, Lihi Eder, Vibeke Strand, Musaab Elmamoun, Pil Højgaard, Jeffrey Chau, Maarten de Wit, Niti Goel, Chris A Lindsay, Oliver FitzGerald, Bev Shea, Dorcas Beaton, Ana-Maria Orbai
The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)-Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis (PsA) Core Set working group is in the process of selecting core instruments for PsA clinical trials. During a 2-h workshop and breakout group discussions at the GRAPPA 2017 annual meeting in Amsterdam, the Netherlands, participants discussed the first set of candidate instruments to be taken through the OMERACT Filter 2.1 instrument selection process: 66/68 swollen/tender joint count (66/68JC), Spondyloarthritis Consortium of Canada (SPARCC) enthesitis index, patient's global assessment (GRAPPA and OMERACT formulations), Health Assessment Questionnaire-Disability Index (HAQ-DI), Psoriatic Arthritis Impact of Disease (PsAID) questionnaires 9 and 12, and Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue...
June 2018: Journal of Rheumatology. Supplement
Devy Zisman, Matthew L Stoll, Yonatan Butbul Aviel, Elizabeth D Mellins
Juvenile psoriatic arthritis (JPsA), a subtype of juvenile idiopathic arthritis (JIA), constitutes 5% of JIA. The literature is inconsistent regarding features of JPsA, and physicians debate whether it is a distinct entity within JIA. A biphasic age of onset distribution has been noted. Early-onset disease is characterized by female predominance, small joint involvement, dactylitis, and positive antinuclear antibodies. Late-onset JPsA resembles adult-onset psoriatic arthritis (PsA), with male predominance, psoriasis, enthesitis, and axial disease...
June 2018: Journal of Rheumatology. Supplement
Philip S Helliwell, Dafna D Gladman, Alice B Gottlieb
The 2017 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) was held in Amsterdam, the Netherlands, and was attended by rheumatologists, dermatologists, representatives of biopharmaceutical companies, and patients. As in previous years, GRAPPA members held a symposium for trainees to discuss their research in psoriatic disease with experts in the field. Other subjects featured during the annual meeting included a discussion of the history, clinical features, controversies, and immunogenetics of juvenile psoriatic arthritis; updates from working groups in Outcome Measures in Rheumatology and International Dermatology Outcome Measures; a discussion of the benefits and challenges of setting up a longitudinal psoriatic arthritis (PsA) database; 3 separate discussions of the effects of the microbiome on skin and joints in psoriasis and PsA; a discussion of options for assessing joints and entheses in PsA by ultrasonography and magnetic resonance imaging; an update on GRAPPA's research and educational projects; a discussion of patient centricity, including the incorporation of patient research partners (PRP) into psoriasis and PsA research and educational efforts, from GRAPPA's PRP; and a discussion of the GRAPPA-Collaborative Research Network's inaugural meeting...
June 2018: Journal of Rheumatology. Supplement
Abdulla Watad, Richard J Cuthbert, Howard Amital, Dennis McGonagle
PURPOSE OF REVIEW: Recognition of the importance of enthesitis as the pivotal pathological process underpinning spondyloarthropathies (SpA) has increased in recent years. Thus, we summarized the current knowledge on the pathogenic role of enthesitis on SpA shown by both animal models and human studies in vivo. RECENT FINDINGS: Experimental models have shown several SpA-like diseases that commence at entheses and are linked to nail disease as well as dactylitis, two important entheseal-associated conditions in humans...
May 30, 2018: Current Rheumatology Reports
Giovanni Ciancio, Laura Sighinolfi, Federica Furini, Daniela Segala, Ilaria Farina, Elisa Galuppi, Elena De Stefani, Loredana Simone, Sergio Boccia, Anastasio Grilli, Paolo Pazzi, Marco Libanore, Carlo Contini, Marcello Govoni
OBJECTIVES: As a strong association between human immunodeficiency virus (HIV) infection and spondyloarthritis (SpA) has been hypothesised, our main objective was to explore by power Doppler ultrasonography (PDUS) the presence of subclinical enthesitis in asymptomatic HIV patients. The presence of subclinical synovitis was also evaluated. METHODS: Consecutive asymptomatic HIV patients were studied and compared with asymptomatic HCV patients and healthy controls (HC)...
May 24, 2018: Clinical and Experimental Rheumatology
Plamen Todorov, Rodina Nestorova, Anastas Batalov
Background: Iliac crest pain syndrome is a regional pain syndrome that has been identified in many patients with low back pain. Based on anatomical studies, it was suggested that the potential substrate of this syndrome might be the enthesis of the erector spinae muscle at the posterior medial iliac crest. As there have been no imaging studies of this important enthesis, our aim was to assess its characteristics by ultrasound. Methods: Erector spinae enthesis was first studied in a cadaver...
March 2018: Journal of Ultrasonography
Philippe Carron, Gaëlle Varkas, Thomas Renson, Roos Colman, Dirk Elewaut, Filip Van den Bosch
BACKGROUND: New treatment algorithms using TNF blockers in early stages of spondyloarthritis (SpA) induce high rates of clinical remission or low disease activity. It could be anticipated that such early intervention strategies in peripheral SpA (pSpA) may induce drug-free remission. OBJECTIVE: To evaluate drug-free clinical remission after induction therapy with golimumab (GLM) in patients with active pSpA in a very early stage of the disease. To identify patient characteristics predicting sustained drug-free remission...
May 27, 2018: Arthritis & Rheumatology
Clément Prati, Céline Demougeot, Xavier Guillot, Maxime Sondag, Frank Verhoeven, Daniel Wendling
Ankylosing spondylitis (AS) is a chronic inflammatory joint disease that involves the entheses, causing inflammatory pain and functional impairments. Patients may experience extraarticular manifestations such as uveitis, psoriasis, and inflammatory bowel disease. These, together with the increased risk of cardiovascular disease and osteoporosis and the development of spinal fusion, are the main determinants of adverse disease outcomes. As with many systemic inflammatory diseases, AS is associated with excess cardiovascular mortality due to increased risks of myocardial infarction, stroke, and venous thromboembolism...
May 19, 2018: Joint, Bone, Spine: Revue du Rhumatisme
U Syrbe, X Baraliakos
Spondyloarthritis (SpA) describes the group of inflammatory diseases characterized by inflammation within axial joints and/or peripheral arthritis, enthesitis, and dactylitis. Disease development is strongly determined by genes and particularly associated with the presence of HLA-B27. Transgenic expression in animal models leads to induction of a SpA-like disease, suggesting a direct effect of HLA-B27 on disease development. Genome-wide association studies in SpA patients have identified further associations between polymorphisms in genes with an immune function, in particular in genes controlling the interleukin (IL)-23/IL-17 signaling pathway...
May 16, 2018: Zeitschrift Für Rheumatologie
Josefina Marin, María Laura Acosta Felquer, Enrique R Soriano
Certolizumab pegol (CZP) is a pegylated humanized tumor necrosis factor-α inhibitor (TNFi) approved for the treatment of ankylosing spondylitis (AS) in the USA and for AS and non-radiographic axial spondyloarthritis (nr-axSpA) in Europe and in some Latin American countries. CZP lacks Fc region, preventing complement fixation and cytotoxicity mediated by antibody; CZP does not actively cross the placenta, unlike other TNFi. RAPID-axSpA study is a Phase III trial conducted in patients with AS and nr-axSpA as double blind and placebo controlled to week 24, dose blind to week 48 and open label to week 204...
2018: Open Access Rheumatology: Research and Reviews
Ayyappa S Duba, Stephanie D Mathew
The seronegative spondyloarthropathies are a group of five diseases characterized by inflammatory oligoarticular arthritis, enthesitis, and axial involvement. They have an increased incidence of the HLA-B27 gene. They are commonly associated with extra-articular features including involvement of the skin, eyes, and gastrointestinal tract. Early recognition and referral are key to limit disability, and comanagement with primary care and rheumatology offers the best outcomes.
June 2018: Primary Care
T Rusman, R F van Vollenhoven, I E van der Horst-Bruinsma
PURPOSE OF REVIEW: Ankylosing spondylitis (AS) was historically seen as a predominantly male disease. However, more recent data showed a more homogenous sex prevalence. Unfortunately, in many studies in axial spondyloarthritis (axSpA), the number of women included is low and the analyses are often not stratified for gender distribution. The purpose of this review is to aggregate the existing data on gender differences in axSpA in order to increase the awareness that female axSpA patients are still under-recognized...
May 12, 2018: Current Rheumatology Reports
Angelique Rondags, Suzanne Arends, Freke R Wink, Barbara Horváth, Anneke Spoorenberg
BACKGROUND: Spondyloarthritis (SpA), a chronic inflammatory, rheumatic disease, and hidradenitis suppurativa (HS), a chronic, debilitating, inflammatory skin disease, share several clinical and pathophysiological features, such as the association with inflammatory bowel disease and elevated cytokine levels IL-17 and TNF-α. Recently, SpA was reported to be more prevalent (2.3-28.2%) in patients with HS than in the general population. Conversely, the prevalence of HS in SpA is not exactly known...
March 20, 2018: Seminars in Arthritis and Rheumatism
Cristina F Rabelo, Talita Siara Almeida Baptista, Laura Esteves Petersen, Moisés Evandro Bauer, Mauro Waldemar Keiserman, Henrique Luiz Staub
Introduction: Ankylosing spondylitis (AS) is a chronic disease featuring axial changes, peripheral arthritis and systemic involvement. Proinflammatory cytokines are probably involved in AS pathogenesis. The relationship of circulating cytokines with instruments of AS evaluation is an open field of research. Objective: The aim of this study was to compare serum levels of cytokines in AS patients and healthy controls, and search for correlations of cytokines with indexes of disease activity and quality of life...
2018: Open Access Rheumatology: Research and Reviews
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