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Axial SpA

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
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
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
Riccardo Terenzi, Sara Monti, Giulia Tesei, Linda Carli
The term spondyloarthritis (SpA) represents a condition characterised by a broad spectrum of clinical manifestations, laboratory abnormalities and imaging features; in particular, SpA is an inflammatory condition in which both peripheral and axial joints might be affected. The majority of people with this disease have either psoriatic arthritis or axial spondyloarthritis, which includes ankylosing spondylitis. Less common subgroups are enteropathic SpA, which is associated with inflammatory bowel diseases (Crohn's disease and ulcerative colitis), reactive arthritis, which can occur in people following gastrointestinal or genitourinary infections and undifferentiated SpA, that does not meet the diagnostic criteria of the other subgroups at onset, but that may evolve to do so later...
January 2018: Clinical and Experimental Rheumatology
Christopher Ritchlin
The inclusion of the imaging arm in the Assessment of SpondyloArthritis International Society (ASAS) Classification Criteria catalyzed a transformation in the classification, diagnosis and treatment of axial SpA (1). A majority of patients with inflammatory back pain do not demonstrate radiographic changes and some were classified as undifferentiated spondyloarthritis (SpA) based on associated clinical features. (2). This nebulous classification was confusing at best and not recognized by many clinicians. As a result, the therapeutic approach to this group of patients was not well-defined...
February 12, 2018: Arthritis & Rheumatology
Michele Maria Luchetti, Francesco Ciccia, Chiara Avellini, Devis Benfaremo, Giuliana Guggino, Alessia Farinelli, Monia Ciferri, Matteo Rossini, Silvia Svegliati, Tatiana Spadoni, Laura Bolognini, Giammarco Fava, Piergiorgio Mosca, Rosaria Gesuita, Edlira Skrami, Giovanni Triolo, Armando Gabrielli
OBJECTIVE: The early diagnosis of inflammatory bowel disease (IBD)-associated spondyloarthritis (SpA/IBD) in patients affected by IBD represents a major topic in clinical practice; in particular, to date there are no available serum biomarkers revealing the presence of joint inflammation in these patients. Sclerostin (SOST), an antagonist of the Wnt/β-catenin pathway, and antisclerostin-immunoglobulin G (anti-SOST-IgG) have been recently studied in patients with ankylosing spondylitis (AS) as a putative marker of disease activity...
February 1, 2018: Journal of Rheumatology
Daniel Wendling, Cédric Lukas, Clément Prati, Pascal Claudepierre, Laure Gossec, Philippe Goupille, Christophe Hudry, Corinne Miceli-Richard, Anna Molto, Thao Pham, Alain Saraux, Maxime Dougados
OBJECTIVE: To update French Society for Rheumatology recommendations about the management in clinical practice of patients with spondyloarthritis (SpA). SpA is considered across the range of clinical phenotypes (axial, peripheral, and entheseal) and concomitant manifestations. Psoriatic arthritis is included among the SpA phenotypes. METHODS: According to the standard procedure advocated by the EULAR for developing recommendations, we first reviewed the literature published since the previous version of the recommendations issued in June 2013...
January 30, 2018: Joint, Bone, Spine: Revue du Rhumatisme
Sandra Lúcia Euzébio Ribeiro, Ana Paula Beckhauser de Campos, Penélope Esther Palominos, Adriana Bruscato Bortoluzzo, Marta Aline Coelho da Costa, Talita de Oliveira Ribeiro, Percival Degrava Sampaio-Barros
The objective of this study was to analyze the clinical profile of the spondyloarthritides (SpA) in distinct Brazilian regions. A common protocol of investigation was prospectively applied to 202 SpA patients, including 138 patients from the South and 64 patients from the North. All the patients were classified as axial or peripheral SpA. Clinical and demographic variables and disease indexes were analyzed. Bonferroni correction was used to adjust the level of significance of each test; results with p value < 0...
February 1, 2018: Clinical Rheumatology
Francesco S Mennini, Raffaella Viti, Andrea Marcellusi, Paolo Sciattella, Ombretta Viapiana, Maurizio Rossini
Background and aim: Spondyloarthritis (SpA) is a disease that normally affects the axial skeleton. It progressively leads to overall stiffness up to severe postural deformity of rachis and functional impotence. The objective of the study was to quantify, through an economic model, the impact of specialized testing and pharmacological treatments carried out by the National Health Service (NHS) in normal clinical practice, before the patient is diagnosed with SpA in Italy. In line with the analysis objective, the chosen perspective is that of the NHS...
2018: ClinicoEconomics and Outcomes Research: CEOR
Sabrina Yesmin, Syed Jamil Abdal, Aminur Rahman, Md Nazrul Islam, Alamgir Mustak Ahammad, Shamim Ahmed, Md Abu Shahin, Minhaj Rahim Chowdhury, Syed Atiqul Haq
AIM: Inflammatory back pain (IBP) is the earliest symptom of axial and other forms of spondyloarthritis (SpA). However, there are no published data on prevalence of IBP among patients suffering from chronic low back pain (CLBP) in Bangladesh. In this study, we estimated the prevalence of IBP and the subtypes of SpA in a tertiary hospital in Bangladesh. METHODS: This 1 year cross-sectional study was conducted among 240 CLBP patients in a rheumatology outpatient clinic...
January 18, 2018: International Journal of Rheumatic Diseases
Fabio Massimo Perrotta, Antonia De Socio, Silvia Scriffignano, Ennio Lubrano
Remission or low disease activity should be the target of therapy in spondyloarthritis (SpA). Due to the complexity of the disease, several composite indices that assess all disease domains were proposed to define a status of low disease activity/remission in both axial and peripheral SpA. With the introduction, in the past years, of effective biologic and targeted synthetic treatments aimed at inhibiting key cytokines and intracellular pathways, the goal of clinical remission has become an achievable target in these conditions...
January 17, 2018: Expert Review of Clinical Immunology
Ole Rintek Madsen
The study objective was to examine natural variation of the patient-reported outcome measures fatigue, pain, patient global assessment (PaGl) and the Bath Ankylosing Spondylitis Functional Index (BASFI) in patients with stable axial spondyloarthropathy (ax-SpA) defined on the basis of the Bath Spondylitis Ankylosing Disease Activity Index (BASDAI). 107 TNF-inhibitor treated stable ax-SpA patients were identified in the Danish rheumatology registry (DANBIO). According to the Assessment of SpondyloArthritis international Society (ASAS) response criteria, stable disease was defined as a change in BASDAI < 20 between two consecutive visits...
March 2018: Rheumatology International
Julio Ramírez, Juan Carlos Nieto-González, Rafael Curbelo Rodríguez, Santos Castañeda, Loreto Carmona
OBJECTIVES: To describe the prevalence of osteoporosis, the prevalence and incidence of fractures, and the frequency of risk factors for low bone mineral density (BMD) in axial spondyloarthritis (Ax-SpA). METHODS: A systematic review and meta-analysis of observational studies was conducted. Medline, Embase, and Cochrane Library databases were searched with a sensitive strategy. Large cross-sectional and longitudinal studies published in the last 10 years (January 2006-2016) with representative samples of patients with Ax-SpA estimating the frequency of osteoporosis, risk factors or fractures were selected...
December 7, 2017: Seminars in Arthritis and Rheumatism
Loukman Omarjee, Vincent Jaquinandi, Guillaume Mahe
Spondylarthritis (SpA) is an inflammatory rheumatic disease associated with increased incidence of major adverse cardiovascular events (MACEs). Recently, Paramarta et al. proposed the use of the tyrosine kinase inhibitor Nilotinib in Spondyloarthritis to target certain inflammatory pathways. However, Nilotinib, which is highly effective for the treatment of patients with chronic myeloid leukaemia (CML), is also associated with an increased risk of MACEs. The authors suggest that Nilotinib may be effective in peripheral SpA by modulating inflammation, but not in axial SpA...
December 15, 2017: Journal of Translational Medicine
Elena Nikiphorou, Désirée van der Heijde, Sam Norton, Robert Bm Landewé, Anna Molto, Maxime Dougados, Filip E Van den Bosch, Sofia Ramiro
OBJECTIVES: The value of biological disease-modifying antirheumatic drugs (bDMARDs) in spondyloarthritis (SpA) is well recognised, but global access to these treatments can be limited due to high costs and other factors. This study explores country variation in the use of bDMARDs in SpA in relation to country-level socioeconomic factors. METHODS: Patients fulfilling the Assessment in SpondyloArthritis International Society (ASAS) SpA criteria in the multinational, cross-sectional ASAS Comorbidities in Spondyloarthritis study were studied...
March 2018: Annals of the Rheumatic Diseases
Gil Bornstein, Merav Lidar, Pnina Langevitz, Alexander Fardman, Ilan Ben-Zvi, Chagai Grossman
OBJECTIVES: To evaluate the prevalence of immunogenicity of TNF-α blockers in axial spondyloarthritis (SpA) patients and to assess the effect of immunogenicity on drug levels and clinical response. METHPDS: Patients with axial SpA treated with either infliximab (INF), adalimumab (ADA) or etanercept (ETN) were recruited to our observational cross-sectional study. Demographic and clinical data were collected and disease activity scores were assessed. Drug trough levels and anti-drug antibodies were measured in serum samples and collected before the next administration...
November 28, 2017: Clinical and Experimental Rheumatology
Miranda van Lunteren, Zineb Ez-Zaitouni, Camilla Fongen, Robert Landewé, Roberta Ramonda, Désirée van der Heijde, Floris A van Gaalen
Objectives: To assess if a change in disease activity is associated with a change in work productivity loss (WPL) over 1 year in early axial SpA (axSpA) patients. Methods: Baseline and 1 year data of axSpA patients in the SPondyloArthritis Caught Early cohort were analysed. Linear regression models were built explaining the change in the Ankylosing Spondylitis Disease Activity Score (ASDAS) over time by the change in absenteeism, presenteeism, WPL and activity impairment over time...
December 1, 2017: Rheumatology
Mansour Alazmi, Ismail Sari, Bharath Krishnan, Robert D Inman, Nigil Haroon
OBJECTIVES: Lack of response to TNF inhibitory (TNFi) agents is not uncommon, encountered during the treatment of axial spondyloarthritis (AxSpA) patients and can be classified as primary (PLR) or secondary (SLR) lack of response. The primary aim of this study was to evaluate factors associated with TNFi failure types and their characteristics in AxSpA. METHODS: Adult AxSpA patients who were TNFi naive at the time of baseline evaluation and started on their first biologics for active axial disease were identified...
November 10, 2017: Arthritis Care & Research
Jyoti Panwar, Pulukool Sandhya, Madhavi Kandagaddala, Aswin Nair, Visalakshi Jeyaseelan, Debashish Danda
Sacroiliitis is one of the criteria for classification as spondyloarthritis (SpA), though not unique to SpA. Other conditions including gout may be erroneously diagnosed as SpA due to sacroiliitis. The objective was to identify specific CT findings in sacroiliitis associated with SpA and gout. In this retrospective study, CT images of patients with sacroiliitis and clinical diagnosis of gout or SpA from 2010 to 2015 were independently reviewed by two radiologists, blinded to diagnosis. Axial and coronal oblique images were analyzed for characteristics of erosions...
November 8, 2017: Clinical Rheumatology
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