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1

Ankylosing Spondylitis and Psoriatic Arthritis  

MedlinePLUS

... Q&A From Spondylitis Plus >>> PSORIATIC ARTHRITIS Overview Psoriasis is a scaly rash that occurs most frequently on the elbows, knees and scalp, but can cover much of the body. It is a chronic, inflammatory disease of the skin, scalp, nails and joints. A normal skin cell ...

2

Hl-A antigens associated with rheumatoid arthritis and ankylosing spondylitis in an ethnic homogeneous population.  

PubMed

The HL-A phenotypes of 52 patients with rhematoid arthritis and 26 patients with ankylosing spondylitis from an ethnic homogeneous population have been determined. No definite association has been established with rheumatoid arthritis, while a very significant association has been found between ankylosing spondylitis and HL-A 27 antigen. This finding suggests that certain patients with ankylosing spondylitis have a genetically determined susceptibility to their disease which could be due to a cross-tolerance mechanism enabling infectious agent antigens to mimic certain histo-compatibility antigens, or to a linkage between HL-A genes and those controlling immune responsiveness. PMID:1222227

Marcolongo, R; Contu, L

1975-04-10

3

Rehabilitation in rheumatoid arthritis and ankylosing spondylitis: differences and similarities  

Microsoft Academic Search

The aim of the paper is to summarize and compare the best available evi- dence concerning the effectiveness of rehabilitative interventions and provide an overview of recommendations or in- ternational guidelines on non-pharma- cological treatments in rheumatoid ar- thritis (RA) and ankylosing spondylitis (AS). It was found that, compared to RA, there are relatively fewer non-pharma- cological intervention studies in

Sophia Rehabilitation; Theodora P. M. Vliet Vlieland; Linda C. Li; Vliet Vlieland

4

Golimumab: in the treatment of rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.  

PubMed

Golimumab is a human anti-tumor necrosis factor (TNF) monoclonal antibody that acts principally by targeting and neutralizing TNF to prevent inflammation and destruction of cartilage and bone. Large, randomized, double-blind trials in patients with rheumatoid arthritis who were methotrexate-naïve (GO-BEFORE) or -experienced (GO-FORWARD) have shown that golimumab 50 or 100 mg every 4 weeks, in combination with methotrexate, was more effective than methotrexate alone for improving signs and symptoms of arthritis at weeks 14 and/or 24, according to American College of Rheumatology (ACR) criteria. In patients with active rheumatoid arthritis despite previous treatment with anti-TNF agents (GO-AFTER), golimumab 50 or 100 mg every 4 weeks was more effective than placebo for improving ACR responses at weeks 14 and 24; most patients in the study received concomitant methotrexate. In patients with psoriatic arthritis in the GO-REVEAL study, significantly more golimumab than placebo recipients achieved a >or=20% improvement in ACR criteria at week 14. Golimumab was also superior to placebo for improving the signs and symptoms of ankylosing spondylitis in the GO-RAISE study; significantly more golimumab than placebo recipients achieved a >or=20% improvement in the Assessment in Ankylosing Spondylitis (ASAS) criteria at week 14. In the five phase III trials in patients with rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis, there was no clear evidence of improved ACR or ASAS responses with the 100 mg dosage compared with the 50 mg dosage of golimumab. The tolerability profile of golimumab was generally consistent with that of other anti-TNF agents. PMID:19489653

Oldfield, Vicki; Plosker, Greg L

2009-01-01

5

Ankylosing spondylitis.  

PubMed

Ankylosing spondylitis belongs to a group of rheumatic diseases known as the spondyloarthropathies (SpA), which show a strong association with the genetic marker HLA-B27. Inflammatory back pain and stiffness are prominent early in the disease, whereas chronic, aggressive disease may produce pain and marked axial immobility or deformity. Modern medicine has no established treatment for it. From the Ayurvedic perspective, the disease can fall under amavata, which may be effectively managed when intervention is started in its early stages. Niruha basthi with Balaguduchyadi yoga, combined by Shamana treatment with Rasnerandadi kwatha and Simhanada guggulu have been found effective in curbing its progression. This article presents a single case report in which these treatments achieved considerable success. PMID:21547050

Edavalath, Mukesh

2010-07-01

6

Recommendations of the French Society for Rheumatology regarding TNF? antagonist therapy in patients with ankylosing spondylitis or psoriatic arthritis: 2007 update  

Microsoft Academic Search

ObjectiveTo update French Society for Rheumatology guidelines regarding the use of tumor necrosis factor ? (TNF?) antagonists for treating patients with ankylosing spondylitis (AS) or psoriatic arthritis (PsA).

Thao Pham; Bruno Fautrel; Emmanuelle Dernis; Philippe Goupille; Francis Guillemin; Xavier Le Loët; Philippe Ravaud; Pascal Claudepierre; Corinne Miceli-Richard; Michel de Bandt; Maxime Breban; Jean-Francis Maillefert; Charles Masson; Alain Saraux; Thierry Schaeverbeke; Daniel Wendling; Xavier Mariette; Bernard Combe

2007-01-01

7

Structural damage in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: traditional views, novel insights gained from TNF blockade, and concepts for the future  

Microsoft Academic Search

Structural changes of bone and cartilage are a hallmark of inflammatory joint diseases such as rheumatoid arthritis (RA),\\u000a psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Despite certain similarities – in particular, inflammation as\\u000a the driving force for structural changes – the three major inflammatory joint diseases show considerably different pathologies.\\u000a Whereas RA primarily results in bone and cartilage resorption, PsA

Georg Schett; Laura C Coates; Zoe R Ash; Stefanie Finzel; Phillip G Conaghan

2011-01-01

8

Atherosclerosis and cardiovascular disease in the spondyloarthritides, particularly ankylosing spondylitis and psoriatic arthritis.  

PubMed

The spondyloarthritides (SpA) are a group of idiopathic inflammatory diseases affecting the axial and/or peripheral skeleton. Recent evidence points towards an increased mortality and morbidity due to cardiovascular disease, especially within the two major forms of SpA, ankylosing spondylitis and psoriatic arthritis. Several studies have identified alterations of the lipid profile, insulin sensitivity and other metabolic cardiovascular risk factors in SpA patients. An array of vascular morphologic and functional abnormalities has also been reported in these diseases, supporting the hypothesis of accelerated atherosclerosis in SpA. Inflammation appears to be a major player, involved both in the impairment of the classic cardiovascular risk factors, as well as directly in the process of endothelial injury, dysfunction and ultimately atherosclerosis. Multiple studies in rheumatoid arthritis have suggested that effective suppression of inflammation with synthetic disease-modifying anti-rheumatic drugs or with biologics may also exert favourable effects in the cardiovascular risk. Although such evidence is currently lacking for SpA, there is little doubt that physicians caring for patients with SpA should aim at controlling both inflammation and traditional cardiovascular risk factors. Such an integrated approach is expected to benefit patients in multiple levels. PMID:23406817

Papagoras, Charalampos; Voulgari, Paraskevi V; Drosos, Alexandros A

2013-01-01

9

Antibody responses to gut bacteria in ankylosing spondylitis, rheumatoid arthritis, Crohn's disease and ulcerative colitis  

Microsoft Academic Search

Specific immunoreactive anti-Klebsiella antibodies are found in patients with ankylosing spondylitis (AS), a significant proportion of whom have occult inflammatory\\u000a bowel disease. Molecular mimicry between Klebsiella or other bacterial antigens and HLA-B27 has been suggested in the pathogenesis of AS. The specificity of increased immunoreactivity\\u000a against Klebsiella remains to be assessed against the abundant anaerobic bacterial flora, present either in

H. Tiwana; C. Wilson; R. S. Walmsley; A. J. Wakefield; M. S. N. Smith; N. L. Cox; M. J. Hudson; A. Ebringer

1997-01-01

10

The economic burden of disease: comparison between rheumatoid arthritis and ankylosing spondylitis.  

PubMed

During the last decade the economic burden of rheumatic diseases has been increasingly recognised. Even though more studies have been published on rheumatoid arthritis (RA) than ankylosing spondylitis (AS) sufficient data is available for comparison of some economic consequences. This overview addresses mainly the societal impact of RA and AS on (1) labour force participation, on (2) the costs of healthcare consumption and reduced productivity and on (3) health in terms of QALY.In order to examine labour force participation comparison with the general population is preferable. These studies demonstrate increased withdrawal from work in both diseases but more frequently in RA. Risk factors for reduced labour force participation in RA and AS are longer disease duration, lower education and unfavourable labour market conditions. The influence of the sex on employment depends on several factors such as the type of disease and the labour force participation of the general population.In RA overall mean direct costs of healthcare consumption and indirect costs of reduced productivity are above that of AS, particularly after long disease duration. Out-of-pocket expenditures costs were higher in females RA patients than in males while this was less clear in AS. The main cost driver in both diseases for all type of costs was reduced physical function.The societal valuation of health (utility) showed similar reductions of quality adjusted life years (QALYs) in RA and AS when compared with the general population.In conclusion, while the societal valuation of the impact of both diseases on health is similar, the decrease in worker participation is more pronounced in RA and direct as well as productivity costs are higher. However, since AS starts at an earlier age, the lifetime economic burden might be higher. There is a strong relation between physical function and each aspect of economic impact. PMID:19822056

Boonen, A; Mau, W

2009-01-01

11

Alternative Treatments for Ankylosing Spondylitis  

MedlinePLUS

... stands for "transcutaneous electrical nerve stimulation". The American Physical Therapy Association defines TENS as application of electrical current ... long-term treatment of ankylosing spondylitis with integrated traditional Chinese and western medicine. Zhongguo Zhong XiYi Jie ...

12

Diagnostic delay in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis: results from the Danish nationwide DANBIO registry  

PubMed Central

Background/purpose Early diagnosis of inflammatory rheumatic diseases is important in order to improve long-term outcome. We studied whether delay in diagnosis (time between onset of symptoms and establishment of diagnosis) in patients with rheumatoid arthritis (RA), psoriatic arthritis (PSA) and ankylosing spondylitis (AS) changed from year 2000 to 2011. Methods Month and year of initial symptoms and diagnosis, gender, hospital, year of birth and date of first data entry were obtained for 13?721 patients with RA, PSA or AS who had been registered in the DANBIO registry. Time between symptom onset and diagnosis was modelled using generalised linear regression to predict the average duration for each calendar year of initial symptoms with adjustments for gender, year of birth and date of DANBIO entry. Results Patients with valid data (RA: 10?416 (73%); PSA: 1970 (68%); AS: 1335 (65%)) did not differ significantly from the whole DANBIO population, except more missing data in early years. The regression model showed that the mean duration from initial symptoms to diagnosis for RA, PSA and AS declined steadily from 30, 53 and 66?months (year 2000), respectively, to 3–4?months (year 2011). Sensitivity analyses including patients who were included after 2005, patients who had received biological treatment or had symptom onset less than 2 and 5?years prior to first entry into DANBIO showed similar results. Conclusion Since the year 2000, a significant reduction in diagnostic delay was observed in this large cohort of patients with RA, PSA or AS, probably reflecting a stronger awareness of the importance of early diagnosis. PMID:24534758

Sørensen, Jan; Hetland, Merete Lund

2015-01-01

13

Golimumab: A novel human anti-TNF-? monoclonal antibody for the treatment of rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis  

PubMed Central

Introduction: The introduction of tumor necrosis factor-? (TNF-?) inhibitors represented a significant advance in the management of rheumatoid arthritis (RA) and other chronic inflammatory diseases. Although three TNF-? inhibitors have been approved for the treatment of RA by the US Food and Drug Administration (FDA) and the European Medicinal Products Evaluation Agency (EMEA), not all patients achieve a satisfactory clinical improvement with these therapeutic agents. The mode of administration of these medications is inconvenient for some patients. Aims: Golimumab is a novel anti-TNF-? monoclonal antibody that is in clinical development for the treatment of RA, psoriatic arthritis (PsA), and ankylosing spondylitis (AS), either as a first-line biologic therapy or an alternative after other TNF-? inhibitors have been discontinued. This review summarizes the development of, and clinical evidence achieved with, golimumab. Evidence review: Golimumab has demonstrated significant efficacy in randomized, double-blind, placebo-controlled trials when administered subcutaneously once every four weeks. It has been generally well tolerated in clinical trials and demonstrates a safety profile comparable with currently available TNF-? inhibitors. Outcomes summary: Golimumab has been confirmed to be an effective treatment for patients with RA, PsA, and AS in phase III clinical trials as evaluated by traditional measures of disease activity, such as signs and symptoms, as well as measures of physical function, patient reported outcomes, and health economic measures. The efficacy and safety profile of golimumab in RA, PsA, and AS appears to be similar to other anti-TNF agents. However, golimumab has the potential advantage of once monthly subcutaneous administration and the possibility of both subcutaneous and intravenous administration. PMID:20694072

Kay, Jonathan; Rahman, Mahboob U

2010-01-01

14

[Welfare as the goal of the analgesic pharmacotherapy accompanying biological treatment in patients with rheumatoid arthritis and ankylosing spondylitis].  

PubMed

Therapy of chronic rheumatic diseases, such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS) needs a comprehensive approach to the patient, based on the control of pain and improvement in overall condition, which affects the quality-of-life. This requires optimizing the treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or analgesics and control of adverse drug reactions. The aim of the study was to evaluate the efficacy and safety of pain pharmacotherapy in patients with rheumatoid arthritis and ankylosing spondylitis treated as the basic pharmacotherapy-biological drugs, the analysis of awareness of pharmacovigilance and evaluation of analgesic treatment costs. Material and methods. Examined group consisted of 102 people with RA or AS received biological therapy. Test method was questionnaire with closed and open questions. Results. 86.2% of respondents used a pain medication (41%--an ad hoc basis, but 23%--at least once a day), while 79.4%--NSAIDs (33%--an ad hoc basis and 17%--at least once a day). In 85.3% of those not observed adverse effects of pain pharmacotherapy. 5 persons declared abdominal pain. Most of the patients complied with the recommendations of the doctor in the pain treatment. For the third respondents the cost of pharmacotherapy of pain was monthly 1-10 zl, but 6% of patients paying for drugs from 50-60 and above 60 zl monthly. Conclusions. Biological treatment in RA and AS is effective but requires additional analgesic therapy. Adverse effects seen during pharmacological treatment of chronic pain in rheumatic diseases are, in practice sporadic. Therapeutic patient education with chronic diseases is proper. Costs borne by the patient's pain relief in this group are not too high. PMID:25546988

Tomasiewicz, Beata; Hurkacz, Magdalena; Jarzibowski, Jaros?aw; Wiela-Hoje?ska, Anna

2014-11-01

15

Structural damage in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: traditional views, novel insights gained from TNF blockade, and concepts for the future  

PubMed Central

Structural changes of bone and cartilage are a hallmark of inflammatory joint diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Despite certain similarities – in particular, inflammation as the driving force for structural changes – the three major inflammatory joint diseases show considerably different pathologies. Whereas RA primarily results in bone and cartilage resorption, PsA combines destructive elements with anabolic bone responses, and AS is the prototype of a hyper-responsive joint disease associated with substantial bone and cartilage apposition. In the present review we summarize the clinical picture and pathophysiologic processes of bone and cartilage damage in RA, PsA, and AS, we describe the key insights obtained from the introduction of TNF blockade, and we discuss the future challenges and frontiers of structural damage in arthritis. PMID:21624183

2011-01-01

16

Health-related quality of life in ankylosing spondylitis, fibromyalgia syndrome, and rheumatoid arthritis: a comparison with a selected sample of healthy ?ndividuals  

Microsoft Academic Search

In this study, we compared health-related quality of life (HRQoL) scores of patients with rheumatoid arthritis (RA), fibromyalgia\\u000a syndrome (FS), or ankylosing spondylitis (AS), with those of a selected sample of healthy individuals. The study group comprised\\u000a 530 patients (264 with RA, 149 with FS, and 117 with AS). Three hundred fifteen healthy controls were used for comparison.\\u000a HRQoL scores

Nimet Ovayolu; Ozlem Ovayolu; Gülendam Karadag

2011-01-01

17

Effectiveness and safety of adalimumab in patients with ankylosing spondylitis or psoriatic arthritis and history of anti-tumor necrosis factor therapy  

Microsoft Academic Search

INTRODUCTION: Tumor necrosis factor (TNF) antagonists reduce the signs and symptoms of spondyloarthritides, including ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Our objective was to evaluate the effectiveness and safety of adalimumab, 40 mg every other week, for patients with AS or PsA and prior treatment with infliximab (IFX) and\\/or etanercept (ETN). METHODS: Both trials were 12-week, open-label studies with

Martin Rudwaleit; Filip Van den Bosch; Martina Kron; Sonja Kary; Hartmut Kupper

2010-01-01

18

Adalimumab: long-term safety in 23 458 patients from global clinical trials in rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis and Crohn's disease  

PubMed Central

Background As long-term treatment with antitumour necrosis factor (TNF) drugs becomes accepted practice, the risk assessment requires an understanding of anti-TNF long-term safety. Registry safety data in rheumatoid arthritis (RA) are available, but these patients may not be monitored as closely as patients in a clinical trial. Cross-indication safety reviews of available anti-TNF agents are limited. Objective To analyse the long-term safety of adalimumab treatment. Methods This analysis included 23 458 patients exposed to adalimumab in 71 global clinical trials in RA, juvenile idiopathic arthritis, ankylosing spondylitis (AS), psoriatic arthritis, psoriasis (Ps) and Crohn's disease (CD). Events per 100 patient-years were calculated using events reported after the first dose through 70 days after the last dose. Standardised incidence rates for malignancies were calculated using a National Cancer Institute database. Standardised death rates were calculated using WHO data. Results The most frequently reported serious adverse events across indications were infections with greatest incidence in RA and CD trials. Overall malignancy rates for adalimumab-treated patients were as expected for the general population; the incidence of lymphoma was increased in patients with RA, but within the range expected in RA without anti-TNF therapy; non-melanoma skin cancer incidence was raised in RA, Ps and CD. In all indications, death rates were lower than, or equivalent to, those expected in the general population. Conclusions Analysis of adverse events of interest through nearly 12 years of adalimumab exposure in clinical trials across indications demonstrated individual differences in rates by disease populations, no new safety signals and a safety profile consistent with known information about the anti-TNF class. PMID:22562972

Burmester, Gerd R; Panaccione, Remo; Gordon, Kenneth B; McIlraith, Melissa J; Lacerda, Ana P M

2013-01-01

19

Enhanced jejunal production of antibodies to Klebsiella and other Enterobacteria in patients with ankylosing spondylitis and rheumatoid arthritis  

PubMed Central

OBJECTIVE—To measure gut immunity directly in jejunal fluid in patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA).?METHODS—Antibodies against three different Enterobacterias were measured in jejunal perfusion fluids (collected by a double balloon perfusion device) of 19 patients with AS, 14 patients with RA, and 22 healthy controls using enzyme linked immunosorbent assay.?RESULTS—The AS patients had significantly increased jejunal fluid concentrations of IgM, IgG, and IgA class antibodies against Klebsiella pneumoniae, and IgM and IgA class antibodies against Escherichia coli and Proteus mirabilis compared with healthy controls. When compared with the patients with RA, the AS patients had higher concentrations of IgA and IgG class antibodies only against K pneumoniae. The RA patients had higher IgM class antibody concentrations against all three studied Enterobacterias, when compared with the healthy controls, suggesting an enhanced mucosal immune response in these patients. A three month treatment with sulphasalazine did not decrease enterobacterial antibody concentrations in the 10 patients with AS.?CONCLUSION—There is strong direct evidence for an abnormal mucosal humoral immune response particularly to K pneumoniae in patients with AS.?? PMID:9486004

Maki-Ikola, O.; Hallgren, R.; Kanerud, L.; Feltelius, N.; Knutsson, L.; Granfors, K.

1997-01-01

20

Thrombin generation in ankylosing spondylitis  

Microsoft Academic Search

Ankylosing spondylitis (AS) is a chronic inflammatory disease associated with an increase in cardiovascular risk. Thrombin\\u000a generation is associated with the risk of thrombosis, and the endogenous thrombin potential (ETP) has been proposed as a parameter\\u000a for plasma-based hypercoagulability. The aim of the study was to evaluate the risk of thrombosis in a group of AS patients\\u000a in comparison to

Clément Prati; Evelyne Racadot; Jean-Pierre Cedoz; Daniel Wendling

2011-01-01

21

Drug Retention Rates and Treatment Discontinuation among Anti-TNF-? Agents in Psoriatic Arthritis and Ankylosing Spondylitis in Clinical Practice  

PubMed Central

Objective. The study aim was to determine treatment persistence rates and to identify causes of discontinuation in psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients in clinical practice. Methods. Patients treated with adalimumab (ADA), etanercept (ETA), or infliximab (INF) were retrospectively included. Treatment persistence rates were analyzed by means of a stepwise logistic regression. Differences between therapy duration were assessed by means of an analysis of variance model (ANOVA), while a chi-square test was used to evaluate relationships between therapies and causes of treatment discontinuation and the administration of concomitant disease-modifying antirheumatic drugs (DMARDs) among therapies and types of disease considering completed courses of therapy versus courses that were discontinued. Results. 268 patients received a total of 353 anti-TNF treatment courses (97 ADA, 180 ETA, and 76 INF). Comparison among therapies showed significant difference regarding the treatment persistence rates due to the contrast between ETA and INF (P = 0.0062). We observed that 84.7% of patients were still responding after 6 months of follow-up. Comparison among diseases showed that there were significant differences between PsA and AS (P = 0.0073) and PsA and PsA with predominant axial involvement (P = 0.0467) in terms of duration of the therapy, while there were no significant differences with regard to the persistence rate. Conclusions. In this cohort, anti-TNF-? therapy was associated with high drug persistence rates. As in rheumatoid arthritis, switching to another anti-TNF-? agent can be an effective option when, during the treatment of AS or PsA, therapy is suspended because of inefficacy or an adverse event. Combination therapy with DMARDs was associated with a better persistence rate. PMID:25110401

Fabbroni, Marta; Costa, Luisa; Pagano, Veronica Anna; Frediani, Bruno; Manganelli, Stefania; Galeazzi, Mauro

2014-01-01

22

What Is Ankylosing Spondylitis?  

MedlinePLUS

... publication. To order the Ankylosing Spondylitiis Q&A full-text version, please contact the NIAMS using the contact ... mailed to you? Visit our online order form. Full NIAMS Site NIH… Turning Discovery Into Health ® ... Comments Moderation Policy Site Map | Viewers and Players

23

The relationship between depressive symptoms, illness perceptions and quality of life in ankylosing spondylitis in comparison to rheumatoid arthritis.  

PubMed

Anxiety and depressive symptoms as well as cognitive variables are important in determining outcome in rheumatic diseases. We aimed to compare psychological distress symptoms and illness perceptions in ankylosing spondylitis (AS) and rheumatoid arthritis (RA) and to test whether their associations with health-related quality of life (HRQoL) were similar in these rheumatologic disorders. In 55 AS and 199 RA patients, we administered the Patient Health Questionnaire (PHQ-9), the Symptom Check-List and the Brief-Illness Perception Questionnaire to assess psychological variables and the World Health Organization Quality of Life Instrument, Short Form to assess HRQoL. We used hierarchical regression analyses to determine the associations between psychological variables and HRQoL after adjusting for demographic variables and disease parameters. The prevalence of clinically significant depressive symptoms (PHQ-9 ? 10) was 14.8 % in AS and 25.1 % in RA patients, but adjustment for demographics rendered these differences in depressive symptoms' severity non-significant. Psychological distress levels and HRQoL were similar in both disorders. Illness concern (b = -0.37) was the only significant independent correlate of physical HRQoL in AS. In RA, depression (b = -0.25), illness concern (b = -0.14) and worries about the consequences of the disease (b = -0.31) were the independent correlates of physical HRQoL. These findings suggest that cognitive variables are important correlates of HRQoL in AS, whereas in RA depressive symptoms and illness perceptions equally contribute to HRQoL. Our data encourage the design of psychotherapeutic trials targeting disease-related cognitions in AS in an attempt to improve patient's physical HRQoL. PMID:23329349

Hyphantis, Thomas; Kotsis, Konstantinos; Tsifetaki, Niki; Creed, Francis; Drosos, Alexandros A; Carvalho, André F; Voulgari, Paraskevi V

2013-05-01

24

Advances in managing ankylosing spondylitis  

PubMed Central

Ankylosing spondylitis (AS) is a chronic inflammatory disease with prominent involvement of the spine and sacroiliac joints which frequently leads to significant spine deformity and disability. The development of effective therapies for AS, particularly with anti-tumor necrosis factor agents, has resulted in improved symptoms and functions for many patients, and clinical research increasingly suggests that effective therapy can also prevent destruction in the spine and other structures. Recent focus of disease classification in AS has emphasized that many individuals with features of inflammatory back pain but no visible changes on plain x-rays have active inflammatory disease when imaged with magnetic resonance imaging (MRI). Recent studies indicate that individuals with “non-radiographic” spondylitis can also respond to anti-inflammatory therapies. Several new agents are also showing promise for treatment of AS. These developments represent a significant advance in the management of this debilitating condition. PMID:25343035

Chen, Patty P.

2014-01-01

25

Andersson lesion in ankylosing spondylitis  

PubMed Central

A middle-aged male patient developed acute back pain and a lumbar vertebral lesion following trivial physical trauma. The lesion was considered as tuberculous on vertebral x-rays and MRI. After biopsy of the lesion and spinal fixation, the patient was kept on empirical antituberculous treatment (ATT) to which he did not respond. On re-evaluation he was diagnosed to have an Andersson lesion in ankylosing spondylitis (AS). ATT was stopped and he was successfully managed by rest, steroids, methotrexate and sulfasalazine. A careful look at the patient’s plain x-ray spine and awareness about the lesion can avoid misdiagnosis of this characteristic vertebral lesion found in AS. PMID:23559648

Dhakad, Urmila; Das, Siddharth K

2013-01-01

26

Ankylosing spondylitis: an impending restraint for gynecological interventions?  

Microsoft Academic Search

To the editor, Hip joint involvement may ensue during the course of ankylosing spondylitis (AS) and can be quite disabling. The disability is usually thought to be confined to posture and gait abnormalities, but in this report we summarize an unforeseen gynecological consequence—a possible, unexpected burden of severe hip arthritis. A 49-year-old lady was seen in the obstetrics and gynecology

Levent Özçakar; Hakan Yaral?

2004-01-01

27

IgM, IgG, and IgA synthesis in vitro in persons suffering from yersinia arthritis and in patients with ankylosing spondylitis.  

PubMed Central

In ankylosing spondylitis (AS) and in yersinia arthritis the main findings in serum immunoglobulin (Ig) studies have been raised IgA in AS and a high anti-yersinia IgA and IgG response and the persistence of IgA class antibodies in yersinia arthritis. In order to study predisposition to high IgA response in AS and yersinia arthritis we measured the in-vitro Ig production in patients with AS and in persons who have once had yersinia arthritis, and we compared it with the Ig production in persons who have had yersiniosis but recovered without getting arthritis and with that in healthy controls. IgA secretion by peripheral blood lymphocytes stimulated by pokeweed mitogen was the same in all 4 groups, and no signs of higher IgA production in AS patients could be found. In AS patients lymphocyte activation by whole yersinia bacteria resulted in higher total IgG production than in healthy controls. The total number of plaque-forming cells in yersinia-stimulated cultures was significantly higher in persons who have had yersiniosis without arthritis than in persons who have suffered from yersinia arthritis or in persons in other groups. AS patients had low IgM production, which reverted to normal when hydrocortisone was added to the culture. The in-vitro Ig production in general did not correlate with the presence of the HLA B27 antigen but rather with the clinical history of the subjects studied. PMID:6370149

Vuento, R; Eskola, J; Leino, R; Koskimies, S; Viander, M

1984-01-01

28

Ankylosing Spondylitis: Diet and Nutrition  

MedlinePLUS

Diet & Nutrition: Quick Links Overview of Diet & Spondylitis >>> Medication & Diet >>> Dietary Supplements >>> Changing Your Diet >>> The London AS / Low Starch Diet >>> Back To The About Spondylitis Main Page >>> DIET & ...

29

Identification of multiple risk variants for ankylosing spondylitis through high-density genotyping of immune-related loci  

PubMed Central

Ankylosing spondylitis is a common, highly heritable inflammatory arthritis affecting primarily the spine and pelvis. In addition to HLA-B*27 alleles, 12 loci have previously been identified that are associated with ankylosing spondylitis in populations of European ancestry, and 2 associated loci have been identified in Asians. In this study, we used the Illumina Immunochip microarray to perform a case-control association study involving 10,619 individuals with ankylosing spondylitis (cases) and 15,145 controls. We identified 13 new risk loci and 12 additional ankylosing spondylitis–associated haplotypes at 11 loci. Two ankylosing spondylitis–associated regions have now been identified encoding four aminopeptidases that are involved in peptide processing before major histocompatibility complex (MHC) class I presentation. Protective variants at two of these loci are associated both with reduced aminopeptidase function and with MHC class I cell surface expression. PMID:23749187

Cortes, Adrian; Hadler, Johanna; Pointon, Jenny P; Robinson, Philip C; Karaderi, Tugce; Leo, Paul; Cremin, Katie; Pryce, Karena; Harris, Jessica; lee, Seunghun; Joo, Kyung Bin; Shim, Seung-Cheol; Weisman, Michael; Ward, Michael; Zhou, Xiaodong; Garchon, Henri-Jean; Chiocchia, Gilles; Nossent, Johannes; Lie, Benedicte A; Førre, Øystein; Tuomilehto, Jaakko; Laiho, Kari; Jiang, Lei; Liu, Yu; Wu, Xin; Bradbury, Linda A; Elewaut, Dirk; Burgos-Vargas, Ruben; Stebbings, Simon; Appleton, Louise; Farrah, Claire; Lau, Jonathan; Kenna, Tony J; Haroon, Nigil; Ferreira, Manuel A; Yang, Jian; Mulero, Juan; Fernandez-Sueiro, Jose Luis; Gonzalez-Gay, Miguel A; lopez-Larrea, Carlos; Deloukas, Panos; Donnelly, Peter; Bowness, Paul; Gafney, Karl; Gaston, Hill; Gladman, Dafna D; Rahman, Proton; Maksymowych, Walter P; Xu, Huji; Crusius, J Bart A; van der Horst-Bruinsma, Irene E; Chou, Chung-Tei; Valle-Oñate, Raphael; Romero-Sánchez, Consuelo; Hansen, Inger Myrnes; Pimentel-Santos, Fernando M; Inman, Robert D; Videm, Vibeke; Martin, Javier; Breban, Maxime; Reveille, John D; Evans, David M; Kim, Tae-Hwan; Wordsworth, Bryan Paul; Brown, Matthew A

2013-01-01

30

Identification of multiple risk variants for ankylosing spondylitis through high-density genotyping of immune-related loci.  

PubMed

Ankylosing spondylitis is a common, highly heritable inflammatory arthritis affecting primarily the spine and pelvis. In addition to HLA-B*27 alleles, 12 loci have previously been identified that are associated with ankylosing spondylitis in populations of European ancestry, and 2 associated loci have been identified in Asians. In this study, we used the Illumina Immunochip microarray to perform a case-control association study involving 10,619 individuals with ankylosing spondylitis (cases) and 15,145 controls. We identified 13 new risk loci and 12 additional ankylosing spondylitis-associated haplotypes at 11 loci. Two ankylosing spondylitis-associated regions have now been identified encoding four aminopeptidases that are involved in peptide processing before major histocompatibility complex (MHC) class I presentation. Protective variants at two of these loci are associated both with reduced aminopeptidase function and with MHC class I cell surface expression. PMID:23749187

Cortes, Adrian; Hadler, Johanna; Pointon, Jenny P; Robinson, Philip C; Karaderi, Tugce; Leo, Paul; Cremin, Katie; Pryce, Karena; Harris, Jessica; Lee, Seunghun; Joo, Kyung Bin; Shim, Seung-Cheol; Weisman, Michael; Ward, Michael; Zhou, Xiaodong; Garchon, Henri-Jean; Chiocchia, Gilles; Nossent, Johannes; Lie, Benedicte A; Førre, Øystein; Tuomilehto, Jaakko; Laiho, Kari; Jiang, Lei; Liu, Yu; Wu, Xin; Bradbury, Linda A; Elewaut, Dirk; Burgos-Vargas, Ruben; Stebbings, Simon; Appleton, Louise; Farrah, Claire; Lau, Jonathan; Kenna, Tony J; Haroon, Nigil; Ferreira, Manuel A; Yang, Jian; Mulero, Juan; Fernandez-Sueiro, Jose Luis; Gonzalez-Gay, Miguel A; Lopez-Larrea, Carlos; Deloukas, Panos; Donnelly, Peter; Bowness, Paul; Gafney, Karl; Gaston, Hill; Gladman, Dafna D; Rahman, Proton; Maksymowych, Walter P; Xu, Huji; Crusius, J Bart A; van der Horst-Bruinsma, Irene E; Chou, Chung-Tei; Valle-Oñate, Raphael; Romero-Sánchez, Consuelo; Hansen, Inger Myrnes; Pimentel-Santos, Fernando M; Inman, Robert D; Videm, Vibeke; Martin, Javier; Breban, Maxime; Reveille, John D; Evans, David M; Kim, Tae-Hwan; Wordsworth, Bryan Paul; Brown, Matthew A

2013-07-01

31

Update on ankylosing spondylitis: current concepts in pathogenesis.  

PubMed

Ankylosing spondylitis is an insidiously progressive and debilitating form of arthritis involving the axial skeleton. The long delay in diagnosis and insufficient response to currently available therapeutics both advocate for a greater understanding of disease pathogenesis. Genome-wide association studies of this highly genetic disease have implicated specific immune pathways, including the interleukin (IL)-17/IL-23 pathway, control of nuclear factor kappa B (NF-?B) activation, amino acid trimming for major histocompatibility complex (MHC) antigen presentation, and other genes controlling CD8 and CD4 T cell subsets. The relevance of these pathways has borne out in animal and human subject studies, in particular, the response to novel therapeutic agents. Genetics and the findings of autoantibodies in ankylosing spondylitis revisit the question of autoimmune vs. autoinflammatory etiology. As environmental partners to genetics, recent attention has focused on the roles of microbiota and biomechanical stress in initiating and perpetuating inflammation. Herein, we review these current developments in the investigation of ankylosing spondylitis pathogenesis. PMID:25447326

Smith, Judith A

2015-01-01

32

Circulating Protein Fragments of Cartilage and Connective Tissue Degradation Are Diagnostic and Prognostic Markers of Rheumatoid Arthritis and Ankylosing Spondylitis  

PubMed Central

Inflammation driven connective tissue turnover is key in rheumatic diseases, such as ankylosing spondylitis (AS). Few biomarkers are available for measuring disease prognosis or the efficacy of interventions applied in these tissue-related conditions. Type II collagen is the primary structural protein of cartilage and type III collagen of connective tissues, and obvious targets for the collagenalytic, which increase during tissue inflammation. The objective of the study was to investigate the diagnostic and prognostic utility of cartilage, C2M, and synovial, C3M, turnover biomarkers in AS. Serum samples were retrieved from patients suffering from AS (n?=?103), RA (n?=?47) and healthy controls (n?=?56). AS progressors were defined as having new vertebral syndesmophytes or more that 3 unit change in mSASSS over a two-year period. Type II collagen degradation markers in serum were measured by the C2M ELISA, and type III collagen degradation by the C3M ELISA. Logistic regression and dichotomized decision tree were used to analyze the prognostic value of the markers individually or in combination. Both C2M and C3M levels were significantly higher in RA patients than in healthy controls (p<0.0001). Diagnostic utility was analyzed by ROC and areas under the curve (AUCs) were 72% and 89% for C2M and C3M, respectively. Both C2M and C3M, were significantly higher in serum samples from AS patient than from healthy controls (p<0.0001). The AUCs of C2M and C3M, respectively, were 70% and 81% for AS. A combination of C2M and C3M, dichotomized according to best cut-offs for individual markers, could correctly identify 80% of the progressors and 61% of the non-progressors. The present study is the first to show that specific biomarkers of cartilage and connective tissue degradation facilitate both diagnosis and prediction of progression of RA and AS. PMID:23365672

Bay-Jensen, Anne C.; Wichuk, Stephanie; Byrjalsen, Inger; Leeming, Diana J.; Morency, Nathalie; Christiansen, Claus; Karsdal, Morten A.; Maksymowych, Walter P.

2013-01-01

33

Patellar Tendon Properties and Lower Limb Function in Rheumatoid Arthritis and Ankylosing Spondylitis versus Healthy Controls: A Cross-Sectional Study  

PubMed Central

Objective. Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) lead to inflammation in tendons and peritendinous tissues, but effects on biomechanical tendon function are unknown. This study investigated patellar tendon (PT) properties in stable, established RA and AS patients. Methods. We compared 18 RA patients (13 women, 59.0 ± 2.8 years, mean ± SEM) with 18 age- and sex-matched healthy controls (58.2 ± 3.2 years), and 12 AS patients (4 women, 52.9 ± 3.4 years) with 12 matched controls (54.5 ± 4.7 years). Assessments with electromyography, isokinetic dynamometry, and ultrasound included quadriceps muscle force and cross-sectional area (CSA), PT stiffness, and PT CSA. Additionally, measures of physical function and disease activity were performed. Results. PT stiffness and physical function were lower in RA and AS patients compared to healthy controls, without a significant difference in force production. PT CSA was significantly larger leading to reduction in Young's modulus (YM) in AS, but not in RA. Conclusion. The adverse changes in PT properties in RA and AS may contribute to their impaired physical function. AS, but not RA, leads to PT thickening without increasing PT stiffness, suggesting that PT thickening in AS is a disorganised repair process. Longitudinal studies need to investigate the time course of these changes and their response to exercise training. PMID:23844402

Matschke, Verena; Jones, Jeremy G.; Lemmey, Andrew B.; Maddison, Peter J.; Thom, Jeanette M.

2013-01-01

34

Patient-reported adherence to coprescribed proton pump inhibitor gastroprotection in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis patients using nonsteroidal anti-inflammatory drugs  

PubMed Central

Background Patients with osteoarthritis (OA), rheumatoid arthritis (RA), or ankylosing spondylitis (AS) are commonly treated with nonsteroidal anti-inflammatory drugs (NSAIDs), sometimes with a concomitant gastroprotective proton pump inhibitor (PPI). The present study examines real-life patient adherence to PPIs when coprescribed with NSAIDs. Methods This retrospective medical record survey identified patients diagnosed with OA, RA, or AS who had PPIs coprescribed with NSAIDs for prevention of NSAID-associated gastrointestinal ulcers. Actual NSAID and PPI intake was retrospectively recorded using a self-reported questionnaire. Adherence to PPI treatment was assessed using descriptive statistics. Results In total, 96 patients (69% female, mean age 67 years, 72% OA, 16% RA, 12% AS) were included. The mean patient-reported adherence to coprescribed PPIs was 73%–81%. The percentage of patients with a self-reported adherence of ?80% was 26%. No predictive factors for low adherence could be identified. Conclusion Despite doctors’ instructions to use PPIs concomitantly with NSAIDs, the mean patient-reported adherence to coprescribed PPIs in this population indicates a risk of a “gastroprotective treatment gap”. The patients’ adherence to gastroprotective PPIs for the prevention of NSAID-associated upper gastrointestinal ulcers can be improved. PMID:25429206

Henriksson, Kenneth; From, Jesper; Stratelis, Georgios

2014-01-01

35

Imbalance between HAT and HDAC Activities in the PBMCs of Patients with Ankylosing Spondylitis or Rheumatoid Arthritis and Influence of HDAC Inhibitors on TNF Alpha Production  

PubMed Central

Objective Acetylation or deacetylation of histone proteins may modulate cytokine gene transcription such as TNF alpha (TNF). We evaluated the balance between histone deacetytlase (HDAC) and histone acetyltransferase (HAT) in patients with rheumatoid arthritis (RA) or ankylosing spondylitis (AS) compared to healthy controls (HC) and determined the influence of HDAC inhibitors (trichostatin A -TSA- or Sirtinol -Sirt-) on these enzymatic activities and on the PBMC production of TNF. Methods 52 patients with RA, 21 with AS and 38 HC were evaluated. HAT and HDAC activities were measured on nuclear extracts from PBMC using colorimetric assays. Enzymatic activities were determined prior to and after ex vivo treatment of PBMC by TSA or Sirt. TNF levels were evaluated in PBMC culture supernatants in the absence or presence of TSA or Sirt. Results HAT and HDAC activities were significantly reduced in AS, while these activities reached similar levels in RA and HC. Ex vivo treatment of PBMC by HDACi tended to decrease HDAC expression in HC, but Sirt significantly reduced HAT in RA. TNF production by PBMC was significantly down-regulated by Sirt in HC and AS patients. Conclusion HAT and HDAC were disturbed in AS while no major changes were found in RA. HDACi may modulate HDAC and HAT PBMC expression, especially Sirt in RA. Sirtinol was able to down regulate TNF production by PBMC in HC and AS. An imbalance between HAT and HDAC activities might provide the rationale for the development of HDACi in the therapeutic approach to inflammatory rheumatic diseases. PMID:24039666

Toussirot, Eric; Abbas, Wasim; Khan, Kashif Aziz; Tissot, Marion; Jeudy, Alicia; Baud, Lucile; Bertolini, Ewa; Wendling, Daniel; Herbein, Georges

2013-01-01

36

Agreement of Turkish Physiatrists with the Assessment in Spondyloarthritis International Society and the European League Against Rheumatism Recommendations for the Management of Ankylosing Spondylitis and Rheumatoid Arthritis  

PubMed Central

Background: New developments in the field of targeted therapies or biologic agents led more effective management of ankylosing spondylitis (AS) and rheumatoid arthritis (RA). Recommendations for the management of rheumatic diseases propose to reduce inappropriate use of medications, minimize variations among countries, and enable cost-effective use of health care resources. Objective: The aim this study was to evaluate conceptual agreement of ASsessment in SpondyloArthritis International Society (ASAS) and the EUropean League Against Rheumatism (EULAR) recommendations for the management of AS and EULAR recommendations for RA and to assess the rate of application among Turkish physiatrists in daily clinical practice. Methods: An online survey link has been sent to 1756 Turkish physiatrists with e-mails asking to rate agreement on 11-item ASAS/EULAR AS recommendations and 15-item EULAR RA recommendations with synthetic and biological disease-modifying anti-rheumatic drugs. Also barriers and difficulties for using biologic agents were assessed. Results: Three hundred nine physiatrists (17.5%) completed the survey. The conceptual agreement with both recommendations was very high (Level of agreement; mean 8.35±0.82 and 8.90± 0.67 for RA and AS recommendations, respectively), and the self-declared application of overall recommendations in the clinical practice was also high for both RA and AS (72.42% and 75.71%, respectively). Conclusion: Turkish physiatrists are in good conceptual agreement with the evidence-based recommendations for the management of AS and RA. These efforts may serve to disseminate the knowledge and increase the current awareness among physicians who serve to these patients and also implementation of these recommendations is expected to increase as well. PMID:22481985

Ozgocmen, Salih; Akgul, Ozgur; Ak?nc?, Aysen; Ataman, Sebnem; Birtane, Murat; Bodur, Hatice; Günayd?n, Rezan; Kuru, Ömer; Rezvani, Aylin; ?endur, Omer Faruk; ?enel, Kaz?m; Tuncer, Tiraje

2012-01-01

37

Coping Strategies for Health and Daily-Life Stressors in Patients With Rheumatoid Arthritis, Ankylosing Spondylitis, and Gout: STROBE-Compliant Article.  

PubMed

This article aims to identify the strategies for coping with health and daily-life stressors of Mexican patients with chronic rheumatic disease.We analyzed the baseline data of a cohort of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and gout. Their strategies for coping were identified with a validated questionnaire. Comparisons between health and daily-life stressors and between the 3 clinical conditions were made. With regression analyses, we determined the contribution of individual, socioeconomic, educational, and health-related quality-of-life variables to health status and coping strategy.We identified several predominant coping strategies in response to daily-life and health stressors in 261 patients with RA, 226 with AS, and 206 with gout. Evasive and reappraisal strategies were predominant when patients cope with health stressors; emotional/negative and evasive strategies predominated when coping with daily-life stressors. There was a significant association between the evasive pattern and the low short-form health survey (SF-36) scores and health stressors across the 3 diseases. Besides some differences between diagnoses, the most important finding was the predominance of the evasive strategy and its association with low SF-36 score and high level of pain in patients with gout.Patients with rheumatic diseases cope in different ways when confronted with health and daily-life stressors. The strategy of coping differs across diagnoses; emotional/negative and evasive strategies are associated with poor health-related quality of life. The identification of the coping strategies could result in the design of psychosocial interventions to improve self-management. PMID:25761177

Peláez-Ballestas, Ingris; Boonen, Annelis; Vázquez-Mellado, Janitzia; Reyes-Lagunes, Isabel; Hernández-Garduño, Adolfo; Goycochea, Maria Victoria; Bernard-Medina, Ana G; Rodríguez-Amado, Jacqueline; Casasola-Vargas, Julio; Garza-Elizondo, Mario A; Aceves, Francisco J; Shumski, Clara; Burgos-Vargas, Ruben

2015-03-01

38

A comparison of telephone and paper self-completed questionnaires of main patient-related outcome measures in patients with ankylosing spondylitis and psoriatic arthritis.  

PubMed

A cross-sectional study was performed to assess the correlation between telephone and self-administration of patient-related outcomes (PROs) used in the assessment of ankylosing spondylitis (AS) patients. Participants underwent a telephone interview in which the following measures were evaluated: numerical rating scales (NRSs) for global health, pain intensity, global pain, back pain, and back pain at night; BASDI, BASFI, Health Assessment Questionnaire (HAQ), ASQoL, EuroQol, SF-12, and Work Productivity and Activity Impairment (WPAI) questionnaire. Within 48 h after the telephone interview, patients were appointed for a clinical visit in which the same questionnaires and in the same order were self-administered. The degree of correlation of outcomes measures between telephone interview and self-administration was assessed with the intraclass correlation coefficient (ICC). The two modes of assessing PROs were highly reliable, with ICC of 0.81 for BASDAI, 0.82 for BASFI, and 0.75 for HAQ. NRSs for global health, global pain intensity, back pain, and back pain at night also showed ICCs between 0.51 and 0.70, and only NRS for global disease activity showed an ICC of 0.45. This results were similar in patients with AS and patients with psoriatic arthritis. Social functioning and mental health domains of the SF-12 as well as EuroQol had poor correlations. The ICCs for WPAI outcomes were very good or good. We conclude that PROs in AS patients are comparable in both self-administered paper questionnaires and via a telephone interview. Different modes of assessing PRO measures facilitate the assessment of patients with AS in routine practice. PMID:23793389

Ariza-Ariza, Rafael; Hernández-Cruz, Blanca; Navarro-Compán, Victoria; Leyva Pardo, Christian; Juanola, Xavier; Navarro-Sarabia, Federico

2013-11-01

39

Living with Ankylosing Spondylitis: the patient's perspective.  

PubMed

Ankylosing Spondylitis (AS) is a potentially debilitating chronic condition that necessitates a biopsychosocial approach for successful long-term management. However, the psychosocial consequences of AS are not well understood. In this study patients (N = 68) reported impacts of AS across a wide range of life domains; negative impacts included physical effects of AS, changes in mood or personality, effects on social life and relationships with friends and family, low self-esteem, stigma and worry about the future; positive impacts included increased exercise, feelings of achievement and empathy, stronger relationships, slower pace of life and a more positive perspective. Implications for treatment are discussed. PMID:19687119

Hamilton-West, Kate E; Quine, Lyn

2009-09-01

40

Adherence to treatment in patients with ankylosing spondylitis.  

PubMed

This study aims to determine the level of adherence to treatment in ankylosing spondylitis (AS) patients and to identify possible factors associated to lack of adherence. We included consecutive AS patients (NY modified criteria). Sociodemographic and clinical data were collected. Patients answered auto-reported questionnaires: Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life, and Center for Epidemiological Studies Depression scale. Patients with rheumatoid arthritis (RA) (ACR'87 criteria) were assessed as the control group. The adherence of the studied groups to medical treatment and exercises was measured by means of two questionnaires: Compliance Questionnaire on Rheumatology (CQR) and Exercise Attitude Questionnaire-18 (EAQ-18). The study included 59 patients with AS and 53 patients with RA. Of the AS patients, 43 (72.9%) were male, median age 47 years (interquartile range (IQR) 33-57) and median disease duration of 120 months (IQR 33-57). Of the RA patients, 37 (69.8%) were female, had a median age of 56 years (IQR 43.5-60) and a median disease duration of 156 months (IQR 96-288). There were no significant differences in the results of the adherence questionnaires between both groups, with a total median of 68.42 for the CQR in both groups and of 40.7 in AS vs. 42.6 in RA for the EAQ. When dichotomizing patients as adherent and non-adherent, taking as good adherence a cut value in the CQR and EAQ higher than 60, adherence to pharmacological treatment was significantly higher in RA vs. AS (92.5 vs. 74.6%, p = 0.01) and there were no differences in the EAQ. On the uni- and multivariate analysis, lack of adherence to treatment was not associated to sex, age, disease duration, education, health insurance, depressive status, and disease activity parameters in neither group of patients. AS have an acceptable adherence to pharmacological treatment, although it is lower than RA patients; nonetheless, both groups show a lack of adherence to exercise. PMID:23515597

Arturi, Pablo; Schneeberger, Emilce Edith; Sommerfleck, Fernando; Buschiazzo, Emilio; Ledesma, César; Maldonado Cocco, José Antonio; Citera, Gustavo

2013-07-01

41

The classification and diagnostic criteria of ankylosing spondylitis.  

PubMed

Ankylosing spondylitis is the prototype of immune-mediated inflammatory rheumatic diseases grouped under the term spondyloarthritis (SpA). An early diagnosis has now become increasingly important because effective therapies are available and anti-TNF drugs are even more effective if used in early stages of the disease. In ankylosing spondylitis, the 1984 modified New York criteria have been used widely in clinical studies and daily practice but are not applicable in early disease when the characteristic radiographic signs of sacroiliitis are not visible but active sacroiliitis is readily detectable by magnetic resonance imaging (MRI). Thus there has been a need for new classification or diagnostic criteria to identify inflammatory spondyloarthritis at early stage of the disease. This led to the concept of axial SpA to include the entire spectrum of patients with axial disease both, with and without radiographic damage. New classification criteria for the wider group of SpA have been proposed by ASAS (Assessment of Spondylo Arthritis International Society); and the patients are sub-grouped into (1) a predominantly axial disease, termed axial SpA including AS and non-radiographic axial SpA; (2) peripheral SpA. The clinical course and disease process of non-radiographic axial spondyloarthritis remains unclear. However the development of the SpA criteria by ASAS particularly for axial SpA, is an important step for early diagnosis and better management of these patients. PMID:24534717

Raychaudhuri, Siba P; Deodhar, Atul

2014-01-01

42

T lymphocyte subset imbalances in patients contribute to ankylosing spondylitis  

PubMed Central

Ankylosing spondylitis is a chronic inflammatory rheumatic disease, which is characterized by inflammation of the spine and the sacroiliac joints. To date, the disease etiology remains unclear. In the present study, the correlation of T lymphocyte subset changes with the progression of ankylosing spondylitis was investigated. A total of 55 patients with ankylosing spondylitis (22 severe and 23 mild cases) and 20 healthy individuals were selected. Firstly, the punctured cells in the lesions and the serum were collected, and the lymphocytes and the peripheral blood mononuclear cells were prepared. Secondly, quantitative PCR, ELISA and flow cytometry analyses were carried out to detect the levels of a series of immunoglobulins, complements, helper T cells, cytotoxic T cells, regulatory cells and cytokines. The expression levels of ?-globulin, ?-globulin, immunoglobulin (Ig)G, IgA, IgM, serum complement C3, and complement C4 were found to be significantly increased in ankylosing spondylitis patients. In addition, the percentage of Th1 and Th17 cells was found to be significantly higher in the ankylosing spondylitis groups (mild and severe) compared with the healthy individuals. As a result, the Th1/Th2 and Th17/Treg ratios were significantly higher in patients with ankylosing spondylitis. In addition, T lymphocyte subset ratio imbalances contributed to an increased expression of immune mediators, including interferon (IFN)-? and interleukin (IL)-17A. The mRNA and protein expression levels of IFN-? and IL-17A were found to be higher in the ankylosing spondylitis groups compared with the control group. The present study provided further evidence on the function and underlying mechanism of T lymphocyte subsets, which may be useful in the diagnosis and treatment of ankylosing spondylitis. PMID:25452811

WANG, CHENGGONG; LIAO, QIANDE; HU, YIHE; ZHONG, DA

2015-01-01

43

Long-term safety and efficacy of etanercept in the treatment of ankylosing spondylitis  

PubMed Central

To date, anti-tumor necrosis factor alfa (anti-TNF-?) therapy is the only alternative to nonsteroidal anti-inflammatory drugs for the treatment of ankylosing spondylitis. Etanercept is a soluble TNF receptor, with a mode of action and pharmacokinetics different to those of antibodies and distinctive efficacy and safety. Etanercept has demonstrated efficacy in the treatment of ankylosing spondylitis, with or without radiographic sacroiliitis, and other manifestations of the disease, including peripheral arthritis, enthesitis, and psoriasis. Etanercept is not efficacious in inflammatory bowel disease, and its efficacy in the treatment of uveitis appears to be lower than that of other anti-TNF drugs. Studies of etanercept confirmed regression of bone edema on magnetic resonance imaging of the spine and sacroiliac joint, but failed to reduce radiographic progression, as do the other anti-TNF drugs. It seems that a proportion of patients remain in disease remission when the etanercept dose is reduced or administration intervals are extended. Etanercept is generally well tolerated with an acceptable safety profile in the treatment of ankylosing spondylitis. The most common adverse effect of etanercept treatment is injection site reactions, which are generally self-limiting. Reactivation of tuberculosis, reactivation of hepatitis B virus infection, congestive heart failure, demyelinating neurologic disorders, hematologic disorders like aplastic anemia and pancytopenia, vasculitis, immunogenicity, and exacerbation or induction of psoriasis are class effects of all the anti-TNF drugs, and have been seen in patients with ankylosing spondylitis. However, etanercept is less likely to induce reactivation of tuberculosis than the other anti-TNF drugs and it has been suggested that etanercept might be less immunogenic, especially in ankylosing spondylitis. Acute uveitis, Crohn’s disease, and sarcoidosis are other adverse events that have been rarely associated with etanercept therapy in patients with ankylosing spondylitis. PMID:24101863

Senabre-Gallego, José Miguel; Santos-Ramírez, Carlos; Santos-Soler, Gregorio; Salas-Heredia, Esteban; Sánchez-Barrioluengo, Mabel; Barber, Xavier; Rosas, José

2013-01-01

44

Evaluation of the novel ultrasound score for large joints in psoriatic arthritis and ankylosing spondylitis: six month experience in daily clinical practice  

PubMed Central

Background To evaluate the utility of the recently introduced SOLAR score (sonography of large joints in Rheumatology), which has been validated in RA patients, in a cohort of patients with Psoriatic Arthritis (PsA) and Ankylosing Spondylitis (AS) presenting with involvement of large peripheral joints. Methods The recently established SOLAR score has been designed to determine the degree of inflammation in the shoulder, the elbow, the hip and the knee joint in patients suffering from RA. Since large joints are frequently involved in PsA and AS, synovitis and synovial vascularity were scored semiquantitatively (grade 0–3) by grey scale (GSUS) and power Doppler ultrasound (PDUS) utilizing the validated scoring system. Each joint was scanned from different angles, the knee joint for example was divided into four areas to score for synovitis: the suprapatellar longitudinal, the medial longitudinal, the lateral longitudinal, and the posterior region. Each area was scored from 0–3, so a maximum score of 12 could be achieved. PsA and AS patients presenting with peripheral joint disease involving large joints were examined at baseline, 3 and 6 months after initiation of local or systemic therapy (DMARDs/Biologics). For evaluation of the inflammatory status, the erythrocyte sedimentation rate (ESR) was determined. Results A cohort of 126 patients were enclosed, and 83 of these were followed for 6 months. At baseline before modification of the therapy, patients received DMARDs (n = 83), DMARDs plus biologics (n?=?30), or biologic monotherapy (n?=?29). Following intervention, all US scores demonstrated a marked improvement. The GSUS and the PDUS scores for all joint areas, except the PDUS score of the hip, exhibited a significant improvement (p?

2013-01-01

45

Ankylosing Spondylitis in Iran; Late Diagnosis and Its Causes  

PubMed Central

Background: Ankylosing spondylitis (AS) is a chronic destructive and inflammatory disease of the axial skeleton manifested by back pain and progressive stiffness of the spine. Objectives: The aim of the present cross-sectional study was to evaluate and identify factors leading to delayed diagnosis of AS in Iranian patients. Patients and Methods: Sixty patients, (53 males, 7 females) with a diagnosis of AS according to the modified New York criteria were recruited. Diagnosis delay was defined as the interval between a patient’s first spondyloarthritic symptoms [inflammatory back pain (IBP), inflammatory arthritis, enthesopathy and uveitis] and a correct diagnosis of AS. Results: The average age of patients at diagnosis of AS was 36.4 ± 4.5 years and the average of delay in diagnosis was 6.2 ± 3.5 years. The most common diagnosis at the first visit was disc herniation (68.3%). Delay in diagnosis of Human Leukocyte Antigen (HLA-B27) positive and negative patients were 4.6 ± 2.2 years and 10.1 ± 3.2 years, respectively (P = 0.0001). Diagnosis delay in patients with morning stiffness and IBP were significantly shorter than that of patients without these symptoms (P = 0.0001 and P = 0.001, respectively). Patients with uveitis had the shortest diagnosis delay (P = 0.02). The Bath Ankylosing spondylitis disease activity index (BASDAI) was not significantly different in early (< 3years) and late (> 3years) diagnosis (3.3 ± 0.9 and 3.6 ± 0.7, respectively) (P = 0.18), but the Both ankylosing spondylitis functional index (BASFI) was significantly different between them (3.3 ± 1.0 and 4.1 ± 0.7 respectively) (P = 0.001). Conclusions: In this study, delay in diagnosis was similar to other studies. Educating physicians to careful history taking especially in the case of IBP, non-musculoskeletal symptoms such as uveitis and precise physical examination are important in early diagnosis. PMID:24910782

Hajialilo, Mehrzad; Ghorbanihaghjo, Amir; Khabbazi, Alireza; Kolahi, Suosan; Rashtchizadeh, Nadereh

2014-01-01

46

Rheumatoid Arthritis Educational Video Series  

MedlinePLUS Videos and Cool Tools

2015 Rheumatology Conference early bird registration ends March 23! Register Today! Appointments • Support Our Research Arthritis Information Disease Information Rheumatoid Arthritis Psoriatic Arthritis Ankylosing Spondylitis ...

47

Whole body MR imaging in ankylosing spondylitis: a descriptive pilot study in patients with suspected early and active confirmed ankylosing spondylitis  

PubMed Central

Background Ankylosing spondylitis is a chronic inflammatory rheumatic disorder which usually begins in early adulthood. The diagnosis is often delayed by many years. MR imaging has become the preferred imaging method for detection of early inflammation of the axial skeleton in ankylosing spondylitis. The goal of this study was to assess the frequency and distribution of abnormalities on whole body MR imaging in patients with suspected early ankylosing spondylitis and with active confirmed ankylosing spondylitis. Methods Ten patients with suspected early ankylosing spondylitis and ten patients with confirmed ankylosing spondylitis were enrolled. On an 18-channel MR system, coronal and sagittal T1 weighted and STIR sequences were acquired covering the entire spine, sacrum, anterior chest wall, shoulder girdle, and pelvis. The total examination time was 30 minutes. Results In both groups inflammatory lesions of the lower thoracic spine were frequent (number of patients with suspected early/confirmed ankylosing spondylitis: 7/9). In confirmed ankylosing spondylitis the upper thoracic spine (3/6) and the lumbar spine (4/8) were more commonly involved. The inferior iliac quadrant of the sacroiliac joints was frequently altered in both groups (8/8). The superior iliac (2/5), inferior sacral (6/10) and superior sacral (3/6) quadrants were more frequently affected in confirmed ankylosing spondylitis. Abnormalities of the manubriosternal joint (2/4), the sternoclavicular joints (1/2) and hip joint effusion (4/3) were also seen. Conclusion In both suspected early ankylosing spondylitis and confirmed ankylosing spondylitis, whole body MR examinations frequently demonstrate inflammatory lesions outside the sacroiliac joints. These lesions are similarly distributed but occur less frequently in suspected early compared to confirmed ankylosing spondylitis. Due to the small sample size in this pilot study these results need to be confirmed in larger studies with this emerging technique. PMID:17326845

Weber, Ulrich; Pfirrmann, Christian WA; Kissling, Rudolf O; Hodler, Juerg; Zanetti, Marco

2007-01-01

48

Ankylosing Spondylitis: From Cells to Genes  

PubMed Central

Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown etiology, though it is considered an autoimmune disease. HLA-B27 is the risk factor most often associated with AS, and although the mechanism of involvement is unclear, the subtypes and other features of the relationship between HLA-B27 and AS have been studied for years. Additionally, the key role of IL-17 and Th17 cells in autoimmunity and inflammation suggests that the latter and the cytokines involved in their generation could play a role in the pathogenesis of this disease. Recent studies have described the sources of IL-17 and IL-23, as well as the characterization of Th17 cells in autoimmune diseases. Other cells, such as NK and regulatory T cells, have been implicated in autoimmunity and have been evaluated to ascertain their possible role in AS. Moreover, several polymorphisms, mutations and deletions in the regulatory proteins, protein-coding regions, and promoter regions of different genes involved in immune responses have been discovered and evaluated for possible genetic linkages to AS. In this review, we analyze the features of HLA-B27 and the suggested mechanisms of its involvement in AS while also focusing on the characterization of the immune response and the identification of genes associated with AS. PMID:23970995

Zambrano-Zaragoza, José Francisco; Agraz-Cibrian, Juan Manuel; González-Reyes, Christian; Durán-Avelar, Ma. de Jesús; Vibanco-Pérez, Norberto

2013-01-01

49

Integrative Structural Biomechanical Concepts of Ankylosing Spondylitis  

PubMed Central

Ankylosing spondylitis (AS) is not fully explained by inflammatory processes. Clinical, epidemiological, genetic, and course of disease features indicate additional host-related risk processes and predispositions. Collectively, the pattern of predisposition to onset in adolescent and young adult ages, male preponderance, and widely varied severity of AS is unique among rheumatic diseases. However, this pattern could reflect biomechanical and structural differences between the sexes, naturally occurring musculoskeletal changes over life cycles, and a population polymorphism. During juvenile development, the body is more flexible and weaker than during adolescent maturation and young adulthood, when strengthening and stiffening considerably increase. During middle and later ages, the musculoskeletal system again weakens. The novel concept of an innate axial myofascial hypertonicity reflects basic mechanobiological principles in human function, tissue reactivity, and pathology. However, these processes have been little studied and require critical testing. The proposed physical mechanisms likely interact with recognized immunobiological pathways. The structural biomechanical processes and tissue reactions might possibly precede initiation of other AS-related pathways. Research in the combined structural mechanobiology and immunobiology processes promises to improve understanding of the initiation and perpetuation of AS than prevailing concepts. The combined processes might better explain characteristic enthesopathic and inflammatory processes in AS. PMID:22216409

Masi, Alfonse T.; Nair, Kalyani; Andonian, Brian J.; Prus, Kristina M.; Kelly, Joseph; Sanchez, Jose R.; Henderson, Jacqueline

2011-01-01

50

Imaging Manifestations of Spinal Fractures in Ankylosing Spondylitis  

Microsoft Academic Search

BACKGROUND AND PURPOSE: Spinal fractures in ankylosing spondylitis (AS) were diffi- cult to diagnose before CT and MR imaging were available. The purpose of our investigation was to characterize spinal fractures and determine the value of different imaging modalities in AS. METHODS: Twelve successive cases of spinal fractures were identified in MR imaging files of AS patients. Conventional radiographs were

Yi-Fen Wang; Michael Mu-Huo Teng; Cheng-Yen Chang; Hung-Ta Wu; Shih-Tien Wang

51

Report of 12 cases of ankylosing spondylitis patients treated with Tripterygium wilfordii  

Microsoft Academic Search

Objective  Description of the clinical response of 12 consecutive cases of disease-active ankylosing spondylitis (AS) treated with the\\u000a herbal medicine Tripterygium wilfordii Hook f (TwHf; lei gong teng, thunder god vine), which has been reported in controlled studies to be effective in rheumatoid\\u000a arthritis (RA).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The clinical status of 12 patients with active AS who were started on 60 mgday-1 of a

Wei Ji; Juan Li; Yue Lin; Ya-nan Song; Miaojia Zhang; Yao Ke; Yile Ren; Xiaohu Deng; Jianglin Zhang; Feng Huang; David Yu

2010-01-01

52

Fracture of the odontoid peg in ankylosing spondylitis: case report.  

PubMed

Fractures in patients with ankylosing spondylitis tend to affect the lower cervical spine. We describe a 50-year-old man who sustained fractures of the odontoid peg and body of the second cervical vertebra after a hyperextension injury. In absence of atlanto-occipital fusion, deformity from previous lower cervical spine injury may have contributed to susceptibility for this very rare combination of fractures. The patient was treated surgically with a good result. PMID:7897715

Peh, W C; Ho, E K

1995-03-01

53

Symptomatic noncompressive motoromyelopathy presents as early manifestation in ankylosing spondylitis  

Microsoft Academic Search

Ankylosing spondylitis (AS) is an autoimmune spondyloarthropathy involving principally the sacroiliac joint and axial skeleton.\\u000a Spinal cord involvement is an infrequent and late complication. It mostly results from compressive myelopathy due to skeletal\\u000a osteopathy and usually presents with radiculomyelopathic sensory and motor deficits. To report three patients who suffered\\u000a a progressive paraparesis\\/tetraparesis compatible with motor myelopathy without typical skeletal symptom.

Wei-Hsi Chen; Hsin-Ling Yin; Hung-Sheng Lin; Chung-Jen Chen

2011-01-01

54

Nursing and safety of silver needle diathermy treating ankylosing spondylitis.  

PubMed

This paper aims to discuss the nursing and safety of silver needle diathermy in the treatment for ankylosing spondylitis. We nursed 46 patients with ankylosing spondylitis treated with silver needle diathermy. Specific nursing was focused on physical condition evaluation and mental nursing before treatment, observation during and after treatment, diet nursing, needle eye nursing, functional training and propaganda and education when discharged. The result suggested that all the patients received mental nursing, diet guide, skin care, health education, functional training and follow-up visit from the nurse and all of them could endure silver needle diathermy as discomfort or drug allergy was barely found, so were slight scald and skin infection nearby the needle eye caused by fainting during acupuncture, accidental puncture or overheat. Follow-up visit showed that no patient suffered obvious untoward effect and the pain, joint range of motion and living condition were distinctly improved a week after discharging. In conclusion, during the treatment for ankylosing spondylitis applying silver needle diathermy, the nursing before, during and after the treatment can obviously reduce the complication, accelerate the recovery, which is highly safe. PMID:25796147

Ning, Huaxiu; Wang, Yun; Yuan, Yiwen; Ning, Huaying

2015-03-01

55

Golimumab 3-year safety update: an analysis of pooled data from the long-term extensions of randomised, double-blind, placebo-controlled trials conducted in patients with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis  

PubMed Central

Objective To assess pooled golimumab safety up to year 3 of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) trials. Methods Golimumab 50 and 100?mg, administered subcutaneously (SC) every 4?weeks (q4wk), were assessed in patients with active RA (methotrexate-naïve, methotrexate-experienced and anti-TNF (tumour necrosis factor)-experienced), PsA or AS, despite conventional therapy. Placebo control continued up to week (wk) 24 (wk 52, methotrexate-naïve), with early escape at wk 16 (wk 28, methotrexate-naïve); subsequently, all patients received golimumab 50 or 100?mg q4wk. After the blinded controlled period, golimumab doses could be adjusted per investigator discretion. Pooled safety analyses reported herein include data from placebo-controlled and uncontrolled study periods up to wk 160. Determinations of incidences/100 patient-years (pt-yrs) for rare events also included RA patients from a phase IIb trial. Results Across five phase III trials of SC golimumab, 639 patients received placebo and 2226 received golimumab 50?mg (n=1249) and/or 100?mg (n=1501) up to wk 160 (patients may be included in more than one group because non-responders were allowed early escape); 1179 patients were treated for ?156?weeks. For placebo, golimumab 50?mg and golimumab 100?mg, respective adverse event incidences/100 pt-yrs (95% CIs) up to wk 160 were: 0.28 (0.01 to 1.56), 0.30 (0.12 to 0.62), 0.41 (0.23 to 0.69) for death; 5.31 (3.20 to 8.30), 3.03 (2.36 to 3.82), 5.09 (4.36 to 5.90) for serious infection; 0.00 (0.00 to 0.84), 0.17 (0.05 to 0.44), 0.35 (0.18 to 0.62) for tuberculosis; 0.00 (0.00 to 0.84), 0.13 (0.03 to 0.38), 0.24 (0.10 to 0.46) for opportunistic infection; 0.00 (0.00 to 0.84), 0.00 (0.00 to 0.13), 0.12 (0.03 to 0.30) for demyelination; and 0.00 (0.00 to 0.84), 0.04 (0.00 to 0.24), 0.18 (0.06 to 0.38) for lymphoma. Conclusions SC golimumab safety up to 3?years remained consistent with that of other TNF antagonists. Golimumab 100?mg showed numerically higher incidences of serious infections, demyelinating events and lymphoma than 50?mg; safety follow-up up to year 5 continues. PMID:24344160

Kay, Jonathan; Fleischmann, Roy; Keystone, Edward; Hsia, Elizabeth C; Hsu, Benjamin; Mack, Michael; Goldstein, Neil; Braun, Jürgen; Kavanaugh, Arthur

2015-01-01

56

Continuous posterior lumbar plexus and continuous parasacral and intubation with lighted stylet for ankylosing spondylitis  

PubMed Central

Ankylosing spondylitis is characterized by progressive ossification of the spinal column with resultant stiffness. Ankylosing spondylitis can present significant challenges to the anaesthetist as a consequence of the potential difficult airway and performing neuraxial blockade. We describe a case of intubation with lighted stylet, and use of the continuous lumbosacral plexus for THA and postoperative analgesia with an elastomeric pump. Key words: Airways difficult anticipated, anesthesia, ankoylosing spondylitis, arthroplasty, conduction, continuous lumbosacral plexus, hip, infusion pumps, intubation awake, replacement

Imbelloni, Luiz Eduardo; Lucena, Neli

2015-01-01

57

Continuous posterior lumbar plexus and continuous parasacral and intubation with lighted stylet for ankylosing spondylitis.  

PubMed

Ankylosing spondylitis is characterized by progressive ossification of the spinal column with resultant stiffness. Ankylosing spondylitis can present significant challenges to the anaesthetist as a consequence of the potential difficult airway and performing neuraxial blockade. We describe a case of intubation with lighted stylet, and use of the continuous lumbosacral plexus for THA and postoperative analgesia with an elastomeric pump. Key words: Airways difficult anticipated, anesthesia, ankoylosing spondylitis, arthroplasty, conduction, continuous lumbosacral plexus, hip, infusion pumps, intubation awake, replacement. PMID:25886430

Imbelloni, Luiz Eduardo; Lucena, Neli

2015-01-01

58

Ankylosing spondylitis clinical registries: principles, practices and possibilities.  

PubMed

The need for a rigorously developed longitudinal registry of patients with spondyloarthritis (SpA) is clear and urgent. Like randomized controlled trials, registries rely on a prospective, systematic protocol-driven approach to data acquisition to assess outcomes for a prescribed cohort of patients. Registries seek to capture large numbers of patients across large geographic zones and can serve as a valuable resource for patient advocacy, patient education and support, incidence and prevalence, and broad demographic profiles. Building on 3 existing registries--the Prospective Study of Outcomes in Ankylosing Spondylitis, the Program to Understand the Longterm Outcomes of Spondyloarthritis (PULSAR) and the University Health Network Spondyloarthritis Program--these registries and the Spondylitis Association of America propose to form a combined registry of North American SpA patients. The combined registry would, ideally, complement ongoing clinical goals and improve patient care. PMID:23841118

Caplan, Liron; Clegg, Daniel O; Inman, Robert D

2013-06-01

59

Renal AA amyloidosis in a patient with Bence Jones proteinuria and ankylosing spondylitis.  

PubMed Central

A patient with a 10 year history of monoclonal gammopathy of undetermined significance and Bence Jones proteinuria, and a 44 year history of ankylosing spondylitis, developed a nephrotic syndrome secondary to renal amyloidosis. Clinically the amyloidosis was ascribed to Bence Jones proteinuria rather than to the burnt out ankylosing spondylitis. However, histochemical and immunofluorescence staining techniques used to type the amyloid fibrils showed AA amyloidosis, implicating ankylosing spondylitis rather than monoclonal gammopathy as the underlying cause of the patient's systemic amyloidosis and consequent nephrotic syndrome. It is recommended that immunostaining of amyloid become a routine procedure to detect occult or apparently inactive disease. Images PMID:1430270

Quinton, R; Siersema, P D; Michiels, J J; ten Kate, F J

1992-01-01

60

Plasma homocysteine status in patients with ankylosing spondylitis.  

PubMed

Homocysteine (Hcy), a sulfur-containing amino acid, is eliminated through B vitamins-dependent pathways. Hyperhomocysteinemia has been found to be an independent risk factor for atherosclerotic cardiovascular, cerebrovascular, and peripheral vascular diseases. Recently, psoriasis, lupus, and rheumatoid arthritis were reported to be associated with hyperhomocysteinemia. This study was aimed to evaluate the changes of plasma Hcy level before and after sulfasalazine and MTX therapy in patients with ankylosing spondylitis (AS). One hundred and two patients with AS and ten normal controls were enrolled in the cross-sectional case-control study. Fasting plasma Hcy levels were determined by ELISA kits (IMX, Abbott). Hcy levels were compared to their Bath AS disease activity index (BASDAI) and the usage of sulfasalazine and/or MTX. Active disease was defined by BASDAI as more than 3 in a 10-cm scale with ESR >20 mm/h. For those patients with plasma Hcy >or=15 micromol/l, a perspective trial of daily supplement of vitamin B-12 0.5 mg, B-6 50 mg, and folic acid 5 mg for 2 weeks were also tested for the efficacy. Plasma Hcy level increased significantly in AS patients under sulfasalazine (10.4+/-3.8 micromol/l, p<0.05), MTX (11.9+/-4.7, p<0.05) and sulfasalazine/MTX combination treatment (11.2+/-2.6, p<0.05) compared with normal controls (8.6+/-1.2 micromol/l) and AS patients without DMARD(9.4+/- 2.6 micromol/l). No correlation between disease activity and plasma Hcy level was found. Daily supplement of vitamin B-12 0.5 mg, B-6 50 mg, and folic acid 5 mg can lower Hcy level in 2 weeks (32.3+/-24.0 vs 15.6+/-11.1 micromol/l, p=0.007). Plasma homocysteine level did significantly increase in AS patients under sulfasalazine or MTX treatment. B-vitamins should be considered as a routine supplementation for patients who underwent sulfasalazine and/or MTX treatment. Further longitudinal studies are required to confirm the conclusions. PMID:17024318

Wei, James Cheng-Chung; Jan, Ming-Shiou; Yu, Chen-Tung; Huang, Yi-Chia; Yang, Chi-Chiang; Tsou, Hsi-Kai; Lee, Hong-Shan; Chou, Chang-Tei; Tsay, Gregory; Chou, Ming-Chih

2007-05-01

61

No significant association between Fc receptor-like 3 gene polymorphisms and human leukocyte antigen-B27 positive ankylosing spondylitis in Han Chinese population  

Microsoft Academic Search

Ankylosing spondylitis (AS) is a rhematoid arthritis, which is a common autoimmune disease with a complex genetic etiology.\\u000a Although HLA-B27 has been identified to be associated with AS, a number of other genes may also be involved in the disease.\\u000a Fc receptor-like 3 (FCRL3) gene has been shown to be associated with rheumatoid arthritis in Japanese population. Here we\\u000a aim

Guo Xia; Faming Pan; Fangfang Liao; Xiaowu Tang; Rui Ge; Yang Mei; Heping Pan; Shengqian Xu; Jianhua Xu

2010-01-01

62

Ankylosing Spondylitis and Posture Control: The Role of Visual Input  

PubMed Central

Objectives. To assess the motor control during quiet stance in patients with established ankylosing spondylitis (AS) and to evaluate the effect of visual input on the maintenance of a quiet posture. Methods. 12 male AS patients (mean age 50.1?±?13.2 years) and 12 matched healthy subjects performed 2 sessions of 3 trials in quiet stance, with eyes open (EO) and with eyes closed (EC) on a baropodometric platform. The oscillation of the centre of feet pressure (CoP) was acquired. Indices of stability and balance control were assessed by the sway path (SP) of the CoP, the frequency bandwidth (FB1) that includes the 80% of the area under the amplitude spectrum, the mean amplitude of the peaks (MP) of the sway density curve (SDC), and the mean distance (MD) between 2 peaks of the SDC. Results. In severe AS patients, the MD between two peaks of the SDC and the SP of the center of feet pressure were significantly higher than controls during both EO and EC conditions. The MP was significantly reduced just on EC. Conclusions. Ankylosing spondylitis exerts negative effect on postural stability, not compensable by visual inputs. Our findings may be useful in the rehabilitative management of the increased risk of falling in AS.

De Nunzio, Alessandro Marco; Iervolino, Salvatore; Zincarelli, Carmela; Di Gioia, Luisa; Rengo, Giuseppe; Multari, Vincenzo; Peluso, Rosario; Di Minno, Matteo Nicola Dario; Pappone, Nicola

2015-01-01

63

Ankylosing spondylitis and posture control: the role of visual input.  

PubMed

Objectives. To assess the motor control during quiet stance in patients with established ankylosing spondylitis (AS) and to evaluate the effect of visual input on the maintenance of a quiet posture. Methods. 12 male AS patients (mean age 50.1?±?13.2 years) and 12 matched healthy subjects performed 2 sessions of 3 trials in quiet stance, with eyes open (EO) and with eyes closed (EC) on a baropodometric platform. The oscillation of the centre of feet pressure (CoP) was acquired. Indices of stability and balance control were assessed by the sway path (SP) of the CoP, the frequency bandwidth (FB1) that includes the 80% of the area under the amplitude spectrum, the mean amplitude of the peaks (MP) of the sway density curve (SDC), and the mean distance (MD) between 2 peaks of the SDC. Results. In severe AS patients, the MD between two peaks of the SDC and the SP of the center of feet pressure were significantly higher than controls during both EO and EC conditions. The MP was significantly reduced just on EC. Conclusions. Ankylosing spondylitis exerts negative effect on postural stability, not compensable by visual inputs. Our findings may be useful in the rehabilitative management of the increased risk of falling in AS. PMID:25821831

De Nunzio, Alessandro Marco; Iervolino, Salvatore; Zincarelli, Carmela; Di Gioia, Luisa; Rengo, Giuseppe; Multari, Vincenzo; Peluso, Rosario; Di Minno, Matteo Nicola Dario; Pappone, Nicola

2015-01-01

64

Factors related to change in global health after group physical therapy in ankylosing spondylitis  

Microsoft Academic Search

Summary The purpose of this study was to evaluate how improvements in global health in patients with ankylosing spondylitis (AS), who had received group physical therapy, were associated with changes in physical functioning and other outcome measures.

A. Hidding; S. VAN DER LINDEN

1995-01-01

65

Normal anti-Klebsiella lymphocytotoxicity in ankylosing spondylitis  

SciTech Connect

We compared in vitro lymphocytotoxicity (LCT) of peripheral blood lymphocytes (PBL), obtained from patients with ankylosing spondylitis (AS) and normal controls (NC). Assays were performed with antibacterial antisera prepared from AS- and NC-derived Klebsiella and coliforms Escherichia coli. LCT assessed by eosin staining was not significantly different in PBL of 12 AS patients and 28 controls when reacted with 3 Klebsiella and 1 E coli antisera. LCT assessed by /sup 51/Cr release was not significantly different for PBL of 20 age- and sex-matched pairs of AS patients and NC when reacted with 3 Klebsiella and 1 E coli antisera. Similarly, LCT-/sup 51/Cr of PBL of 15 matched AS and NC pairs was not significantly different for anti-K21, a serotype putatively implicated in Klebsiella-HLA-B27 antigenic cross-reactivity. Our results do not support the notion of molecular mimicry between Klebsiella and B27 in the pathogenesis of primary AS.

Kinsella, T.D.; Fritzler, M.J.; Lewkonia, R.M.

1986-03-01

66

Relapsing Polychondritis in a Patient with Ankylosing Spondylitis Using Etanercept  

PubMed Central

Relapsing polychondritis (RP) is an autoimmune disease characterized by recurrent episodes of inflammation and progressive destruction of cartilaginous tissues, especially of the ears, nose, joints, and tracheobronchial tree. Its etiology is not well understood, but some studies have linked its pathophysiology with autoimmune disease and autoantibody production. We described a case of a 46-year-old male patient with ankylosing spondylitis who developed RP after the use of etanercept. Few similar cases have been described in the literature. However, they show a possible association between the use of biological inhibitors of tumor necrosis factor (anti-TNF?), which potentially produces autoantibodies, and the development of RP. The treatment was based on data in the literature and included the cessation of biological therapy and the addition of corticosteroids with substantial improvement. PMID:25276463

Azevedo, Valderilio Feijó; Galli, Natalia Bassalobre; Kleinfelder, Alais Daiane Fadini; D'Ippolito, Julia Farabolini; Gulin Tolentino, Andressa; Paiva, Eduardo

2014-01-01

67

Interaction between ERAP1 and HLA-B27 in ankylosing spondylitis implicates peptide handling in the mechanism for HLA-B27 in disease susceptibility  

PubMed Central

Ankylosing spondylitis is a common form of inflammatory arthritis predominantly affecting the spine and pelvis that occurs in approximately 5 out of 1,000 adults of European descent. Here we report the identification of three variants in the RUNX3, LTBRTNFRSF1A and IL12B regions convincingly associated with ankylosing spondylitis (P < 5 × 10?8 in the combined discovery and replication datasets) and a further four loci at PTGER4, TBKBP1, ANTXR2 and CARD9 that show strong association across all our datasets (P < 5 × 10?6 overall, with support in each of the three datasets studied). We also show that polymorphisms of ERAP1, which encodes an endoplasmic reticulum aminopeptidase involved in peptide trimming before HLA class I presentation, only affect ankylosing spondylitis risk in HLA-B27–positive individuals. These findings provide strong evidence that HLA-B27 operates in ankylosing spondylitis through a mechanism involving aberrant processing of antigenic peptides. PMID:21743469

Evans, David M; Spencer, Chris C A; Pointon, Jennifer J; Su, Zhan; Harvey, David; Kochan, Grazyna; Oppermann, Udo; Dilthey, Alexander; Pirinen, Matti; Stone, Millicent A; Appleton, Louise; Moutsianas, Loukas; Leslie, Stephen; Wordsworth, Tom; Kenna, Tony J; Karaderi, Tugce; Thomas, Gethin P; Ward, Michael M; Weisman, Michael H; Farrar, Claire; Bradbury, Linda A; Danoy, Patrick; Inman, Robert D; Maksymowych, Walter; Gladman, Dafna; Rahman, Proton; Morgan, Ann; Marzo-Ortega, Helena; Bowness, Paul; Gaffney, Karl; Gaston, J S Hill; Smith, Malcolm; Bruges-Armas, Jacome; Couto, Ana-Rita; Sorrentino, Rosa; Paladini, Fabiana; Ferreira, Manuel A; Xu, Huji; Liu, Yu; Jiang, Lei; Lopez-Larrea, Carlos; Díaz-Peña, Roberto; López-Vázquez, Antonio; Zayats, Tetyana; Band, Gavin; Bellenguez, Céline; Blackburn, Hannah; Blackwell, Jenefer M; Bramon, Elvira; Bumpstead, Suzannah J; Casas, Juan P; Corvin, Aiden; Craddock, Nicholas; Deloukas, Panos; Dronov, Serge; Duncanson, Audrey; Edkins, Sarah; Freeman, Colin; Gillman, Matthew; Gray, Emma; Gwilliam, Rhian; Hammond, Naomi; Hunt, Sarah E; Jankowski, Janusz; Jayakumar, Alagurevathi; Langford, Cordelia; Liddle, Jennifer; Markus, Hugh S; Mathew, Christopher G; McCann, Owen T; McCarthy, Mark I; Palmer, Colin N A; Peltonen, Leena; Plomin, Robert; Potter, Simon C; Rautanen, Anna; Ravindrarajah, Radhi; Ricketts, Michelle; Samani, Nilesh; Sawcer, Stephen J; Strange, Amy; Trembath, Richard C; Viswanathan, Ananth C; Waller, Matthew; Weston, Paul; Whittaker, Pamela; Widaa, Sara; Wood, Nicholas W; McVean, Gilean; Reveille, John D; Wordsworth, B Paul; Brown, Matthew A; Donnelly, Peter

2013-01-01

68

Interaction between ERAP1 and HLA-B27 in ankylosing spondylitis implicates peptide handling in the mechanism for HLA-B27 in disease susceptibility.  

PubMed

Ankylosing spondylitis is a common form of inflammatory arthritis predominantly affecting the spine and pelvis that occurs in approximately 5 out of 1,000 adults of European descent. Here we report the identification of three variants in the RUNX3, LTBR-TNFRSF1A and IL12B regions convincingly associated with ankylosing spondylitis (P < 5 × 10(-8) in the combined discovery and replication datasets) and a further four loci at PTGER4, TBKBP1, ANTXR2 and CARD9 that show strong association across all our datasets (P < 5 × 10(-6) overall, with support in each of the three datasets studied). We also show that polymorphisms of ERAP1, which encodes an endoplasmic reticulum aminopeptidase involved in peptide trimming before HLA class I presentation, only affect ankylosing spondylitis risk in HLA-B27-positive individuals. These findings provide strong evidence that HLA-B27 operates in ankylosing spondylitis through a mechanism involving aberrant processing of antigenic peptides. PMID:21743469

Evans, David M; Spencer, Chris C A; Pointon, Jennifer J; Su, Zhan; Harvey, David; Kochan, Grazyna; Oppermann, Udo; Opperman, Udo; Dilthey, Alexander; Pirinen, Matti; Stone, Millicent A; Appleton, Louise; Moutsianas, Loukas; Moutsianis, Loukas; Leslie, Stephen; Wordsworth, Tom; Kenna, Tony J; Karaderi, Tugce; Thomas, Gethin P; Ward, Michael M; Weisman, Michael H; Farrar, Claire; Bradbury, Linda A; Danoy, Patrick; Inman, Robert D; Maksymowych, Walter; Gladman, Dafna; Rahman, Proton; Morgan, Ann; Marzo-Ortega, Helena; Bowness, Paul; Gaffney, Karl; Gaston, J S Hill; Smith, Malcolm; Bruges-Armas, Jacome; Couto, Ana-Rita; Sorrentino, Rosa; Paladini, Fabiana; Ferreira, Manuel A; Xu, Huji; Liu, Yu; Jiang, Lei; Lopez-Larrea, Carlos; Díaz-Peña, Roberto; López-Vázquez, Antonio; Zayats, Tetyana; Band, Gavin; Bellenguez, Céline; Blackburn, Hannah; Blackwell, Jenefer M; Bramon, Elvira; Bumpstead, Suzannah J; Casas, Juan P; Corvin, Aiden; Craddock, Nicholas; Deloukas, Panos; Dronov, Serge; Duncanson, Audrey; Edkins, Sarah; Freeman, Colin; Gillman, Matthew; Gray, Emma; Gwilliam, Rhian; Hammond, Naomi; Hunt, Sarah E; Jankowski, Janusz; Jayakumar, Alagurevathi; Langford, Cordelia; Liddle, Jennifer; Markus, Hugh S; Mathew, Christopher G; McCann, Owen T; McCarthy, Mark I; Palmer, Colin N A; Peltonen, Leena; Plomin, Robert; Potter, Simon C; Rautanen, Anna; Ravindrarajah, Radhi; Ricketts, Michelle; Samani, Nilesh; Sawcer, Stephen J; Strange, Amy; Trembath, Richard C; Viswanathan, Ananth C; Waller, Matthew; Weston, Paul; Whittaker, Pamela; Widaa, Sara; Wood, Nicholas W; McVean, Gilean; Reveille, John D; Wordsworth, B Paul; Brown, Matthew A; Donnelly, Peter

2011-08-01

69

Translation and validation of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) for use in Ukraine.  

PubMed

The aim of this study was to translate and adapt the original English-language versions of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) into Ukrainian and validate the instruments by administering them to Ukrainian patients with ankylosing spondylitis (AS). After consensual translation, cultural adaptation, and back-translation into English, the Ukrainian versions of BASDAI and BASFI were transformed into numerical rating scales and tested on 87 Ukrainian AS patients meeting the modified 1984 New York criteria for AS. The Ukrainian versions were easily understood by the patients and displayed high levels of internal consistency and good reliability. The BASDAI (Ukrainian version) showed significant correlation with the duration of morning stiffness and the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) and weak correlation with CRP. The BASFI (Ukrainian version) showed significant correlations with Schober's test, occiput-to-wall distance, and chest expansion measure. Both instruments were sensitive to modifications in the treatment regimen. Accordingly, the Ukrainian-language versions of BASDAI and BASFI reported here can be used to monitor the clinical status of Ukrainian patients with AS. PMID:21494807

Nadashkevich, Oleg; Masyk, Oleksiy

2011-10-01

70

Optimisation of rheumatology assessments - the actual situation in axial spondyloarthritis including ankylosing spondylitis.  

PubMed

The spondyloarthritides (SpA) are currently differentiated into axial and peripheral SpA. Patients with axial SpA (axSpA) may be further classified into the classical form ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA). The SpA are genetically linked, and the subtypes including psoriatic arthritis (PsA) share characteristic clinical symptoms such as inflammatory back pain (IBP) and enthesitis. IMP can be due to sacroiliitis and spondylitis, enthesitis may occur with or without arthritis, and anterior uveitis, as well as other extraarticular manifestations such as psoriasis and chronic inflammatory bowel disease (IBD). In addition to clinical findings, imaging, mainly conventional radiography and magnetic resonance imaging (MRI), and laboratory results such as HLA B27 and CRP are important tools for classification and diagnosis of SpA. The Assessment of SpondyloArthritis international Society (ASAS), an international group of experts in the field of SpA since 1995, has published on assessments and outcome parameters in SpA. The publication of classification criteria for axSpA has now largely replaced the 1984 criteria for AS. However, the established cut-off between AS and nr-axSpA, 'definite' structural changes in the sacroiliac joints, has been recently debated because of limited reliability. Since imaging plays an important role in all criteria sets, the ASAS group has recently published definitions for inflammatory changes in the SIJ and the spine. The most important domains in AS are disease activity, function, spinal mobility, structural damage, and quality of life, some of which are discussed in this manuscript. For axSpA there are two major tools to assess disease activity, the BASDAI and the ASDAS, one for function, the BASFI, and several mobility measures including the BASMI. The AS Health Index (AS-HI) is introduced elsewhere in this supplement. PMID:25365096

Braun, J; Kiltz, U; Baraliakos, X; van der Heijde, D

2014-01-01

71

Ankylosing spondylitis functional and activity indices in clinical practice  

PubMed Central

Background: Clinicians have at hand several indices to evaluate disease activity and functionality in ankylosing spondylitis (AS), in order to evaluate the prognostic and the treatment of AS patients. Objectives: to examine the relationship between functional and activity scores in AS; to note whether disease activity is associated with any clinical or laboratory variables. Methods: the study included AS patients, classified according to the revised New York criteria; data recorded: demographics, disease duration, type of articular involvement, HLA B27 presence, history of uveitis, calculation of BASFI, BASDAI and ASDASCRP, quantification of inflammation markers. Results: 50 AS patients; ASDASCRP correlated significantly (p < 0.001) with BASFI (r = 811), BASDAI (r = 0.810) and with erythrocyte sedimentation rate (ESR; r = 0.505); HLA B27 positive patients had a median BASDAI 5 times higher than HLA B27 negative patients (p = 0.033); compared with patients with strictly axial disease form, patients with axial and peripheral disease had a median ESR 3 times higher (p = 0.042) and a median BASDAI 2 times higher (p = 0.050). Conclusions: functional and activity AS indices are strongly correlated in assessing disease severity; inflammation and HLA B27 can predict the high value of these indices; axial and peripheral disease pattern is associated with higher disease activity. PMID:24653763

Popescu, C; Trandafir, M; B?dic?, AM; Morar, F; Prede?eanu, D

2014-01-01

72

Infliximab treatment in ankylosing spondylitis: an observational study  

PubMed Central

Methods: 35 patients with AS with mean (SD) age 42.5 (12.6) years and mean (SD) disease duration 14.5 (8.0) years were studied for 2 years. Patients entering the study had a negative tuberculin skin test, were fully informed about the treatment, and were followed up regularly. Infliximab, 5 mg/kg weight, was given intravenously at weeks 0, 2, 6, and every 8 weeks thereafter. Data concerning infliximab tolerability, adverse events, interval, and drug discontinuation were all recorded. Clinical improvement according to the BASDAI and the Ankylosing Spondylitis Assessment Study group (ASAS) 20%, 40%, and ASAS 5/6 response criteria were recorded. Results: After 1 year, 20 (57%) patients achieved the BASDAI 50% response criteria, 25 (71%) achieved ASAS 20%, 23 (66%) reached ASAS 40%, and 18 (51%) attained ASAS 5/6. After 2 years' treatment, 11 (31%) patients achieved BASDAI 50% response criteria, 14 (40%) ASAS 20%, 11 (31%) ASAS 40%, and 9 (26%) ASAS 5/6. Clinical improvement was associated with an improved BASFI and reduction of CRP. After 2 years' treatment, "infliximab survival" was 89%. Treatment was well tolerated and adverse events were mild; 3 patients discontinued the study. Conclusion: Infliximab was effective, safe, and well tolerated in patients with AS. PMID:15564309

Nikas, S; Alamanos, Y; Voulgari, P; Pliakou, X; Papadopoulos, C; Drosos, A

2005-01-01

73

ERAP1 in the pathogenesis of ankylosing spondylitis.  

PubMed

The endoplasmic reticulum aminopeptidase 1 (ERAP1) performs a major role in antigen processing, trimming N-terminally extended peptides to the final epitope for presentation by major histocompatibility complex class I molecules. Recent genome-wide association studies have identified single nucleotide polymorphisms (SNPs) within ERAP1 as being associated with disease, in particular ankylosing spondylitis (AS). AS is a polygenic chronic inflammatory disease with a strong genetic link to HLA-B27 known for over 40 years. The association of ERAP1 SNPs with AS susceptibility is only observed in HLA-B27-positive individuals, which intersect on the antigen processing pathway. Recent evidence examining the trimming activity of polymorphic ERAP1 highlights its role in generating peptides for loading onto and stabilizing HLA-B27, and the consequent alterations in the interaction of specific NK cell receptors, and the activation of the unfolded protein response as important in the mechanism of disease pathogenesis. Here, we discuss the recent genetic association findings linking ERAP1 SNPs with AS disease susceptibility and the effect of these variants on ERAP1 function, highlighting mechanisms by which AS may arise. The identification of these functional variants of ERAP1 may lead to better stratification of AS patients by providing a diagnostic tool and a potential therapeutic target. PMID:25434650

Reeves, Emma; Elliott, Tim; James, Edward; Edwards, Christopher J

2014-12-01

74

Effects of Glossopharyngeal Insufflation in Ankylosing Spondylitis: A Pilot Study  

PubMed Central

In Ankylosing Spondylitis (AS), thoracic range of motion is often greatly limited. The objective of the study was to describe the effects of 12 weeks of Glossopharyngeal Insufflation (GI) training in patients with AS. Dynamic spirometry included vital capacity, forced expiratory volume, and peak expiratory flow. Thoracic and lumbar range of motion was assessed by tragus-to-wall distance, modified Schober test, and tape measure. Disease activity, activity limitation, and health perception were assessed using the BAS-Indices, and tension in the thoracic region during GI was assessed using the Borg CR-10 scale. Adherence to training was recorded in an activity log, along with any remarks on the training. Ten patients were recruited and six male patients fulfilled the study protocol. Three patients were able to learn GI by exceeding their maximal vital capacity with 5% using GI. A significant increase in thoracic range of motion both on costae IV (P = 0.04) and at the level of the xiphoid process (P = 0.04) was seen. Thus, patients with AS can practice GI, it is safe if maximal exertion is avoided, and patients with some mobility in the chest can increase their lung function substantially by performing GI during 12 weeks. PMID:25506364

Brodin, Nina; Lindholm, Peter; Lennartsson, Claudia; Nygren-Bonnier, Malin

2014-01-01

75

Ankylosing spondylitis in monozygotic twins: studies on immunological parameters  

PubMed Central

OBJECTIVE—To examine immunological parameters that might explain disease discordance in monozygotic twin pairs with ankylosing spondylitis (AS).?METHODS—11 monozygotic twin pairs (nine with AS, two with undifferentiated spondyloarthropathy) were investigated. The peripheral T cell receptor V? repertoire was investigated using FACS analysis and 14 different V? antibodies. In addition serum samples were tested for antibodies to Klebsiella pneumoniae, Streptococcus pyogenes, Candida albicans, Proteus mirabilis, and Escherichia coli. Peripheral blood lymphocyte reactivity against a number of bacteria was investigated by interferon ? ELISPOT assays.?RESULTS—Twins suffering from AS showed cellular hyporeactivity against K pneumoniae, S pyogenes, C albicans in the ELISPOT assays compared with healthy twins. In contrast with the antibody data, where no significant differences were observed between the two groups, AS concordant twins showed the most pronounced differences in their V? repertoire on CD4+ and CD8+ lymphocytes.?CONCLUSIONS—Cellular hyporeactivity of peripheral blood cells to bacterial antigens might reflect defective T cell responses allowing bacterial antigens to persist in diseased patients. There are probably other environmental factors that influence disease concordance.?? PMID:10381488

Hohler, T.; Hug, R.; Schneider, P.; Krummenauer, F.; Gripenberg-Lerche, C.; Granfors, K.; Marker-Hermann, E.

1999-01-01

76

Delayed Traumatic Diaphragm Hernia after Thoracolumbar Fracture in a Patient with Ankylosing Spondylitis  

PubMed Central

Traumatic diaphragm hernia can occur in rare cases and generally accompanies thoracic or abdominal injuries. When suffering from ankylosing spondylitis, a small force can develop into vertebral fracture and an adjacent structural injury, and lead to diaphragm hernia without accompanying concomitant thoracoabdominal injury. A high level of suspicion may be a most reliable diagnostic tool in the detection of a diaphragm injury, and we need to keep in mind a possibility in a patient with ankylosing spondylitis and a thoracolumbar fracture, even in the case of minor trauma. PMID:25733996

Lee, Hyoun-Ho; Kim, Sang Woo; Jung, Young Jin

2015-01-01

77

Pitfalls and complications in the treatment of cervical spine fractures in patients with ankylosing spondylitis.  

PubMed

Patients with ankylosing spondylitis are at significant risk for sustaining cervical spine injuries following trauma predisposed by kyphosis, stiffness and osteoporotic bone quality of the spine. The risk of sustaining neurological deficits in this patient population is higher than average. The present review article provides an outline on the specific injury patterns in the cervical spine, diagnostic algorithms and specific treatment modalities dictated by the underlying disease in patients with ankylosing spondylitis. An emphasis is placed on the risks and complication patterns in the treatment of these rare, but challenging injuries. PMID:18538019

Heyde, Christoph-E; Fakler, Johannes K; Hasenboehler, Erik; Stahel, Philip F; John, Thilo; Robinson, Yohan; Tschoeke, Sven K; Kayser, Ralph

2008-01-01

78

Pitfalls and complications in the treatment of cervical spine fractures in patients with ankylosing spondylitis  

PubMed Central

Patients with ankylosing spondylitis are at significant risk for sustaining cervical spine injuries following trauma predisposed by kyphosis, stiffness and osteoporotic bone quality of the spine. The risk of sustaining neurological deficits in this patient population is higher than average. The present review article provides an outline on the specific injury patterns in the cervical spine, diagnostic algorithms and specific treatment modalities dictated by the underlying disease in patients with ankylosing spondylitis. An emphasis is placed on the risks and complication patterns in the treatment of these rare, but challenging injuries. PMID:18538019

Heyde, Christoph-E; Fakler, Johannes K; Hasenboehler, Erik; Stahel, Philip F; John, Thilo; Robinson, Yohan; Tschoeke, Sven K; Kayser, Ralph

2008-01-01

79

Might axial myofascial properties and biomechanical mechanisms be relevant to ankylosing spondylitis and axial spondyloarthritis?  

PubMed

Ankylosing spondylitis and axial spondyloarthropathy have characteristic age- and sex-specific onset patterns, typical entheseal lesions, and marked heritability, but the integrative mechanisms causing the pathophysiological and structural alterations remain largely undefined. Myofascial tissues are integrated in the body into webs and networks which permit transmission of passive and active tensional forces that provide stabilizing support and help to control movements. Axial myofascial hypertonicity was hypothesized as a potential excessive polymorphic trait which could contribute to chronic biomechanical overloading and exaggerated stresses at entheseal sites. Such a mechanism may help to integrate many of the characteristic host, pathological, and structural features of ankylosing spondylitis and axial spondyloarthritis. Biomechanical stress and strain were recently documented to correlate with peripheral entheseal inflammation and new bone formation in a murine model of spondyloarthritis. Ankylosing spondylitis has traditionally been classified by the modified New York criteria, which require the presence of definite radiographic sacroiliac joint lesions. New classification criteria for axial spondyloarthritis now include patients who do not fulfill the modified New York criteria. The male-to-female sex ratios clearly differed between the two patient categories - 2:1 or 3:1 in ankylosing spondylitis and 1:1 in non-radiographic axial spondyloarthritis - and this suggests a spectral concept of disease and, among females, milder structural alterations. Magnetic resonance imaging of active and chronic lesions in ankylosing spondylitis and axial spondyloarthritis reveals complex patterns, usually interpreted as inflammatory reactions, but shows similarities to acute degenerative disc disease, which attributed to edema formation following mechanical stresses and micro-damage. A basic question is whether mechanically induced microinjury and immunologically mediated inflammatory mechanisms operate in both ankylosing spondylitis and degenerative disc disease but differ in relative degrees. The hypothesized biomechanical properties raised in this commentary require documentation of their association with the onset risk and course of ankylosing spondylitis and axial spondyloarthritis. If particular subsets of ankylosing spondylitis and axial spondyloarthritis patients are confirmed to have altered axial myofascial properties, their biological basis and underlying biomechanical mechanisms promise to become clarified. Understanding how biomechanical and physical properties can affect symptomatic and structural manifestations of these disorders could also improve their management. PMID:25166000

Masi, Alfonse T

2014-01-01

80

Angioimmunoblastic T cell lymphoma in an ankylosing spondylitis patient treated with etanercept.  

PubMed

Angioimmunoblastic T cell lymphoma (AITL) is a rare non-Hodgkin lymphoma that presents with profound immune dysfunction and immunodeficiency. The clinical and laboratory findings associated with AITL are similar to those of rheumatic disease, and AITL has been reported to be concurrent in patients with several rheumatic diseases. We present one case of AITL occurring in a patient with ankylosing spondylitis (AS) after treatment with etanercept. Constitutional symptoms and aggravation of peripheral arthritis in elderly AS patients may be due not only to flare-ups of AS but also to other complicating diseases, such as lymphoma. Although the occurrence of lymphoma in AS patients treated with etanercept has only rarely been reported, clinicians should keep in mind that instances of aggravation of peripheral arthritis in elderly AS patients occurring after immunosuppressant treatment may be due to other complicating systemic diseases such as AITL, rather than the rheumatic disease itself. Further study is needed in order to investigate whether or not using a TNF-? blocker such as etanercept increases the risk of lymphoma, especially for cases associated with Epstein-Barr virus. PMID:22791222

Jung, Kyong-Hee; Lim, Mie Jin; Kwon, Seong Ryul; Joo, Ko Woon; Yi, Hyeon Gyu; Choi, Suk Jin; Park, Won

2013-07-01

81

Psychological correlates of self-reported functional limitation in patients with ankylosing spondylitis  

PubMed Central

Introduction Functional status is an integral component of health-related quality of life in patients with ankylosing spondylitis (AS). The purpose of this study was to investigate the role of psychological variables in self-reported functional limitation in patients with AS, while controlling for demographic and medical variables. Methods 294 AS patients meeting modified New York Criteria completed psychological measures evaluating depression, resilience, active and passive coping, internality and helplessness at the baseline visit. Demographic, clinical, and radiologic data were also collected. Univariate and multivariate analyses were completed to determine the strength of correlation of psychological variables with functional limitation, as measured by the Bath AS Functional Index (BASFI). Results In the multivariate regression analysis, the psychological variables contributed significantly to the variance in BASFI scores, adding an additional 24% to the overall R-square beyond that accounted by demographic and medical variables (R-square 32%), resulting in a final R-square of 56%. Specifically, arthritis helplessness, depression and passive coping beside age, ESR and the Bath AS Radiograph Index accounted for a significant portion of the variance in BASFI scores in the final model. Conclusions Arthritis helplessness, depression, and passive coping accounted for significant variability in self-reported functional limitation beyond demographic and clinical variables in patients with AS. Psychological health should be examined and accounted for when assessing functional status in the AS patients. PMID:19968879

2009-01-01

82

Logistic transmission modeling of HLA and ankylosing spondylitis  

SciTech Connect

A nonparametric and general method of linkage analysis has been developed and used to evaluate histocompatibility (HLA) linkage to ankylosing spondylitis (AS) from the data of Berg & Moller. The conditional logistic function has been used to establish linkage by stepwise modelling of transmission from parent to progeny. Logistic transmission models have been explored to better understand the relationship of HLA to AS. The alleles at HLA-A and -B were determined in 38 families (32 monoplex and 6 multiplex). We have found that linkage is supported in this data over the random transmission of alleles at only HLA-B. Models constructed at HLA-B are powerful with, for example, coefficients for B27 of 1.9 (S.E. = 0.4) and B40 of 1.6 (S.E. = 0.8) contributing to a model with {chi}{sup 2} = 30 with 2 df and p < 3x10{sup -7}. No models are found supporting linkage at HLA-A and, therefore, the data at HLA-A does not add support for linkage beyond that present at HLA-B (e.g., {chi}{sup 2} for improvement < 1). These results establish that HLA-B is linked to AS. They further provide evidence that the gene responsible for AS is located nearer to HLA-B than it is to HLA-A. Also, the analysis shows that a number of HLA-B alleles may contribute to the risk of AS, beyond the B27 allele which has repeatedly been associated with AS.

Scofield, R.H.; Neas, B.R.; Harley, J.B. [Univ. of Oklahoma, Oklahoma City, OK (United States)

1994-09-01

83

Gender differences in Iranian patients with ankylosing spondylitis.  

PubMed

Inequalities in features and severity of ankylosing spondylitis (AS) have been noticed between men and women, suggesting a possible influence of gender on disease phenotypes. Comparing disease features and characterization of gender differences in clinical features and medications could help elucidate the potential influence of gender on the severity of AS in patients. This study aims to assess the influence of gender on disease patterns in Iranian patients with AS. Three hundred and twenty patients diagnosed with primary AS were assessed for demographic variables, clinical manifestations, HLA status, disease severity, functional capacities, quality of life, and treatment status. Sixty-seven women and 253 men were included corresponding to a male to female ratio of 3.78:1. Both groups were similar regarding ethnicity, positive family history, and juvenile onset AS. HLA-B27 was more frequent among males (78.3 vs. 55.2%; p?

Shahlaee, Abtin; Mahmoudi, Mahdi; Nicknam, Mohammad Hossein; Farhadi, Elham; Fallahi, Sasan; Jamshidi, Ahmad Reza

2015-02-01

84

Therapeutic effects of individual physical therapy in ankylosing spondylitis related to duration of disease  

Microsoft Academic Search

Physical therapy in ankylosing spondylitis (AS) is considered important for maintaining or improving mobility, fitness, functioning, and global health. We studied the influence of disease duration on the short term effects of supervised individual therapy. One hundred forty-four AS outpatients (modified New York Criteria; mean age: 43 years; median duration of disease: 4 years; range: 0–33) received 12 supervised individual

A. Hidding; S. Linden; L. Witte

1993-01-01

85

Slow ascending myelopathy, tetraplegia, carcinoma of the bladder and amyloidosis in a patient with ankylosing spondylitis  

Microsoft Academic Search

Objective: We report a case of slow ascending myelopathy in a patient with ankylosing spondylitis (AS). Design: Case Report of a 60-year-old patient suffering from AS, who developed over a period of 39 years a slow ascending myelopathy leading to tetraplegia, squamous cell carcinoma of the bladder and amyloidosis of the small intestine secondary to neuropathic bladder and bowel. Setting:

M Zwecker; A Daich; N Blumen; G Zeilig; A Ohry

2000-01-01

86

Chest Wall Motion during Speech Production in Patients with Advanced Ankylosing Spondylitis  

ERIC Educational Resources Information Center

Purpose: To test the hypothesis that ankylosing spondylitis (AS) alters the pattern of chest wall motion during speech production. Method: The pattern of chest wall motion during speech was measured with respiratory inductive plethysmography in 6 participants with advanced AS (5 men, 1 woman, age 45 plus or minus 8 years, Schober test 1.45 plus or…

Kalliakosta, Georgia; Mandros, Charalampos; Tzelepis, George E.

2007-01-01

87

Sequential studies in ankylosing spondylitis. Association of Klebsiella pneumoniae with active disease  

Microsoft Academic Search

A study of 163 patients with ankylosing spondylitis seen on 433 occasions showed that active inflammatory disease was strongly associated with the presence of Klebsiella pneumoniae in the faeces (P less than 0.001). Sequential studies showed that in patients with inactive disease the presence of a positive culture for Klebsiella was associated with the subsequent development of active inflammatory disease

R W Ebringer; D R Cawdell; P Cowling; A Ebringer

1978-01-01

88

2010 update of the ASAS\\/EULAR recommendations for the management of ankylosing spondylitis  

Microsoft Academic Search

This first update of the ASAS\\/EULAR recommendations on the management of ankylosing spondylitis (AS) is based on the original paper, a systematic review of existing recommendations and the literature since 2005 and the discussion and agreement among 21 international experts, 2 patients and 2 physiotherapists in a meeting in February 2010. Each original bullet point was discussed in detail and

J. von Braun; R van den Berg; X. Baraliakos; H. Boehm; R. Burgos-Vargas; E. Collantes-Estevez; H. Dagfinrud; B. A. C. Dijkmans; M. Dougados; P Emery; P. Geher; M. Hammoudeh; R. D. Inman; M. Jongkees; M. A. Khan; U. Kiltz; TK Kvien; M Leirisalo-Repo; W. P. Maksymowych; I. Olivieri; K. Pavelka; J. Sieper; E. Stanislawska-Biernat; D. Wendling; S Özgocmen; C van Drogen; BJ van Royen; Heijde van der H. D

2011-01-01

89

Surgical Outcomes after Traumatic Vertebral Fractures in Patients with Ankylosing Spondylitis  

PubMed Central

Objective Ankylosing spondylitis is an inflammatory rheumatic disease mainly affecting the axial skeleton. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. In this study, we reviewed fractures in patients with ankylosing spondylitis that had been clinically diagnosed to better define the mechanism of injury, associated neurological deficit, predisposing factors, and management strategies. Methods Between January 2003 and December 2013, 12 patients with 13 fractures with neurological complications were treated. Neuroimaging evaluation was obtained in all patients by using plain radiography, CT scan, and MR imaging. The ASIA Impairment Scale was used in order to evaluate the neurologic status of the patients. Management was based on the presence or absence of spinal instability. Results A total of 9 cervical and 4 thoracolumbar fractures were identified in a review of patients in whom ankylosing spondylitis had been diagnosed. Of these, 7 fractures were associated with a hyperextension mechanism. 10 cases resulted in a fracture by minor trauma. Posttraumatic neurological deficits were demonstrated in 11 cases and neurological improvement after surgery was observed in 5 of these cases. Conclusions Patients with ankylosing spondylitis are highly susceptible to spinal fracture and spinal cord injury even after only mild trauma. Initial CT or MR imaging of the whole spine is recommended even if the patient's symptoms are mild. The patient should also have early surgical stabilization to correct spinal deformity and avoid worsening of the patient's neurological status. PMID:25328647

An, Seong-Bae; Kim, Keung-Nyun; Chin, Dong-Kyu; Kim, Keun-Su; Cho, Yong-Eun

2014-01-01

90

An investigation of factors limiting aerobic capacity in patients with ankylosing spondylitis  

Microsoft Academic Search

Ankylosing spondylitis (AS) has been shown to produce exercise limitation and breathlessness. The purpose of this study was to investigate factors which may be responsible for limiting aerobic capacity in patients with AS.Twenty patients with no other cardio-respiratory disease performed integrative cardiopulmonary exercise testing (CPET). The results were compared to 20 age and gender matched healthy controls. Variables that might

R. Carter; P. Riantawan; S. W. Banham; R. D. Sturrock

1999-01-01

91

Relationship of bone mineral density with disease activity and functional ability in patients with ankylosing spondylitis: a cross-sectional study  

Microsoft Academic Search

In ankylosing spondylitis, inflammatory activity probably plays a key role in the pathophysiology of bone loss. The aim of\\u000a the study was to investigate the relationship of bone mineral density (BMD) at the lumbar spine and hip region with some measures\\u000a of disease activity and functional ability in patients with ankylosing spondylitis. In 80 patients with established ankylosing\\u000a spondylitis, disease

Simeon Grazio; Zvonko Kusi?; Selma Cvijeti?; Frane Grubiši?; Antonija Balenovi?; Tomislav Nem?i?; Valentina Matijevi?-Mikeli?; Marija Punda; Joachim Sieper

92

The indirect costs of ankylosing spondylitis: a systematic review and meta-analysis.  

PubMed

The aim of this systematic review was to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with ankylosing spondylitis. The search was conducted using Medline, Embase and Centre for Reviews and Dissemination databases. All collected costs were recalculated to average annual cost per patient, expressed in 2013 prices USD using the consumer price index and purchasing power parity. Identified studies were then analyzed to assess their possible inclusion in the meta-analysis. We identified 32 records. The average annual indirect cost per patient varies among all the identified results from US$660.95 to 45,953.87. The mean annual indirect per patient equals US$6454.76. This systematic review summarizes current data related to indirect costs generated by ankylosing spondylitis; it revealed the great economic burden of the disease for society. We observed a great variety of the considered components of indirect costs and their definitions. PMID:25579502

Malinowski, Krzysztof Piotr; Kawalec, Pawe?

2015-04-01

93

Exercise and ankylosing spondylitis with New York modified criteria: a systematic review of controlled trials with meta-analysis.  

PubMed

Ankylosing spondylitis is a systemic rheumatic disease that affects the axial skeleton, causing inflammatory back pain, structural and functional changes which decrease quality of life. Several treatments for ankylosing spondylitis have been proposed and among them the use of exercise. The present study aims to synthesize information from the literature and identify the results of controlled clinical trials on exercise in patients with ankylosing spondylitis with the New York modified diagnostic criteria and to assess whether exercise is more effective than physical activity to reduce functional impairment. The sources of studies used were: LILACS, Pubmed, EBSCOhost, B-on, personal communication, manual research and lists of references. The criteria used for the studies selection was controlled clinical trials, participants with New York modified diagnostic criteria for ankylosing spondylitis, and with interventions through exercise. The variables studied were related to primary outcomes such as BASFI (Bath Ankylosing Spondylitis Functional Index) as a functional index, BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) as an index of intensity of disease activity and BASMI (Bath Ankylosing Spondylitis Metrology Index) as a metrological index assessing patient's limitation on movement. From the 603 studies identified after screening only 37 articles were selected for eligibility, from which 18 studies were included. The methodological quality was assessed to select those with an high methodological expressiveness using the PEDro scale. A cumulative meta-analysis was subsequently performed to compare exercise versus usual level of physical activity. Exercise shows significant statistical outcomes for the BASFI, BASDAI and BASMI, higher than those found for usual level of physical activity. PMID:25351868

Martins, N A; Furtado, Guilherme Eustáquio; Campos, Maria João; Leitão, José Carlos; Filaire, Edith; Ferreira, José Pedro

2014-01-01

94

HLA class I associations of ankylosing spondylitis in the white population in the United Kingdom  

Microsoft Academic Search

OBJECTIVE: To investigate the HLA class I associations of ankylosing spondylitis (AS) in the white population, with particular reference to HLA-B27 subtypes. METHODS: HLA-B27 and -B60 typing was performed in 284 white patients with AS. Allele frequencies of HLA-B27 and HLA-B60 from 5926 white bone marrow donors were used for comparison. HLA-B27 subtyping was performed by single strand conformation polymorphism

M A Brown; K D Pile; L G Kennedy; A Calin; C Darke; J Bell; B P Wordsworth; F Cornélis

1996-01-01

95

Relationship of environmental exposures and ankylosing spondylitis and spinal mobility: US NHAENS, 2009-2010.  

PubMed

It was aimed to study the relationships of different sets of urinary environmental chemical concentrations and ankylosing spondylitis in a national and population-based setting. Data were extracted from United States National Health and Nutrition Examination Surveys, 2009-2010. Information on demographics was obtained by household interview and ankylosing spondylitis clinical measures and urines were taken at examination. People with abnormal occiput-to-wall distance were found to have higher urinary cadmium (OR 2.17, 95?% CI 1.34-3.52, p?=?0.004), antimony (OR 1.74, 95?% CI 1.15-2.62, p?=?0.012), tungsten (OR 1.91, 95?% CI 1.39-2.64, p?=?0.001), uranium (OR 1.49, 95?% CI 1.03-2.15, p?=?0.036), and trimethylarsine oxide (OR 5.01, 95?% CI 2.34-10.71, p?ankylosing spondylitis clinical measures, compared to those who resided in households that were built in 1990 or after. The odds were 1.74 for households built in 1978-1989 and 1.81 for those built in 1940 or earlier. PMID:25103950

Shiue, Ivy

2014-08-01

96

Clinical research for curing ankylosing spondylitis through combiningetanercept, thalidomide and sulfasalazine.  

PubMed

This article is to explore the curative effect of treating ankylosing spondylitis (AS) through combining etanercept, thalidomide and sulfasalazine. Sixty-two patients with AS were divided into 3 groups: experimental group Ais treated by etanercept+ thalidomide + sulfasalazine for 1 year (n=22); control group B was treated with etanercept; control group C was treated with thalidomide + sulfasalazine for 1 year (n=20). In 1st, 3rd, 6th, 12th month after the treatment, ASAS20 and ASAS50 were obtained through Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), erythrocyte sedimentation rate (ESR), C react protein (CRP) and then curative effect was analyzed. In 1 and 3 months after the treatment, each indicator had downtrend, and ASAS20 of experimental group and etanercept control group reached 100%; ASAS50 increased compared with the first months' treatment; although ASAS20 and ASAS50 in thalidomide control group was smaller, they increased; in 6 and 12 months after the treatment, ASAS20 improvement ratio in group A still remained on 100%, ASA50 improvement ratio increased; recurrence rate of group B increased; ASA20 and ASA50 had a continuous and significant increase, but its their was less than group A. This study proved that, the effect of curing AS combiningetanercept, thalidomide and sulfasalazine is better, therefore, it is a high-feasible treatment approach. PMID:25631513

Xiao, Peng; Pang, Changhe; Zhu, Xu; Wu, Xuejian

2015-01-01

97

Biomarkers and cytokines of bone turnover: extensive evaluation in a cohort of patients with ankylosing spondylitis  

PubMed Central

Background Ankylosing spondylitis (AS) is a chronic inflammatory disease of spine and sacroiliac joints; it is characterized by new bone formation, and the disease processes can be accompanied by osteoporosis. In the present study, we investigated changes in bone mineral density (BMD) and in the levels of various bone turnover-related biomarkers and cytokines in a cohort of AS patients, with regard to clinical parameters, disease activity, and treatment regimen. Methods 55 AS patients and 33 healthy controls included in the study. Spinal mobility was assessed by the Bath Ankylosing Spondylitis Metrology Index (BASMI), and radiologic changes were scored by the Bath Ankylosing Spondylitis Radiologic Index (BASRI). Patients were also evaluated with the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Bone mineral density (BMD) assessed by dual energy X-ray absorptiometry. Various biomarkers and cytokines of bone turnover including osteoprotegerin (OPG), serum band 5 tartrate-resistant acid phosphatase (TRAP-5), soluble receptor activator of nuclear factor kappa-B ligand (sRANKL), secreted frizzled-related protein 1 (sFRP-1), Dickkopf-related protein 1 (DKK-1), and sclerostin were studied. Results The levels of TRAP-5, NTX, sRANKL, sclerostin, sFRP-1, DKK-1, and IFN?, were similar between the patients and controls (p?>?0.05), while BMD of femoral neck, and OPG levels were significantly lower in AS patients (p?

2012-01-01

98

Identification of Potential Transcriptomic Markers in Developing Ankylosing Spondylitis: A Meta-Analysis of Gene Expression Profiles  

PubMed Central

The goal of this study was to identify potential transcriptomic markers in developing ankylosing spondylitis by a meta-analysis of multiple public microarray datasets. Using the INMEX (integrative meta-analysis of expression data) program, we performed the meta-analysis to identify consistently differentially expressed (DE) genes in ankylosing spondylitis and further performed functional interpretation (gene ontology analysis and pathway analysis) of the DE genes identified in the meta-analysis. Three microarray datasets (26 cases and 29 controls in total) were collected for meta-analysis. 905 consistently DE genes were identified in ankylosing spondylitis, among which 482 genes were upregulated and 423 genes were downregulated. The upregulated gene with the smallest combined rank product (RP) was GNG11 (combined RP = 299.64). The downregulated gene with the smallest combined RP was S100P (combined RP = 335.94). In the gene ontology (GO) analysis, the most significantly enriched GO term was “immune system process” (P = 3.46 × 10?26). The most significant pathway identified in the pathway analysis was antigen processing and presentation (P = 8.40 × 10?5). The consistently DE genes in ankylosing spondylitis and biological pathways associated with those DE genes identified provide valuable information for studying the pathophysiology of ankylosing spondylitis. PMID:25688367

Fang, Fang; Pan, Jian; Xu, Lixiao; Li, Gang; Wang, Jian

2015-01-01

99

Baseline predictors of response and discontinuation of tumor necrosis factor-alpha blocking therapy in ankylosing spondylitis: a prospective longitudinal observational cohort study  

PubMed Central

Introduction Identifying ankylosing spondylitis (AS) patients who are likely to benefit from tumor necrosis factor-alpha (TNF-?) blocking therapy is important, especially in view of the costs and potential side effects of these agents. Recently, the AS Disease Activity Score (ASDAS) has been developed to assess both subjective and objective aspects of AS disease activity. However, data about the predictive value of the ASDAS with respect to clinical response to TNF-? blocking therapy are lacking. The aim of the present study was to identify baseline predictors of response and discontinuation of TNF-? blocking therapy in AS patients in daily clinical practice. Methods AS outpatients who started TNF-? blocking therapy were included in the Groningen Leeuwarden Ankylosing Spondylitis (GLAS) study, an ongoing prospective longitudinal observational cohort study with follow-up visits according to a fixed protocol. For the present analysis, patients were excluded if they had previously received anti-TNF-? treatment. Predictor analyses of response and treatment discontinuation were performed using logistic and Cox regression models, respectively. Results Between November 2004 and April 2010, 220 patients started treatment with infliximab (n = 32), etanercept (n = 137), or adalimumab (n = 51). At three and six months, 68% and 63% of patients were Assessments in Ankylosing Spondylitis (ASAS)20 responders, 49% and 46% ASAS40 responders, and 49% and 50% Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)50 responders, respectively. Baseline predictors of response were younger age, male gender, higher ASDAS score, higher erythrocyte sedimentation rate (ESR) level, higher C-reactive protein (CRP) level, presence of peripheral arthritis, higher patient's global assessment of disease activity, and lower modified Schober test. In August 2010, 64% of patients were still using their TNF-? blocking agent with a median follow-up of 33.1 months (range 2.4 to 68.2). Baseline predictors of discontinuation of TNF-? blocking therapy were female gender, absence of peripheral arthritis, higher BASDAI, lower ESR level, and lower CRP level. Conclusions Besides younger age and male gender, objective variables such as higher inflammatory markers or ASDAS score were identified as independent baseline predictors of response and/or continuation of TNF-? blocking therapy. In contrast, higher baseline BASDAI score was independently associated with treatment discontinuation. Based on these results, it seems clinically relevant to include more objective variables in the evaluation of anti-TNF-? treatment. PMID:21689401

2011-01-01

100

Effects of tumor necrosis factor-alpha on sexual activity of male patients with ankylosing spondylitis.  

PubMed

The objective of this study was to investigate the therapeutic effect of a tumor necrosis factor-alpha (TNF-?) antagonist on the sexual quality of life of male patients with ankylosing spondylitis (AS). In this open-label study, 42 AS patients were grouped into the TNF-? antagonist treatment group and the non-TNF-? antagonist treatment group for 3 months. Clinical and laboratory indices and changes in the sexual quality of life were compared to assess the efficacy of TNF-? antagonists on sexual activity. The relationship between sexual quality and disease activity was analyzed. There were no significant differences in baseline data between the two groups. After treatment, disease activity and quality of life were improved in these two groups. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score (1.9?±?1.6 vs. 3.0?±?1.3, p?=?0.020), erythrocyte sedimentation rate (ESR) (9?±?7 mm/1 h vs. 18?±?17 mm/1 h, p?=?0.031), and C-reactive protein (CRP) levels (1.8?±?2.1 mg/dl vs. 6.2?±?8.5 mg/dl, p?=?0.035) were significantly lower in the TNF-? antagonist treatment group than in the non-TNF-? antagonist treatment group. The extent of improvement in the quality of life was more evident in the TNF-? antagonist treatment group. The average degree of improvement in the quality of life was negatively related to the BASDAI score and the Bath Ankylosing Spondylitis Functional Index score in the TNF-? antagonist treatment group (r?=?-0.497, p?=?0.018; r?=?-0.558, p?=?0.007, respectively). Sexual quality of life and disease activity are improved after treatment with TNF-? antagonists in male patients with AS. The extent of improvement in sexual quality and disease activity are positively related. PMID:25064131

Dong, Xin; Zheng, Yi; Shi, Tian-Yan; Liu, Hong-Yan

2015-05-01

101

Cauda equina syndrome associated with multiple lumbar arachnoid cysts in ankylosing spondylitis: improvement following surgical therapy.  

PubMed Central

A case of cauda equina syndrome with multiple lumbar arachnoid cysts complicating ankylosing spondylitis (AS) is described. The value of computerised tomography (CT) and magnetic resonance imaging (MRI) as a non-invasive means of establishing the diagnosis is emphasised. In contrast to previously reported cases the patient showed neurological improvement following surgical therapy. Surgery may be indicated in some patients, particularly when there is nerve root compression by the arachnoid cysts and when the patient is seen early before irreversible damage to the cauda equina has occurred. Images PMID:2292702

Shaw, P J; Allcutt, D A; Bates, D; Crawford, P J

1990-01-01

102

Corrective surgery for deformity of the upper cervical spine due to ankylosing spondylitis  

PubMed Central

Rotational and flexion deformity of C1-C2 due to ankylosing spondylitis is rare. We did surgical correction in one such case by lateral release, resection of the posterior arch of C1 and mobilization of the vertebral arteries, wedge osteotomy of the lateral masses of C1 and internal fixation under general anesthesia. There were no vascular and neurological complications during the surgery. After operation the atlantoaxial rotational deformity was corrected and the normal cervical lordosis was restored. At 1 year followup his visual field and feeding became normal and internal fixation was stable. PMID:24741145

Lin, Bin; Zhang, Bi; Li, Zhu-mei; Li, Qiu-sheng

2014-01-01

103

Vasculitis and long standing ankylosing spondylitis in a patient with familial Mediterranean fever  

PubMed Central

Coexistence of familial Mediterranean fever (FMF) and other inflammatory disorders has been frequently reported, but no specific underlying factor has been identified. We report a patient with FMF who is presented with long-standing ankylosing spondylitis (AS) and cutaneous leukocytoklastic vasculitis (LV) of the lower limbs. It is the first report on combination of FMF with AS and LV. The Mediterranean Fever (MEFV) gene mutation of heterozygote (R202Q/R726A) and HLA-B27 are detected in this case, and are believed to form genetic susceptibility to LV. PMID:25538787

Taylan, Ali; Yildiz, Yasar; Sari, Ismail; Ozkok, Guliz

2014-01-01

104

Description of the registry of patients with ankylosing spondylitis in Turkey: TRASD-IP.  

PubMed

A web-based application patient follow-up program was developed to create a registry of patients with ankylosing spondylitis (AS) by the Turkiye Romatizma Arastirma Savas Dernegi (TRASD) AS Study Group. This study describes the methodological background and patient characteristics. The patient follow-up program is a web-based questionnaire, which contains sections on socio-demographic data, anamnesis, personal and family history, systemic and musculoskeletal examination, laboratory and imaging data and treatment. Between October 1, 2007 and February 28, 2009, 1,381 patients from 41 centers were included in the registry (1,038 males [75.2%]; mean age 39.5 ± 10.7 years). Mean disease duration was 12.1 ± 8.5 years, and mean time from initial symptom to diagnosis was 5 ± 6.8 years (median 2 years). HLA-B27 positivity was detected in 73.7% of 262 patients tested. Manifestations of extraarticular involvement were anterior uveitis (13.2%), psoriasis and other skin and mucous membrane lesions (6%) and inflammatory bowel disease (3.8%). The prevalence of peripheral arthritis was 11.2%. In 51.7% of patients, the Bath AS Disease Activity Index was ?4. But since our patients consisted of the ones with more severe disease who referred to the tertiary centers and needed a regular follow-up, they may not represent the general AS population. Disease-modifying anti-rheumatic drugs were being used by 41.9% of patients, with 16.4% using anti-TNF agents. TRASD-IP (Izlem Programi: Follow-up program) is the first AS registry in Turkey. Such databases are very useful and provide a basis for data collection from large numbers of subjects. TRASD-IP gives information on the clinical and demographic profiles of patients, and the efficacy and safety of anti-TNF drugs, examines the impact on quality of life, and provides real-life data that may be used in cost-effectiveness analyses. PMID:20711591

Bodur, Hatice; Ataman, Sebnem; Bu?dayc?, Derya Soy; Rezvani, Aylin; Nas, Kemal; Uzunca, Kaan; Emlakç?o?lu, Emel; Karatepe, Alt?nay Göksel; Durmu?, Bekir; Sezgin, Melek; Ayhan, Figen; Yazgan, Pelin; Duruöz, Tuncay; Yener, Mahmut; Gürgan, Alev; K?rnap, Mehmet; Cakar, Engin; Altan, Lale; Soydemir, Raikan; Capk?n, Erhan; Tekeo?lu, Ibrahim; Ayd?n, Gülümser; Günendi, Zafer; Nac?r, Bar??; Sall?, Ali; Oztürk, Cihat; Memi?, Asuman; Turan, Yasemin; Kozano?lu, Erkan; Sivrio?lu, Konçuy

2012-01-01

105

Bone turnover markers, anterior pituitary and gonadal hormones, and bone mass evaluation using quantitative computed tomography in ankylosing spondylitis  

Microsoft Academic Search

The objective of this study was to determine bone mineral density (BMD) distribution in ankylosing spondylitis (AS) using quantitative computed tomography (QCT), to study bone turnover and anterior pituitary and gonadal hormonal axis in AS, and to look for correlations between BMD, bone remodeling markers and gonadal and anterior pituitary hormones. Forty-three male consecutive patients with AS were enrolled prospectively

Abdellah El Maghraoui; Saida Tellal; Souad Chaouir; Khalil Lebbar; Ahmed Bezza; Abderrazak Nouijai; Lahsen Achemlal; Sanaa Bouhssain; El Mostapha Derouiche

2005-01-01

106

Association of 1.25 vitamin D 3 deficiency, disease activity and low bone mass in ankylosing spondylitis  

Microsoft Academic Search

Vertebral fractures due to osteoporosis are a common but frequently unrecognized complication in established ankylosing spondylitis (AS). It is known that inflammatory activity in rheumatic diseases (i.e., proinflammatory cytokines) itself plays a possible role in the pathophysiology of bone loss. The aim of this study was to analyze whether inflammatory activity and an alteration of the vitamin D metabolism play

U. Lange; J. Teichmann; J. Strunk; U. Müller-Ladner; K. L. Schmidt

2005-01-01

107

Core set of recommendations for patients with ankylosing spondylitis concerning behaviour and environmental adaptations.  

PubMed

Advice concerning behaviour and adaptations of living and working environment is considered an unmet need by patients with ankylosing spondylitis (AS). The aim of this study was to develop a core set of recommendations to be given to patients by their rheumatologists. A systematic literature research of scientific and patient-oriented literature revealed 70 raw recommendations. These recommendations were evaluated and ranked at a meeting of the Ankylosing Spondylitis International Federation (ASIF, 26 participants including 19 patients with AS, 5 rheumatologists and 2 physiotherapists from 13 countries) in November 2011. Thereafter, the 59 remaining recommendations were extensively discussed, supplemented, reworded, condensed and voted on during a meeting of local branch leaders of the AS patient organisation in Germany (Deutsche Vereinigung Morbus Bechterew, DVMB) with 80 participants (95 % of whom with AS), 2 rheumatologists and 1 occupational therapist in March 2012. The core set of final recommendations comprises (1) a general statement regarding living with AS which was considered highly important by patients and (2) the following domains: sitting position, walking, sleeping, at work, exercises, sports and recreational activities, diet and lifestyle, sexuality and pregnancy, fall prevention, car driving and advantages of membership in an AS-specific patient organisation. Most recommendations are relevant already in early disease, others concern advanced AS (e.g. fall prevention and car driving). The selected recommendations received high agreements (80-100 %). A first core set of recommendations for the behaviour and environmental adaptations of patients with AS was established under participation of many patients. PMID:23539272

Feldtkeller, Ernst; Lind-Albrecht, Gudrun; Rudwaleit, Martin

2013-09-01

108

Plasma homocysteine status in patients with ankylosing spondylitis  

Microsoft Academic Search

Homocysteine (Hcy), a sulfur-containing amino acid, is eliminated through B vitamins-dependent pathways. Hyperhomocysteinemia\\u000a has been found to be an independent risk factor for atherosclerotic cardiovascular, cerebrovascular, and peripheral vascular\\u000a diseases. Recently, psoriasis, lupus, and rheumatoid arthritis were reported to be associated with hyperhomocysteinemia. This\\u000a study was aimed to evaluate the changes of plasma Hcy level before and after sulfasalazine and

James Cheng-Chung Wei; Ming-Shiou Jan; Chen-Tung Yu; Yi-Chia Huang; Chi-Chiang Yang; Hsi-Kai Tsou; Hong-Shan Lee; Chang-Tei Chou; Gregory Tsay; Ming-Chih Chou

2007-01-01

109

Comparison of rates of referral and diagnosis of axial spondyloarthritis before and after an ankylosing spondylitis public awareness campaign.  

PubMed

The objective of this research is to measure the effect of a national ankylosing spondylitis (AS) public awareness campaign on numbers of referrals for suspected AS and numbers of cases diagnosed with axial spondyloarthritis (SpA). A television advertising campaign was conducted by Arthritis New Zealand in 2011 to raise public awareness of AS. A retrospective analysis was made of referrals received by the three rheumatology services 3 months before the campaign started and 3 months after the campaign ended. The age, gender, number of referrals for suspected AS and number of referrals resulting in a diagnosis of axial SpA were recorded. Independent analysis showed that the awareness campaign reached 82 % of the primary target audience. In the 3 months after the awareness campaign, there was a significant increase in referrals for suspected AS compared with the 3 months before the campaign (54 vs. 88, 63 %, p?=?0.0056). Referrals for other conditions did not change. The number of referrals resulting in a diagnosis of axial SpA also increased (27 vs. 44, 63 %, p?=?0.0576). The mean ages of the patients referred and of those diagnosed with axial SpA did not change. The male/female ratio was 1:1 among the referrals for suspected AS and 2:1 in referrals diagnosed with axial SpA, before and after the campaign. The Arthritis New Zealand AS public awareness campaign was associated with a significant increase in referrals to rheumatology services for suspected AS and an increase in the diagnosis of axial SpA in clinics. PMID:24609715

Harrison, Andrew A; Badenhorst, Christoffel; Kirby, Sandra; White, Douglas; Athens, Josie; Stebbings, Simon

2014-07-01

110

REGIONAL RADIOGRAPHIC DAMAGE AND FUNCTIONAL LIMITATIONS IN PATIENTS WITH ANKYLOSING SPONDYLITIS: DIFFERENCES IN EARLY AND LATE DISEASE  

PubMed Central

Objective Radiographic damage and functional limitations both increase with the duration of ankylosing spondylitis (AS). We examined whether radiographic damage contributed more to functional limitations in late AS than in early AS, and if the strength of association varied with the anatomic region of damage. Methods In this cross-sectional study of 801 patients with AS, we examined associations of the lumbar modified Stoke AS Spine Score (mSASSS), cervical mSASSS, lumbar posterior fusion, cervical posterior fusion, and hip arthritis with the Bath AS Functional Index (BASFI) and the Health Assessment Questionnaire (HAQ-S). Results Higher lumbar and cervical mSASSS were associated with more functional limitations, but there was an interaction between mSASSS and the duration of AS such that the strength of their association with functional limitations decreased with increasing duration of AS. Cervical posterior fusion was associated with worse functioning independent of mSASSS. Hip arthritis was significantly associated with functional limitations independent of measures of spinal damage. Among patients with AS ? 40 years, the number of comorbid conditions accounted for most of the variation in functioning. Results were similar for both the BASFI and HAQ-S. Conclusions Although both radiographic damage and functional limitations increase over time in AS, the relative contribution of radiographic damage to functional limitations is lower among patients with longstanding AS than early AS, suggesting patients may accommodate to limited flexibility. Damage in different skeletal regions impacts functioning over the duration of AS. Functional limitations due to comorbidity supervene in late AS. PMID:23042639

Ward, Michael M.; Learch, Thomas J.; Gensler, Lianne S.; Davis, John C.; Reveille, John D.; Weisman, Michael H.

2012-01-01

111

Association between Ankylosing Spondylitis and the miR-146a and miR-499 Polymorphisms  

PubMed Central

miRNAs are small, non-coding RNAs that regulate the expression of multiple target genes at the post-transcriptional level. Single-nucleotide polymorphisms (SNPs) in miRNA sequences may alter miRNA expression and have been implicated in the pathogenesis of multiple forms of arthritis, including rheumatoid arthritis (RA) and osteoarthritis. The present study explored the association between ankylosing spondylitis (AS) and two single nucleotide polymorphisms (SNPs), miR-146a rs2910164G>C and miR-499 rs3746444T>C, in a Han Chinese population. A case–control study consisting of 102 subjects with AS and 105 healthy controls was designed. The two miRNA SNPs were identified by direct sequencing. Subsequently, their gene and genotype frequencies were compared with healthy controls. A significant difference was observed in the miR-146a rs2910164G>C SNP. The frequency of the G allele was markedly higher in the AS patients than in the healthy controls (P = 0.005, Pc = 0.01, OR = 1.787), and the frequency of the GG genotype was higher in AS patients than in controls (P = 0.014, Pc = 0.042, OR = 2.516). However, no significant association was found between the miR-499 rs3746444T>C variant and susceptibility to AS. This is the first study to address the association between the miR-146a rs2910164G>C and miR-499 rs3746444T>C polymorphisms and AS, and it suggests a potential pathogenic factor for AS. Further studies are needed to validate our findings in a larger series, as well as in other ethnic backgrounds. PMID:25836258

Chen, Jing Feng; Wang, Tian Yang; Wang, Ling Ling; Tang, Li Li; Lin, Xian-yang; Zhang, Chun-wu; Chen, Bi-cheng

2015-01-01

112

Intestinal Behçet’s disease appearing during treatment with adalimumab in a patient with ankylosing spondylitis  

PubMed Central

Behçet’s disease (BD) is a chronic inflammatory disease affecting multiple organ systems, such as the skin, joints, blood vessels, central nervous system, and gastrointestinal tract. Intestinal BD is characterized by intestinal ulcerations and gastrointestinal symptoms. The medical treatment of intestinal BD includes corticosteroids and immunosupressants. There have been several reports of tumor necrosis factor-? (TNF-?) blockers being successful in treatment of refractory intestinal BD. Here, we report on a patient who was diagnosed with intestinal BD despite treatment with the fully humanized TNF-? blocker (adalimumab) for underlying ankylosing spondylitis. This patient achieved clinical remission and complete mucosal healing through the addition of a steroid and azathioprine to the adalimumab regimen. PMID:23983446

Chung, Sook Hee; Park, Soo Jung; Hong, Sung Pil; Cheon, Jae Hee; Kim, Tae Il; Kim, Won Ho

2013-01-01

113

Non-HLA genes in ankylosing spondylitis: what meta-analyses have shown?  

PubMed

HLA-B27 association with ankylosing spondylitis (AS) is one of the strongest ever reported in the literature. However, only a small proportion of 5-8% of HLA-B27 positive individuals of the general population develops the disease. In recent years, polymorphisms of many non-HLA genes were reported to be associated with AS. In this review, we summarise the current knowledge of non-HLA genetic factors contributing to AS susceptibility based on meta-analyses in order to overcome the limitations of individual genetic studies e.g. the small samples' sizes, the small samples' origin diversities, and the low statistical power of statistical analyses. PMID:25068597

Chatzikyriakidou, Anthoula; Voulgari, Paraskevi V; Drosos, Alexandros A

2014-01-01

114

Health-related quality of life in patients with ankylosing spondylitis: a comprehensive review.  

PubMed

Ankylosing spondylitis (AS) is a complex systemic rheumatological disease which often causes severe disability and impaired quality of life (QoL). We searched the PubMed/MEDLINE electronic database for available literature on QoL and its predictors in patients with AS. Recent evidence indicates that AS patients have poorer QoL compared to the general population, but similar to that of patients with other rheumatological disorders. Disease activity is one of the most powerful predictors of QoL, however latest advances in pharmacological treatment (namely, anti-TNF-?) along with physical exercise can minimize the effects of AS on QoL. Psychological distress symptoms contribute to impaired QoL both directly and indirectly by influencing disease activity. The impact of other psychosocial variables, however, is less studied and more prospective investigations are necessary, which could eventually lead to the development of psychosocial interventions that are personalized to this patient population. PMID:25193010

Kotsis, Konstantinos; Voulgari, Paraskevi V; Drosos, Alexandros A; Carvalho, André F; Hyphantis, Thomas

2014-12-01

115

Blind confirmation in Leiden of Geczy factor on the cells of Dutch patients with ankylosing spondylitis  

SciTech Connect

A follow-up blind study, of the ability of cross-reactive antisera to distinguish between the cells of Dutch patients with ankylosing spondylitis (AS) and normal controls, was performed in Leiden. Of the 45 cell samples tested, 29 were fresh peripheral blood mononuclear (PBM) cells while 15 were cryopreserved PBM. No false positives but one false negative was identified among the 45 samples, and the negative was confirmed after the recoded cryopreserved cells from this patient were retested. It is concluded that the cross-reactive antisera raised in Sydney give good discrimination between patients and normals. Factors affecting the success of the /sup 51/Cr-release cytotoxicity assay, and possible reasons for the failure of others to confirm these observations, are briefly discussed.

Geczy, A.F.; van Leeuwen, A.; van Rood, J.J.; Ivanyi, P.; Breur, B.S.; Cats, A.

1986-11-01

116

Inefficacy or Paradoxical Effect? Uveitis in Ankylosing Spondylitis Treated with Etanercept  

PubMed Central

Ankylosing spondylitis (AS) is presented with axial and peripheral articular involvement. Uveitis is a severe and rather specific manifestation of AS. Biologics targeting tumor necrosis factor (TNF) ? are effective on both articular and ocular manifestations of disease. The occurrence of uveitis in patients that never had eye involvement or the relapse of uveitis is described during anti-TNF? treatment. The frequency of these events is slightly higher during therapy with etanercept. The available TNF? blockers show different pharmacokinetics and pharmacodynamics yielding different biological effects. There is an ongoing debate whether uveitis during anti-TNF? has to be considered as paradoxical effect or an inadequate response to therapy. Here, we present a case report and review what the evidences for the two hypotheses are. PMID:24991219

Ometto, Francesca; Botsios, Costantino; Punzi, Leonardo

2014-01-01

117

Osteoporosis in ankylosing spondylitis - prevalence, risk factors and methods of assessment  

PubMed Central

Introduction Osteoporosis can be a complication of ankylosing spondylitis (AS), but diagnosing spinal osteoporosis can be difficult since pathologic new bone formation interferes with the assessment of the bone mineral density (BMD). The aims of the current study were to investigate prevalence and risk factors for reduced BMD in a Swedish cohort of AS patients, and to examine how progressive ankylosis influences BMD with the use of dual-energy x-ray absorptiometry (DXA) of the lumbar spine in different projections. Methods Methods of assessment were questionnaires, back mobility tests, blood samples, lateral spine radiographs for syndesmophyte grading (mSASSS), DXA of the hip, radius and lumbar spine in anteroposterior (AP) and lateral projections with estimation of volumetric BMD (vBMD). Results AS patients (modified New York criteria), 87 women and 117 men, mean age 50 ± 13 years and disease duration 15 ± 11 years were included. According to World Health Organization (WHO) criteria 21% osteoporosis and 44% osteopenia was diagnosed in patients > = 50 years. Under age 50 BMD below expected range for age was found in 5%. Interestingly lateral lumbar DXA showed significantly lower BMD and revealed significantly more cases with osteoporosis as compared with AP DXA. Lumbar vBMD was not different between sexes, but women had significantly more lumbar osteoporosis measured with AP DXA (P < 0.001). Men had significantly higher mSASSS (P < 0.001). Low BMD was associated with high age, disease duration, mSASSS, Bath Ankylosing Spondylitis Metrology Index (BASMI), inflammatory parameters and low body mass index (BMI). Increasing mSASSS correlated significantly with decreasing lateral and volumetric lumbar BMD, while AP lumbar BMD showed tendency to increase. Conclusions Osteoporosis and osteopenia is common in AS and associated with high disease burden. Lateral and volumetric lumbar DXA are more sensitive than AP DXA in detecting osteoporosis and are less affected by syndesmophyte formation. PMID:22569245

2012-01-01

118

Factors influencing health status and disability of patients with ankylosing spondylitis in the Czech Republic.  

PubMed

The aim of the study was to evaluate factors that influence health status and work disability in patients with ankylosing spondylitis (AS) in the Czech Republic. Data were collected in a retrospective fashion directly from patients with AS using mailed questionnaires containing questions regarding sociodemographic characteristics of patients, the course of their disease, therapy, rehabilitation, quality of life, and ability to work. HAQ-DI (Health Assessment Questionnaire-Disability Index) and BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) were also included in the questionnaires; 1,008 questionnaires were suitable for further statistical analysis. The average age +/- SD of patients was 50.2 +/- 10.7 years, the average symptom duration was 23.0 +/- 11.6 years. Mean time from first symptoms to diagnosis was 9.1 years. Full disability had been awarded to 303 patients (30%) at some point of their disease. Twenty seven percent of patients reported receiving full disability pension for 10 or more years. Four hundred fifty six subjects (45%) were currently or had been previously receiving partial disability pension. Receiving disability pension was more frequent among men (64%) compared to women (56%) (P = 0.012), despite the fact that women had higher BASDAI (P < 0.001) and HAQ-DI (P = 0.004) scores. Patients with a family history of AS had higher BASDAI and HAQ-DI scores (P = 0.001 and P = 0.008, respectively) compared to patients without a family history of AS. BASDAI and HAQ-DI scores correlated with age and duration of illness, younger patients and those with shorter disease duration had lower values. Fifty eight percent of patients reported a BASDAI score > or =4 (current cutoff value for initiation of biological therapy), but only 1% of patients were treated by anti TNF alpha agents within the last year. Seven hundred ninety one patients underwent spa treatment in the previous year; 96% of them experienced improvement of their health condition. PMID:18247079

Forejtová, S; Mann, H; Stolfa, J; Vedral, K; Fenclová, I; Némethová, D; Pavelka, K

2008-08-01

119

Adalimumab in ankylosing spondylitis: an evidence-based review of its place in therapy  

PubMed Central

Introduction: Ankylosing spondylitis (AS) is an idiopathic chronic inflammatory disease that has prominent effects on the spine and peripheral joints. In addition, extraarticular manifestations such as enthesitis and acute anterior uveitis may be clinically important. In recent years, the therapy of AS has changed, largely due to the introduction of inhibitors of the proinflammatory cytokine tumor necrosis factor (TNF). Adalimumab, a human monoclonal antibody specifically for TNF, is the most recent of the TNF blocking agents that have been approved for the treatment of active, nonsteroidal antiinflammatory drug (NSAID)-refractory patients with AS. Aims: To evaluate the evidence for the therapeutic value of adalimumab in ankylosing spondylitis. Evidence review: There is clear evidence that adalimumab, administered 40 mg subcutaneously every 2 weeks, substantially improves the signs and symptoms of NSAID-refractory, active AS when compared with placebo treatment. There is ample evidence that adalimumab causes significant improvements in physical health status and overall AS-specific, health-related quality of life and physical functioning, which consequently leads to better work productivity. There is substantial evidence that adalimumab improves spinal and sacroiliac joint inflammation in AS patients. Initial results from clinical trials suggest that there is no increased risk of serious infections or malignancies in adalimumab-treated patients with AS. The most common adverse events were injection-site reactions. Limited economic evidence suggests that adalimumab 40 mg may be cost effective when used according to current valid treatment guidelines. Place in therapy: Adalimumab is an effective treatment for patients with active AS. PMID:21221193

Hennigan, Stephanie; Ackermann, Christoph; Kavanaugh, Arthur

2007-01-01

120

Patient perspectives of managing fatigue in Ankylosing Spondylitis, and views on potential interventions: a qualitative study  

PubMed Central

Background Fatigue is a major component of living with ankylosing spondylitis (AS), though it has been largely over-looked, and currently there are no specific agreed management strategies. Methods This qualitative exploratory study involved participants who are members of an existing population-based ankylosing spondylitis (PAS) cohort. Participants residing in South West Wales were invited to participate in a focus group to discuss; (1) effects of fatigue, (2) self-management strategies and (3) potential future interventions. The focus groups were audio-recorded and the transcripts were analysed using thematic analysis. Results Participants consisted of 3 males/4 females (group 1) and 4 males/3 females (group 2), aged between 35 and 73?years (mean age 53?years). Three main themes were identified: (1) The effects of fatigue were multi-dimensional with participants expressing feelings of being ‘drained’ (physical), ‘upset’ (emotional) and experiencing ‘low-mood’ (psychological); (2) The most commonly reported self-management strategy for fatigue was a balanced combination of activity (exercise) and rest. Medication was reluctantly taken due to side-effects and worries over dependency; (3) Participants expressed a preference for psychological therapies rather than pharmacological for managing fatigue. Information on Mindfulness-Based Stress Reduction (MBSR) was received with interest, with recommendations for delivery in a group format with the option of distance-based delivery for people who were not able to attend a group course. Conclusions Patients frequently try and manage their fatigue without any formal guidance or support. Our research indicates there is a need for future research to focus on psychological interventions to address the multi-faceted aspects of fatigue in AS. PMID:23659344

2013-01-01

121

Anterior fracture dislocation of the odontoid peg in ankylosing spondylitis as a cause for rhinolalia clausa: a case study.  

PubMed

We present an unusual cause of rhinolalia clausa secondary to an oropharyngeal mass. A 69-year-old male presented to the otorhinolaryngology clinic with a one year history of a 'plummy' voice. He had a longstanding history of severe ankylosing spondylitis. Examination revealed an obvious hyponasal voice and a smooth hard mass in the midline of the posterior nasopharyngeal and oropharyngeal walls. Subsequent computed tomography scans and lateral plain neck X-ray showed a fracture dislocation of the odontoid peg, secondary to ankylosing spondylitis, which had eroded through the body of the C1 vertebra to lie anteriorly, resulting in the aforementioned impression into the pharyngeal mucosa. The radiological images, the role of the nasal airways in phonation and the causes of hyponasal speech are discussed. PMID:17466090

Hilton, J M; Tassone, P; Hanif, J; Blagnys, B

2008-01-01

122

Spinal Mobility, Vertebral Squaring, Pulmonary Function, Pain, Fatigue, and Quality of Life in Patients With Ankylosing Spondylitis  

PubMed Central

Objective To investigate the relationships between spinal mobility, pulmonary function, structural change of the spine, pain, fatigue, and quality of life (QOL) in patients with ankylosing spondylitis (AS). Methods Thirty-six patients with AS were recruited. Their spinal mobility was examined through seven physical tests: modified Schober test, lateral bending, chest expansion, occiput to wall, finger to ground, bimalleolar distance, and range of motion (ROM) of the spine. Pulmonary Function Test (PFT) was performed using a spirometer, and vertebral squaring was evaluated through the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). QOL, disease activity, functional capacity, and fatigue were evaluated by SF-36 Health Survey (SF-36), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), and the Multidimensional Assessment of Fatigue (MAF) scale, respectively. Perceived physical condition and degree of pain were assessed using 10 cm visual analogue scale. Results Participants showed reduced spinal mobility, which was negatively correlated with mSASSS. PFT results showed reduced forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) and increased FEV1/FVC. Reduced FEV1 and FVC showed positive correlations with reduced spinal mobility and a negative relationship with mSASSS. Perceived physical condition and degree of pain were both significantly related to the SF-36, BASDAI, BASFI, and MAF scores. Conclusion This study shows that both reduced spinal mobility and radiographic changes in the vertebral body may have a predictive value for pulmonary impairment in patients with AS. Likewise, pain and perceived physical condition may play an important role in the QOL, functional capacity, and fatigue level of these patients. PMID:24236255

Cho, Hyungpil; Kim, Taikon; Kim, Tae-Hwan; Lee, Seunghun

2013-01-01

123

Relationship Between Disease Activity and Serum Levels of Vitamin D Metabolites and Parathyroid Hormone in Ankylosing Spondylitis  

Microsoft Academic Search

:   Vertebral fractures due to osteoporosis are a common but frequently unrecognized complication of ankylosing spondylitis (AS)\\u000a and various factors may contribute to the development of osteoporosis in AS. It is known that inflammatory activity in rheumatic\\u000a disease (i.e., proinflammatory cytokines) itself plays a possible role in the pathophysiology of bone loss. 1,25-Dihydroxyvitamin\\u000a D3 (1,25(OH)2D3) seems to be another possible

U. Lange; O. Jung; J. Teichmann; G. Neeck

2001-01-01

124

A survey of European and Canadian rheumatologists regarding the treatment of patients with ankylosing spondylitis and extra-articular manifestations  

Microsoft Academic Search

Ankylosing spondylitis (AS) is a disabling inflammatory disease accompanied by a variety of extra-articular manifestations\\u000a in a significant number of patients. These manifestations, including Crohn’s disease, ulcerative colitis, psoriasis, and uveitis,\\u000a share a similar inflammatory mechanism with one another and with AS. Extra-articular manifestations are observed in a larger\\u000a percentage of patients with AS and spondyloarthritides (SpAs) than the normal

Filip Van den Bosch

2010-01-01

125

Significant association between insertion/deletion polymorphism of the angiotensin-convertig enzyme gene and ankylosing spondylitis  

PubMed Central

Purpose Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease that characteristically affects the sacroiliac joints and the spine. Also iritis and uveitis can be serious complications of AS that can damage the eye and impair vision. The exact pathogenesis of AS remains poorly understood but genetic factors play a key role in its development. Human leukocyte antigen B27 (HLA-B27) is the major genetic susceptibility marker in AS. To our knowledge, angiotensin converting enzyme (ACE) gene I/D polymorphisms have not yet been investigated in AS patients in Turkish population.This study was conducted in Turkish patients with AS to determine the frequency of I/D polymorphism genotypes of angiotensin converting enzyme gene. Methods Genomic DNA obtained from 262 persons (122 patients with ankylosing spondylitis and 140 healthy controls) was used in the study. ACE I/D polymorphism genotypes were determined by using polymerase chain reaction with specific primers. Results There was statistically significant difference between the groups with respect to genotype distribution (p<0.001). When we examine ACE genotype frequencies according to the clinical characteristics there was a statistically significant association between DD genotype and ocular involvement (p=0.04) also sacroiliac joint involvement (p=0.03). Conclusions As a result of our study, angiotensin converting enzyme gene I/D polymorphism DD genotype could be a genetic marker in ankylosing spondylitis in a Turkish study population. PMID:22876137

Inan?r, Ahmet; Yigit, Serbulent; Tural, Sengul; Ozturk, Sibel Demir; Akkanet, Songul; Habibo?lu, Abdulkadir

2012-01-01

126

The impact of whole-body cryotherapy on parameters of spinal mobility in patients with ankylosing spondylitis.  

PubMed

Background. The aim of our study was to assess the impact of whole-body cryotherapy with subsequent kinesitherapy on spinal mobility parameters in patients with ankylosing spondylitis. Material and methods. We enrolled 32 men with ankylosing spondylitis in a clinical trial. The subjects were randomly divided into 2 groups consisting of 16 persons, with no significant differences in age, duration, or stage of disease, treated with a cycle of 10 whole-body cryotherapy procedures with subsequent kinesitherapy or kinesitherapy alone, respectively. Routine spinal mobility parameters were determined for all patients before and after the end of the therapeutic cycle. Results. Significant improvement of spinal mobility was observed in both groups of patients, but in patients exposed to whole-body cryotherapy with subsequent kinesitherapy the percentage changes in the values of particular parameters were more distinct as compared to patients in whom kinesitherapy alone was used, mainly in respect to lumbar and thoracic spinal mobility. Conclusion. The use of whole-body cryotherapy as a component of comprehensive therapy in patients with ankylosing spondylitis produces significant improvements in spinal mobility parameters as compared to patients in whom kinesitherapy alone is used. PMID:17611448

Stanek, Agata; Siero?, Aleksander; Cie?lar, Grzegorz; Matyszkiewicz, Beata; Rozmus-Kuczia, Irena

2005-10-30

127

Ankylosing Spondylitis  

MedlinePLUS

... resonance imaging (MRI). A procedure that provides high-resolution computerized images of internal body tissues. MRI uses ... part of the U.S. Department of Health and Human Services’ National Institutes of Health (NIH), is to ...

128

Golimumab administered subcutaneously every 4?weeks in ankylosing spondylitis: 5-year results of the GO-RAISE study  

PubMed Central

Objective Assess golimumab efficacy/safety through 5?years in patients with active ankylosing spondylitis (AS). Methods 356 patients with AS were randomly assigned to placebo, golimumab 50?mg or 100?mg every 4?weeks. At week 16, patients with inadequate response early escaped with blinded dose adjustments (placebo to 50?mg, 50?mg to 100?mg). At week 24, all patients receiving placebo crossed over to 50?mg. Blinded active therapy continued through week 104; from week 104 to week 252, the golimumab dose could be adjusted. Intent-to-treat and observed efficacy data were assessed by randomised treatment groups. Results At week 256, and with >4.5?years of golimumab, overall intent-to-treat Assessment in SpondyloArthritis international Society criteria for 20% improvement (ASAS20) and ASAS40 response rates were 66.0% (235/356) and 57.0% (203/356), respectively; Bath AS Disease Activity Index 50% improvement response was 55.9% (199/356). Observed response rates among the 255 (72%) patients who continued golimumab through week 252 were consistent, albeit somewhat higher. Among patients who increased golimumab from 50 to 100?mg, 60.6% (20/33) and 44.7% (17/38) achieved ASAS20/ASAS40 responses, respectively, following ?2 consecutive doses of golimumab 100?mg. Golimumab safety through week 268 was similar to that through week 24 regardless of dose. Conclusions Clinical improvements observed in patients treated with golimumab through week 24 were sustained through week 256 (5?years). Long-term golimumab safety is consistent with that of other established tumour-necrosis-factor-antagonists. Trial registration number ClinicalTrials.gov: NCT00265083. PMID:25387477

Deodhar, Atul; Braun, Jürgen; Inman, Robert D; Zhou, Yiying; Xu, Stephen; Han, Chenglong; Hsu, Benjamin

2015-01-01

129

Analysis of the CD8+ T cell response to the G1 domain of aggrecan in ankylosing spondylitis  

PubMed Central

Background: CD4+ T cell responses to the G1 domain of aggrecan in patients with ankylosing spondylitis (AS) were recently reported. Whether such an immune response can be seen in the CD8+ subpopulation has not yet been determined. Objective: To determine if HLA-B27 restricted G1-specific CD8+ T cells are present in AS and to analyse immunodominant CD8+ T cell epitopes. Methods: Peripheral blood mononuclear cells of 45 patients with AS were stimulated with overlapping 18-mer peptides covering the whole G1 protein. Results were compared with those for patients with rheumatoid arthritis (RA) and healthy controls. For epitope analysis, G1-specific interferon gamma positive (IFN?+) T cells were isolated by magnetic activated cell sorting. After in vitro expansion, CD8+ T cells were restimulated with 14 subpools of G1 peptides. T cells responding to G1 peptide subpools were quantified by flow cytometry according to IFN? secretion. Predicted peptides were subsequently confirmed by stimulation with single peptides. Results: G1-specific CD8+ T cell responses were found in 29/45 (64%) patients with AS, 18/35 (51%) patients with RA, but not in healthy controls. Five CD8+ T cell epitopes were identified as immunodominant in five patients. However, the T cell response was not HLA-B27 restricted. Nonamer peptides with an HLA-B27 binding motif did not induce a T cell response. Conclusion: A G1 peptide-specific CD8+ T cell response is present in AS but also in patients with RA. It does not seem to be HLA-B27 restricted. Whether such a response has a role in the pathogenesis of AS needs clarification. PMID:15539415

Zou, J; Appel, H; Rudwaleit, M; Thiel, A; Sieper, J

2005-01-01

130

Higher frequency of peripheral blood follicular regulatory T cells in patients with new onset ankylosing spondylitis.  

PubMed

Follicular helper T (TFH) cells and B cells are linked to the pathogenesis of ankylosing spondylitis (AS). Follicular regulatory T (TFR) cells suppress TFH cell and germinal center B cell numbers in vivo. The role of TFR cells in AS is unknown. The frequency of peripheral blood inducible FOXP3+CXCR5+CD4+TFR cells and CXCR5+CD4+TFH cells were taken from 20 onset AS patients and 10 healthy controls, and were examined by flow cytometry, their disease activity were measured by the Bath Ankylosing Spondylitis Disease Activity Index. The concentrations of serum interleukin (IL)-21, immunoglobulin G, immunoglobulin A, immunoglobulin M and C-reactive protein were examined, and the values of erythrocyte sedimentation rate were measured. The frequency of peripheral blood FOXP3+CXCR5+CD4+TFR cells, CXCR5+CD4+TFH cells, the ratio of FOXP3+CXCR5+CD4+TFR/CXCR5+CD4+TFH cells and the concentration of serum IL-21 in the AS patients were significantly higher than those in the healthy controls (P < 0.0001, P = 0.0027, P < 0.0001, P = 0.0039, respectively). The frequency of FOXP3+CXCR5+CD4+TFR cells and the ratio of FOXP3+CXCR5+CD4+TFR/CXCR5+CD4+TFH cells still significantly rose in those patients after standard treatment (P = 0.0006, P < 0.0001), the concentration of serum IL-21 decreased after treatment (P = 0.0049), accompanied by significantly minimized disease activities. Furthermore, the TFR cells were negatively correlated with serum immunoglobulin A in those patients before treatment (r = -0.582, P = 0.0071), and the frequency of TFR cells was negatively correlated with that of TFH cells and the concentration of serum IL-21 after treatment (r = -0.550, P = 0.046; r = -0.581, P = 0.0371). TFR cells might participate in the pathogenesis of AS, and might be responsible for controlling the autoantibodies, the frequency and function of TFH cells to inhibit the development of AS. PMID:25345823

Shan, Yuxing; Qi, Changlin; Zhao, Jixue; Liu, Yijun; Gao, Hui; Zhao, Ding; Ding, Fupeng; Wang, Jing; Jiang, Yanfang

2015-02-01

131

Direct costs of ankylosing spondylitis and its determinants: an analysis among three European countries  

PubMed Central

Objective: To assess direct costs associated with ankylosing spondylitis (AS). To determine which variables, including country, predict costs. Methods: 216 patients with AS from the Netherlands, France, and Belgium participated in a two year observational study and filled in bimonthly economic questionnaires. Disease related healthcare resource use was measured and direct costs were calculated from a societal perspective (true cost estimates) and from a financial perspective (country-specific tariffs). Predictors of costs were assessed using Cox's regression analysis. Results: 209 patients provided sufficient data for cost analysis. Mean annual societal direct costs for each patient were €2640, of which 82% were direct healthcare costs. In univariate analysis costs were higher in the Netherlands than in Belgium, but this difference disappeared after adjusting for baseline differences in patients' characteristics among countries. Longer disease duration, lower education, worse physical function, and higher disease activity were predictors of costs. Mean annual direct costs from a financial perspective were €2122, €1402, and €941 per patient in the Netherlands, France, and Belgium, respectively. For each country, costs from a financial perspective were significantly lower than costs from a societal perspective. Conclusion: Direct costs for AS are substantial in three European countries but not significantly different after adjusting for baseline characteristics among countries. Worse physical function and higher disease activity are important determinants of costs, suggesting better disease control might reduce the costs of AS. The difference in costs from a societal and financial perspective emphasises the importance of an economic analysis. PMID:12860728

Boonen, A; van der Heijde, D; Landewe, R; Guillemin, F; Rutten-van, M; Dougados, M; Mielants, H; de Vlam, K; van der Tempel, H; Boesen, S; Spoorenberg, A; Schouten, H; van der Linden, S.

2003-01-01

132

Immunogenetic Study in Chinese Population with Ankylosing Spondylitis: Are There Specific Genes Recently Disclosed?  

PubMed Central

Purpose. Ankylosing spondylitis (AS) is a systemic, autoimmune disease resulting in the destruction of the affected joints. Over the past 5 years, several new genes or genetic regions associated with AS have been identified in the Chinese population. This paper aims to discuss the major findings and related potential mechanisms of these studies in our population. Recent Findings. In recent years, due to the rapid advances in computational genetics and technology, there has been an increasing list of well-validated genes or genetic regions associated with AS susceptibility. So far, several genes or genetic regions have now been reported in the Han ethnic Chinese population, containing the major histocompatibility complex (MHC), ERAP1, IL-23R, 12q12, 2p15, 5q14.3, and so on. Different hypotheses for disease mechanisms have been investigated on the basis of the functional studies of these genes or genetic regions. Summary. This paper tries to summarize the association of several candidate genes with risk for AS in the Han ethnic Chinese population and aims to identify the novel inflammatory pathways and provide potential strategies for better therapies. PMID:23401698

Zhai, Jiayu; Rong, Ju; Li, Qiuxia; Gu, Jieruo

2013-01-01

133

Computer Aided Evaluation of Ankylosing Spondylitis Using High-Resolution CT  

PubMed Central

Ankylosing Spondylitis is a disease characterized by abnormal bone structures (syndesmophytes) growing at intervertebral disk spaces. Because this growth is so slow as to be undetectable on plain radiographs taken over years, it is desirable to resort to computerized techniques to complement qualitative human judgment with precise quantitative measures. We developed an algorithm with minimal user intervention that provides such measures using high-resolution computed tomography (CT) images. To the best of our knowledge it is the first time that determination of the disease’s status is attempted by direct measurement of the syndesmophytes. The first part of our algorithm segments the whole vertebral body using a 3-D multiscale cascade of successive level sets. The second part extracts the continuous ridgeline of the vertebral body where syndesmophytes are located. For that we designed a novel level set implementation capable of evolving on the isosurface of an object represented by a triangular mesh using curvature features. The third part of the algorithm segments the syndesmophytes from the vertebral body using local cutting planes and quantitates them. We present experimental work done with 10 patients from each of which we processed five vertebrae. The results of our algorithm were validated by comparison with a semi-quantitative evaluation made by a medical expert who visually inspected the CT scans. Correlation between the two evaluations was found to be 0.936 (p < 10?18). PMID:18779065

Yao, Jianhua; Ward, Michael M.; Yao, Lawrence; Summers, Ronald M.

2009-01-01

134

Impact of ankylosing spondylitis on sexual function: A systematic review and meta-analysis  

PubMed Central

A number of studies have reported the association of sexual problems with ankylosing spondylitis (AS); however, the results have been conflicting. The present study aimed to investigate the impact of AS on sexual function. To develop a more comprehensive understanding of sexual function in patients with AS, a systematic review and meta-analysis of the literature up to 2013 was conducted. Studies that assessed the impact of AS on sexual function by adopting the International Index of Erectile Function or the Female Sexual Function Index (FSFI) scoring system were included. Statistical analysis was performed using Review Manager statistical software (version 5.2). The weighted mean differences were calculated by employing a fixed or random effects model. A total of 484 cases from five studies were identified as being well-documented and included in the meta-analysis. Compared with healthy controls, male patients with AS have a significant reduction in sexual function scores of erectile function (?3.07), orgasmic function (?1.17), sexual drive (?0.72) and intercourse satisfaction (?1.89). Female patients with AS have a lower FSFI score in domains of desire (?0.34) and arousal (?0.87). In conclusion, AS has a certain impact on the sexual function of male patients. AS appears to have a greater influence on the sexual function of males compared with that of females. However, the mechanism by which AS affects sexual function requires further evaluation by further studies of a larger population of patients. PMID:25780459

LIU, YA-FEI; DONG, HUI; CHEN, ZHE; WANG, YU; TU, SHENG-HAO

2015-01-01

135

Suppression subtractive hybridization reveals differentially expressed genes in supraspinous ligaments of patients with ankylosing spondylitis.  

PubMed

Ankylosing spondylitis (AS) is a severe chronic inflammatory disease that may ultimately result in the development of a 'bamboo?like' spine. Although the pathological changes that occur in AS have been extensively investigated, the mechanism underlying spinal fusion during AS remains elusive. Differentially expressed genes (DEGs) in paraspinal tissues from patients with AS compared with those from healthy controls were therefore investigated. Polymerase chain reaction (PCR)?based suppression subtractive hybridization was performed using total mRNA from the supraspinal ligaments of three patients with AS and three patients with spinal fractures as controls. From this, 27 genes were identified in all of the three independent forward libraries, which were defined as DEGs associated with AS. Reverse transcription?quantitative PCR demonstrated that six DEGs were overexpressed in the tissues from patients with AS compared with those from individuals in the control group, including those encoding transforming growth factor ? types I and III receptor, vascular endothelial growth factor, matrix metalloproteinase?3, core?binding factor ?1 and bone morphogenetic protein 2. Western blot analysis showed increased expression in all six of these proteins in the samples from patients with AS compared with those in the control groups. These findings suggested that changes in the expression of these genes and proteins are associated with the development of spinal fusion during the pathogenesis of AS. Furthermore, these genes may be novel markers of the risk of developing AS, in addition to being targets for the treatment of this disease. PMID:25632965

Zhang, Ying; Hu, Xu; Zhang, Chao; Zhou, Yue; Chu, Tong-Wei

2015-06-01

136

Anti-TNF Therapy in Ankylosing Spondylitis: Insights for the Clinician  

PubMed Central

The introduction of tumour necrosis factor (TNF)-blocking therapy has revolutionized the management of ankylosing spondylitis (AS) over the last decade. This review highlights the current evidence relating to the use of TNF-blocking therapy in AS. International guidelines for the use of TNF blockers in AS are summarized. An outline of the evidence for efficacy and safety of these drugs is included, highlighting recent data from registries and real-life observational studies. Such cohort data is also reviewed highlighting the evidence for ‘switching’ TNF blockers in AS in the case of non-response or adverse events. The potential new application of TNF blockers in preradiographic axial spondyloarthropathy (SpA) or ‘early AS’ is discussed with reviews of two recent studies in this area. Finally research into the possible additional impacts of TNF therapies is reviewed. The question of whether TNF blockers are truly disease modifying in AS remains unanswered with conflicting reports. The additional burden of AS in terms of cardiovascular disease is now becoming understood. Recent data from basic science studies highlights the potential impact of TNF blockers on this excess cardiovascular morbidity and mortality. Future studies and registry data will be able to assess whether TNF blockers have an additional role in controlling systemic inflammation and its associated cardiovascular risk. PMID:22870436

Coates, Laura C.; Marzo-Ortega, Helena; Bennett, Alexander N.; Emery, Paul

2010-01-01

137

Prevalence and risk factors of low bone mineral density in juvenile onset ankylosing spondylitis.  

PubMed

The objective of this study is to assess the prevalence and risk in patients with juvenile onset ankylosing spondylitis (JoAS) complicated with low bone mineral density (BMD). A total of 112 children and adolescents with JoAS were enrolled in the study. Bone mass was measured from the lumbar spine and the left proximal femur using dual-energy X-ray absorptiometry. According to the 2007 International Society of Clinical Densitometry definitions, a Z score of less than -2 was termed as "low BMD." Stepwise regression analysis was used to investigate associations between low BMD and disease-related factors including gender, age, weight, height, body mass index, disease duration, HLA-B27 antigen, grades of sacroiliitis, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), patient global assessment (PGA), spine pain, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Low BMD was found in 18 (16.1 %) cases in at least one of the two measured regions. Lumbar spine BMD had negative correlations with BASDAI, BASFI, spine pain, ESR, and CRP (P < 0.05). Hip BMD significantly negatively correlated with BASDAI and PGA (P < 0.05). In conclusion, patients with JoAS are likely to develop low BMD, which may be related to high disease activity. PMID:24854154

Bao, Jun; Chen, Yi; Bao, Yi-Xiao

2014-08-01

138

Common Mediterranean Fever (MEFV) Gene Mutations Associated with Ankylosing Spondylitis in Turkish Population  

PubMed Central

Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease. Mediterranean fever (MEFV) gene, which has already been identified as being responsible for familial Mediterranean fever (FMF), is also a suspicious gene for AS because of the clinical association of these two diseases. The aim of this study was to explore the frequency and clinical significance of MEFV gene mutations (M694V, M680I, V726A, E148Q and P369S) in a cohort of Turkish patients with AS. Genomic DNAs of 103 AS patients and 120 controls were isolated and genotyped using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methods. There was a statistically significant difference of the MEFV gene mutation carrier rates between AS patients and healthy controls (p = 0.004, OR: 2.5, 95% CI: 1.32–4.76). This association was also observed in allele frequencies (p = 0.005, OR: 2.3, 95% CI: 1.27–4.2). A relatively higher frequency was observed for M694V mutation in AS patients than controls (10.7% versus 4.2% , p = 0.060). There were no significant differences between MEFV mutation carriers and non-carriers with respect to the clinical and demographic characteristics. The results of this study suggest that MEFV gene mutations are positively associated with a predisposition to develop AS. PMID:22960328

Yigit, Serbulent; Inanir, Ahmet; Karakus, Nevin; Kesici, Esra; Bozkurt, Nihan

2012-01-01

139

What factors determine patients' preference for tumour necrosis factor inhibitors in ankylosing spondylitis?  

PubMed

Tumour necrosis factor inhibitor (TNFi) therapy, either intravenous (IV) or subcutaneous (SQ), demonstrates similar efficacy in ankylosing spondylitis (AS). The objective of this study was to examine factors influencing patient preference of TNFi. Fifty-nine (79.7%) participants were male with mean age 43.9 years and disease duration of 22.0 years. Fifty-nine patients (79.7%) agreed with the statement 'My doctor gave me a choice and I made a decision based on my personal preference'. Patients commenced first on IV TNFi most commonly cited reduced frequency of injections (96.6%), administration by a trained professional (89.7%) and use of infusion time for leisure activities (86.2%). Patients commenced on SQ TNFi cited flexibility with timing of treatment (80%), shortened administration time (73.3%) and the convenience of home therapy (73.3%). Shared clinical decision-making between clinicians and patients may be desirable for AS patients commencing TNFi therapy. PMID:19219481

Fajri, Dessy W; Brand, Caroline A; Dharmage, Shyamali C; Martin, Belinda J; Buchanan, Russell R C; Schachna, Lionel

2009-05-01

140

Functionally distinct ERAP1 allotype combinations distinguish individuals with Ankylosing Spondylitis.  

PubMed

For more than 40 y, expression of HLA-B27 has been strongly associated with the chronic inflammatory disease Ankylosing Spondylitis (AS); however, the mechanisms underlying this association are still unknown. Single nucleotide polymorphisms within the aminopeptidase endoplasmic reticulum aminopeptidase 1 (ERAP1), which is essential for trimming peptides before they are presented to T cells by major histocompatibility complex (MHC) class I molecules, have been linked with disease. We show that ERAP1 is a highly polymorphic molecule comprising allotypes of single nucleotide polymorphisms. The prevalence of specific ERAP1 allotypes is different between AS cases and controls. Both chromosomal copies of ERAP1 are codominantly expressed, and analysis of allotype pairs provided clear stratification of individuals with AS versus controls. Functional analyses demonstrated that ERAP1 allotype pairs seen in AS cases were poor at generating optimal peptide ligands for binding to murine H-2K(b) and -D(b) and the AS-associated HLA-B*2705. We therefore provide strong evidence that polymorphic ERAP1 alters protein function predisposing an individual to AS via its influence on the antigen processing pathway. PMID:25422414

Reeves, Emma; Colebatch-Bourn, Alexandra; Elliott, Tim; Edwards, Christopher J; James, Edward

2014-12-01

141

2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis  

PubMed Central

This first update of the ASAS/EULAR recommendations on the management of ankylosing spondylitis (AS) is based on the original paper, a systematic review of existing recommendations and the literature since 2005 and the discussion and agreement among 21 international experts, 2 patients and 2 physiotherapists in a meeting in February 2010. Each original bullet point was discussed in detail and reworded if necessary. Decisions on new recommendations were made — if necessary after voting. The strength of the recommendations (SOR) was scored on an 11-point numerical rating scale after the meeting by email. These recommendations apply to patients of all ages that fulfill the modified NY criteria for AS, independent of extra-articular manifestations, and they take into account all drug and non-drug interventions related to AS. Four overarching principles were introduced, implying that one bullet has been moved to this section. There are now 11 bullet points including 2 new ones, one related to extra-articular manifestations and one to changes in the disease course. With a mean score of 9.1 (range 8-10) the SOR was generally very good. PMID:21540199

Braun, J; van den Berg, R; Baraliakos, X; Boehm, H; Burgos-Vargas, R; Collantes-Estevez, E; Dagfinrud, H; Dijkmans, B; Dougados, M; Emery, P; Geher, P; Hammoudeh, M; Inman, RD; Jongkees, M; Khan, MA; Kiltz, U; Kvien, TK; Leirisalo-Repo, M; Maksymowych, WP; Olivieri, I; Pavelka, K; Sieper, J; Stanislawska-Biernat, E; Wendling, D; Özgocmen, S; van Drogen, C; van Royen, BJ; van der Heijde, D

2011-01-01

142

2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis.  

PubMed

This first update of the ASAS/EULAR recommendations on the management of ankylosing spondylitis (AS) is based on the original paper, a systematic review of existing recommendations and the literature since 2005 and the discussion and agreement among 21 international experts, 2 patients and 2 physiotherapists in a meeting in February 2010. Each original bullet point was discussed in detail and reworded if necessary. Decisions on new recommendations were made - if necessary after voting. The strength of the recommendations (SOR) was scored on an 11-point numerical rating scale after the meeting by email. These recommendations apply to patients of all ages that fulfill the modified NY criteria for AS, independent of extra-articular manifestations, and they take into account all drug and non-drug interventions related to AS. Four overarching principles were introduced, implying that one bullet has been moved to this section. There are now 11 bullet points including 2 new ones, one related to extra-articular manifestations and one to changes in the disease course. With a mean score of 9.1 (range 8-10) the SOR was generally very good. PMID:21540199

Braun, J; van den Berg, R; Baraliakos, X; Boehm, H; Burgos-Vargas, R; Collantes-Estevez, E; Dagfinrud, H; Dijkmans, B; Dougados, M; Emery, P; Geher, P; Hammoudeh, M; Inman, R D; Jongkees, M; Khan, M A; Kiltz, U; Kvien, Tk; Leirisalo-Repo, M; Maksymowych, W P; Olivieri, I; Pavelka, K; Sieper, J; Stanislawska-Biernat, E; Wendling, D; Ozgocmen, S; van Drogen, C; van Royen, Bj; van der Heijde, D

2011-06-01

143

The Risk of Asthma in Patients with Ankylosing Spondylitis: A Population-Based Cohort Study  

PubMed Central

Background The relationship between asthma and ankylosing spondylitis (AS) is controversial. We examined the risk of asthma among AS patients in a nationwide population. Methods We conducted a retrospective cohort study using data from the National Health Insurance (NHI) system of Taiwan. The cohort included 5,974 patients newly diagnosed with AS from 2000 to 2010. The date of diagnosis was defined as the index date. A 4-fold of general population without AS was randomly selected frequency matched by age, gender and the index year. The occurrence and hazard ratio (HR) of asthma were estimated by the end of 2011. Results The overall incidence of asthma was 1.74 folds greater in the AS cohort than in the non-AS cohort (8.26 versus 4.74 per 1000 person-years) with a multivariable Cox method measured adjusted HR of 1.54 (95% confidence interval (CI), 1.34–1.76). The adjusted HR of asthma associated with AS was higher in women (1.59; 95% CI, 1.33–1.90), those aged 50–64 years (1.66; 95% CI, 1.31–2.09), or those without comorbidities (1.82; 95% CI, 1.54–2.13). Conclusion Patients with AS are at a higher risk of developing asthma than the general population, regardless of gender and age. The pathophysiology needs further investigation. PMID:25658339

Shen, Te-Chun; Lin, Cheng-Li; Wei, Chang-Ching; Chen, Chia-Hung; Tu, Chih-Yen; Hsia, Te-Chun; Shih, Chuen-Ming; Hsu, Wu-Huei; Sung, Fung-Chang

2015-01-01

144

Early-onset ankylosing spondylitis is associated with a functional MICA polymorphism.  

PubMed

Major histocompatibility complex (MHC) class I chain-related A (MICA) molecules deliver activating signals through the NKG2D receptor expressed on the surface of natural killer (NK), CD8alphabeta and gammadelta T cells, and the MICA gene is polymorphic. The recently described MICA amino acid substitution at position 129 (MICA-129) seems to affect its binding to NKG2D. We investigated whether this dimorphism (MICA-129met [methionine] and MICA-129val [valine]) is associated with susceptibility to ankylosing spondylitis (AS) in a cohort of Algerian patients stratified according to their HLAB27 status and the age of onset of the disease. DNA from 129 patients and 76 healthy individuals were analyzed to determine the HLA-B generic type as well as MICA-129 polymorphism. Statistical analysis revealed: (1) a weaker association between AS and HLA-B27 in Algerians than in that reported for European patients (63% versus 80-90%), suggesting a possible influence of other genetic/environmental determinants in the studied population and (2) an association between MICA-129 met/met genotype and juvenile AS (p = 0.02) independent of HLA-B27 status. These data suggest a potential role for a functionally relevant MICA gene polymorphism in autoimmune/inflammatory disease susceptibility. PMID:16386647

Amroun, Habiba; Djoudi, Hachemi; Busson, Marc; Allat, Rachida; El Sherbini, Shérif Mohsen; Sloma, Ivan; Ramasawmy, Rajendranath; Brun, Manuel; Dulphy, Nicolas; Krishnamoorthy, Rajagopal; Toubert, Antoine; Charron, Dominique; Abbadi, Mohamed Chérif; Tamouza, Ryad

2005-10-01

145

A registry of ankylosing spondylitis registries and prospects for global interfacing  

PubMed Central

Purpose of review To review the optimal criteria and conditions for establishing a clinical registry, as well as detailing their application in a number of ankylosing spondylitis (AS) and axial spondyloarthritis (axSpA) Registries already in existence. Recent findings Recent genetic studies and studies of long-term treatment efficacy and side-effects have underscored the need for large numbers of patients, much larger than would be possible from a single center or consortium. An optimal Registry should have its aims established upfront, with appropriate governance and oversight, and inclusion and exclusion criteria for participating collaborators and subject defined. Collaborators contributing subjects to a Registry should use validated instruments for which they have been previously trained. The numerous cross-sectional and longitudinal Registries on AS and axSpA have been recently established that differ widely depending on the referral and selection issues. Summary The challenge of large-scale examinations of genetics, comorbidities, medication usage, and side-effects in spondyloarthritis underscores the need for combining data from well characterized registries of AS patients which require careful planning. There are currently many such registries available internationally, offering promise for collaborations and data pooling that can answer some of the pressing questions facing rheumatology clinicians and researchers. PMID:23656716

Reveille, John D.

2013-01-01

146

Protocol for a population-based Ankylosing Spondylitis (PAS) cohort in Wales  

PubMed Central

Background To develop a population-based cohort of people with ankylosing spondylitis (AS) in Wales using (1) secondary care clinical datasets, (2) patient-derived questionnaire data and (3) routinely-collected information in order to examine disease history and the health economic cost of AS. Methods This data model will include and link (1) secondary care clinician datasets (i.e. electronic patient notes from the rheumatologist) (2) patient completed questionnaires (giving information on disease activity, medication, function, quality of life, work limitations and health service utilisation) and (3) a broad range of routinely collected data (including; GP records, in-patient hospital admission data, emergency department data, laboratory/pathology data and social services databases). The protocol involves the use of a unique and powerful data linkage system which allows datasets to be interlinked and to complement each other. Discussion This cohort can integrate patient supplied, primary and secondary care data into a unified data model. This can be used to study a range of issues such as; the true economic costs to the health care system and the patient, factors associated with the development of severe disease, long term adverse events of new and existing medication and to understand the disease history of this condition. It will benefit patients, clinicians and health care managers. This study forms a pilot project for the use of routine data/patient data linked cohorts for other chronic conditions. PMID:20809952

2010-01-01

147

Isolation of IgG Antibodies to Toxocara in Ankylosing Spondylitis Patients with Acute Anterior Uveitis  

PubMed Central

Purpose Since few reports had been published on the prevalence of toxocariasis in ankylosing spondylitis (AS) patients with acute non-granulomatous anterior uveitis (ANGAU), the aim of this work was to determine the presence of antibodies against Toxocara canis in AS patients with ANGAU. Methods Thirty-six patients (14 female and 22 male) with AS were enrolled in the study. The history of ANGAU was accepted only if diagnosed by an ophthalmologist. The detection of IgG antibodies to T. canis was determined by enzyme-linked immunosorbent assay. In addition, antibodies to Ascaris lumbricoides were also tested to verify non-specific reactions. Results The prevalence of ANGAU in the AS patients was 58% (21 / 36), and 38% (8 / 21) of the patients with ANGAU were positive for antibodies to Toxocara, while 7% (1 / 15) of AS patients without ANGAU were positive for T. canis (p = 0.038, two tails; mid-p exact). No antibodies were detected to A. lumbricoides antigens in the serum samples of patients with AS. Conclusions These data suggest that the seroprevalence of antibodies to T. canis is high in Mexican patients with AS-associated uveitis, suggesting a chronic asymptomatic toxocariosis, which could be associated with the pathogenesis of ANGAU; however, further larger-scale studies are needed to confirm this observation. PMID:24882953

Jiménez-Balderas, Francisco-Javier; García-Jaimes, Janete; Ríos, Rita; Zonana-Nacach, Abraham; Tapia-Romero, Raquel; Villanueva, Nayeli; Méndez-Samperio, Patricia

2014-01-01

148

Activating killer immunoglobulin-like receptors genes are associated with increased susceptibility to ankylosing spondylitis.  

PubMed

The aim of this study was to analyse the association of specific killer cell immunoglobulin-like receptors (KIR) genes and haplotypes with susceptibility to ankylosing spondylitis (AS) and its different clinical manifestations in a Spanish population. The presence or absence of all KIR genes was studied for their association with AS. A total of 176 patients with AS and 435 healthy control subjects were selected for this study based on clinical criteria. The commercial KIR-sequence-specific oligonucleotides (SSO) typing kit was used to investigate KIR typing. Frequencies of KIR2DS1 and KIR3DS1 genes were increased significantly in patients compared with healthy controls [52·8 versus 38·2%, PBonf < 0·01, odds ratio (OR)?=?1·81 (1·28-2·59); 51·7 versus 37·5%, PBonf < 0·01, OR?=?1·79 (1·25-2·54)]. Moreover, the frequency of activating genotypes in the AS patient group was significantly higher than in the healthy control group (P?

Díaz-Peña, R; Vidal-Castiñeira, J R; Mulero, J; Sánchez, A; Queiro, R; López-Larrea, C

2015-05-01

149

Spinal cord stimulator placement in a patient with complex regional pain syndrome and ankylosing spondylitis: a novel approach with dual benefits.  

PubMed

Spinal cord stimulation is a treatment modality used to treat various chronic pain conditions, including complex regional pain syndrome (CRPS). We present a case in which spinal cord stimulation was used for the treatment of lower extremity CRPS in a patient with ankylosing spondylitis. Preoperative imaging demonstrated fusion of the lumbothoracic spine with obliteration of the interlaminar spaces. The sacral hiatus remained open and was used to access the epidural space, facilitating the placement of 2 thoracic epidural electrodes. The resulting stimulation controlled not only the patient's lower extremity CRPS pain but also alleviated his chronic axial pain secondary to ankylosing spondylitis. PMID:25611990

Okpareke, Ikenna; Young, Adam C; Amin, Sandeep

2014-05-15

150

Experiences of mothers living with inflammatory arthritis  

Microsoft Academic Search

Objective. To describe the impact of chronic, inflammatory arthritis on parenting and to develop a conceptual frame- work for subsequent study of mothering. Methods. A qualitative, grounded theory design guided data collection and analysis. In-depth interviews were conducted with a purposive sample of 12 women with either rheumatoid arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, or systemic lupus erythematosus who were

Catherine L. Backman; Linda del Fabro Smith; Sharon Smith; Pamela L. Montie; Melinda Suto

2007-01-01

151

Bone turnover markers, anterior pituitary and gonadal hormones, and bone mass evaluation using quantitative computed tomography in ankylosing spondylitis.  

PubMed

The objective of this study was to determine bone mineral density (BMD) distribution in ankylosing spondylitis (AS) using quantitative computed tomography (QCT), to study bone turnover and anterior pituitary and gonadal hormonal axis in AS, and to look for correlations between BMD, bone remodeling markers and gonadal and anterior pituitary hormones. Forty-three male consecutive patients with AS were enrolled prospectively [mean (SD) age of 36.4 (11.3) years (range: 17-67) and mean disease duration of 6.8 (5.2) years (range: 0.4-19)]. Spine BMD was measured in all patients by QCT, and the results were compared to 29 male patients undergoing lumbar CT scan for sciatica. Bone turnover and anterior pituitary and gonadal axis were assessed in 29 patients, and the results were compared to 30 male healthy blood donors. The mean (SD) BMD was 127.7 mg/cm(3) (48.9) (range: 8.8-265.7) and 152.1 (25.3) (range: 34.2-190.4) in patients and controls, respectively (p = 0.018). Patients had lower serum levels of osteocalcin and higher levels of serum testosterone, luteinizing hormone (LH), and prolactin than controls with a significant statistical difference. There was a positive significant statistical correlation between BMD and chest expansion, Schober's test, C7-wall distance, and negative significant statistical correlation with age, disease duration, Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Radiology Index (BASRI), and serum prolactin. No correlation was observed between bone turnover parameters and AS symptomatic and structural severity indexes. BMD is lower with increasing age and late and severe disease. Decreased bone formation with normal resorption and increased levels of serum prolactin may be involved in its pathophysiology. PMID:15592691

El Maghraoui, Abdellah; Tellal, Saida; Chaouir, Souad; Lebbar, Khalil; Bezza, Ahmed; Nouijai, Abderrazak; Achemlal, Lahsen; Bouhssain, Sanaa; Derouiche, El Mostapha

2005-08-01

152

Sleep disturbances are associated with increased pain, disease activity, depression, and anxiety in ankylosing spondylitis: a case-control study  

PubMed Central

Introduction Literature data suggest that sleep disturbances are prevalent among patients with ankylosing spondylitis (AS) and have a close correlation with pain. Other studies indicate that sleep disturbances are constantly accompanied by depression and anxiety in AS, but their interrelations are poorly understood. This study was designed to evaluate sleep disturbances and their association with demographic variables, pain, disease-specific variables, functional status, covering depression and anxiety in AS patients. Methods The 314 patients with AS and age- and sex-matched controls took part in the study, completed a battery of questionnaires, and participated in long-term follow-up. Blood samples were taken to measure C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR). The association among sleep, pain, disease activity, functional status, depression, and anxiety were assessed by using Pearson/Spearman correlations and multiple regression analysis. Results The Pittsburgh Sleep Quality Index (PSQI) score of the Chinese version was significantly higher in the AS group than in the control group (P = 0.020). Of the 314 patients with AS, 184 (58.6%) had a high risk for sleep disturbances. The PSQI score was associated with age, years of education, ESR, CRP, overall assessment of health, pain, morning stiffness, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), depression, and anxiety (all P < 0.001), but were not associated with disease duration, fingertip-to-floor distance, and Bath Ankylosing Spondylitis Metrology Index (BASMI) (P > 0.05). In hierarchic multiple regression analysis, the medical and psychological variables contributed significantly to the variance in sleep-disturbances scores, adding an additional 23.9% to the overall R2 beyond that accounted for by demographic variables (R-square, 8.5%), resulting in a final R2of 42.6%. Multiple stepwise regression analysis revealed that anxiety was the maximal statistical contribution in predicting sleep disturbances (standardized coefficients, 0.287). Conclusions The prevalence of sleep disturbances in AS patients is higher than it is generally thought to be. Depression, anxiety, nocturnal pain, and total back pain are the major contributors of sleep disturbances in AS. PMID:23058191

2012-01-01

153

High-frequency sensorineural hearing loss in patients with ankylosing spondylitis: is it an extrarticuler feature of disease?  

Microsoft Academic Search

Objective  The aim of this study was to investigate the ear involvement, especially at extended higher frequencies than those previously\\u000a studied, in patients with ankylosing spondylitis (AS).\\u000a \\u000a \\u000a \\u000a Patients and methods  We prospectively evaluated 45 consecutive patients with AS. All patients underwent a complete physical examination of the\\u000a ear, nose, and throat and an audiologic evaluation that included pure-tone audiometry at conventional and

Mehmet Adam; Alper Nabi Erkan; Didem Arslan; Berrin Leblebici; Levent Özlüo?lu; M. Nafiz Akman

2008-01-01

154

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  

PubMed Central

Objectives To evaluate the efficacy and safety of certolizumab pegol (CZP) after 24?weeks in RAPID-axSpA (NCT01087762), an ongoing Phase 3 trial in patients with axial spondyloarthritis (axSpA), including patients with ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA). Methods Patients with active axSpA were randomised 1:1:1 to placebo, CZP 200?mg every 2?weeks (Q2W) or CZP 400?mg every 4?weeks (Q4W). In total 325 patients were randomised. Primary endpoint was ASAS20 (Assessment of SpondyloArthritis international Society 20) response at week 12. Secondary outcomes included change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Metrology Index (BASMI) linear. Results Baseline disease activity was similar between AS and nr-axSpA. At week 12, ASAS20 response rates were significantly higher in CZP 200?mg Q2W and CZP 400?mg Q4W arms versus placebo (57.7 and 63.6 vs 38.3, p?0.004). At week 24, combined CZP arms showed significant (p<0.001) differences in change from baseline versus placebo in BASFI (?2.28 vs ?0.40), BASDAI (?3.05 vs ?1.05), and BASMI (?0.52 vs ?0.07). Improvements were observed as early as week 1. Similar improvements were reported with CZP versus placebo in both AS and nr-axSpA subpopulations. Adverse events were reported in 70.4% vs 62.6%, and serious adverse events in 4.7% vs 4.7% of All CZP versus placebo groups. No deaths or malignancies were reported. Conclusions CZP rapidly reduced the signs and symptoms of axSpA, with no new safety signals observed compared to the safety profile of CZP in RA. Similar improvements were observed across CZP dosing regimens, and in AS and nr-axSpA patients. PMID:24013647

Landewé, R; Braun, J; Deodhar, A; Dougados, M; Maksymowych, W P; Mease, P J; Reveille, J D; Rudwaleit, M; van der Heijde, D; Stach, C; Hoepken, B; Fichtner, A; Coteur, G; de Longueville, M; Sieper, J

2014-01-01

155

Ankylosing spondylitis is associated with the anthrax toxin receptor 2 gene (ANTXR2)  

PubMed Central

Objectives ANTXR2 variants have been associated with ankylosing spondylitis (AS) in two previous genome-wide association studies (GWAS) (p?9×10?8). However, a genome-wide significant association (p<5×10?8) was not observed. We conducted a more comprehensive analysis of ANTXR2 in an independent UK sample to confirm and refine this association. Methods A replication study was carried out with 2978 cases and 8365 controls. Then, these were combined with non-overlapping samples from the two previous GWAS in a meta-analysis. Human leukocyte antigen (HLA)-B27 stratification was also performed to test for ANTXR2-HLA-B27 interaction. Results Out of nine single nucleotide polymorphisms (SNP) in the study, five SNPs were nominally associated (p<0.05) with AS in the replication dataset. In the meta-analysis, eight SNPs showed evidence of association, the strongest being with rs12504282 (OR=0.88, p=6.7×10?9). Seven of these SNPs showed evidence for association in the HLA-B27-positive subgroup, but none was associated with HLA-B27-negative AS. However, no statistically significant interaction was detected between HLA-B27 and ANTXR2 variants. Conclusions ANTXR2 variants are clearly associated with AS. The top SNPs from two previous GWAS (rs4333130 and rs4389526) and this study (rs12504282) are in strong linkage disequilibrium (r2?0.76). All are located near a putative regulatory region. Further studies are required to clarify the role played by these ANTXR2 variants in AS. PMID:25169729

Karaderi, T; Keidel, S M; Pointon, J J; Appleton, L H; Brown, M A; Evans, D M; Wordsworth, B P

2014-01-01

156

The effect of physical activity and motivation on function in ankylosing spondylitis: A cohort study  

PubMed Central

Objectives Exercise is reported to improve function for people with ankylosing spondylitis (AS) but it is not clear if this effect is causal or if patients with milder disease find it easier to exercise. This study examines the effect of exercise and motivation to exercise on function, while controlling for disease severity. Methods Participants who were members of an existing AS cohort were asked about physical activity, motivation to exercise, function, and disease severity. Path analysis on STATA was used to examine the correlation between factors associated with function at time of exercise and with function after 3 months of follow-up. Results The response rate to the questionnaire was 88% (326/371). Improvement in function was greatest for people with higher physical activity levels and those who were more motivated to exercise—this was especially the case for patients with the most severe disease activity. The effect of motivation to exercise not only had a direct effect on function, but also an indirect effect of improving activity levels thereby improving both current and future function. People with high intrinsic motivation (driven by pleasure) had the greatest benefit to activity and function. Conclusions Exercise does improve function, especially for those with severe disease. In addition, motivation alone improves function as much as exercising itself. Therefore, interventions targeting motivation to exercise would have as much effect on improving function as interventions offering exercise opportunities. In addition, any intervention that both improves motivation and increases opportunities to exercise would have a 2-fold influence on function. PMID:23351615

Brophy, Sinead; Cooksey, Roxanne; Davies, Helen; Dennis, Michael S.; Zhou, Shang-Ming; Siebert, Stefan

2013-01-01

157

Occupational Physical Activities and Long-Term Functional and Radiographic Outcomes in Patients With Ankylosing Spondylitis  

PubMed Central

Objective We sought to identify specific occupational activities associated with functional limitations and radiographic damage in patients with longstanding ankylosing spondylitis (AS). Methods We asked patients diagnosed with AS for ?20 years to report all past occupations, which we mapped to specific physical activities using the Occupational Information Network, which is the US Department of Labor job classification database. For each occupation reported, we obtained ratings for 13 physical abilities of the worker and 13 aspects of the work environment or work tasks (work context) thought to be most relevant to patients with AS. Averages for each measure, weighted by the number of years in each job, were related to the degree of functional limitation as assessed by the Bath AS Functional Index (BASFI) and to the extent of spinal radiographic damage as assessed by the Bath AS Radiology Index for the spine (BASRI-s). Results Among 397 patients, those with a history of jobs requiring dynamic flexibility (the ability to repeatedly bend, stretch, twist, or reach) had more functional limitations than those whose past jobs required little or no dynamic flexibility (adjusted mean BASFI score 48.3 in the top quartile versus 38.1 in all others). Those whose past jobs required more dynamic flexibility, extent flexibility, and exposure to whole body vibration also had significantly higher BASRI-s scores. Conclusion Bending, twisting, and stretching are the occupational activities associated with greater functional limitations and radiographic damage in patients with longstanding AS. Exposure to whole body vibration was also associated with more radiographic damage. PMID:18512723

Ward, Michael M.; Reveille, John D.; Learch, Thomas J.; Davis, John C.; Weisman, Michael H.

2009-01-01

158

Association between apparent diffusion coefficient and intervertebral disc degeneration in patients with ankylosing spondylitis  

PubMed Central

Purpose: To assess the relation between ankylosing spondylitis (AS) and degenerative disc disease emerging in association with various intrinsic and extrinsic factors and to evaluate the correlation between degree of degeneration in intervertebral discs and apparent diffusion coefficient (ADC) values. Methods: Thirty-five patients with AS and a control group of 35 patients were included in the study. Three hundred fifty intervertebral discs were assessed in terms of degeneration by analyzing signal intensities and morphologies on T2 weighted series of a 1.5 Tesla magnetic resonance scanner. ADC values were determined in diffusion weighted images (DWI) using a “b value of 500 s/mm2”. Patients in the AS and control groups were compared in terms of intervertebral disc degeneration, and association between degree of degeneration and ADC values was analyzed. Results: The mean of total degeneration degrees for five lumbar intervertebral discs was significantly higher in the patients with AS compared to the control group (16.77±4.67 vs 13.00±4.08, respectively; P=0.001). When intervertebral discs were analyzed separately, disc degeneration was again significantly higher in patients with AS compared to the control group, with the exception of L5-S1. Age, cholesterol level, triglyceride level, duration of disease and BASFI index were significantly associated with degree of degeneration in patients with AS. A negative correlation was determined between disc degeneration and ADC value. Conclusion: AS is a risk factor for degenerative disc disease due to its systemic effects, the fact it leads to posture impairment and its inflammatory effects on the vertebrae. A decrease in ADC values is observed as degeneration worsens in degenerative disc disease. PMID:25785119

Resorlu, Mustafa; Gokmen, Ferhat; Resorlu, Hatice; Adam, Gurhan; Akbal, Ayla; Cevizci, Sibel; Sariyildirim, Abdullah; Savas, Yilmaz; Guven, Mustafa; Aras, Adem Bozkurt

2015-01-01

159

Health status of patients with ankylosing spondylitis: a comparison with the general population  

PubMed Central

Objective: To examine the subjective health in patients with ankylosing spondylitis (AS) compared with the general population, and to explore the associations between health status and age, sex of the patients, and educational level in AS. Methods: Health status was assessed with a generic instrument (SF-36) in 314 patients with AS and in 2323 people from the general population. Subgroup analyses were performed according to age, sex, and educational level. Standard difference scores (s-scores) were calculated to ensure the clinical meaningfulness of the norm based comparisons. Results: Both men and women with AS reported significantly impaired health on all scales of the SF-36. Women reported significantly worse health on physical health domains. However, when calculating differences from the general population, numerically larger s-scores were found for men (except for physical role and vitality). The relative impact of AS seems to diminish with increasing age. In AS, better health was significantly associated with higher education across all scales. Deviations from the general population on the non-physical health aspects were especially pronounced in patients with low education. Conclusions: All key dimensions of health are affected by AS. The physical aspects seem to be most severely affected, but in the less educated group of patients, the disease impact on the mental health aspects was also considerable. Evaluation and management planning should take the complexity of AS into consideration. The focus on physical function should be maintained, and additional attention should be paid to the mental and social consequences of AS. PMID:15547084

Dagfinrud, H; Mengshoel, A; Hagen, K; Loge, J; Kvien, T

2004-01-01

160

Plasma soluble urokinase plasminogen activator receptor (suPAR) levels in ankylosing spondylitis.  

PubMed

Recent studies demonstrated that soluble urokinase plasminogen activator receptor (suPAR) is a valuable marker in the recognition of an inflammatory response. Ongoing inflammation leads to elevated plasma suPAR levels. We aimed to characterize plasma suPAR levels in ankylosing spondylitis (AS) patients compared to healthy individuals in order to reveal if suPAR could be used as a clinical marker of inflammation in AS. We measured plasma suPAR and C-reactive protein (CRP) levels as well as erythrocyte sedimentation rate (ESR) in 33 AS patients at various stages of disease duration and activity and 29 healthy controls. CRP and ESR values were higher in AS patients than in healthy individuals, while suPAR values were comparable (median [interquartile range]: 2.97 [2.57-3.80] ng/mL vs. 2.80 [2.06-3.42] ng/mL, P>0.05). In AS patients, a correlation was detected between BASDAI scores and CRP as well as ESR values but not suPAR levels (P=0.0005, r=0.57 and P=0.01, r=0.43, respectively). Unlike in many other inflammatory conditions, plasma suPAR levels do not reflect inflammation in AS. To assess the inflammatory status in AS, ESR and particularly CRP values are still more appropriate clinical markers. In line with earlier findings, our results indicate that, unlike suPAR, both of these markers are positively correlated with disease activity in AS. PMID:22999906

Toldi, Gergely; Szalay, Balázs; Bek?, Gabriella; Kovács, László; Vásárhelyi, Barna; Balog, Attila

2013-01-01

161

Comparison of early and late pleuropulmonary findings of ankylosing spondylitis by high-resolution computed tomography and effects on patients’ daily life  

Microsoft Academic Search

Ankylosing spondylitis (AS) is a multisystemic disease and extra-articular features may develop as pleuropulmonary involvement. We aimed to show and compare the early and late pleuropulmonary findings of AS and its effects on patients’ daily life by causing dyspnea. The study consisted of 38 patients (33 male, 5 female). All patients met the New York criteria for AS. Patients were

Remzi Altin; ?enay Özdolap; Ahmet Savranlar; Selda Sar?kaya; Meltem Tor; Levent Kart; Hüseyin Özdemir

2005-01-01

162

Cervical spine fracture in a patient with ankylosing spondylitis causing a C2-T9 spinal epidural hematoma- Treatment resulted in a rapid and complete recovery from tetraplegia: Case report and literature review  

PubMed Central

Full recovery from tetraplegia is uncommon in cervical spine injury. This has not being reported for cervical spine fracture in a patient with ankylosing spondylitis causing spinal epidural hematoma. We report on a case of cervical spine fracture in a patient with ankylosing spondylitis who came with tetraplegia. He underwent a two stage fixation and fusion. He had a complete recovery. Two hours after the operation he regained full strength in all the limbs while in the Intensive Care Unit. He went back to full employment. There are only two other reports in the literature where patients with ankylosing spondylitis and extradural hematoma who underwent treatment within 12 h and recovered completely from tetraparesis and paraplegia respectively. Patient with ankylosing spondylitis has a higher incidence of spinal fracture and extradural hematoma. Good outcome can be achieved by early diagnosis and treatment. This can ensure not only a stable spine, but also a rapid and complete recovery in a tetraplegic patient.

Wong, Albert Sii Hieng; Yu, Denis Hee youg

2015-01-01

163

Raised incidence of ankylosing spondylitis among Inuit populations could be due to high HLA-B27 association and starch consumption.  

PubMed

Ankylosing spondylitis (AS) is a chronic inflammatory arthritis mainly affecting the spinal joints. It would appear that the most likely causative agent in the development of AS is an environmental factor in the genetically susceptible, HLA-B27 positive, individuals. Extensive data from several countries support the notion that Klebsiella pneumonia bacteria are the most likely culprit in the causation of AS. These microbes possess antigens which resemble HLA-B27 and spinal collagens. Increased intake of high-starch diet is directly proportional to the gut-associated bacterial load, especially in the large intestine, and among these microbial agents, Klebsiella is considered as one of the main constituting components. Therefore, a low-starch diet intake alongside the currently used medical therapeutic modalities could be beneficial in the management of patients with early AS. It is suggested that a change in the dietary habits from high protein, low-starch marine components to the Westernized high-starch diet among the Inuit peoples of Alaska and Canada could be considered as one of the main contributing factors in the increased prevalence of AS during the last few decades within this genetically unmixed native population. PMID:25385438

Rashid, Taha; Wilson, Clyde; Ebringer, Alan

2014-11-11

164

Ratio of neutrophil/lymphocyte and platelet/lymphocyte in patient with ankylosing spondylitis that are treating with anti-TNF  

PubMed Central

Ankylosing spondylitis (AS) is a type of chronic inflammatory arthritis resulting in ankylosis of the spine and inflammation in the tendons. After NSAIDs, the use of anti-TNF medications has provided a significant contribution to the treatment of patients with AS. The present study was a retrospective, controlled and multicenter study. A total of 105 patients followed in the outpatient clinics of the Department of Physical Therapy in Abant Izzet Baysal University and Harran University and 50 healthy controls were included in the study. The patients had been receiving anti-TNF therapy at least for 6 months. Hemogram results of the patient and control groups examined retrospectively. There was no significant difference between the groups in terms of N/L ratio; however, the P/L ratio was significantly different between the two groups. The present study found a significantly different P/L ratio in patients with AS when compared to the control group. However, the N/L ratio was not significantly different between the groups. The P/L ratio can be used as a marker to monitor disease progression and indicate subclinical inflammation in patients with AS. PMID:25356158

Boyraz, ?smail; Koç, Bünyamin; Boyac?, Ahmet; Tuto?lu, Ahmet; Sarman, Hakan; Özkan, Hilal

2014-01-01

165

Adverse Events of Anti-Tumor Necrosis Factor ? Therapy in Ankylosing Spondylitis  

PubMed Central

Objective This study aims to investigate the prevalence of short-term and long-term adverse events associated with tumor necrosis factor-? (TNF-?) blocker treatment in Chinese Han patients suffering from ankylosing spondylitis (AS). Methods The study included 402 Chinese Han AS patients treated with TNF-? blockers. Baseline data was collected. All patients were monitored for adverse events 2 hours following administration. Long-term treatment was evaluated at 8, 12, 52 and 104 weeks follow-up for 172 patients treated with TNF-? blockers. Results Short-term adverse events occurred in 20.15% (81/402), including rash (3.5%; 14/402), pruritus (1.2%; 5/402), nausea (2.2%; 9/402), headache (0.7%; 3/402), skin allergies (4.0%; 16/402), fever (0.5%; 2/402), palpitations (3.0%; 12/402), dyspnea (0.5%; 2/402), chest pain (0.2%; 2/402), abdominal pain (1.0%; 4/402), hypertension (2.2%; 9/402), papilledema (0.5%; 2/402), laryngeal edema (0.2%; 1/402) and premature ventricular contraction (0.2%; 1/402). Long-term adverse events occurred in 59 (34.3%; 59/172) patients, including pneumonia (7.6%; 13/172), urinary tract infections (9.9%; 17/172), otitis media (4.7%; 8/172), tuberculosis (3.5%; 17/172), abscess (1.2%; 2/172), oral candidiasis (0.6%; 1/172), elevation of transaminase (1.7%; 3/172), anemia (1.2%; 2/172), hematuresis (0.6%; 1/172), constipation (2.3%; 4/172), weight loss (0.6%; 1/172), exfoliative dermatitis (0.6%; 1/172). CRP, ESR and disease duration were found to be associated with an increased risk of immediate and long-term adverse events (P<0.05). Long-term treatment with Infliximab was associated with more adverse events than rhTNFR-Fc (P<0.01). Conclusion This study reports on the prevalence of adverse events in short-term and long-term treatment with TNF-? blocker monotherapy in Chinese Han AS patients. Duration of disease, erythrocyte sedimentation rate, and c-reactive protein serum levels were found to be associated with increased adverse events with anti-TNF-? therapy. Long-term treatment with Infliximab was associated with more adverse events than rhTNFR-Fc. PMID:25764452

Tong, Qiang; Cai, Qing; de Mooij, Tristan; Xu, Xia; Dai, Shengming; Qu, Wenchun; Zhao, Dongbao

2015-01-01

166

Beneficial effects of tripterygium glycosides tablet on biomarkers in patients with ankylosing spondylitis.  

PubMed

The aim of the current study was to explore the effects and possible mechanisms of tripterygium glycosides tablet (TGT) in the treatment of active ankylosing spondylitis (AS). Thirty?six patients with active AS were given a 20 mg TGT treatment three times per day for 12 weeks, and 21 unrelated healthy controls were recruited as the control group. Efficacy measures included the Bath AS disease activity index (BASDAI), erythrocyte sedimentation rate (ESR) and C?reactive protein (CRP) prior and subsequent to TGT treatment. Serum dickkopf homolog 1 (DKK1) and interleukin-17 (IL?17) levels before and after TGT treatment were assessed using reverse transcription?quantitative polymerase chain reaction (RT?qPCR) and ELISA assay. The levels of several serum biomarkers were determined by ELISA, including receptor activator of nuclear factor ??B ligand (RANKL), osteoprotegerin (OPG), bone alkaline phosphatase (BAP), bone morphogenetic protein?2 (BMP?2), matrix metalloproteinase?3 (MMP?3), cross?linked telopeptide of type II collagen (CTX?II), vascular endothelial growth factor (VEGF), and prostaglandin E2 (PGE2). After 12 weeks of TGT treatment, the BASDAI score of the patients was significantly reduced (P<0.05), their levels of ESR and CRP were significantly reduced to a normal level (P<0.05, P<0.05), RT?PCR and ELISA showed a significant increase in the level of DKK1 expression (P<0.05) and a significant decreased IL?17 expression (P<0.05), there was a significant increase in the expression of OPG, BAP and BMP?2 (P<0.01, P<0.01, P<0.01) and a significant reduction in the expression levels of RANKL, CTX?II. MMP?3, PGE2, and VEGF (P<0.01, P<0.01, P<0.01, P<0.05, P<0.01) compared with those of the controls. TGT is effective at improving the signs and symptoms of patients with AS through the regulation of serum biomarkers, and the mechanisms may be associated with the anti?inflammatory effect, inhibition of new bone formation and potential bone?protective effects. PMID:25760304

Ji, Wei; Chen, Yajun; Zhao, Xia; Guo, Yunke; Zhong, Lingyu; Li, Honggang; Wang, Dan; Song, Yanna

2015-07-01

167

Etanercept in the treatment of ankylosing spondylitis: A systematic review and meta-analysis  

PubMed Central

Etanercept (ETN) has been widely applied in the treatment of ankylosing spondylitis (AS). As the use of ETN has increased, associated adverse effects have been reported frequently. Previous meta-analyses have focused on comparing the differences in clinical outcomes between ETN and placebo (PBO). The present meta-analysis evaluated randomised controlled trials (RCTs) to compare the effects of ETN and a PBO or sulfasalazine (SSZ) in patients with AS. The study population characteristics and the main results, including the Assessment in AS 20% response (ASAS 20), the Bath AS Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI), were extracted. The pooled odds ratios (ORs) or weighted mean differences (MDs) were calculated using a fixed or random effects model. Fifteen randomised controlled trials (RCTs) involving 2,194 subjects were included. Compared with a PBO, ETN significantly improved the ASAS 20 [P<0.00001; OR, 8.25; 95% confidence interval (CI), 5.92–11.50], BASDAI (P<0.00001; MD, ?18.81; 95% CI, ?24.47 to ?13.15) and BASFI (P<0.00001; standard MD, ?0.68; 95% CI, ?0.85 to ?0.50). In comparison with SSZ, ETN significantly decreased the BASDAI (P<0.00001; MD, ?2.40; 95% CI, ?2.89 to ?1.90) and C-reactive protein (CRP) levels (P<0.0001; MD, ?8.01; 95% CI, ?11.73 to ?4.29). The most common adverse effect of ETN was an injection site reaction. This meta-analysis shows that ETN monotherapy is effective in improving physical function and reducing disease activity in patients with AS. Compared with SSZ, ETN markedly decreased the BASDAI and CRP levels. However, the efficacy of ETN in treating AS requires further evaluation by more RCTs in a larger population of patients prior to recommending ETN as a substitute for synthetic disease-modifying antirheumatic drug (DMARD) monotherapy, or combinations of synthetic DMARDs. PMID:25289064

LIU, YA-FEI; DONG, HUI; TU, SHENG-HAO; ZHENG, CUI-HONG; LIU, PEI-LIN; HU, YONG-HONG

2014-01-01

168

Psychological correlates of self-reported functional limitation in patients with ankylosing spondylitis  

E-print Network

exercise (yes) Physical therapy (yes) Resilience coping (BRCS) Arthritis internality Arthritis helplessness Depression (exercise Physical therapy Psychological variables Arthritis internality (6-36) Arthritis helplessness (5-25) Resilience coping (BRCS) (0-20) Depression (

2009-01-01

169

The epidemiology of ankylosing spondylitis and the commencement of anti?TNF therapy in daily rheumatology practice  

PubMed Central

Objectives This study aimed to describe the epidemiology of ankylosing spondylitis (AS) in rheumatology practice at the beginning of the anti?TNF (tumour necrosis factor) era, and to evaluate the initiation of anti?TNF therapy in a clinical setting where prescription is regulated by the authority's imposed reimbursement criteria. Methods Between February 2004 and February 2005, all Belgian rheumatologists in academic and non?academic outpatient settings were invited to register all AS patients who visited their practice. A random sample of these patients was further examined by an in?depth clinical profile. In a follow?up investigation, we recorded whether patients initiated anti?TNF therapy and compared this to their eligibility at baseline evaluation. Results 89 rheumatologists participated and registered 2141 patients; 1023 patients were clinically evaluated. These 847 fulfilled the New York modified criteria for definite AS and 176 for probable AS. The profile of AS in rheumatology practice is characterised by longstanding and active disease with a high frequency of extra?articular manifestations and metrological and functional impairment. At a median of 2?months after the clinical evaluation, anti?TNF therapy was initiated in 263 of 603 (44%) evaluable patients with definite AS and in 22 of 138 (16%) evaluable patients with probable AS (total 38%). More than 85% of the patients who started anti?TNF therapy had an increased Bath Ankylosing Spondylitis Disease Activity Index despite previous NSAID (non?steroidal anti?inflammatory drug) use. Conclusions Of a representative cohort of 1023 Belgian AS patients seen in daily rheumatology practice, about 40% commenced anti?TNF therapy. Decision factors to start anti?TNF therapy may include disease activity and severity. PMID:17261531

Cruyssen, Bert Vander; Ribbens, Clio; Boonen, Annelies; Mielants, Herman; de Vlam, Kurt; Lenaerts, Jan; Steinfeld, Serge; Van den Bosch, Filip; Dewulf, Lode; Vastesaeger, Nathan

2007-01-01

170

Bone microarchitecture in ankylosing spondylitis and the association with bone mineral density, fractures, and syndesmophytes  

PubMed Central

Introduction Osteoporosis of the axial skeleton is a known complication of ankylosing spondylitis (AS), but bone loss affecting the peripheral skeleton is less studied. This study on volumetric bone mineral density (vBMD) and bone microarchitecture in AS was conducted to compare peripheral vBMD in AS patients with that in healthy controls, to study vBMD in axial compared with peripheral bone, and to explore the relation between vertebral fractures, spinal osteoproliferation, and peripheral bone microarchitecture and density. Methods High-resolution peripheral quantitative computed tomography (HRpQCT) of ultradistal radius and tibia and QCT and dual-energy x-ray absorptiometry (DXA) of lumbar spine were performed in 69 male AS patients (NY criteria). Spinal radiographs were assessed for vertebral fractures and syndesmophyte formation (mSASSS). The HRpQCT measurements were compared with the measurements of healthy controls. Results The AS patients had lower cortical vBMD in radius (P?=?0.004) and lower trabecular vBMD in tibia (P?=?0.033), than did the controls. Strong correlations were found between trabecular vBMD in lumbar spine, radius (rS?=?0.762; P?

2013-01-01

171

Effects of home-based daily exercise therapy on joint mobility, daily activity, pain, and depression in patients with ankylosing spondylitis  

Microsoft Academic Search

We investigated the effects of home-based daily exercise on joint mobility, functional capacity, pain, and depression in patients with ankylosing spondylitis (AS). The patients were randomly assigned to a wait-list control group or to an exercise-therapy group. The exercise-therapy group performed a 20-min exercise program once per day for 8 consecutive weeks. After 8 weeks, compared with the control group,

Hyun-Ja Lim; Young-Im Moon; Myeong Soo Lee

2005-01-01

172

Atherosclerosis in male patients with ankylosing spondylitis: the relation with methylenetetrahydrofolate reductase (C677T) gene polymorphism and plasma homocysteine levels.  

PubMed

The aim of this study was to determine the intima-media thickness (IMT) in carotid arteries and to assess the relation of these values with plasma homocysteine (pHcy) levels and methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism in patients with Ankylosing spondylitis (AS). Serum lipids, vitamin B12, folic acid, pHcy and acute phase protein levels were measured in all cases. MTHFR C677T gene polymorphisms were determined, and IMT of main carotid artery were evaluated ultrasonographically in all subjects. Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity score and Bath Ankylosing Spondylitis Metrology Index were used to assess disease activity and spinal mobility. Fifty AS patients (mean age of 36.6 ± 4.79 years) and 50 control subjects (36.34 ± 4.72 years) were included in the study. Plasma homocysteine levels of AS patients and control group were also similar (14.26 ± 9.96 vs. 11.81 ± 5.53 ?mol/L). Hyperhomocysteinemia was present in 11 subjects in patient group (22.0 %), while it was seen in 5 subjects in the control group (10.0 %). The MTHFR C677T genotype distribution was as follows: CC 31 (62 %), CT 14 (28 %), TT 5 (10 %) in AS patients. The mean carotid IMT values were also found to be similar between the groups. The most important factor influencing pHcy level was found as MTHFR 677TT genotype. We indicated no difference of atherosclerosis indices revealed by IMT values and pHcy levels AS patients and control subjects. But an association between MTHFR 677 gene polymorphism and pHcy levels was concluded, which may suggest that MTHFR 677 TT polymorphism may be a potential prognostic factor for cardiovascular disease in patients with AS. PMID:23247802

Geçene, Muharrem; Tuncay, Figen; Borman, P?nar; Yücel, Dogan; Senes, Mehmet; Y?lmaz, Behice Kaniye

2013-06-01

173

The relationship between disease activity measured by the BASDAI and psychological status, stressful life events, and sleep quality in ankylosing spondylitis.  

PubMed

Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is a standard instrument regularly used to assess disease activity of patients with ankylosing spondylitis (AS). However, the well-being of a patient is also affected by impairment of function as well as psychological status and other factors. The objective of this study was to evaluate if psychological status, stressful life events, and sleep quality contribute significantly to BASDAI. Six hundred eighty-three AS patients satisfying the Modified New York Criteria for AS were recruited from the rheumatology clinics of seven hospitals in China. Patients with other concomitant disorders were excluded. Participants were requested to complete a set of clinical examinations and the following questionnaires: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index Questionnaire (PSQI), Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S), and Social Readjustment Rating Scale (SRRS). Spearman correlation analysis showed that BASDAI was highly associated with degree and duration of morning stiffness, overall pain, nocturnal back pain, overall back pain, anxiety, and BASFI (all P??0.05). Multiple stepwise regression analysis indicated that overall pain was the maximal statistical contribution in predicting disease activity (standardized coefficient, 0.335). In hierarchic multiple regression analysis, psychological variables added an only additional 2.7 % to the overall R (2) beyond that accounted for by demographic and medical variables, resulting in a final R (2) of 53.5 %. Although BASDAI is a very good measurement of pain and stiffness and to a certain extent effect of functional impairment in AS, it barely takes into account psychological status, stress life events, and sleep quality These factors should be evaluated by other modalities. PMID:24946723

Jiang, Yutong; Yang, Mingcan; Wu, Husheng; Song, Hui; Zhan, Feng; Liu, Shengyun; Gao, Guanmin; Liu, Zhangsuo; Hu, Zhaoxian; He, Peigen; Zhang, Shengtao; Hu, Zaiying; Lin, Zhiming; Zhang, Yanli; Li, Yinong; Shen, Lingxun; Huang, Anbing; Liao, Zetao; Cao, Shuangyan; Wei, Yanlin; Li, Li; Li, Qiuxia; Lv, Qing; Qi, Jun; Huang, Jianlin; Li, Tianwang; Jin, O; Pan, Yunfeng; Gu, J

2015-03-01

174

Adalimumab effectiveness for the treatment of ankylosing spondylitis is maintained for up to 2 years: long-term results from the ATLAS trial  

PubMed Central

Objective: To determine the long-term effect of adalimumab on patients with ankylosing spondylitis (AS) who participated in the Adalimumab Trial Evaluating Long-Term Efficacy and Safety in AS (ATLAS), a randomised, double-blind, placebo controlled, 24-week trial. Methods: Patients received adalimumab 40 mg every other week (eow) or placebo for 24 weeks in ATLAS. At week 24, patients were switched to open-label adalimumab 40 mg eow. Efficacy measures included 20% improvement in the Assessment in SpondyloArthritis International Society (ASAS) criteria (ASAS20), ASAS40 and ASAS partial remission responses and changes in individual components of the ASAS20 response evaluations, for example, Bath AS Functional Index (BASFI) and Bath AS Disease Activity Index (BASDAI). Two-year interim data were analysed based on the total duration of adalimumab exposure, irrespective of the treatment randomisation group. Results: At 2 years, 255 (82.0%) of the original 311 ATLAS patients continued receiving adalimumab treatment. Improvements in ASAS responses observed in ATLAS were sustained during long-term treatment; 64.5% (200/310) were ASAS20 responders, 50.6% (157/310) were ASAS40 responders and 33.5% (104/310) had maintained ASAS-defined partial remission. Changes in individual ASAS response components were sustained or improved during long-term adalimumab treatment. From ATLAS baseline to 2 years of adalimumab exposure, respectively, BASDAI improved from 6.3 (SD 1.7) to 2.4 (SD 2.3) and BASFI improved from 5.2 (SD 2.4) to 2.9 (SD 2.5). Adalimumab was well tolerated. No cases of tuberculosis, congestive heart failure, lupus-like symptoms, or demyelinating disease were reported. Conclusions: Adalimumab reduced the signs and symptoms of AS and induced partial remission for up to 2 years. The long-term safety profile was similar to the short-term safety profile. Trial registration information: NCT00085644 PMID:18701556

van der Heijde, D; Schiff, M H; Sieper, J; Kivitz, A J; Wong, R L; Kupper, H; Dijkmans, B A C; Mease, P J; Davis, J C

2009-01-01

175

Translation into Brazilian Portuguese, cross-cultural adaptation and validation of the Stanford presenteeism scale-6 and work instability scale for ankylosing spondylitis.  

PubMed

Loss of productivity at work, as a result of health problems, is becoming an issue of interest due to the high burden it represents in society. The measurement of such phenomenon can be made using generic and specific scales for certain diseases such as the Stanford Presenteeism Scale (SPS-6) and the Work Instability Scale for Ankylosing Spondylitis (AS-WIS), specific for patients with ankylosing spondylitis (AS). The aim of this study was to translate and perform a cross-cultural adaptation of SPS-6 and AS-WIS into Portuguese and check their psychometric properties. The study also aimed to evaluate the relationship between the general scores of the scales and the main sociodemographic and clinical data, lifestyles, and absenteeism in patients with AS and correlate these variables with SPS-6 and AS-WIS scales. A sample of 120 patients with AS and 80 workers at a university hospital was evaluated. The processes for the translation and cross-cultural adaptation of the instruments followed preestablished steps and rules presented in the literature. For the evaluation of measurement properties and correlations between scales, intra-class correlation coefficient (reproducibility analysis), Cronbach alpha (internal consistency), and Pearson correlation coefficient (validity) were employed. The inter-observer (0.986) and intra-observer (0.992) reproducibilities of the AS-WIS were shown to be high as well as the internal consistency (0.995). Similarly, the inter-observer reliability of SPS-6 was considered good (0.890), although it showed a poorer performance when considering the same observer (Pearson correlation coefficient?=?0.675 and intra-class correlation?=?0.656). Internal consistency, for the total number of items, as measured by Cronbach alpha, was 0.889. The validity of the scales was evaluated thru the comparison of the achieved scores with the results of the WLQ, SF-36, ASQoL, BASFI, BASDAI, HAQ-S, and SRQ-20 instruments. Correlations between loss of productivity at work, worse quality of life, presence of emotional disturbances, and worse health conditions were positive. The process of translation, cross-cultural adaptation, and validation of the SPS-6 as a generic measurement for the loss of productivity at work and of the AS-WIS as a specific measurement for patients with AS are valid, reproducible, and specific instruments to be used in Brazil. In both scales, productivity at work was associated to advanced age, higher rate of absenteeism in the last month and year, presence of peripheral arthritis, and a larger number of comorbidities in patients with AS. The AS-WIS and SPS-6 showed a good correlation among them although they are not mutually exclusive but supplementary. PMID:24221505

Frauendorf, Renata; de Medeiros Pinheiro, Marcelo; Ciconelli, Rozana Mesquita

2014-12-01

176

The Effects of Massage on Pain, Stiffness, and Fatigue Levels Associated with Ankylosing Spondylitis: A Case Study  

PubMed Central

Objectives: To study the effects of massage on pain, stiffness, and fatigue in a patient recently diagnosed with ankylosing spondylitis (AS). Methods: A 47-year-old woman with AS diagnosed 11 months earlier received 7 massages across a 28-day period. Her pain, stiffness, and fatigue were recorded using visual analogue scales daily during the study period. Spinal mobility was measured at each massage session with finger-to-floor measurements for both forward and lateral flexion. The client also used a daily journal to supply pertinent information on quality of life. Results: Improvement was recorded in all dependent variables, with stiffness intensity showing the greatest improvement, to a final value of 0.75 from an initial value of 5. Duration of stiffness also showed improvement, to a final value of 1.2 from an initial value of 3.5. Improvement was also found in general pain (final value: 1; initial value: 4), fatigue (final value: 1.5; initial value 5), and forward and lateral flexion (forward flexion distance—final: 4 inches; initial: 6 inches; lateral flexion, left distance: final, 16.5 inches; initial, 21 inches; right distance: final, 16.5 inches; initial, 20.5 inches). Conclusions: Massage shows promise as a treatment for symptoms associated with AS. Further study is needed to validate these effects and to determine the feasibility of massage as an adjunct to standard care for AS patients with mild-to-moderate symptoms of AS. PMID:21589691

Chunco, Rosemary

2011-01-01

177

Employment, work disability, and work days lost in patients with ankylosing spondylitis: a cross sectional study of Dutch patients  

PubMed Central

OBJECTIVE—To evaluate employment status, work disability, and work days lost in patients with ankylosing spondylitis (AS).?METHODS—A questionnaire was sent to 709 patients with AS aged 16-60. The results of 658 of the patients could be analysed.?RESULTS—After adjustment for age, labour force participation was decreased by 15.4% in male patients and 5.2% in female patients compared with the general Dutch population. Work disability (all causes) was 15.7% and 16.9% higher than expected in the general population for male and female patients respectively. In particular, the proportion of those with a partial work disability pension was increased. Patients with a paid job lost 5.0% of work days as the result of having AS, accounting for a mean of 10.1 days of sick leave due to AS per patient per year in addition to the national average of 12.3 unspecified days of sick leave.?CONCLUSION—This study on work status in AS provides data adjusted for age and sex, and the differences from the reference population were significant. The impact of AS on employment and work disability is considerable. Work status in patients with AS needs more attention as an outcome measure in future research.?? PMID:11247865

Boonen, A; Chorus, A; Miedema, H; van der Heijde, D; van der Tempel, H; van der Linden, S.

2001-01-01

178

Risk of coronary artery disease in patients with ankylosing spondylitis: a systematic review and meta-analysis  

PubMed Central

Objective To investigate the association between coronary artery disease (CAD) and ankylosing spondylitis (AS). Methods We conducted a systematic review and meta-analysis of observational studies that reported relative risks, hazard ratios, standardized prevalence ratio or standardized incidence ratios with 95% confidence comparing CAD risk in patients with AS versus non-AS controls. Pooled risk ratios and 95% confidence intervals (CIs) were calculated using a random-effect, generic inverse variance of DerSimonian and Laird. Results Out of 229 potentially relevant articles, ten studies (five retrospective cohort studies and five cross-sectional studies) were identified and included in our data analysis. The overall pooled risk ratio of CAD in patients with AS was 1.41 (95% CI: 1.29-1.54). The pooled risk ratios for cross-sectional and cohort studies were 2.08 (95% CI: 1.28-3.40) and 1.36 (95% CI: 1.31-1.41), respectively. The statistical heterogeneity of this meta-analysis was moderate with an I2 of 56%. Conclusions Our study demonstrated a statistically significant increased CAD risk among patients with AS with 41% excess risk.

Srivali, Narat; Kittanamongkolchai, Wonngarm

2015-01-01

179

Intra-Tester and Inter-Tester Reliability of Chest Expansion Measurement in Clients with Ankylosing Spondylitis and Healthy Individuals  

PubMed Central

The purpose of this study was to examine the intra-tester and inter-tester reliability of chest expansion (CE) using a tape measure, in people with ankylosing spondylitis (AS) and healthy subjects. Twenty-two subjects with AS with a mean age of 41.4 years and 25 healthy subjects with a mean age of 41.0 years were tested in two arm positions: hands on head and arms at the sides, the tape measure being placed at the level of xiphisternum. There were three testers for subjects with AS and two testers for healthy subjects. Three trials in both arm positions were recorded by each tester on two separate occasions which were 10 minutes apart. Results showed intraclass correlation coefficients (ICC) for intra-tester reliability good (0.85 to 0.97) across the occasions. Intraclass correlation coefficients for inter-tester reliability were also very good (0.93 to 0.97). As reliability is good it is suggested that CE can be used for monitoring disease progression and efficacy of intervention with confidence within tester and between testers.

Senjyu, Hideaki; Williams, Linda; White, Colin

2004-01-01

180

Inflammatory pseudotumor around metal-on-polyethylene total hip arthroplasty in patients with ankylosing spondylitis: description of two cases and review of literature.  

PubMed

Inflammatory pseudotumor has been commonly reported in patients undertaking total hip replacement (THR) for different reasons. The precise etiology of this biological reaction and whether the primary disease has an influence on pseudotumor formation remain unclear. There seems to be a consensus that metal ions and debris do play an important role during this process. Recently, however, compared to metal particles along, immune response induced by metal particles attracts more attention. We present two cases of pseudotumor who have accepted THR for ankylosing spondylitis (AS) and later required revision surgery and hindquarter amputation, respectively. By thorough literature review, we tried to investigate the association between inflammatory pseudotumors and immunology. PMID:25778059

Fu, Dong; Sun, Wei; Shen, Jiakang; Ma, Xiaojun; Cai, Zhengdong; Hua, Yingqi

2015-12-01

181

Analysis on the interaction between IL1F7 gene and environmental factors on patients with ankylosing spondylitis: a case-only study  

Microsoft Academic Search

To examine the interaction between IL-1F7 gene and environmental factors in patients with ankylosing spondylities (AS). 150\\u000a AS Han Chinese patients (all human leukocyte antigen-B27 positive) were genotyped using a panel of single-nucleotide polymorphism\\u000a markers within IL-1F7 gene (rs3811047) by ligase detection reactions. Polymerase chain reaction with sequence-specific primer\\u000a was used to determine HLA-B27 subtypes. We analyzed the interaction between

Rui Ge; Faming Pan; Fangfang Liao; Guo Xia; Yang Mei; Beibei Shen; Tianchen Zhang; Jing Gao; Li Zhang; Zhenhua Duan; Shengqian Xu; Jianhua Xu

2011-01-01

182

Lumbar osteotomy for correction of thoracolumbar kyphotic deformity in ankylosing spondylitis. A structured review of three methods of treatment  

PubMed Central

OBJECTIVES—Three operative techniques have been described to correct thoracolumbar kyphotic deformity (TLKD) resulting from ankylosing spondylitis (AS) at the level of the lumbar spine: opening wedge osteotomy, polysegmental wedge osteotomies, and closing wedge osteotomy. Little knowledge exists on the indication for, and outcome of these corrective lumbar osteotomies.?METHODS—A structured review of the medical literature was performed.?RESULTS—A search of the literature revealed 856 patients reported in 41 articles published between 1945 and 1998. The mean age at time of operation was 41 years, male-female ratio 7.5 to 1. In 451 patients an open wedge osteotomy was performed. Polysegmental wedge osteotomies were performed in 249 patients and a closing wedge osteotomy in 156 patients. Most of the studies primarily focus on the surgical technique. Technical outcome data were poorly reported. Sixteen reports, including 523 patients, met the inclusion criteria of this study, and could be analysed for technical outcome data. The average correction achieved with each surgical techniques ranged from 37 to 40 degrees. Loss of correction was mainly reported in patients treated by open wedge osteotomy and polysegmental wedge osteotomies. Neurological complications were reported in all three techniques. The perioperative mortality was 4%. Pulmonary, cardiac and intestinal problems were found to be the major cause of fatal complications.?CONCLUSION—Lumbar osteotomy for correction of TLKD resulting from AS is a major surgery. The indication for these lumbar osteotomies as well as the degree of correction in the lumbar spine has not yet been established. Furthermore, there is a need for a generally accepted clinical score that encompasses accurate preoperative and postoperative assessment of the spinal deformity. The results of this review suggest that the data from the literature are not suitable for decision making with regard to surgical treatment of TLKD resulting from AS.?? PMID:10381482

Van Royen, B J; De Gast, A

1999-01-01

183

Opportunistic computed tomography screening shows a high incidence of osteoporosis in ankylosing spondylitis patients with acute vertebral fractures.  

PubMed

Advanced ankylosing spondylitis is associated with reductions in bone mineral density (BMD), contributing to pain and predisposing to fractures. Quantifying this reduction is complicated because overgrowth of bone and loss of trabecular bone occur concurrently. Traditional methods such as dual-energy X-ray absorptiometry struggle to generate accurate estimates of BMD in these patients. The aim of this study was to evaluate the utility of computed tomography (CT) attenuation in generating estimates of BMD in patients with severe AS who had sustained vertebral fractures. Patients with severe AS and bridging syndesmophytes who presented, with acute fractures of the spine, were reviewed to assess whether they had a CT scan in the 6 mo before or after injury that included an image of the L1 vertebra; if it did, the scans were selected for analysis. A total of 17 patients were evaluated. Using a CT attenuation threshold of 135 HU balanced for sensitivity and specificity, 14 of 17 (82%) patients were osteoporotic. Using a CT attenuation threshold for higher sensitivity (160 HU), 15 of 17 (88%) patients were osteoporotic. Even using the L1 CT attenuation threshold of 110 HU for higher specificity, 14 of 17 (82%) patients were osteoporotic. CT attenuation demonstrates that a high proportion of AS patients who sustain fractures have osteoporosis. This overcomes some of the difficulties that have been encountered with the use of dual-energy X-ray absorptiometry in this group of patients. This simple and accessible method saves on time, cost, and exposure to radiation and can help in the planning of a patient's management. PMID:25172008

Emohare, Osa; Cagan, Amanda; Polly, David W; Gertner, Elie

2015-01-01

184

Combined Home Exercise Is More Effective Than Range-of-Motion Home Exercise in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial  

PubMed Central

Home exercise is often recommended for management of patients with ankylosing spondylitis (AS); however, what kind of home exercise is more beneficial for patients with AS has not been determined yet. We aimed to compare the effectiveness of combined home exercise (COMB) and range-of-motion home exercise (ROM) in patients with AS. Nineteen subjects with AS completed either COMB (n = 9) or ROM (n = 10) program. The COMB program included range-of-motion, strengthening, and aerobic exercise while the ROM program consisted of daily range-of-motion exercise only. After exercise instruction, subjects in each group performed home exercise for 3 months. Assessment included cardiopulmonary exercise test, pulmonary function test, spinal mobility measurement, chest expansion, Bath Ankylosing Spondylitis Functional Index (BASFI), and other functional ability and laboratory tests. After exercise, the COMB group showed significant improvement in peak oxygen uptake (12.3%, P = 0.008) and BASFI (P = 0.028), and the changed score between pre- and postexercise data was significantly greater in the COMB group regarding peak oxygen uptake and BASFI. Significant improvement in finger-to-floor distance after 3-month exercise was found only in the COMB group (P = 0.033). This study demonstrates that a combined home exercise is more effective than range-of-motion home exercise alone in aerobic capacity and functional ability. PMID:25276785

Chuang, Chih-Cheng; Tseng, Ching-Shiang; Wei, James Cheng-Chung; Hsu, Wei-Chun; Lin, Yi-Jia

2014-01-01

185

Decreased Frequencies of Circulating Follicular Helper T Cell Counterparts and Plasmablasts in Ankylosing Spondylitis Patients Naïve for TNF Blockers  

PubMed Central

Follicular helper T cells (Tfh), localized in lymphoid organs, promote B cell differentiation and function. Circulating CD4 T cells expressing CXCR5, ICOS and/or PD-1 are counterparts of Tfh. Three subpopulations of circulating CD4+CXCR5+ cells have been described: CXCR3+CCR6- (Tfh-Th1), CXCR3-CCR6+ (Tfh-Th17), and CXCR3-CCR6- (Tfh-Th2). Only Tfh-Th17 and Tfh-Th2 function as B cell helpers. Our objective was to study the frequencies of circulating Tfh (cTfh), cTfh subsets and plasmablasts (CD19+CD20-CD27+CD38high cells), and the function of cTfh cells, in patients with Ankylosing Spondylitis (AS). To this end, peripheral blood was drawn from healthy controls (HC) (n?=?50), AS patients naïve for TNF blockers (AS/nb) (n?=?25) and AS patients treated with TNF blockers (AS/b) (n?=?25). The frequencies of cTfh and plasmablasts were determined by flow cytometry. Cocultures of magnetically sorted CD4+CXCR5+ T cells with autologous CD19+CD27- naïve B cells were established from 3 AS/nb patients and 3 HC, and concentrations of IgG, A and M were measured in supernatants. We obseved that AS/nb but not AS/b patients, demonstrated decreased frequencies of circulating CD4+CXCR5+ICOS+PD-1+ cells and plasmablasts, together with a decreased (Tfh-Th17+Tfh-Th2)/Tfh-Th1 ratio. The amounts of IgG and IgA produced in cocultures of CD4+CXCR5+ T cells with CD19+CD27- B cells of AS/nb patients were significantly lower than observed in cocultures established from HC. In summary, AS/nb but not AS/b patients, demonstrate a decreased frequency of cTfh and plasmablasts, and an underrepresentation of cTfh subsets bearing a B helper phenotype. In addition, peripheral blood CD4+CXCR5+ T cells of AS/nb patients showed a decreased capacity to help B cells ex vivo. PMID:25203742

Bautista-Caro, María-Belén; Arroyo-Villa, Irene; Castillo-Gallego, Concepción; de Miguel, Eugenio; Peiteado, Diana; Plasencia-Rodríguez, Chamaida; Villalba, Alejandro; Sánchez-Mateos, Paloma; Puig-Kröger, Amaya; Martín-Mola, Emilio; Miranda-Carús, María-Eugenia

2014-01-01

186

Spinal Radiographic Progression in Patients with Ankylosing Spondylitis Treated with TNF-? Blocking Therapy: A Prospective Longitudinal Observational Cohort Study  

PubMed Central

Objectives To evaluate spinal radiographic damage over time and to explore the associations of radiographic progression with patient characteristics and clinical assessments including disease activity in ankylosing spondylitis (AS) patients treated with tumor necrosis factor-alpha (TNF-?) blocking therapy in daily clinical practice. Methods Consecutive outpatients from the Groningen Leeuwarden AS (GLAS) cohort were included based on the availability of cervical and lumbar radiographs before start of TNF-? blocking therapy and after 2, 4, and/or 6 years of follow-up. Clinical data were assessed at the same time points. Radiographs were scored by two independent readers using the modified Stoke AS Spine Score (mSASSS). Spinal radiographic progression in relation to clinical assessments was analyzed using generalized estimating equations. Results 176 AS patients were included, 58% had syndesmophytes at baseline. Median mSASSS increased significantly from 10.7 (IQR: 4.6–24.0) at baseline to 14.8 (IQR: 7.9–32.8) at 6 years. At the group level, spinal radiographic progression was linear with a mean progression rate of 1.3 mSASSS units per 2 years. Both spinal radiographic damage at baseline and radiographic progression were highly variable between AS patients. Male gender, older age, longer disease duration, higher BMI, longer smoking duration, high CRP, and high ASDAS were significantly associated with syndesmophytes at baseline. Significantly more radiographic progression was seen in patients with versus without syndesmophytes (2.0 vs. 0.5 mSASSS units per 2 years) and in patients >40 versus ?40 years of age (1.8 vs. 0.7 mSASSS units per 2 years). No longitudinal associations between radiographic progression and clinical assessments were found. Conclusions This prospective longitudinal observational cohort study in daily clinical practice shows overall slow and linear spinal radiographic progression in AS patients treated with TNF-? blocking therapy. At the individual level, progression was highly variable. Patients with syndesmophytes at baseline showed a 4-fold higher radiographic progression rate than patients without syndesmophytes. PMID:25879956

Maas, Fiona; Spoorenberg, Anneke; Brouwer, Elisabeth; Bos, Reinhard; Efde, Monique; Chaudhry, Rizwana N.; Veeger, Nic J. G. M.; van Ooijen, Peter M. A.; Wolf, Rinze; Bootsma, Hendrika; van der Veer, Eveline; Arends, Suzanne

2015-01-01

187

Long-term outcome of patients with active ankylosing spondylitis with etanercept-sustained efficacy and safety after seven years  

PubMed Central

Introduction Data from clinical studies on the long-term efficacy and safety of anti-tumor necrosis factor (TNF)-? therapy in patients with ankylosing spondylitis (AS) are scarce. This is the first report on continuous treatment with the TNF? fusion protein etanercept over seven years (y). Methods Overall, 26 patients with active AS were initially treated with etanercept 2 × 25 mg s.c./week with no concomitant disease modifying anti-rheumatic drugs (DMARDs) or steroids. The clinical response was assessed by standardized parameters. The primary outcome was the proportion of patients in the Spondyloarthritis International Society (ASAS) partial remission at seven years. AS disease activity scores (ASDAS) for status and improvement were compared to conventional outcome measures. Results Overall, 21/26 patients (81%) completed two years of treatment and 16/26 patients (62%) completed seven years. In the completer analysis, 31% patients were in ASAS partial remission at seven years, while 44% patients showed an ASDAS inactive disease status. Mean Bath AS activity index (BASDAI) scores, which were elevated at baseline (6.3 ± 0.9), showed constant improvement and remained low: 3.1 ± 2.5 at two years and 2.5 ± 2.2 at seven years, while ASDAS also improved (3.9 ± 0.7 at baseline, 1.8 ± 0.9 at two years, 1.6 ± 0.8 at seven years), all P <0.001. From the 10 dropouts, only 5 patients discontinued treatment due to adverse events. Patients who completed the study had lower baseline Bath AS function index (BASFI) scores vs. patients who discontinued. No other clinical parameter at baseline could predict any long-term outcome. Conclusions This study confirms the clinical efficacy and safety of etanercept in patients with active AS over seven years of continuous treatment. After seven years, more than half of the initially treated patients remained on anti-TNF therapy, and one-third were in partial remission. Trial Registration ClinicalTrials.gov: NCT01289743 PMID:23786760

2013-01-01

188

Restrictive pulmonary function is more prevalent in patients with ankylosing spondylitis than in matched population controls and is associated with impaired spinal mobility: a comparative study  

PubMed Central

Introduction Pulmonary involvement is a known manifestation in patients with ankylosing spondylitis (AS). However, previous studies have been based on small samples and the reported prevalence and associations with typical clinical features vary. The purpose of this study was to compare pulmonary function (PF) in patients with AS and population controls, and to study associations between PF and disease related variables, cardio-respiratory fitness and demographic variables in patients with AS. Methods In a cross-sectional controlled study, 147 AS patients and 121 controls underwent examinations, including demographic variables, laboratory (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)) and clinical measures (disease activity (AS disease activity score, ASDAS), physical function (Bath ankylosing spondylitis functional index, BASFI), spinal mobility (Bath ankylosing spondylitis metrology index, BASMI), chest expansion, cardio-respiratory fitness (peak oxygen uptake, VO2peak) and pulmonary function test (PFT) (spirometry)). Cumulative probability plots were used to visualize associations between the ASDAS and BASMI scores and the corresponding forced vital capacity (FVC%, percentage of predicted value controlled for the influence of confounding factors) score for each patient. Univariate ANCOVAs were performed to explore group differences in PF adjusting for relevant variables, and a multiple regression model was used to estimate the explanatory power of independent variables (demographic, disease related, VO2peak) on restrictive ventilatory impairment (FVC%). Results AS patients showed significantly lower PF values compared with controls, and significantly more patients were categorized with restrictive pattern (18% vs. 0%, P < 0.001). Cumulative probability plots showed significant associations between spinal mobility measures (BASMI) and FVC% for individual patients. BASMI, chest expansion and male gender contributed significantly and independently in a multiple regression model predicting the variation of FVC% in AS patients, whereas disease activity, physical function and VO2peak did not contribute significantly. The final model explained 45% of the variance in FVC% (P < 0.001). Conclusions This study showed significantly impaired pulmonary function in the AS patients compared to controls and reference data, and demonstrated a clear relationship between reduced spinal mobility and restrictive PF in AS patients. The results support the assumption of an association between musculoskeletal limitations and restrictive respiratory impairment in AS, emphasizing the importance of maintaining spinal flexibility in the management of the disease. Further, patients with severely reduced spinal mobility should be referred for pulmonary function examination and relevant follow-up treatment. PMID:22277377

2012-01-01

189

CT- and fluoroscopy-guided percutaneous screw fixation of a "carrot-stick" spinal fracture in an elderly man with ankylosing spondylitis.  

PubMed

We present a case of percutaneous fixation of a "carrot-stick" spinal fracture in an elderly patient with ankylosing spondylitis (AS). A surgical stabilization was not possible in this 83-year-old man with comorbidities. Under local anesthesia, percutaneous screw fixation of a transdiscal shear fracture at the level T10-T11 was performed using computed tomography (CT) and fluoroscopy guidance. Two 4.0-mm Asnis III cannulated screws were placed to fix facet joints using transfacet pedicle pathway. The procedure time was 30 min. Using the visual analog scale (VAS), pain decreased from 10, preoperatively, to 1 after the procedure. Radiographic fusion was observed at a 3-month post-procedural CT scan. CT- and fluoroscopy-guided percutaneous screw fixation of spinal fractures could potentially be an alternative to surgery in elderly AS patients with poor performance status. PMID:23842576

Huwart, Laurent; Amoretti, Nicolas

2013-12-01

190

Case-Only Designs for Exploring the Interaction Between FCRL4 Gene and Suspected Environmental Factors in Patients with Ankylosing Spondylitis.  

PubMed

The aim of this study was to explore the interaction between FCRL4 gene and environmental factors in patients with ankylosing spondylitis. Two hundred ninety-seven ankylosing spondylitis (AS) Han Chinese patients were selected who were diagnosed at the Department of Rheumatology, First Affiliated Hospital, Anhui Medical University, in accordance with the modified New York criteria. The single nucleotide polymorphism (SNP) was genotyped by multiplex SNaPshot technique. The interaction between FCRL4 gene and ten environmental factors in AS patients was assessed by using a case-only study. The interaction between FCRL4 gene (rs2777963) and environmental factors was analyzed by chi-square test and logistic models. p values, odds ratio, and 95 % confidence intervals (CIs) were used for estimating the effects of interaction. Odds ratio (OR) for the interaction of gene ×?environment (G?×?E) between drinking group and non-drinking group was 2.61 [95 % CI (1.30, 5.23), p?=?0.007], with statistical significance. Within the cooking oil group, there also may be an interaction of G?×?E between main animal oil and main plant oil [OR?=?10.55, 95 % CI (5.55, 20.04), p?

Ding, Ning; Hu, Yanting; Zeng, Zhen; Liu, Si; Liu, Li; Yang, Ting; Wu, Shanshan; Fan, Dazhi; Xu, Shengqian; Xu, Jianhua; Wang, Jing; Pan, Faming

2015-04-01

191

Diagnosis of Ankylosing Spondylitis  

MedlinePLUS

... right). The x-rays are supposed to show erosion typical of sacroiliitis. Sacroiliitis is the inflammation of ... of much help. A simple ESR (erythrocyte sedimentation rate), also known as sed rate, is commonly an ...

192

Patients with Ankylosing Spondylitis and Low Disease Activity because of Anti-TNF-Alpha Therapy Have Higher TRAIL Levels Than Controls: A Potential Compensatory Effect  

PubMed Central

Objective. TRAIL is a potential biomarker of cardiovascular (CV) disease. Ankylosing spondylitis (AS) is a chronic inflammatory disease associated with metabolic syndrome (MeS) and accelerated atherosclerosis. We assessed whether disease activity, systemic inflammation, and MeS features were associated with circulating TRAIL levels in AS patients undergoing TNF-? antagonist infliximab therapy and if infliximab infusion modified TRAIL levels. Methods. We measured TRAIL serum levels in 30 nondiabetic AS patients without CV disease undergoing anti-TNF-? therapy, immediately before and after an infliximab infusion, and in 48 matched controls. Correlations of TRAIL levels with disease activity, systemic inflammation and MeS features, adipokines, and biomarkers of endothelial activation were evaluated. Changes in TRAIL levels following anti-TNF-? infusion were analyzed. Results. TRAIL levels were higher in AS patients than controls. TRAIL levels displayed an inverse correlation with total and LDL cholesterol. We observed an inverse correlation with QUICKI and a marginal association with HOMA-IR. We also found an inverse correlation with resistin and a marginal association with apelin and OPN. Anti-TNF-? infusion did not change TRAIL levels after 120?. Conclusion. Elevated TRAIL levels in AS patients may be the result of a compensatory mechanism to reduce CV risk in these patients. PMID:24976690

López-Mejías, Raquel; Rueda-Gotor, Javier; Miranda-Filloy, José A.; Ubilla, Begoña; Carnero-López, Beatriz; Palmou-Fontana, Natalia; Gómez-Acebo, Inés; Blanco, Ricardo; Pina, Trinitario; Ochoa, Rodrigo; González-Juanatey, Carlos; González-Gay, Miguel A.

2014-01-01

193

Ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis in royal Egyptian mummies of 18th -20th Dynasties? CT and archaeology studies.  

PubMed

Objective. To study the computed tomography(CT) images of royal Ancient Egyptian mummies dated to the 18th to early 20th Dynasties for the claimed diagnoses of ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) and to correlate the findings with the archaeology literature.Methods. We studied the CT images of 13 royal Ancient Egyptian mummies (1492–1153 BC) for evidence of AS and DISH and correlated our findings with the archaeology literature.Results. The findings of the CT scans excluded the diagnosis of AS, based on the absence of sacroiliac joint erosions or fusion of the facet joints. Four mummies fulfilled the diagnostic criteria for DISH:Amenhotep III (18th Dynasty), Ramesses II, his son Merenptah, and Ramesses III (19th to early 20th Dynasties).The diagnosis of DISH, a commonly a symptomatic disease of old age, in the 4 pharaohs is in concordance with their longevity and active lifestyles.Conclusion. CT findings excluded the diagnosis of AS in the studied royal Ancient Egyptian mummies and brought into question the antiquity of the disease. The CT features of DISH during this ancient period were similar to those commonly seen in modern populations,and it is likely that they will also be similar in the future.The affection of Ramesses II and his son Merenptah supports familial clustering of DISH. The process of mummification may induce changes in the spine that should be considered during investigations of disease in ancient mummies. PMID:25329920

Saleem, Sahar N; Hawass, Zahi

2014-12-01

194

Compliance with NICE guidance on the use of anti-TNFalpha agents in ankylosing spondylitis: an east and west Midlands regional audit.  

PubMed

Here we report on an audit performed to examine compliance with National Institute for Health and Clinical Excellence (NICE) guidelines for the use of anti-tumour necrosis factor alpha (anti-TNFalpha) in treating patients with ankylosing spondylitis (AS). Data from 17 rheumatology centres across the Midlands were collected prospectively from patients with AS attending outpatient clinics and retrospectively in patients receiving anti-TNFalpha but not attending outpatient clinics during the audit. In total, 80% of the 416 patients for whom data were collected were male. Of the 238 patients recruited prospectively, 41% were receiving anti-TNFalpha. Reviewing all patients on anti-TNFalpha (N=275), pre-treatment assessments 12 weeks apart were documented in 55% of patients. After anti-TNFalpha treatment had started, regular 12-weekly assessments occurred in 46% of patients. Therefore, compliance with NICE guidance was found to vary among centres. Based on our audit, clinical capacity, and clinical or patient choice might be influencing the suboptimal adherence seen in assessment timing suggested by NICE guidelines relating to the use of anti-TNFalpha in treating patients with AS. PMID:22930875

Rees, Frances; Peffers, Gillian; Bell, Carolyn; Obrenovic, Karen; Sandhu, Ravinder; Packham, Jonathan; Erb, Nicola

2012-08-01

195

Adalimumab in the treatment of rheumatoid arthritis.  

PubMed

Adalimumab (ADA), a fully human monoclonal antibody against TNF-? is indicated for the treatment of rheumatoid arthritis (RA), psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, Crohn's disease, ulcerative colitis and psoriasis. In RA, it may be prescribed in combination with methotrexate or other disease-modifying antirheumatic drugs or as monotherapy. Studies comparing ADA with other TNF-? inhibitors are limited and are based mainly on meta-analyses of randomised controlled trials and large observational cohorts. In this study, the effectiveness and safety of ADA is compared with that of etanercept and infliximab. PMID:22954150

Voulgari, Paraskevi V; Kaltsonoudis, Evripidis; Papagoras, Charalampos; Drosos, Alexandros A

2012-12-01

196

Evaluation of cardiac autonomic functions in patients with ankylosing spondylitis via heart rate recovery and heart rate variability  

Microsoft Academic Search

Objective  The aim of this study was to evaluate heart rate variability (HRV) and heart rate recovery (HRR) in otherwise healthy ankylosing\\u000a spondlitis (AS) patients and control subjects.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A total of 28 patients with AS and 30 volunteers matched for age and sex were enrolled. All subjects underwent HRV analysis,\\u000a exercise testing (ET), and transthoracic echocardiography. HRR indices were calculated by

Ergun Baris Kaya; Sercan Okutucu; Hakan Aksoy; Ugur Nadir Karakulak; Erol Tulumen; Oya Ozdemir; Fatma Inanici; Kudret Aytemir; Giray Kabakci; Lale Tokgozoglu; Hilmi Ozkutlu; Ali Oto

2010-01-01

197

Efficacy and Safety of Celecoxib in Chinese Patients with Ankylosing Spondylitis: A 6-Week Randomized, Double-Blinded Study with 6-Week Open-Label Extension Treatment  

PubMed Central

Background Nonsteroidal anti-inflammatory drugs are the first-line option for treating ankylosing spondylitis (AS) in China. However, no large-scale controlled trials have been conducted in this ethnic population. Objective To evaluate the efficacy and safety of 6 weeks’ treatment with celecoxib in patients with AS in China. Methods This Phase 3, double-blind, parallel-group study randomized patients with AS aged ?18 to 65 years 1:1 to receive celecoxib 200 mg once daily or diclofenac sustained release 75 mg once daily. After 6 weeks, patients could use celecoxib 400 mg once daily or maintain blinded therapy. The primary efficacy end point was mean change from baseline at Week 6 for Patient’s Global Assessment of Pain Intensity score (100-mm visual analog scale). Noninferiority was established if the upper bound of the CI was <10 mm. Secondary objectives included patients’ and physicians’ assessments of disease activity, change from baseline in C-reactive protein level, and safety. Results In the per-protocol analysis set the least squares mean change from baseline in the Patient’s Global Assessment of Pain Intensity score at Week 6 was –23.8 mm and –27.1 mm in patients receiving celecoxib (n = 111) and diclofenac (n = 108), respectively. The 2-sided 95% CI for the treatment difference (celecoxib – diclofenac) was –2.2 to 8.8. Overall, 4.2% and 6.7% of patients in the celecoxib and diclofenac groups, respectively, reported treatment-related adverse events. All were mild to moderate in severity. Conclusions Celecoxib 200 mg once daily is noninferior to diclofenac sustained release 75 mg once daily for pain treatment in Chinese patients with AS. ClinicalTrials.gov identifier: NCT00762463. PMID:25516774

Huang, Feng; Gu, Jieruo; Liu, Yi; Zhu, Ping; Zheng, Yi; Fu, Jin; Pan, Sharon; Le, Shi

2014-01-01

198

High prevalence of spondyloarthritis and ankylosing spondylitis among familial Mediterranean fever patients and their first-degree relatives: further evidence for the connection  

PubMed Central

Introduction Familial Mediterranean fever (FMF) is an auto-inflammatory disease characterized by recurrent attacks of fever and serositis. Limited data suggest that the prevalence of sacroiliitis is increased in patients with FMF. In our present study, we assessed the prevalence of spondyloarthritis (SpA), including ankylosing spondylitis (AS), among a cohort of FMF patients and their unaffected first-degree relatives (FDRs). Methods The current study cohort comprised a consecutive group of 201 unrelated patients with FMF and 319 FDRs (? 16 years old). These subjects were examined according to a standard protocol. Results A total of 157 FMF patients (78.1%) and 233 (73%) unaffected FDRs reported back pain. Fifteen FMF patients (7.5%) and nine unaffected FDRs fulfilled the modified New York (mNY) criteria for AS. One additional FDR with AS was identified after review of the medical records. None of the FMF patients with AS was HLA-B27 positive. The allele frequency of M694V among the FMF patients with radiographic sacroiliitis was significantly higher in comparison with those without sacroiliitis (OR 4.3). When compared with the general population, the risk ratios for SpA and AS among the FDRs of our FMF patients were 3.3 (95% CI; 2.0 to 5.5) and for AS 2.9 (95% CI; 1.3 to 6.4), respectively. Conclusions Our study suggests that a) factors other than HLA-B27 play a role in the association of FMF and SpA/AS; b) MEFV gene variations may be one of the geographic/region-specific potential pathogenetic links between these two disorders in the Turkish population. PMID:23356447

2013-01-01

199

Increasing proportion of female patients with ankylosing spondylitis: a population-based study of trends in the incidence and prevalence of AS  

PubMed Central

Objective With the introduction of MRI in diagnosis and tumour necrosis factor inhibitors for treatment, the field of ankylosing spondylitis (AS) has undergone significant changes. We carried out a population-based study of the trends in incidence and prevalence of AS over the past 15?years. Methods This is a retrospective analysis of provincial health administrative databases. Residents of Ontario, Canada aged 15?years or older diagnosed with AS between 1995 and 2010 were included in the study. Crude as well as age-standardised and sex-standardised incidence and prevalence of AS between 1995 and 2010 were calculated. Trends in prevalence and incidence of male and female patients with AS were separately analysed. Results We identified 24?976 Ontarians with AS. Age/sex-standardised AS prevalence increased from 79/100?000 in 1995 to 213/100?000 in 2010. Men had higher prevalence than women, but the male/female prevalence ratio decreased from 1.70 in 1995 to 1.21 by 2010. A higher proportion of male compared with female patients with AS were diagnosed in the 15–45 age group. Annual incidence rates revealed increasing diagnosis of AS among women after 2003. Conclusions The prevalence of AS in Ontario has nearly tripled over the past two decades. The proportion of women with new diagnosis of AS is increasing, a trend that began around the year 2003. A higher proportion of male compared with female patients with AS are diagnosed at an earlier age. PMID:25510888

Haroon, Nisha N; Paterson, J Michael; Li, Ping; Haroon, Nigil

2014-01-01

200

Serum fatty acid profiles and potential biomarkers of ankylosing spondylitis determined by gas chromatography-mass spectrometry and multivariate statistical analysis.  

PubMed

Ankylosing spondylitis (AS) is a common chronic inflammatory rheumatic disease. Early and accurate detection is essential for effective disease treatment. Recently, research has focused on genomics and proteomics. However, the associated metabolic variations, especially fatty acid profiles, have been poorly discussed. In this study, the gas chromatography-mass spectrometry (GC-MS) approach and multivariate statistical analysis were used to investigate the metabolic profiles of serum free fatty acids (FFAs) and esterified fatty acids (EFAs) in AS patients. The results showed that significant differences in most of the FFA (C12:0, C16:0, C16:1, C18:3, C20:4, C20:5, C22:5 and C22:6) and EFA (C12:0, C16:1, C18:0, C18:1, C18:2, C18:3, C20:4 and C22:6) concentrations were found between the AS patients and healthy controls (p?

Chen, Rui; Han, Su; Dong, Daming; Wang, Yansong; Liu, Qingpeng; Xie, Wei; Li, Mi; Yao, Meng

2015-04-01

201

Whole blood transcriptional profiling in ankylosing spondylitis identifies novel candidate genes that might contribute to the inflammatory and tissue-destructive disease aspects  

PubMed Central

Introduction A number of genetic-association studies have identified genes contributing to ankylosing spondylitis (AS) susceptibility but such approaches provide little information as to the gene activity changes occurring during the disease process. Transcriptional profiling generates a 'snapshot' of the sampled cells' activity and thus can provide insights into the molecular processes driving the disease process. We undertook a whole-genome microarray approach to identify candidate genes associated with AS and validated these gene-expression changes in a larger sample cohort. Methods A total of 18 active AS patients, classified according to the New York criteria, and 18 gender- and age-matched controls were profiled using Illumina HT-12 whole-genome expression BeadChips which carry cDNAs for 48,000 genes and transcripts. Class comparison analysis identified a number of differentially expressed candidate genes. These candidate genes were then validated in a larger cohort using qPCR-based TaqMan low density arrays (TLDAs). Results A total of 239 probes corresponding to 221 genes were identified as being significantly different between patients and controls with a P-value <0.0005 (80% confidence level of false discovery rate). Forty-seven genes were then selected for validation studies, using the TLDAs. Thirteen of these genes were validated in the second patient cohort with 12 downregulated 1.3- to 2-fold and only 1 upregulated (1.6-fold). Among a number of identified genes with well-documented inflammatory roles we also validated genes that might be of great interest to the understanding of AS progression such as SPOCK2 (osteonectin) and EP300, which modulate cartilage and bone metabolism. Conclusions We have validated a gene expression signature for AS from whole blood and identified strong candidate genes that may play roles in both the inflammatory and joint destruction aspects of the disease. PMID:21470430

2011-01-01

202

Mutations in the B30.2 domain of pyrin and the risk of ankylosing spondylitis in the Chinese Han population: a case-control study.  

PubMed

Ankylosing spondylitis (AS) and familial Mediterranean fever (FMF) are a common autoimmune disease and a classic autoinflammatory disease, respectively. Mediterranean fever (MEFV) encodes the pyrin protein and is the causal disease gene in FMF. This protein is an important regulator of innate immunity and may play a key role in the development of AS. To identify the mutations in the B30.2 domain of pyrin and to uncover the relationships between these mutations and AS risk in the Chinese Han population, we extracted genomic DNA from the peripheral blood of 200 AS patients and 200 matched controls and performed polymerase chain reactions (PCRs) and direct sequencing on those samples. Statistical analysis indicated that only Met694Val (rs61752717) in the B30.2 domain of pyrin could affect the risk of AS (P = 0.042; odds ratio [OR] = 5.103; 95% confidence interval [CI] = 1.111-23.437 for the model of Met (M) vs. Val (V), P = 0.040; OR = 5.211; 95% CI = 1.127-24.091 for the model of MM vs. MV+VV). Moreover, M694V is significantly associated with a higher level of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in AS patients. Our results are the first to suggest that the M694V allele of the pyrin was associated with AS risk in the Chinese Han population and that this mutation may be associated with the inflammatory response in the development of AS. PMID:25036284

He, Chongru; Li, Jia; Xu, Weidong

2014-11-01

203

The effect of golimumab on haemoglobin levels in patients with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis  

PubMed Central

Objective. To evaluate the effect of golimumab on haemoglobin levels in patients with RA, PsA or AS. Methods. Secondary analysis was performed on integrated data from five randomized controlled studies: three RA, one PsA and one AS (2303 patients total). Golimumab 50 or 100 mg was injected s.c. every 4 weeks with or without MTX. Control groups received placebo injections plus MTX or background therapy. Patients with haemoglobin levels below the age- and sex-specific normal ranges were considered to have anaemia. Ferritin levels were used to distinguish anaemia of mixed aetiology (?15 and <60 ng/ml) and anaemia of inflammation (?60 ng/ml). Changes from baseline to weeks 14 and 24 in haemoglobin level were compared between treatment groups using an analysis of variance on the van der Waerden normal scores. Results. At baseline, 21% of RA patients, 9% of PsA patients and 15% of AS patients had anaemia. Of these, 24%, 57% and 25%, respectively, had anaemia of inflammation. The median increase from baseline to week 14 in the haemoglobin level of anaemic patients was 0.3 g/dl in the control group and 0.9 g/dl in the golimumab group (P < 0.001). Haemoglobin levels improved within the subgroups of patients with anaemia of mixed aetiology (control, 0.4 g/dl vs golimumab, 0.7 g/dl) (P = 0.305) and with anaemia of inflammation (0.2 vs 1.4 g/dl, respectively) (P < 0.001). Conclusion. Compared with the control group, patients receiving golimumab treatment had significantly improved haemoglobin levels, particularly among patients with anaemia of inflammation. PMID:23838027

Kay, Jonathan; Wasko, Mary Chester; Keystone, Edward; Kavanaugh, Arthur; Deodhar, Atul; Murphy, Frederick T.; Magnus, Jeanette H.; Hsia, Elizabeth C.; Hsu, Benjamin; Xu, Stephen; Rahman, Mahboob U.; Doyle, Mittie K.

2013-01-01

204

Spinal non-Hodgkin's lymphoma mimicking a flare of disease in a patient with ankylosing spondylitis treated with anti-TNF agents: case report and review of the literature.  

PubMed

We report the case of a 52-year-old man with long-standing HLAB27-positive ankylosing spondylitis treated with anti-tumour necrosis factor (TNF) alpha therapy who was admitted to our rheumatology department complaining of increasing lumbar and buttock pain radiating to the posterior thigh, associated with numbness in the leg, gait disturbance and low-grade fever. The clinical picture was initially interpreted as a flare of disease but was not responsive to treatment. A contrast-enhanced spinal MRI was performed with evidence of a diffuse signal abnormality involving the sacroiliac joints and the spine, with evidence of spondylodiscitis of L5 and with a lesion causing L5-S1 root compression and infiltrating the iliopsoas muscle. These findings confirmed the possibility of a reactivation of disease associated with an infectious process. The most frequent causes of infectious spondylodiscitis were excluded, and a biopsy was then performed. Histological analysis revealed a high-grade B-cell non-Hodgkin's lymphoma of the spine. This case highlights how a differential diagnosis of low back pain with neurological symptoms can be particularly troublesome in ankylosing spondylitis and that continuous vigilance is warranted in patients treated with long-term immunosuppressive therapies. PMID:24699989

Monti, Sara; Boffini, Nicola; Lucioni, Marco; Paulli, Marco; Montecucco, Carlomaurizio; Caporali, Roberto

2014-04-01

205

Is Nephrolithiasis an Unrecognized Extra-Articular Manifestation in Ankylosing Spondylitis? A Prospective Population-Based Swedish National Cohort Study with Matched General Population Comparator Subjects  

PubMed Central

Background Ankylosing spondylitis (AS) is associated with several extra-articular manifestations. Nephrolithiasis (NL) has not been recognized as one of those, however, several factors known to increase the risk of NL are at play in AS patients. The objective was to estimate rates and predictors of NL in Swedish patients with AS compared to the general population. Methods and Findings We performed a prospective population-based nationwide cohort study based on linkage of data from Swedish registries. 8,572 AS patients were followed for 49,258 person-years (py) and 39,639 matched general population comparators were followed for 223,985 py. Patients were followed prospectively together with comparator subjects from January 2001 through December 2009. The first occurrence of NL during follow-up was the primary outcome. Hazard Ratios (HR) were used to compare these rates adjusting for comorbidities and treatment, and to assess predictors for NL. Mean age at study entry was 46 years (inter quartile range 36–56 years), 65% were males. Based on 250 vs. 466 NL events, the adjusted HR of NL in AS patients was 2.1 (95%CI 1.8 to 2.4). Predictors of NL within the AS group included prior diagnosis of inflammatory bowel disease (IBD) (HR 2.3; 95%CI 1.7 to 3.3), prior diagnosis of NL (HR 16.4; 95%CI 11.5 to 23.4), and patients receiving anti-TNF treatment (HR 1.6; 95%CI 1.2 to 2.1). Male sex was a risk factor for NL both in AS patients and in the general population. Limitations The risk for residual confounding and inability to study the chemical nature of NL were considered the main limitations of the study. Conclusions Patients with AS are at increased risk of NL, which may be considered a novel extra-articular manifestation. Previous history of NL, IBD, AS disease severity and male sex were identified as predictors of NL in AS. PMID:25423471

Jakobsen, Ane Krag; Jacobsson, Lennart T. H.; Patschan, Oliver; Askling, Johan; Kristensen, Lars Erik

2014-01-01

206

Major cost savings associated with biologic dose reduction in patients with inflammatory arthritis.  

PubMed

The purpose of this study was to explore whether patients with Inflammatory Arthritis (IA) (Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) or Ankylosing Spondylitis (AS)) would remain in remission following a reduction in biologic dosing frequency and to calculate the cost savings associated with dose reduction. This prospective non-blinded non-randomised study commenced in 2010. Patients with Inflammatory Arthritis being treated with a biologic agent were screened for disease activity. A cohort of those in remission according to standardized disease activity indices (DAS28 < 2.6, BASDAI < 4) was offered a reduction in dosing frequency of two commonly used biologic therapies (etanercept 50 mg once per fortnight instead of weekly, adalimumab 40 mg once per month instead of fortnightly). Patients were assessed for disease activity at 3, 6, 12, 18 and 24 months following reduction in dosing frequency. Cost saving was calculated. 79 patients with inflammatory arthritis in remission were recruited. 57% had rheumatoid arthritis (n = 45), 13% psoriatic arthritis (n = 10) and 30% ankylosing spondylitis (n = 24). 57% (n = 45) were taking etanercept and 43% (n = 34) adalimumab. The percentage of patients in remission at 24 months was 56% (n = 44). This resulted in an actual saving to the state of approximately 600,000 euro over two years. This study demonstrates the reduction in biologic dosing frequency is feasible in Inflammatory Arthritis. There was a considerable cost saving at two years. The potential for major cost savings in biologic usage should be pursued further. PMID:25702349

Murphy, C L; Awan, S; Sullivan, M O; Chavrimootoo, S; Bannon, C; Martin, L; Duffy, T; Murphy, E; Barry, M

2015-01-01

207

Genetics Home Reference: Ankylosing spondylitis  

MedlinePLUS

... part of a family of genes called the human leukocyte antigen (HLA) complex. The HLA complex helps the immune system distinguish the body's own proteins from proteins made by foreign invaders ( ...

208

A randomised, double-blind, multicentre, parallel-group, prospective study comparing the pharmacokinetics, safety, and efficacy of CT-P13 and innovator infliximab in patients with ankylosing spondylitis: the PLANETAS study  

PubMed Central

Objectives To compare the pharmacokinetics (PK), safety and efficacy of innovator infliximab (INX) and CT-P13, a biosimilar to INX, in patients with active ankylosing spondylitis (AS). Methods Phase 1 randomised, double-blind, multicentre, multinational, parallel-group study. Patients were randomised to receive 5?mg/kg of CT-P13 (n=125) or INX (n=125). Primary endpoints were area under the concentration-time curve (AUC) at steady state and observed maximum steady state serum concentration (Cmax,ss) between weeks 22 and 30. Additional PK, efficacy endpoints, including 20% and 40% improvement response according to Assessment in Ankylosing Spondylitis International Working Group criteria (ASAS20 and ASAS40), and safety outcomes were also assessed. Results Geometric mean AUC was 32?765.8??gh/ml for CT-P13 and 31?359.3??gh/ml for INX. Geometric mean Cmax,ss was 147.0 ??g/ml for CT-P13 and 144.8??g/ml for INX. The ratio of geometric means was 104.5% (90% CI 94% to 116%) for AUC and 101.5% (90% CI 95% to 109%) for Cmax,ss. ASAS20 and ASAS40 responses at week 30 were 70.5% and 51.8% for CT-P13 and 72.4% and 47.4% for INX, respectively. In the CT-P13 and INX groups more than one adverse event occurred in 64.8% and 63.9% of patients, infusion reactions occurred in 3.9% and 4.9%, active tuberculosis occurred in 1.6% and 0.8%, and 27.4% and 22.5% of patients tested positive for anti-drug antibodies, respectively. Conclusions The PK profiles of CT-P13 and INX were equivalent in patients with active AS. CT-P13 was well tolerated, with an efficacy and safety profile comparable to that of INX up to week 30. PMID:23687259

Park, Won; Hrycaj, Pawel; Jeka, Slawomir; Kovalenko, Volodymyr; Lysenko, Grygorii; Miranda, Pedro; Mikazane, Helena; Gutierrez-Ureña, Sergio; Lim, MieJin; Lee, Yeon-Ah; Lee, Sang Joon; Kim, HoUng; Yoo, Dae Hyun; Braun, Jürgen

2013-01-01

209

The effect of three years of TNF alpha blocking therapy on markers of bone turnover and their predictive value for treatment discontinuation in patients with ankylosing spondylitis: a prospective longitudinal observational cohort study  

PubMed Central

Introduction The aim of this study was to investigate the effect of three years of tumor necrosis factor-alpha (TNF-?) blocking therapy on bone turnover as well as to analyze the predictive value of early changes in bone turnover markers (BTM) for treatment discontinuation in patients with ankylosing spondylitis (AS). Methods This is a prospective cohort study of 111 consecutive AS outpatients who started TNF-? blocking therapy. Clinical assessments and BTM were assessed at baseline, three and six months, as well as at one, two, and three years. Z-scores of BTM were calculated to correct for age and gender. Bone mineral density (BMD) was assessed yearly. Results After three years, 72 patients (65%) were still using their first TNF-? blocking agent. In these patients, TNF-? blocking therapy resulted in significantly increased bone-specific alkaline phosphatase, a marker of bone formation; decreased serum collagen-telopeptide (sCTX), a marker of bone resorption; and increased lumbar spine and hip BMD compared to baseline. Baseline to three months decrease in sCTX Z-score (HR: 0.394, 95% CI: 0.263 to 0.591), AS disease activity score (ASDAS; HR: 0.488, 95% CI: 0.317 to 0.752), and physician's global disease activity (HR: 0.739, 95% CI: 0.600 to 0.909) were independent inversely related predictors of time to treatment discontinuation because of inefficacy or intolerance. Early decrease in sCTX Z-score correlated significantly with good long-term response regarding disease activity, physical function and quality of life. Conclusions Three years of TNF-? blocking therapy results in a bone turnover balance that favors bone formation, especially mineralization, in combination with continuous improvement of lumbar spine BMD. Early change in sCTX can serve as an objective measure in the evaluation of TNF-? blocking therapy in AS, in addition to the currently used more subjective measures. PMID:22546520

2012-01-01

210

Polymorphisms of HLA-A, -B, -Cw and DRB1 antigens in Moroccan patients with ankylosing spondylitis and a comparison of clinical features with frequencies of HLA-B*27.  

PubMed

Ankylosing spondylitis (AS) is very often associated with human leukocyte antigen (HLA), particularly HLA-B*27. However, the strength of this association and clinical features may vary in different ethnic groups. Our study aims to assess the distribution of HLA-A, -B, -Cw and DRB1 alleles in Moroccan patients with AS and to compare the clinical features of AS and the frequencies of HLA-B27 in patients from Morocco with other series. Seventy-five patients diagnosed with AS and assessed for clinical manifestations were selected and compared to 100 healthy controls. HLA class I and II antigens were typed by polymerase chain reaction sequence-specific oligonucleotide. HLA-B27 subtypes were studied by polymerase chain reaction amplification with sequence-specific primers. HLA-B27 was found in 64% of patients. It was positively associated with younger age at disease onset, family history, and uveitis while it had a negative association with late onset. Six B*27 subtypes were identified in the AS group. HLA-B*2705 and B*2702 were the most common observed subtypes. Among other HLA genes, a significant increase in the prevalence of HLA-Cw*02 and HLA-DRB*15 was found in AS patients. HLA-B27 is involved in the predisposition of AS in the Moroccan population. HLA-B*2705 and B*2702 were the predominant subtypes supporting previous reports in Caucasian spondyloarthropathies. Other HLA genes, HLA-Cw*02 and HLA-DRB1*15, seem to confer predisposing effect to the disease. However, the lower frequency of HLA-B27 compared to the literature in our study suggests the existence of different genetic and/or environmental factors in Morocco. PMID:25626601

El Mouraghi, I; Ouarour, A; Ghozlani, I; Collantes, E; Solana, R; El Maghraoui, A

2015-02-01

211

[Therapy of psoriatic arthritis].  

PubMed

In psoriatic arthritis (PsA) the heterogeneous spectrum of the disease with arthritis/synovitis, axial manifestation, enthesitis, dactylitis, psoriatic skin disease and nail psoriasis has to be considered. Moreover, PsA activity and severity as well as comorbidities are of importance for making therapeutic decisions. Measurement instruments developed for therapeutic studies of rheumatoid arthritis or ankylosing spondylitis are often not appropriate for application in PsA investigations. In this paper established therapies with nonsteroidal antirheumatic drugs, disease modifying antirheumatic drugs (DMARDs) and TNF-alpha inhibitors and the current EULAR guidelines from 2012 are reviewed. However, there is a need for new therapeutic agents for those patients who do not respond to or do not tolerate the current therapies. Other biologic agents have also been tested for PsA with moderate effects only. New therapeutic options could result from the anti-IL12 and anti-IL23 receptor monoclonal antibody ustekinumab and from small molecules such as the oral PDE-4 inhibitor apremilast. PMID:24043297

Märker-Hermann, E

2013-10-01

212

Psoriatic arthritis: recent progress in pathophysiology and drug development  

PubMed Central

Psoriatic arthritis (PsA) is the second most common inflammatory arthropathy, after rheumatoid arthritis diagnosis, in early arthritis clinics. Most patients have established psoriasis, often for years, prior to the onset of joint pain and swelling; in addition, associated features of nail disease, dactylitis, enthesitis, spondylitis or uveitis may be present. Psoriasis may not be immediately apparent, as small or patchy lesions may occur in the scalp or perineum. PsA presents as a symmetrical polyarthritis, similar to rheumatoid arthritis, or an asymmetrical oligoarthritis with a predilection for the distal interphalangeal joints. Spinal involvement is similar, although not identical, to ankylosing spondylitis. Joint damage occurs early; up to 50% of PsA patients have an 11% annual erosion rate in the first 2 years of disease duration, suggesting it is not a benign condition. There have been significant advances in our understanding of PsA pathogenesis in recent years, in the areas of genetics and molecular biology, implicating both the innate and the adaptive immune systems. This has lead to the introduction of evidence-based targeted therapy, primarily with tumour necrosis factor inhibitor (TNFi) agents. Therapy with disease-modifying anti-rheumatic drugs, such as methotrexate and leflunomide, remains the first-choice therapeutic intervention, even though there are few randomised controlled trials with these agents. In contrast, a number of successful studies of TNFi agents demonstrate excellent efficacy, in combination with methotrexate, and several novel agents are currently in development for the treatment of PsA. PMID:24611179

2013-01-01

213

Arthritis  

MedlinePLUS

... arthritis is often a life-long, progressive disease. Gout Gout is a type of arthritis that usually only ... in the United States, including osteoarthritis, rheumatoid arthritis, gout, lupus, and fibromyalgia. In fact, about half of ...

214

Arthritis  

MedlinePLUS

... children. Infectious arthritis is an infection that has spread from another part of the body to the joint. Psoriatic arthritis affects people with psoriasis. Gout is a painful type of arthritis that ...

215

Microencapsulation: an acclaimed novel drug-delivery system for NSAIDs in arthritis.  

PubMed

Arthritis refers to different medical conditions associated with disorders of the primary structures that determine joint functioning, such as bones, cartilage, and synovial membranes. Drug discovery and delivery to retard the degeneration of joint tissues are challenging. Current treatment of different types of arthritis such as osteoarthritis, rheumatoid arthritis, septic arthritis, juvenile idiopathic arthritis, and ankylosing spondylitis involves the administration of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, diclofenac, aceclofenac, ibuprofen, flurbiprofen, indomethacin piroxicam, dexibuprofen, ketoprofen, nabumetone, nimesulide, and naproxen, mainly by the oral, parenteral, or topical route. However, the frequent dosing that is required with NSAIDs often leads to patient noncompliance, so drug-delivery technologies should be developed to reduce the frequency of dosing and to allow sustained release of medications. Microencapsulation is one of the novel drug-delivery technologies employed to sustain drug release. This method reduces dosing and eliminates gastrointestinal irritation, thus ultimately improving patient compliance in the pharmacotherapy of arthritis. We provide a comprehensive overview of several microencapsulation technologies used in the treatment of arthritis that may reduce the dose-related adverse effects caused by NSAIDs. PMID:21175420

Manjanna, K M; Shivakumar, B; Pramod Kumar, T M

2010-01-01

216

Subtype specific genetic associations for juvenile idiopathic arthritis: ERAP1 with the enthesitis related arthritis subtype and IL23R with juvenile psoriatic arthritis  

PubMed Central

Introduction Juvenile idiopathic arthritis (JIA) is an umbrella term for all chronic childhood arthropathies and can be divided into seven subtypes. It includes the enthesitis related arthritis (ERA) subtype which displays symptoms similar to ankylosing spondylitis (AS) and juvenile-onset psoriatic arthritis which has similarities to psoriatic arthritis (PsA) and psoriasis (Ps). We, therefore, hypothesized that two well-established susceptibility loci for AS and Ps, ERAP1 and IL23R, could also confer susceptibility to these JIA subtypes. Methods Single nucleotide polymorphisms (SNPs) in ERAP1 (rs30187) and IL23R (rs11209026) were genotyped in JIA cases (n = 1,054) and healthy controls (n = 5,200). Genotype frequencies were compared between all JIA cases and controls using the Cochrane-Armitage trend test implemented in PLINK. Stratified analysis by ILAR subtype was performed. Results The ERA subtype showed strong association with ERAP1 SNP (P trend = 0.005). The IL23R SNP showed significant association in the PsA subtype (P trend = 0.04). The SNPs were not associated with JIA overall or with any other subtype. Conclusions We present evidence for subtype specific association of the ERAP1 gene with ERA JIA and the IL23R gene with juvenile-onset PsA. The findings will require validation in independent JIA datasets. These results suggest distinct pathogenic pathways in these subtypes. PMID:21281511

2011-01-01

217

Inflammatory spinal disease in psoriatic arthritis: a report from the GRAPPA 2010 annual meeting.  

PubMed

Diagnosing axial disease in patients with psoriatic arthritis (PsA) has been largely dependent on identifying inflammatory back pain (IBP), which itself has been difficult to define. We review the criteria used to identify IBP in patients with ankylosing spondylitis (AS) and other forms of spondyloarthritis. Recently, the Ankylosing SpondyloArthritis International Society (ASAS) developed a list of clinical and radiographic criteria for identifying IBP in patients with AS. However, it is more difficult to identify IBP in patients with PsA because generally they have less pain than patients with rheumatoid arthritis or AS. Further, PsA patients may have clinical symptoms of pain but negative radiographs. It may be more useful to identify sacroiliitis or syndesmophytes by magnetic resonance imaging (MRI), since MRI identifies lesions in the sacroiliac joints and the spine much earlier than can be detected on radiographs. In summary, all patients with PsA should be assessed for axial involvement with history, physical examination, and imaging. Patients with psoriasis whose history includes onset of back pain before age 40 years, the presence of night pain, and improvement with exercise but not with rest, or who have limited neck or back mobility, should be referred to a rheumatologist. PMID:22298270

Gladman, Dafna D

2012-02-01

218

The Role of Intracellular Organisms in the Pathogenesis of Inflammatory Arthritis  

PubMed Central

Inflammatory arthritis is a condition which is characterised by recurrent episodes of joint pain and swelling. It encompasses a spectrum of disorders ranging from rheumatoid arthritis to ankylosing spondylitis. In these conditions, for reasons that are poorly understood, the immune system raises an inflammatory response within the joint space. In some cases, autoantigens have been identified (e.g., anticitrullinated peptides in rheumatoid arthritis), but the absence of these, in the seronegative arthritides, for example, raises question as to the underlying pathogenesis. Interest has, therefore, turned to host-pathogen interactions and whether aberrant immune responses to these could explain the development of arthritis. This has been most widely studied in reactive arthritis (ReA), where an infectious episode precedes the development of the joint symptoms. In this review, we present the evidence for the role of host-bacterial interactions in the pathogenesis of joint inflammation with particular emphasis on ReA. We discuss a range of possible mechanisms including molecular mimicry, persistent low grade infections, and abnormal host responses to common bacterial causes of reactive arthritis as well as discussing some of the clinical challenges that we face in making the diagnosis and in treatment of persistent symptoms. PMID:24995143

2014-01-01

219

Etanercept in arthritis.  

PubMed

Tumour necrosis factor-alpha (TNF-alpha) is one of the inflammatory cytokines. It is released by activated monocytes, macrophages and T lymphocytes and promotes inflammation. TNF-alpha binds to two receptors; one of these is the type 2 TNF receptor (p75). Etanercept is a soluble TNF-receptor fusion protein. It consists of two linked dimmers, each with a ligand-binding portion of the higher affinity type 2 TNF receptor (p75). This fusion protein binds to TNF-alpha and prevents it from interacting with its receptor. Etanercept is given by subcutaneous administration at a dose of 25 mg twice a week. This dosing reflects its half-life of about 4 days. Clinical trials show etanercept is effective and safe to use in rheumatoid arthritis (RA). It reduces disease activity and limits progressive joint damage in both early and late disease. It can be used as a monotherapy or in combination with methotrexate, and in this, the latter approach appears most effective. It is also effective in psoriatic arthritis and ankylosing spondylitis. Although the biologic appears safe, caution is needed to ensure it does not re-activate tuberculosis. It should not be used in patients with disseminated sclerosis, and there are concerns about a potential relationship to lymphoma. Its high cost means there will be continuing debate about the ideal position of this new biologic within the treatment pathway of RA. At present, it is recommended for use when methotrexate and another disease-modifying drug have failed. PMID:15707475

Scott, D L

2005-01-01

220

A Comparison of Disease Burden in Rheumatoid Arthritis, Psoriatic Arthritis and Axial Spondyloarthritis  

PubMed Central

Objective The main objective of this study was to compare disease burden in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (ax-SpA). Methods In this cross-sectional study, all the RA (1093), PsA (365) and ax-SpA (333) patients who visited the out-patient clinic of the Hospital of Southern Norway Trust during the year 2013 were included; the RA patients all had a RA diagnosis verified by the treating rheumatologist, the PsA patients all fulfilled the ClASsification for Psoriatic ARthritis (CASPAR) criteria and the ax-SpA patients all fulfilled the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for ax-SpA. Patient-reported health status, demographic variables, medications, and composite scores of disease activity were assessed. The main analyses were performed using General Linear Models adjusted for age, sex and multiple comparisons. Correlation analyses were performed using Spearman’s rho. Results The reported pain, joint pain, patient’s global assessment and fatigue were similar in PsA and ax-SpA, but significantly lower in RA. The 28-joint Disease Activity Score (DAS28) (0.3±0.1, p = 0.003), Clinical Disease Activity Index (CDAI) (1.0±0.4, p = 0.028) and Routine Assessment of Patient Index Data 3 (RAPID3) (0.4±0.1, p = 0.004) were all significantly higher in PsA vs. RA. RAPID3 showed moderate to high correlation with DAS28 (rho = 0.521, p<0.001) and CDAI (rho = 0.768, p<0.001) in RA and PsA, and with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (rho = 0.902, p<0.001) and Bath Ankylosing Spondylitis Functional Index (BASFI) (0.865, p<0.001) in ax-SpA and PsA. Conclusion In conclusion, patient- reported outcome measures were similar in our population of PsA and ax-SpA patients, but significantly lower for the RA patients. Composite disease activity measures were lower in RA than in PsA and ax-SpA, but the magnitude of these differences was small and probably not of clinical significance. Our study indicates that disease burden in RA, PsA and ax-SpA may be more similar than previously demonstrated. PMID:25853482

Michelsen, Brigitte; Fiane, Ragnhild; Diamantopoulos, Andreas P.; Soldal, Dag Magnar; Hansen, Inger Johanne W.; Sokka, Tuulikki; Kavanaugh, Arthur; Haugeberg, Glenn

2015-01-01

221

Higher LPS-stimulated TNF-alpha mRNA levels in peripheral blood mononuclear cells from Chinese ankylosing spondylitis patients with -308G/A polymorphism in promoter region of tumor necrosis factor: association with distinct A33/B58/Cw10 haplotypes.  

PubMed

To investigate the effects of TNF-alpha -308, -238 promoter polymorphisms on TNF-alpha transcription in B27 positive Chinese patients with ankylosing spondylitis (AS). The possible relationship between polymorphisms, MHC antigens, and quantitative TNF-alpha mRNA expression were evaluated. Single nucleotide polymorphisms (SNPS) of TNF-alpha -308 and -238 were performed by PCR-amplification refractory mutation system method (PCR-ARMS) in sixty-seven B27-positive AS patients and 60 HLA-B27 positive healthy controls in Chinese. Quantitative measurement of TNF-alpha mRNA in peripheral blood mononuclear cells was performed with real time RT-PCR. The polymorphisms were correlated to quantitative TNF-alpha mRNA, and MHC antigens (determined by SSP method) in AS patients. The prevalence rate of both -308G/A and -238G/A TNF-alpha promoter polymorphisms in patients were not significantly different from those in normal subjects. However, a significant high LPS-stimulated TNF-alpha mRNA expression was found in peripheral blood mononuclear cells from patients with promoter -308G/A polymorphism (TNF2) as compared to those in -308G/G genotype (TNF1). Furthermore, -308G/A polymorphism in patients was found to be tightly associated with distinct haplotypes of A33/B58/Cw10 [12 out of 14 -308G/A patients (85.7%) versus none in 53 -308G/G patients], independent of B27 antigen. HLA-A33-B58-Cw10 haplotypes associated TNF-alpha promoter -308G/A polymorphism might play an important role in disease pathogenesis of AS in Chinese population, partially related to a driving force of a higher TNF-alpha production. It confirms once again the importance and complexity of MHC related molecules in disease pathogenesis of AS. PMID:18719920

Lu, Ming-Chi; Yang, K L; Tung, Chien-Hsueh; Huang, Kuang-Yung; Yu, Hui-Chun; Liu, Su-Qin; Lai, Ning-Sheng

2008-12-01

222

Arthritis  

MedlinePLUS

... and walnuts. Avoid excessive alcohol and smoking. Apply capsaicin cream over your painful joints. You may feel ... damage. Prescription medicines: Biologics are used for the treatment of autoimmune arthritis. They include etanercept (Enbrel), infliximab ( ...

223

Arthritis  

NSDL National Science Digital Library

This patient education program explains certain arthritic conditions, including osteoarthritis and rheumatoid arthritis, and their treatment options. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

Patient Education Institute

224

42 CFR 100.3 - Vaccine injury table.  

Code of Federal Regulations, 2012 CFR

...trauma, neoplasms, neuropathic disorders, bone and cartilage disorders and arthritis associated with ankylosing spondylitis, psoriasis, inflammatory bowel disease, Reiter's syndrome, or blood disorders. (iii) Arthralgia (joint pain) or...

2012-10-01

225

42 CFR 100.3 - Vaccine injury table.  

Code of Federal Regulations, 2013 CFR

...trauma, neoplasms, neuropathic disorders, bone and cartilage disorders and arthritis associated with ankylosing spondylitis, psoriasis, inflammatory bowel disease, Reiter's syndrome, or blood disorders. (iii) Arthralgia (joint pain) or...

2013-10-01

226

Induction of Regulatory t Cells by Low Dose il2 in Autoimmune and Inflammatory Diseases  

ClinicalTrials.gov

Rheumatoid Arthritis; Ankylosing Spondylitis; Systemic Lupus Erythematosus; Psoriasis; Behcet's Disease; Wegener's Granulomatosis; Takayasu's Disease; Crohn's Disease; Ulcerative Colitis; Autoimmune Hepatitis; Sclerosing Cholangitis

2014-02-06

227

Association of PTPN22 polymorphsims and ankylosing spondylitis susceptibility  

PubMed Central

Background: As a susceptibility gene for AS, the polymorphsims of PTPN22 associated with disease susceptibility. Methods: We selected two SNPs of rs1217406 and rs1217414 within PTPN22 with Haploview software and investigated the relationship between the SNPs of PTPN22 gene and AS susceptibility. 120 AS patients and 100 healthy people were enrolled from Qilu Hospital of Shandong University. And we genotyped the SNPs of PTPN22 with PCR-RFLP method. Results: The results showed that C allele (rs1217406) and T allele (rs1217414) both were risk factors for AS (OR: 3.12, 2.13). The persons with A-T, C-C or C-T haplotypes were more likely to suffer AS (OR: 3.17, 3.66, 4.011). Conclusions: Due to the close relationship of PTPN22 and AS, the study may be helpful for the early diagnosis and differential diagnosis. PMID:25755798

Meng, Qingxi; Zhang, Xiaojun; Liu, Xin; Wang, Weiguo; Yu, Peng; Shan, Qunqun; Mao, Zhaohu; Zhao, Tingbao

2015-01-01

228

Scientists Gain New Insights into Genetic Mechanisms of Ankylosing Spondylitis  

MedlinePLUS

... the University of Texas (UT) Medical School at Houston. Finding the tag SNP enabled Dr. Reveille and ... L, Leslie S, Wordsworth T, Kenna TJ, Karaderi T, Thomas GP, Ward MM, Weisman MH, Farrar C, Bradbury ...

229

Doppler US in rheumatic diseases with special emphasis on rheumatoid arthritis and spondyloarthritis.  

PubMed

Developments in digital ultrasonography (US) technology and the use of high-frequency broadband transducers have increased the quality of US imaging, particularly of superficial tissues. Thus, US, particularly color US or power Doppler US, in which high-resolution transducers are used, has become an important imaging modality in the assessment of rheumatic diseases. Furthermore, therapeutic interventions and biopsies can be performed under US guidance during the assessment of lesions. In this era of effective treatments, such as biologics, improvements in synovial inflammation in rheumatoid arthritis as well as changes in enthesitis in spondyloarthropathies, including ankylosing spondylitis and psoriatic arthritis, can be monitored effectively using gray-scale and/or power Doppler US. US is also a good imaging modality for crystal arthropathies, including gout and pseudogout, in which synovitis, erosions, tophi, and crystal deposition within or around the joint can be visualized readily. Vascular and tenosynovial structures, as well as the salivary glands, can be assessed with US in vasculitis and connective tissue disorders, including systemic lupus erythematosus and Sjögren's syndrome. Current research is focused on improving the sensitivity, specificity, validity, and reproducibility of US findings. In this review, we summarized the role of US, particularly power Doppler US, in rheumatic diseases and inflammation in superficial tissues. PMID:23996840

Toprak, Hüseyin; K?l?ç, Erkan; Serter, Asl?; Kocakoç, Ercan; Özgöçmen, Salih

2014-01-01

230

Global Metabolite Profiling of Synovial Fluid for the Specific Diagnosis of Rheumatoid Arthritis from Other Inflammatory Arthritis  

PubMed Central

Currently, reliable biomarkers that can be used to distinguish rheumatoid arthritis (RA) from other inflammatory diseases are unavailable. To find possible distinctive metabolic patterns and biomarker candidates for RA, we performed global metabolite profiling of synovial fluid samples. Synovial fluid samples from 38 patients with RA, ankylosing spondylitis, Behçet's disease, and gout were analyzed by gas chromatography/time-of-flight mass spectrometry (GC/TOF MS). Orthogonal partial least-squares discriminant and hierarchical clustering analyses were performed for the discrimination of RA and non-RA groups. Variable importance for projection values were determined, and the Wilcoxon-Mann-Whitney test and the breakdown and one-way analysis of variance were conducted to identify potential biomarkers for RA. A total of 105 metabolites were identified from synovial fluid samples. The score plot of orthogonal partial least squares discriminant analysis showed significant discrimination between the RA and non-RA groups. The 20 metabolites, including citrulline, succinate, glutamine, octadecanol, isopalmitic acid, and glycerol, were identified as potential biomarkers for RA. These metabolites were found to be associated with the urea and TCA cycles as well as fatty acid and amino acid metabolism. The metabolomic analysis results demonstrated that global metabolite profiling by GC/TOF MS might be a useful tool for the effective diagnosis and further understanding of RA. PMID:24887281

Xuan, Jinhua; Jung, Young Hoon; Cha, Hoon-Suk; Kim, Kyoung Heon

2014-01-01

231

Reevaluation of some double-blind, randomized studies of dexibuprofen (Seractil): a state-of-the-art overview. Studies in patients with lumbar vertebral column syndrome, rheumatoid arthritis, distortion of the ankle joint, gonarthrosis, ankylosing spondylitis, and activated coxarthrosis.  

PubMed

This article presents a reevaluation of studies previously performed regarding the efficacy and safety of dexibuprofen (Seractil; S(+)-ibuprofen) for use in patients with inflammatory or degenerative diseases. Using appropriate standardized measures (univariate and multivariate analysis with the Mann-Whitney statistic with confidence intervals), the authors were able to compare the effects of treatment in different diseases. For the primary criterion and for the combined analysis of all efficacy criteria, one-sided equivalence was proved in all six studies reviewed. PMID:9013382

Rahlfs, V W; Stat, C

1996-12-01

232

Switching TNF antagonists in patients with chronic arthritis: an observational study of 488 patients over a four-year period  

PubMed Central

The objective of this work is to analyze the survival of infliximab, etanercept and adalimumab in patients who have switched among tumor necrosis factor (TNF) antagonists for the treatment of chronic arthritis. BIOBADASER is a national registry of patients with different forms of chronic arthritis who are treated with biologics. Using this registry, we have analyzed patient switching of TNF antagonists. The cumulative discontinuation rate was calculated using the actuarial method. The log-rank test was used to compare survival curves, and Cox regression models were used to assess independent factors associated with discontinuing medication. Between February 2000 and September 2004, 4,706 patients were registered in BIOBADASER, of whom 68% had rheumatoid arthritis, 11% ankylosing spondylitis, 10% psoriatic arthritis, and 11% other forms of chronic arthritis. One- and two-year drug survival rates of the TNF antagonist were 0.83 and 0.75, respectively. There were 488 patients treated with more than one TNF antagonist. In this situation, survival of the second TNF antagonist decreased to 0.68 and 0.60 at 1 and 2 years, respectively. Survival was better in patients replacing the first TNF antagonist because of adverse events (hazard ratio (HR) for discontinuation 0.55 (95% confidence interval (CI), 0.34–0.84)), and worse in patients older than 60 years (HR 1.10 (95% CI 0.97–2.49)) or who were treated with infliximab (HR 3.22 (95% CI 2.13–4.87)). In summary, in patients who require continuous therapy and have failed to respond to a TNF antagonist, replacement with a different TNF antagonist may be of use under certain situations. This issue will deserve continuous reassessment with the arrival of new medications. PMID:16507128

Gomez-Reino, Juan J; Carmona, Loreto

2006-01-01

233

77 FR 34052 - Pfizer, Inc.; Withdrawal of Approval of Familial Adenomatous Polyposis Indication for CELEBREX  

Federal Register 2010, 2011, 2012, 2013, 2014

...regulations, 21 CFR part 314, subpart H. In addition to FAP, CELEBREX is indicated for the relief of the signs and symptoms of osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis in patients 2 years and older, ankylosing spondylitis,...

2012-06-08

234

Serum soluble bone turnover biomarkers in psoriatic arthritis and psoriatic spondyloarthropathy.  

PubMed

Because psoriatic arthritis (PsA) is an inflammatory disease of joints, serum soluble biomarkers specific for chronic joint and bone inflammation may predict future disease severity and response to therapy, thereby informing stratified medicine approaches. The objectives of our systematic review were to determine whether serum soluble bone and cartilage turnover biomarkers are (1) associated with PsA or psoriatic spondyloarthropathy; and (2) associated with disease activity, disease severity, or clinical phenotype. Ten studies met eligibility criteria. Matrix metalloproteinase (MMP)-3, Dickkopf (DKK)-1, macrophage colony-stimulating factor (M-CSF), crosslinked telopeptide of collagen-1, and tumor necrosis factor-related apoptosis-inducing ligand were associated with PsA, with equivocal results for osteoprotegerin (OPG) and bone alkaline phosphatase (ALP). MMP-3, DKK-1, M-CSF, CPII:C2C (ratio of cartilage degradation vs byproduct formation), and possibly OPG were associated with PsA independently of psoriasis. C1-2C (a neoepitope released when type 2 cartilage is degraded by collagenases) was associated with both tender and swollen joint counts, and bone morphogenetic protein-4 with patient global assessment of disease, pain score, and the Bath Ankylosing Spondylitis Disease Activity Index. Bone ALP was associated with disease activity. M-CSF and receptor activator of nuclear factor-?B ligand were associated with several plain radiographic features. No studies have investigated biomarker associations specifically with axial PsA. PMID:25362660

Jadon, Deepak R; Nightingale, Alison L; McHugh, Neil J; Lindsay, Mark A; Korendowych, Eleanor; Sengupta, Raj

2015-01-01

235

Etanercept and demyelinating disease in a patient with psoriasis  

Microsoft Academic Search

The tumor necrosis factor-a antagonist (TNF-a) etanercept has been approved for the treatment of rheumatoid arthritis, juvenile rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and psoriasis. Earlier reports on the use of etanercept or infliximab in patients with rheumatoid arthritis, psoriatic arthritis, or juvenile rheumatoid arthritis suggested an increased risk of demyelinating disease. It is imperative that dermatologists have a keen

Sean A. Sukal; Lakshmi Nadiminti; Richard D. Granstein

2006-01-01

236

Phenotypic and clinical differences between Caucasian and South Asian patients with psoriatic arthritis living in North East London.  

PubMed

To test for demographic and clinical differences between Caucasian and South Asian patients with psoriatic arthritis (PsA) living in the same environment and for differences between sexes. The demographic characteristics of patients attending outpatient clinics were obtained using a semi-structured questionnaire. Clinical parameters included disease activity (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR), C-reactive protein), function (Bath Ankylosing Spondylitis Functional Index (BASFI)) and visual analogue scale (VAS) scores for well-being and night pain (10 cm, where 10 = worst possible response). The first symptom experienced at disease onset and the main symptoms during the disease course were recorded in the questionnaire. A total of 217 patents were assessed of whom 151 were Caucasians and 66 were Asians. South Asian patients were significantly younger [(mean) 45.9 years [(SD)(±11.4)] for Asians and 53.1 years (±14.2) for Caucasians (p < 0.005)] and were diagnosed at an earlier age [40.7 years (±11.7) for Asians and 46.7 years (±15.8) for Caucasians (p < 0.05)] compared to Caucasians patients. Asian females with PsA had worse disease in terms of activity (ESR = 23.9 mmHg/h; BASDAI = 6.7), function (BASFI = 5.5), night pain (7.1 on VAS) and well-being (6.6 on VAS) compared with Asian males (13.2 mmHg/h, 5.3, 3.6, 4.1, 4.6, respectively) or Caucasian males and females (15.8 mmHg/h, 5.9, 5.3, 5.4, 5.4; 18.9 mmHg/h, 6.1, 6.1, 5.3, 5.8, respectively). There were no significant differences in symptoms at disease onset or the main symptoms during the disease course between Caucasian and Asian patients, although there was a trend towards more frequent enthesitis in Asian females during the course of disease suggested by pain with pressure compared to Asian males. South Asian patients may develop PsA earlier in life than Caucasian patients do, but their clinical characteristics are generally similar. Asian females with PsA have worse disease activity, function, night pain and well-being than Asian males and Caucasian males and females. PMID:23247553

Roussou, Euthalia; Chopra, Sunil; Ngandu, Danny Lunda

2013-05-01

237

Psoriatic arthritis: update on pathophysiology, assessment and management  

Microsoft Academic Search

Psoriatic arthritis (PsA) is classified as a spondyloarthropathy and characterised by synovitis, enthesitis, dactylitis and spondylitis usually manifesting as skin and nail psoriasis. Our understanding about the PsA disease state, its genetics, pathophysiology and comorbidities, as well as the ability to assess and treat the disease, has advanced as a result of significant collaborative efforts by rheumatologists and dermatologists in

Philip J Mease

2011-01-01

238

The CARRA Registry  

ClinicalTrials.gov

Juvenile Idiopathic Arthritis; Systemic Lupus Erythematosus; Mixed Connective Tissue Disease; Juvenile Ankylosing Spondylitis; Juvenile Dermatomyositis; Localized Scleroderma; Systemic Sclerosis; Vasculitis; Sarcoid; Fibromyalgia, Primary; Auto-inflammatory Disease; Idiopathic Uveitis Idiopathic

2014-03-17

239

Prevalence of Past and Reactivated Viral Infections and Efficacy of Cyclosporine A as Monotherapy or in Combination in Patients with Psoriatic Arthritis—Synergy Study: A Longitudinal Observational Study  

PubMed Central

We have prospectively evaluated psoriatic arthritis (PsA) patients for (1) seropositivity for former viral infections and seroconversion and (2) efficacy of cyclosporine A (CsA) alone or in combination with other immunosuppressants in a time period of 12 months. Screening included HBV antibodies and antigens, HCV antibodies and RNA, HSV 1-2, HZV, EBV, and CMV IgG, and IgM, HHV-6 DNA, and HIV 1-2 antibodies. PsA was evaluated by the Psoriasis Area Severity Index (PASI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the Visual Analogue Scale (VAS). At baseline, 126 (56%) out of 225 evaluable patients had 2 or more seropositivities indicative of former infections, and 31 patients (13.8%) presented seropositivity for HCV, HBV, HSV-1 and -2, HHV-6, EBV, or parvovirus infection; one of them, positive for HBAg, was treated with lamivudine, while the remaining 30 received no specific treatment. None of the 31 patients developed virus reactivation. A reduction (P < 0.001) of PASI, BASDAI, and VAS scores was observed at 6 and 12 months. The treatment of PsA with CsA as monotherapy or in combination was safe and effective. In vitro experiments and clinical findings, including those from our study, suggest that CsA as monotherapy or in combination with biologics might be the treatment of choice in PsA HCV-positive patients. PMID:24804261

Colombo, Delia; Grossi, Paolo; Marchesoni, Antonio; Di Nuzzo, Sergio; Griseta, Vito; Gargiulo, Anna; Parodi, Aurora; Bellia, Gilberto

2014-01-01

240

Interferon-? release assay in the diagnosis of latent tuberculosis infection in arthritis patients treated with tumor necrosis factor antagonists in Korea.  

PubMed

The aim of this study was to evaluate the usefulness of the interferon-? release assay (IGRA) for the diagnosis of latent tuberculosis infection (LTBI) in arthritis patients who received tumor necrosis factor (TNF) antagonist in Korea. The study involved 107 consecutive patients: 61 (57%) with ankylosing spondylitis and 46 (43%) with rheumatoid arthritis. Screening tests were performed including the tuberculin skin test (TST), the QuantiFERON-TB Gold In-Tube (QFT-IT) test, and chest radiography. A positive QFT-IT test result, regardless of TST results, was considered an indication for LTBI treatment. If the QFT-IT results were indeterminate, a positive TST was regarded as an indication for LTBI treatment. A Bacillus Calmette-Guérin (BCG) scar was found in 63 patients (59%). LTBI treatment was performed in 37 patients (35%), including 36 with positive QFT-IT results and one with indeterminate QFT-IT and positive TST results. No patients developed tuberculosis during a median of 18 months (range, 13-26 months) of TNF antagonist therapy. In 16 patients who had positive TST and negative QFT-IT results, TNF antagonists were given without LTBI treatment. Tuberculosis did not occur, even in these patients, during a median of 24.5 months (range, 15-33.5 months) of TNF antagonist therapy. IGRA may be used instead of TST for the diagnosis of LTBI in patients before starting TNF antagonists in countries where tuberculosis prevalence is intermediate and the BCG vaccination is mandatory at birth, such as in Korea. PMID:21556777

Chang, Boksoon; Park, Hye Yun; Jeon, Kyeongman; Ahn, Joong Kyong; Cha, Hoon-Suk; Koh, Eun-Mi; Kang, Eun-Suk; Koh, Won-Jung

2011-12-01

241

Joint Involvement Associated with Inflammatory Bowel Disease  

Microsoft Academic Search

Joint involvement associated with inflammatory bowel disease (IBD) belongs to the concept of spondyloarthritis (SpA) and includes two types of arthritis: a peripheral arthritis characterized by the presence of pauciarticular asymmetrical arthritis affecting preferentially joints of lower extremities and an axial arthropathy including inflammatory back pain, sacroiliitis and ankylosing spondylitis (AS). Treatment of arthritis includes a short-term use of NSAIDs

M. De Vos

2009-01-01

242

Spinal fractures in patients with ankylosing spinal disorders: a systematic review of the literature on treatment, neurological status and complications  

PubMed Central

The ankylosed spine is prone to fracture after minor trauma due to its changed biomechanical properties. Although many case reports and small series have been published on patients with ankylosing spondylitis (AS) suffering spine fractures, solid data on clinical outcome are rare. In advanced diffuse idiopathic skeletal hyperostosis (DISH), ossification of spinal ligaments also leads to ankylosis. The prevalence of AS is stable, but since DISH may become more widespread due to its association with age, obesity and type 2 diabetes mellitus, a systematic review of the literature was conducted to increase the current knowledge on treatment, neurological status and complications of patients with preexisting ankylosed spines sustaining spinal trauma. A literature search was performed to obtain all relevant articles concerning the outcome of patients with AS or DISH admitted with spinal fractures. Predefined parameters were extracted from the papers and pooled to study the effect of treatment on neurological status and complications. Ninety-three articles were included, representing 345 AS patients and 55 DISH patients. Most fractures were localized in the cervical spine and resulted from low energy impact. Delayed diagnosis often occurred due to patient and doctor related factors. On admission 67.2% of the AS patients and 40.0% of the DISH patients demonstrated neurologic deficits, while secondary neurological deterioration occurred frequently. Surgical or nonoperative treatment did not alter the neurological prospective for most patients. The complication rate was 51.1% in AS patients and 32.7% in DISH patients. The overall mortality within 3 months after injury was 17.7% in AS and 20.0% in DISH. This review suggests that the clinical outcome of patients with fractures in previously ankylosed spines, due to AS or DISH, is considerably worse compared to the general trauma population. Considering the potential increase in prevalence of DISH cases, this condition may render a new challenge for physicians treating spinal injuries. PMID:18791749

Verlaan, J. J.; Oner, F. C.

2008-01-01

243

Increased Soluble CD4 in Serum of Rheumatoid Arthritis Patients Is Generated by Matrix Metalloproteinase (MMP)-Like Proteinases  

PubMed Central

Higher soluble CD4 (sCD4) levels in serum have been detected in patients of infectious and chronic inflammatory diseases. However, how and why sCD4 is produced remains poorly understood. We establish sensitive ELISA and WB assays for sCD4 detection in conditioned medium of in vitro cell culture system and serum of chronic inflammatory patients. Serum samples from patients with systemic lupus erythematosus (SLE) (n?=?79), rheumatoid arthritis (RA) (n?=?59), ankylosing spondylitis (AS) (n?=?25), gout (n?=?31), and normal controls (n?=?99) were analyzed using ELISA for sCD4 detection. Results from each assay were analyzed by the Kruskal-Wallis test. Dunn’s multiple comparison post-test was then applied between groups. We confirm that cells expressing exogenous CD4 produce sCD4 in a constitutive and PMA-induced manner. Importantly, sCD4 production in a heterologous expression system is inhibited by GM6001 and TAPI-0, suggesting receptor shedding by matrix metalloproteinase (MMP)-like proteinases. Moreover, similar findings are recapitulated in human primary CD4+ T cells. Finally, we show that serum sCD4 levels are increased in patients of chronic inflammatory diseases including RA and SLE, but not in those with gout. Intriguingly, sCD4 levels in RA patients are correlated positively with the disease activities and higher sCD4 levels seem to associate with poor prognosis. Taken together, we conclude that CD4 is shed from cell surface by a MMP-like sheddase and sCD4 level is closely related with the inflammatory condition in certain chronic diseases. Hence, sCD4 might be considered an important parameter for RA disease progression with potential diagnostic importance. PMID:23700441

Chiang, Nien-Yi; Chou, Yeh-Pin; Wu, Yeong-Jian Jan; Luo, Shue-Fen; Kuo, Chang-Fu; Lin, Ko-Ming; Lin, Hsi-Hsien

2013-01-01

244

Psoriatic arthritis  

SciTech Connect

This book contains 11 chapters. Some of the titles are: The history and epidemiologic definition of psoriatic arthritis as a distinct entity; Psoriatic arthritis: Further epidemiologic and genetic considerations; The radiologic features of psoriatic arthritis; and Laboratory findings and pathology of psoriatic arthritis.

Gerber, L.H.; Espinoza, L.R.

1985-01-01

245

Thoughts and perceptions of ankylosing spondylitis patients with regard to TNF inhibitors.  

PubMed

The risk of infections and malignancies is the major area of concern with anti-tumor necrosis factor (anti-TNF) agents. The aim of this study was to investigate patients' views about their treatments and the factors that influence patients' treatment decisions concerning the use of anti-TNF-? drugs. This descriptive study was conducted in a single rheumatology unit. Patients using anti-TNF-? drugs for at least 3 months were included. Patients' thoughts and perceptions about their treatment were evaluated using a questionnaire. A total of 101 (94.1% male) patients were recruited. The patients described their feelings as hopeful, worried, happy, scared, desperate, and hopeless, with the order decreasing beginning with the first. Hope for healing and an expectation of increased quality of life were the most significant determinants for acceptance of treatment. After the drug information was given, patients described their feelings as follows: increase in anxiety, psychologically wearisome, and worrying about their condition worsening in the future. After anti-TNF-? treatment, patients described their experience as follows: "the most effective medicine that I have ever used," "it saved my life," "control procedures that were carried out before the treatment and once every 3 months after the treatment were essential," "I feel myself safe with these controls," and "I advised other people." This study, to our knowledge, is the first to evaluate the attitudes of patients concerning anti-TNF-? drugs from the stage of informed consent to the post-experience stage. We found that standard consent forms caused an increase in the level of anxiety among new users of anti-TNF-? drugs, although the aim was the exact opposite. The reasons for acceptance were the hope for healing, reliance on physicians, and advice of other patients. Most patients accepted follow-up control procedures, which aimed to diagnose adverse effects early. PMID:24374358

Cinar, Fatma Ilknur; Cinar, Muhammet; Yilmaz, Sedat; Simsek, Ismail; Erdem, Hakan; Pay, Salih

2014-07-01

246

Early-Onset Ankylosing Spondylitis Is Associated With a Functional MICA Polymorphism  

Microsoft Academic Search

Major histocompatibility complex (MHC) class I chain–related A (MICA) molecules deliver activating signals through the NKG2D receptor expressed on the surface of natural killer (NK), CD8?? and ?? T cells, and the MICA gene is polymorphic. The recently described MICA amino acid substitution at position 129 (MICA-129) seems to affect its binding to NKG2D. We investigated whether this dimorphism (MICA-129met

Habiba Amroun; Hachemi Djoudi; Marc Busson; Rachida Allat; Shérif Mohsen El Sherbini; Ivan Sloma; Rajendranath Ramasawmy; Manuel Brun; Nicolas Dulphy; Rajagopal Krishnamoorthy; Antoine Toubert; Dominique Charron; Mohamed Chérif Abbadi; Ryad Tamouza

2005-01-01

247

Comparison of two ELISA versions for infliximab serum levels in patients diagnosed with ankylosing spondylitis.  

PubMed

There are various immunosorbent assays which can be used to determine infliximab (IFX) levels. Results vary between assays complicating reliability in everyday clinical practice. The aim of this study was to determine whether quantitative or qualitative assay data prove more accurate in the assessment of infliximab levels in AS patients. We analyzed 40 serum samples, taken prior to infusion, from AS patients who had been undergoing IFX therapy as a first-line of biological treatment for more than a year. IFX levels and IFX-anti-drug antibodies (ADA) were measured using two different ELISA assays [Promonitor(®) IFX R1 and R2 (version 1), Promonitor(®) IFX and anti-IFX (version 2) (Progenika Biopharma, Spain)] strictly following the manufacturer's guidelines. Cohen's unweighted kappa and the intraclass correlation coefficient determined qualitative and quantitative agreement for serum levels in version 1 and version 2. Bland-Altman plots were drawn to compare both assays. The comparison of data measuring IFX levels for version 1 and version 2 resulted in questionable quantitative agreement (ICC 0.659; 95 % CI 0.317-0.830) and moderate qualitative agreement (? 0.607; 95 % CI 0.387-0.879) owing to systematically higher values in version 2 than version 1. Version 2 consistently detected higher levels of infliximab, particularly when analyzed in a quantitative context. Further research is needed to synchronize cutoff levels between essays and diseases so therapeutic drug ranges can be established. PMID:25410014

Hernández-Flórez, Diana; Valor, Lara; de la Torre, Inmaculada; Nieto, Juan Carlos; Martínez-Estupiñán, Lina; González, Carlos; López-Longo, Francisco Javier; Monteagudo, Indalecio; Garrido, Jesús; Naredo, Esperanza; Carreño, Luis

2014-11-20

248

Infectious Arthritis  

MedlinePLUS

... bones meet, such as your elbow or knee. Infectious arthritis is an infection in the joint. The ... from another part of the body. Symptoms of infectious arthritis include Intense pain in the joint Joint ...

249

Psoriatic Arthritis  

MedlinePLUS

... of patients who have a skin rash called psoriasis. This particular arthritis can affect any joint in ... Psoriatic arthritis can occur in people without skin psoriasis, particularly in those who have relatives with psoriasis. ...

250

Cauda Equina Syndrome Associated with Dural Ectasia in Chronic Anlylosing Spondylitis  

PubMed Central

Cauda equina syndrome (CES) associated with dural ectasia is a rare neurologic complication in patients with longstanding ankylosing spondylitis (AS). We report a 68-year-old male with a 30-year history of AS who presented a typical symptom and signs of progressive CES, urinary incontinence and neuropathic pain of the lumbosacral radiculopathy. Computed tomography (CT) and magnetic resonance imaging (MRI) findings showed the unique appearances of dural ectasia, multiple dural diverticula, erosion of posterior element of the lumbar spine, tethering of the conus medullaris and adhesion of the lumbosacral nerve roots to the posterior aspect of the dural ectasia. Considering the progressive worsening of the clinical signs, detethering of the conus medullaris through resection of the filum terminale was performed through a limited laminectomy. However, the urinary incontinence did not improve and there was a partial relief of the neuropathic leg pain only. The possible pathogenetic mechanism of CES-AS and the dural ectasia in this patient with longstanding AS are discussed with a literature review. PMID:25628815

Ha, Sang-woo

2014-01-01

251

Juvenile Idiopathic Arthritis  

MedlinePLUS

... Frequently Asked Questions Español Condiciones Chinese Conditions Juvenile Idiopathic Arthritis En Español Read in Chinese Is Juvenile Idiopathic Arthritis the same as Juvenile Rheumatoid Arthritis? Yes, ...

252

Caeruloplasmin, prealbumin and 6H 2 -macroglobulin as potential 0 indices of disease activity in different arthritides  

Microsoft Academic Search

Summary Caeruloplasmin (Cp), prealbumin and ?2-macroglobulin (?2-M) concentrations in serum were compared in rheumatoid arthritis (RA), osteoarthrosis, ankylosing spondylitis, psoriatic arthritis, Reiter's syndrome, Behçet's syndrome, SLE and normal controls. Cp was significantly elevated (p2-macroglobulin occurred in Reiter's syndrome. However, these differences were generally still within the normal range, and hence these proteins are unlikely to offer alternative indices of disease

K. E. Surrall; H. A. Bird; J. S. Dixon

1987-01-01

253

Comparisons of affinities, avidities, and complement activation of adalimumab, infliximab, and etanercept in binding to soluble and membrane tumor necrosis factor  

Microsoft Academic Search

The TNF antagonists adalimumab, infliximab, and etanercept are effective treatments for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and psoriasis, but only adalimumab and infliximab have been found to be efficacious in Crohn's disease. The present studies evaluated the TNF-binding and complement-activating properties of adalimumab, infliximab, and etanercept to determine whether these properties may explain differences in their clinical efficacy profiles.

Zehra Kaymakcalan; Paul Sakorafas; Sahana Bose; Susanne Scesney; Limin Xiong; Denise Karaoglu Hanzatian; Jochen Salfeld; Eric H. Sasso

2009-01-01

254

Biological and clinical effects of anti-TNF? treatment  

Microsoft Academic Search

Tumor necrosis factor alpha (TNF?) is implicated in the pathogenesis of many chronic inflammatory diseases such as rheumatoid arthritis (RA), psoriasis and psoriatic arthritis (PsA), ankylosing spondylitis (AS), Crohn's disease, ulcerative colitis and uveitis. The availability of new pharmacological agents (infliximab, etanercept, adalimumab), able to selectively block the TNF?, has recently offered new opportunity for the treatment of these diseases.

G. Valesini; C. Iannuccelli; E. Marocchi; L. Pascoli; V. Scalzi; M. Di Franco

2007-01-01

255

QuantiFERON-TB Gold In-Tube Assay for Screening Arthritis Patients for Latent Tuberculosis Infection before Starting Anti-Tumor Necrosis Factor Treatment  

PubMed Central

Background Patients undergoing anti-tumor necrosis factor (TNF) treatment are at an increased risk of reactivating a latent tuberculosis infection (LTBI). This study evaluated the effectiveness of the QuantiFERON-TB Gold In-Tube (QFT) assay for diagnosing LTBI in arthritis patients undergoing anti-TNF treatment. Methods We enrolled 342 consecutive patients from August 2007 to October 2013: 176 (51.5%) patients with ankylosing spondylitis and 166 (48.5%) with rheumatoid arthritis. Screening tests included tuberculin skin test (TST) and QFT assay. Positive QFT results, regardless of TST results, were considered an indicator for LTBI treatment. Results Bacillus Calmette-Guérin scars were found in 236 (69.0%) patients. Of 342 patients, TST and QFT were positive in 122 (35.7%) and 103 (30.1%) patients, respectively, and discordant in 101 (29.5%) patients. During a median follow-up duration of 41.7 months, five patients (1.5%) developed TB in a median of 20.8 months after initiation of anti-TNF treatment (428/100,000 person-years). TB did not occur in 62 TST+/QFT+ patients who received LTBI treatment. Of 41 TST?/QFT+ patients who received LTBI treatment, one (2.4%) developed TB 20.5 months after starting anti-TNF treatment (705/100,000 person-years). Of 60 TST+/QFT? patients who did not receive LTBI treatment, two (3.3%) developed TB 20.8 and 22.0 months after starting anti-TNF treatment (871/100,000 person-years). Of 179 TST?/QFT? patients, two (1.1%) developed TB 7.2 and 22.7 months, respectively, after initiating anti-TNF treatment (341/100,000 person-years). TB incidence rate during the follow-up period did not differ among TST?/QFT+, TST+/QFT?, and TST?/QFT? patients (P = 0.661). Conclusion QFT might be used instead of TST for diagnosing LTBI in patients before starting anti-TNF therapy in countries, such as Korea, where the TB prevalence is intermediate and the BCG vaccination is mandatory at birth. In the absence of a true gold standard test for LTBI, however, there is still a risk of TB development during anti-TNF treatment. PMID:25746854

Jeong, Byeong-Ho; Hwang, Ji-Won; Lee, Jaejoon; Cha, Hoon-Suk; Koh, Eun-Mi; Kang, Eun-Suk; Koh, Won-Jung

2015-01-01

256

[Psoriatic arthritis].  

PubMed

Psoriatic arthritis is a comorbidity frequently associated to psoriasis. A major problem is the absence of diagnostic criteria and the lack of consensus on the classification criteria of this arthritis. The clinical presentation is extremely variable, since axial, peripheric, and enthesopathic lesions can exist alone, successively or in association in a same patient. Peripheric lesions can be mono- or more often oligo- or polyarthritis. Onychopathies and dactylitis are frequently associated to arthritis. The dermatologist must recognize psoriatic arthritis at an early stage, in order to avoid the development of destructive lesions. The treatment includes symptomatic treatments (antalgics, non steroidal anti-inflammatory agents, corticosteroids), long-term treatments (sulfasalazine, methotrexate, azathioprine, ciclosporine, leflunomide), and TNF-alpha-inhibitors. Therapeutic strategies must be adapted to the clinical presentation. PMID:18466795

Claudepierre, P; Bagot, M

2008-02-01

257

Reactive Arthritis  

MedlinePLUS

... meats that are not stored at the proper temperature. Doctors do not know exactly why some people ... several different types of doctors because reactive arthritis affects different parts of the body. However, it may ...

258

Psoriatic Arthritis  

MedlinePLUS

Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin with silvery ... other parts of your body. Some people with psoriasis have psoriatic arthritis. It causes pain, stiffness, and ...

259

Infectious Arthritis  

MedlinePLUS

... upper respiratory infections, human immunodeficiency virus (HIV), hepatitis, parvovirus, rubella and mumps. Many joints can be affected ... more common viral causes of arthritis, such as parvovirus, hepatitis B, hepatitis C and HIV, can usually ...

260

Viral arthritis  

MedlinePLUS

... It may also occur after immunization with the rubella vaccine. This is a common form of childhood joint ... are infected with these viruses or receive the rubella vaccine, only a few people develop arthritis. No risk ...

261

Enteropathic Arthritis  

MedlinePLUS

... the two best-known types of which are ulcerative colitis and Crohn's disease. About one in five people with Crohn's or ulcerative colitis will develop enteropathic arthritis. The most common areas ...

262

Septic arthritis  

MedlinePLUS

... are caused by bacteria such as Staphylococcus or Streptococcus . Chronic septic arthritis (which is less common) is ... than adults to be infected with Group B streptococcus or Haemophilus influenza , if they have not been ...

263

Psoriatic Arthritis  

Microsoft Academic Search

\\u000a Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis (1). Psoriasis is an inflammatory skin condition\\u000a that presents with a red scaly rash often on the extensor surfaces but may also affect the scalp and flexural areas as well\\u000a as palms and soles (2). It commonly affects the nails with either pits or onycholysis. Up to one third of

Dafna D. Gladman

264

Bacterial arthritis.  

PubMed

In this review of the 1990 septic arthritis literature, we revisit synovial fluid leukocytosis, examine the utility of synovial fluid glucose and protein measurements, and look at the levels of two cytokines, tumor necrosis factor and interleukin-1, in infected joint fluids. We see the many faces of gonococcal arthritis and the ravages of septic arthritis when the host has rheumatoid arthritis. Should we recommend antibiotic prophylaxis for the rheumatoid patient with a prosthetic joint who is undergoing a procedure that leads to transient bacteremia? What are some of the salient features of septic arthritis when it involves the sternoclavicular or sacroiliac joints? We also look at some unusual microorganisms, eg, group C Streptococcus, Streptococcus viridans, Listeria monocytogenes, Pseudomonas cepacia, Pseudomonas maltophilia, and Neisseria sicca. In patients with acquired immunodeficiency syndrome, we encounter reports of septic arthritis, osteomyelitis, and spinal epidural abscess caused by opportunistic microorganisms. Two unusual sites of infection include the C1-2 lateral facet joint and subacromial bursa without involvement of the glenohumeral joint. Finally, we examine how to drain a septic knee: the orthopedic point of view. PMID:1911055

Ho, G

1991-08-01

265

HLA-DRB1 alleles encoding the shared epitope associated with rheumatoid arthritis confer additional susceptibility to seronegative spondyloarthropathies in HLA-B27-positive Japanese individuals  

Microsoft Academic Search

Although the crucial role of HLA-B27 for the development of seronegative spondy-loarthropathies (SpA) has been established,\\u000a family and twin studies indicated the presence of additional genetic factors. To determine whether HLA-DRB1 gene acts as an\\u000a additional susceptibility factor for SpA in HLA-B27-positive Japanese individuals, complete HLA-DRB1 allele typing of 23 HLA-B27-positive\\u000a patients (21 with ankylosing spondylitis, one with Reiter’s syndrome,

Tae Komata; Naoyuki Tsuchiya; Yoko Hatta; Masaki Matsushita; Atsuko Ogawa; Hiroshi Mitsui; Katsushi Tokunaga

1999-01-01

266

Headache and Arthritis  

MedlinePLUS

... 10-26 07:12 Headaches and arthritis are common problems and, therefore, create considerable interest in the possible role of arthritis in causing headaches. Several major forms of arthritis exist. Two of the most common types are rheumatoid arthritis and osteoarthritis. Rheumatoid arthritis ...

267

Thoracic spondylitis mimicking idiopathic scoliosis: a case report.  

PubMed

We report the case of a 12-year-old girl with thoracic spondylitis, who initially presented with a painless scoliotic deformity and was therefore misdiagnosed as having idiopathic scoliosis. Six weeks after initiation of brace therapy, increasing back pain necessitated admission. X-Ray, bone scintigraphy and magnetic resonance imaging then revealed a pathologic process in D8. To rule out a tumorous lesion, open biopsy was performed and led to the diagnosis of acute spondylitis. Treatment with oral antibiotics and bed rest led to a complete resolution of the scoliotic deformity, which clearly demonstrated that it was secondary to spondylitis. After 2 years, the girl is persistently well and free of pain. This unusual presentation of spondylitis delayed correct diagnosis and therefore specific treatment in the case of this 12-year-old girl. PMID:11360774

Duchow, J; Schmitt, E; Graf, N

2001-04-01

268

Reactive arthritis.  

PubMed

Reactive arthritis (ReA) is an immune-mediated seronegative arthritis that belongs to the group of spondyloarthropathies and develops after a gastrointestinal or genitourinary system infection. The condition is considered to be characterized by a triad of symptoms (conjunctivitis, arthritis and urethritis) although a constellation of other manifestations may also be present. ReA is characterized by psoriasiform dermatological manifestations that may resemble those of pustular psoriasis and, similar to guttate psoriasis, is a post-infectious entity. Also, the articular manifestations of the disorder are similar to those of psoriatic arthritis and both conditions show a correlation with HLA-B27. These facts have led several authors to suggest that there is a connection between ReA and psoriasis, listing ReA among the disorders related to psoriasis. However, the pathogenetic mechanism behind the condition is complex and poorly understood. Bacterial antigenicity, the type of host response (i.e. Th1/Th2 imbalance) and various genetic factors (i.e. HLA-B27 etc.) play an important role in the development of the disorder. It is unknown whether all the aforementioned factors are part of a mechanism that could be similar to, or share basic aspects with known psoriasis pathogenesis mechanisms. PMID:25199646

Stavropoulos, P G; Soura, E; Kanelleas, A; Katsambas, A; Antoniou, C

2015-03-01

269

Juvenile Idiopathic Arthritis  

MedlinePLUS

... damage. Psoriatic arthritis is when a person has psoriasis and arthritis together. Enthesitis-related arthritis usually affects ... effective exercise program to do at home. Proper nutrition can improve anyone's overall health. A dietitian can ...

270

Forms of Arthritis  

MedlinePLUS

... stiffness, inflammation, swelling and, sometimes, destruction of joints. Gout — a form of arthritis that occurs when uric ... the joints. Some 2.1 million Americans have gout. Lupus — a form of arthritis, like rheumatoid arthritis, ...

271

Calcium pyrophosphate arthritis (Pseudogout)  

MedlinePLUS

Calcium pyrophosphate dihydrate deposition disease; CPPD disease; Acute CPPD arthritis; Pseudogout ... Calcium pyrophosphate arthritis is caused by the collection of salt called calcium pyrophosphate dihydrate (CPPD). The buildup ...

272

Alopecia Areata Universalis Elicited during Treatment with Adalimumab  

Microsoft Academic Search

Adalimumab is a fully humanized recombinant anti-tumour-necrosis-factor (TNF-?) monoclonal antibody which has been approved for rheumatoid arthritis, active ankylosing spondylitis, psoriatic arthritis and Crohn’s disease. We report a case of alopecia areata (AA) universalis occurring 6 months after administration of adalimumab monotherapy in a patient with a long-standing history of psoriatic arthritis and psoriasis. The diagnosis was confirmed by a

Nedzmidin Pelivani; Akmal S. Hassan; Lasse R. Braathen; Robert E. Hunger; Nikhil Yawalkar

2008-01-01

273

Rheumatoid Arthritis  

NSDL National Science Digital Library

This patient education program describes how rheumatoid arthritis develops, the causes, symptoms, diagnosis, and treatments. It also summarizes what patients can do to help manage their disease. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

Patient Education Institute

274

Expanding the armamentarium for the spondyloarthropathies  

Microsoft Academic Search

Ankylosing spondylitis (AS) is a member of the family of spondyloarthropathies, which are inflammatory arthritides largely involving the axial skeleton and commonly accompanied by peripheral arthritis. Genetic factors, particularly the presence of HLA-B27, are major contributors to the susceptibility for AS. Despite some therapeutic advances, the treatment options for patients with AS and related disorders have been limited. Several lines

Paul M Peloso; Jürgen Braun

2004-01-01

275

Genetics of rheumatic disease  

Microsoft Academic Search

Many of the chronic inflammatory and degenerative disorders that present to clinical rheumatologists have a complex genetic aetiology. Over the past decade a dramatic improvement in technology and methodology has accelerated the pace of gene discovery in complex disorders in an exponential fashion. In this review, we focus on rheumatoid arthritis, systemic lupus erythematosus and ankylosing spondylitis and describe some

Alex Clarke; Timothy J Vyse

2009-01-01

276

Update on treatment of psoriatic arthritis.  

PubMed

Some of this past year's key papers or abstracts on psoriatic arthritis (PsA) assessment and treatment are reviewed in this paper. Treatment begins with identification of the PsA patient. Several screening questionnaires have been developed to be used in dermatology and primary care settings to identify which patients with psoriasis have developed PsA as opposed to other common musculoskeletal problems, such as osteoarthritis and fibromyalgia, thus increasing case-finding and targeting referral. PsA can present in a heterogeneous manner, involving arthritis, enthesitis, dactylitis, spondylitis, and skin and nail disease. Measures of these individual domains have been developed for use in clinical trials and improved PsA-specific composite measures of these domains are being evaluated as well. A quantitative therapy target, Minimal Disease Activity criteria, has been developed by the GRAPPA group. Treatment recommendations have been published by EULAR and GRAPPA. Obesity is a risk factor for the development of PsA and may adversely influence treatment outcomes. Although pharmacologic treatment often begins with methotrexate, a recent study does not provide clear evidence of its effectiveness. Anti-TNF therapies remain the gold standard of effectiveness. New therapeutic options are potentially emerging including ustekinumab, abatacept, several IL-17 inhibitors, apremilast, JAK inhibitors, and possibly IL-6 inhibitors. PMID:23259623

Mease, Philip

2012-01-01

277

Updated guidelines for the management of axial disease in psoriatic arthritis.  

PubMed

Axial involvement in patients with psoriatic arthritis (PsA) remains common and can be defined in terms of spinal disease alone or in combination with peripheral manifestations. Diagnosis is based upon inflammatory spinal symptoms or the presence of radiological sacroiliitis and other radiographic signs of spondylitis, or by criteria for axial spondyloarthritis (SpA) defined by ASAS (Assessment of SpondyloArthritis International Society). Although recent data are scarce for efficacy of traditional therapies for axial disease (e.g., nonsteroidal antiinflammatory drugs, methotrexate, etc.), limited data are available for targeted biologics and novel agents. We identify and evaluate the efficacy of therapeutic interventions for treatment of axial disease in PsA. This review is an update of the axial PsA section of the treatment recommendations project by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). PMID:25362712

Nash, Peter; Lubrano, Ennio; Cauli, Alberto; Taylor, William J; Olivieri, Ignazio; Gladman, Dafna D

2014-11-01

278

[Haemophilus aphrophilus as a rare cause of bacterial spondylitis].  

PubMed

We report a case of lumbar spondylitis due to Haemophilus aphrophilus in a 36-year-old man with monoclonal gammopathy of undetermined significance. Haemophilus aphrophilus is a gram-negative capnophilic, slow growing coccobacillus, a component of the normal human flora of the oropharynx. This organism is considered an uncommon human pathogen and has been reported in the literature in only 10 cases of bacterial spondylitis. We review the bacteriological and clinical findings, predisposing conditions and the previously reported infections caused by Haemophilus aphrophilus. The patient responded well to antibiotic treatment with ciprofloxacin. PMID:8701249

Margelli, D; Streit, E

1996-02-24

279

Spondyloarthritides: evolving therapies  

PubMed Central

TNF blockade therapy has substantially advanced the treatment of peripheral spondyloarthritides but revolutionised the treatment of severe ankylosing spondylitis. The capacity of biologic treatment to improve dramatically symptoms and quality of life in patients with spinal disease is undoubted, although important questions remain. Notable amongst these are concerns about skeletal disease modification and the true balance between costs and effectiveness. Guidelines for the biologic treatment of ankylosing spondylitis and psoriatic arthritis have been introduced in North America and Europe with considerable consensus. However, the absence of clear criteria for the diagnosis of early disease leaves the issue of biologic treatment of ankylosing spondylitis at the pre-radiographic stage unresolved. Newer biologic agents are entering the field, although superiority over TNF blockers will be difficult to demonstrate. PMID:21205283

2010-01-01

280

Multisegmental spondylitis due to Tropheryma whipplei: Case report  

Microsoft Academic Search

We report a patient who presented with inflammatory back pain due to multisegmental spondylitis. Following a vertebral biopsy which failed to detect an infectious organism, the patient was treated with etanercept, a tumor necrosis factor (TNF)-? inhibitor, for suspected undifferentiated spondyloarthritis. The back pain worsened and the spondylitic lesions increased. Only in a vertebral rebiopsy with polymerase chain reaction (PCR)

David Spoerl; Diego Bär; Julian Cooper; Thomas Vogt; Alan Tyndall; Ulrich A Walker

2009-01-01

281

Quick Stats on Arthritis  

MedlinePLUS

... compared to Whites. Read more . Top of Page Cost In 2003, the total cost attributed to arthritis and other rheumatic conditions in ... in earnings losses). Read more . Medical expenditures (direct costs) for arthritis and other rheumatic conditions in 2003 ...

282

Sex and Arthritis  

MedlinePLUS

... Pain Pregnancy and Rheumatic Disease Sex and Arthritis Sex and Arthritis PRINT Download PDF Description Sexuality is ... sensation Erectile dysfunction or impotence Begin overcoming barriers Sex is not simply about reaching rapid orgasm with ...

283

Arthritis: Frequently Asked Questions  

MedlinePLUS

... Chronic Disease Self-Management Program Evaluation of First Step to Active Health Choosing Arthritis-Appropriate Physical Activity Johnston County Osteoarthritis Project Lupus Registries Algorithm to Identify Clinically Significant Arthritis ...

284

What Is Juvenile Arthritis?  

MedlinePLUS

... They also try to prevent, identify, and treat problems that result from the arthritis. Most children with arthritis need a blend of treatments – some treatments include drugs, and others do not. How Can You Help Your Child Live Well With Juvenile Arthritis? Juvenile ...

285

Manifestation of palmoplantar pustulosis during or after infliximab therapy for plaque-type psoriasis: report on five cases  

Microsoft Academic Search

Infliximab is a monoclonal antibody directed against TNF-?. It has been approved for use in rheumatoid arthritis, ankylosing\\u000a spondylitis, inflammatory bowel disease, psoriatic arthritis and plaque-type psoriasis. In case reports, positive effects\\u000a on pustular variants of psoriasis have also been reported. However, paradoxically, manifestation of pustular psoriasis and\\u000a plaque-type psoriasis has been reported in patients treated with TNF antagonists including

Rotraut Mössner; Diamant Thaci; Johannes Mohr; Sylvie Pätzold; Hans Peter Bertsch; Ullrich Krüger; Kristian Reich

2008-01-01

286

Manifestation of palmoplantar pustulosis during or after inXiximab therapy for plaque-type psoriasis: report on Wve cases  

Microsoft Academic Search

InXiximab is a monoclonal antibody directed against TNF-. It has been approved for use in rheumatoid arthritis, ankylosing spondylitis, inXammatory bowel dis- ease, psoriatic arthritis and plaque-type psoriasis. In case reports, positive eVects on pustular variants of psoriasis have also been reported. However, paradoxically, manifes- tation of pustular psoriasis and plaque-type psoriasis has been reported in patients treated with TNF

Rotraut Mössner; Diamant Thaci; Johannes Mohr; Sylvie Pätzold; Hans Peter Bertsch; Ullrich Krüger; Kristian Reich

287

Advances in rheumatology: new targeted therapeutics  

Microsoft Academic Search

Treatment of inflammatory arthritides - including rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis -\\u000a has seen much progress in recent years, partially due to increased understanding of the pathogenesis of these diseases at\\u000a the cellular and molecular levels. These conditions share some common mechanisms. Biologic therapies have provided a clear\\u000a advance in the treatment of rheumatological conditions. Currently available TNF-targeting

Paul P Tak; Joachim R Kalden

2011-01-01

288

Adjuvant Posterior Stabilization in the Management of Tuberculous Spondylitis of the Dorsal and Lumbar Spine  

Microsoft Academic Search

Objective Posterior instrumentation and stabilization allowing early mobilization, shortened hospital stay and maintenance of correction after debridement and bone grafting for tuberculous spondylitis through an anterior approach. Indications Tuberculous spondylitis requiring anterior drainage, debridement and decompression, as well as interbody fusion. Significant bone loss of vertebral body. Kyphosis > 25° Concomitant posterior column disease. Contraindications Poor general health precluding such

Ravi Venkatesan; P. Narendra Babu; Alfred J. Daniel; Vernon N. Lee; Sunil Agarwal; David Sadhu; Gabriel D. Sundararaj

2001-01-01

289

Psoriatic Arthritis: Pharmacotherapy Update  

Microsoft Academic Search

Psoriatic arthritis is a systemic disorder that causes chronic pain, altered physical appearance, and loss of function. The\\u000a clinical features are diverse, but the core manifestations are psoriasis, peripheral arthritis, axial disease, enthesitis,\\u000a and dactylitis. Our understanding about the psoriatic arthritis disease state, assessment, and treatment has advanced thanks\\u000a to significant collaborative efforts by rheumatologists and dermatologists in the development

Philip J. Mease

2010-01-01

290

Arthritis of the Hand  

MedlinePLUS

... to wear away. It appears in a predictable pattern in certain joints. Rheumatoid arthritis is a chronic disease that can a? ect many parts of your body. It causes the joint lining (synovium) to swell, which causes pain and sti? ness in the joint. Rheumatoid arthritis most o ...

291

What Is Psoriatic Arthritis?  

MedlinePLUS

... with Psoriasis Genes & Psoriasis Immune System & Psoriasis Women & Psoriasis Diet & Psoriasis Treatments Available Biologics New Oral Treatments Systemics ... Topicals Complementary & Alternative Upcoming Drugs in Development Women & ... & Psoriasis About Psoriatic Arthritis Symptoms & Diagnosis Types Related ...

292

Arthritis and Rheumatic Diseases  

MedlinePLUS

... National Institutes of Health (NIH), leads the Federal medical research effort in arthritis and rheumatic diseases. The NIAMS ... The National Institutes of Health (NIH)—The Nation's Medical Research Agency—includes 27 Institutes and Centers and is ...

293

Reactive Arthritis Treatment  

MedlinePLUS

... treatment (more than three months) of severe, persistent chlamydia-induced reactive arthritis with lymecycline provided some improvement ... a high prevalence of both HLA-B27 and chlamydia infections." Click here to learn more about the ...

294

Arthritis in Children  

MedlinePLUS

... challenging. However, with care from a team of rheumatology professionals, most children with arthritis live full and ... JIA is used most by specialists in pediatric rheumatology, JRA is commonly used in the United States. ...

295

Epigenetics in Rheumatoid Arthritis  

Microsoft Academic Search

Epigenetics is a steadily growing research area. In many human diseases, especially in cancers, but also in autoimmune diseases,\\u000a epigenetic aberrations have been found. Rheumatoid arthritis is an autoimmune disease characterized by chronic inflammation\\u000a and destruction of synovial joints. Even though the etiology is not yet fully understood, rheumatoid arthritis is generally\\u000a considered to be caused by a combination of

Michelle Trenkmann; Matthias Brock; Caroline Ospelt; Steffen Gay

2010-01-01

296

Juvenile Idiopathic Arthritis  

Microsoft Academic Search

\\u000a The term juvenile idiopathic arthritis (JIA) describes a heterogeneous group of several disease subtypes characterized by\\u000a arthritis beginning before the age of 16 years and where symptoms persist for more than 6 weeks. All subtypes of JIA are of\\u000a unknown cause. Although the pathogenesis for each subtype is likely to be different, JIA is generally regarded to be an autoimmune

Günther E. Dannecker; Martin N. Arbogast; Carol B. Lindsley; H. Schacherl; H. J. Girschick; C. Huemer; A. Heiligenhaus; U. Neudorf

297

Genetics Home Reference: Rheumatoid arthritis  

MedlinePLUS

... rheumatoid arthritis affecting other parts of the body. Variations in dozens of genes have been studied as ... significant genetic risk factors for rheumatoid arthritis are variations in human leukocyte antigen (HLA) genes, especially the ...

298

Interstitial granulomatous dermatitis with arthritis.  

PubMed

Interstitial granulomatous dermatitis with arthritis is an uncommon disorder. In its original description, the presence of linear inflammatory indurations on the lateral aspects of the trunk (the rope sign) in association with arthritis were considered the pathognomonic clinical features. Later cases presenting with plaques and papules have been reported. Herein we describe a case of interstitial granulomatous dermatitis with arthritis without the rope sign. The present case supports the idea that interstitial granulomatous dermatitis with arthritis may have variable clinical appearances. PMID:15257555

Altaykan, Asli; Erkin, Gül; Boztepe, Gonca; Gököz, Aytaç

2004-07-01

299

A Case of Postoperative Tuberculous Spondylitis with a Bizarre Course  

PubMed Central

Postoperative infections following spine surgery are usually attributable to bacterial organisms. Staphylococcus aureus is known to be the most common single pathogen leading to this infection, and the number of infections caused by methicillin-resistant Staphylococcus aureus is increasing. However, there is a paucity of literature addressing postoperative infection with Mycobacterium tuberculosis. We encountered a case of tuberculous spondylitis after spine surgery. A man had fever with low back pain three weeks after posterior interbody fusion with instrumentation for a herniated intervertebral disc at the L4-L5 level. He had been treated with antibiotics for an extended period of time under the impression that he had a bacterial infection, but his symptoms and laboratory data had not improved. Polymerase chain reaction for Mycobacterium tuberculosis turned out to be positive. The patient's symptoms finally improved when he was treated with antituberculosis medication. PMID:19884999

Jeon, Do Whan; Jeung, Ul Oh; Lee, Seuk Jae; Lee, Choon-Ki; Kim, Min-Seok; Nam, Woo-Dong

2009-01-01

300

Response to one infusion predicts subsequent improvement as well as the rate of relapse of ankylosing spondylitis infused with three pulses of infliximab  

Microsoft Academic Search

The objective of this study was to evaluate if there are early clinical parameters in AS patients treated with three standard\\u000a infusions of infliximab, which would predict whether a patient will derive a significant improvement at the tenth week, or\\u000a whether there will be a lengthy clinical response after discontinuing the infusions. Sixty three AS patients were given three\\u000a infusions

Feng Huang; Jian Zhu; Liyun Zhang; Jianglin Zhang; Fengchun Zhang; David Yu

2007-01-01

301

Estimates of radiation doses in tissue and organs and risk of excess cancer in the single-course radiotherapy patients treated for ankylosing spondylitis in England and Wales  

SciTech Connect

The estimates of absorbed doses of x rays and excess risk of cancer in bone marrow and heavily irradiated sites are extremely crude and are based on very limited data and on a number of assumptions. Some of these assumptions may later prove to be incorrect, but it is probable that they are correct to within a factor of 2. The excess cancer risk estimates calculated compare well with the most reliable epidemiological surveys thus far studied. This is particularly important for cancers of heavily irradiated sites with long latent periods. The mean followup period for the patients was 16.2 y, and an increase in cancers of heavily irradiated sites may appear in these patients in the 1970s in tissues and organs with long latent periods for the induction of cancer. The accuracy of these estimates is severely limited by the inadequacy of information on doses absorbed by the tissues at risk in the irradiated patients. The information on absorbed dose is essential for an accurate assessment of dose-cancer incidence analysis. Furthermore, in this valuable series of irradiated patients, the information on radiation dosimetry on the radiotherapy charts is central to any reliable determination of somatic risks of radiation with regard to carcinogenesis in man. The work necessary to obtain these data is under way; only when they are available can more precise estimates of risk of cancer induction by radiation in man be obtained.

Fabrikant, J.I.; Lyman, J.T.

1982-02-01

302

Occupational therapy for rheumatoid arthritis  

Microsoft Academic Search

Background: For persons with rheumatoid arthritis (RA) the physical, personal, familial, social and vocational consequences are extensive. Occupational therapy (OT), with the aim to facilitate task performance and to decrease the consequences of rheumatoid arthritis for daily life activities, is considered to be a cornerstone in the management of rheumatoid arthritis. Till now the efficacy of occupational therapy for patients

E. M. J. Steultjens; J. Dekker; L. M. Bouter; D. J. van Schaardenburg; M. A. H. van Kuyk; C. H. M. van den Ende

2004-01-01

303

Immunocytomorphological study on the pathogenesis of ankylosing spondylarthritis.  

PubMed

The present investigation is based on the cytomorphological, histopathological (HE, VG, PAS-Alcian, Safranin 0, Gömöri), histoenzymological (acid phosphatase, chondroitinsulphatase, peroxidase) and immunological (rheumatoid factor (RF), circulating immune complexes (CIC), anticolagen II antibodies and C reactive protein (CRP) study on ankylosing spondylarthritis (2.5 cases). The synovial fluid (SF) synoviocytogram showed cytosis (6.067/mm3), with polynucleosis (65.19%) and ragocytosis (17.73%) as compared with the hydrarthrosie SF characterized by lymphocytosis (47%). Enzymological findings revealed phosphatasic and myeloperoxidasic activity in the ragocytary polymorphonuclear (PMNs) and mononuclear cells. Histopathologically, the severe forms of AS correlated with villous chronic synovitis, associated to processes of obliterating vascularitis, fibrosclerosis, necrosis and calcification of disintegrated synovial structures. The articular cartilage was severly damaged, while osseous necrobiosis was noted at the osteocartilaginous junction. Histoenzymologically, the chondrocytes and synovial macrophages showed lysosomal and oxidative enzymatic activity. Immunological assessments (72 sera and 25 synovial fluid samples) showed pathological values of circulating immune complexes, anticollagen antibodies and C reactive protein. Correlation of immunocytomorphological findings demonstrates the involvement of immunologic and enzymatic factors in the pathogenesis of AS. PMID:9747114

Ciobanu, A; H?l?l?u, F; Laky, D; Ciobanu, I R; Dinulescu, I; St?nculescu, D

1997-01-01

304

Physical Therapy Management of Select Rheumatic Conditions in Older Adults  

Microsoft Academic Search

\\u000a Rheumatic diseases and their resultant musculoskeletal and cardiopulmonary impairments are primary conditions limiting activity\\u000a and function in older adults. Certain rheumatologic conditions such as polymyalgia rheumatica, degenerative spinal stenosis,\\u000a and osteoporosis occur later in life. Other conditions such as rheumatoid arthritis, osteoarthritis (OA), and ankylosing spondylitis\\u000a manifest at younger ages but their clinical manifestations may exacerbate with advancing age and

Maura Daly Iversen; Madhuri K. Kale

305

Perspectives on autoimmunity  

SciTech Connect

The contents of this book are: HLA and Autoimmunity; Self-Recognition and Symmetry in the Immune System; Immunology of Insulin Dependent Diabetes Mellitus; Multiple Sclerosis; Autoimmunity and Immune Pathological Aspects of Virus Disease; Analyses of the Idiotypes and Ligand Binding Characteristics of Human Monoclonal Autoantibodies to DNA: Do We Understand Better Systemic Lupus Erythematosus. Autoimmunity and Rheumatic Fever; Autoimmune Arthritis Induced by Immunization to Mycobacterial Antigens; and The Interaction Between Genetic Factors and Micro-Organisms in Ankylosing Spondylitis: Facts and Fiction.

Cohen, I.R.

1987-01-01

306

Immunogenicity of Anti-TNF-? Agents in Autoimmune Diseases  

Microsoft Academic Search

Prognosis of several autoimmune diseases, especially rheumatoid arthritis (RA), ankylosing spondylitis, Crohn’s disease (CD),\\u000a and psoriasis, usually refractory to conventional treatment improved considerably with the introduction of tumor necrosis\\u000a factor alpha (TNF-?) antagonistic agents, which is now available (infliximab, etanercept, and adalimumab). However, a portion\\u000a of patients persists with active disease, infusion reactions, and relapses even during current biological therapy.

Nádia Emi Aikawa; Jozélio Freire de Carvalho; Clovis Artur Almeida Silva; Eloísa Bonfá

2010-01-01

307

Inverted 'V' osteotomy excision arthroplasty for bony ankylosed elbows  

PubMed Central

Background Bony ankylosis of elbow is challenging and difficult problem to treat. The options are excision arthroplasty and total elbow replacement. We report our midterm results on nine patients, who underwent inverted 'V' osteotomy excision arthroplasty in our hospital with good functional results. Materials Our case series includes 9 patients (seven males and two females) with the mean age of 34 years (13-56 years). Five patients had trauma, two had pyogenic arthritis, one had tuberculous arthritis, and one had pyogenic arthritis following surgical fixation. Results The average duration of follow up is 65 months (45 months-80 months). The mean Mayo's elbow performance score (MEPS) preoperatively was 48 (35-70). The MEPS at final follow up was 80 (60-95). With no movement at elbow and fixed in various degrees of either flexion or extension preoperatively, the mean preoperative position of elbow was 64°(30°to 100°). The mean post operative range of motion at final follow up was 27°of extension (20-500), 116°of flexion (1100-1300), and the arc of motion was 88°(800-1000). One patient had ulnar nerve neuropraxia and another patient developed median nerve neuropraxia, and both recovered completely in six weeks. No patient had symptomatic instability of the elbow. All patients were asymptomatic except one patient, who had pain mainly on heavy activities. Conclusion We conclude that inverted 'V' osteotomy excision arthroplasty is a viable option in the treatment of bony ankylosis of the elbow in young patients. PMID:22142391

2011-01-01

308

Paradoxical Reaction to Golimumab: Tumor Necrosis Factor ? Inhibitor Inducing Psoriasis Pustulosa  

PubMed Central

Importance Golimumab is a human monoclonal antibody, used for rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. Adverse reactions are increasing with this class of medication (tumor necrosis factor ? inhibitors). Observations The authors present a case of a female patient who presented with psoriasis pustulosa after the use of golimumab for rheumatoid arthritis. Conclusions and Relevance Paradoxically, in this case, golimumab, which is used for psoriasis, induced the pustular form of this disease. We are observing an increasing number of patients who develop collateral effects with tumor necrosis factor ? inhibitors, and the understanding of the mechanism of action and how these adverse reactions occur may contribute to avoid these sometimes severe situations. PMID:24348382

Soto Lopes, Marien Siqueira; Trope, Beatriz Moritz; Rochedo Rodriguez, Maria Paula Rua; Grynszpan, Rachel Lima; Cuzzi, Tullia; Ramos-e-Silva, Marcia

2013-01-01

309

MR imaging of pediatric arthritis.  

PubMed

The role of MR imaging in pediatric arthritis is to detect early manifestations of arthritis, evaluate the extent of disease, and monitor disease activity during treatment. More specifically, MR imaging can characterize the pediatric arthropathy based on typical imaging findings, detect early signs of synovitis and erosions, stage the severity of joint involvement, demonstrate associated internal derangement, monitor disease progression or treatment response, and evaluate for complications. This article discusses MR imaging findings of juvenile idiopathic arthritis, enthesis-related arthritis, juvenile psoriatic arthritis, and articular findings in collagen vascular diseases, septic arthritic, hemophilia, neuroarthropathy, and pseudoarthridities. PMID:19524196

Daldrup-Link, Heike E; Steinbach, Lynne

2009-08-01

310

Neonatal Candida arthritis  

PubMed Central

Fungal arthritis is an uncommon yet serious disorder in the newborn. Delay in diagnosis and management can lead to significant morbidity. We report our experience with management of two such cases. Two preterm neonates with multifocal arthritis caused by Candida were studied. Diagnosis was made by clinical examination, laboratory investigations, radiological investigations and culture. Both were treated by aspiration, arthrotomy and antifungal therapy. One patient recovered fully from the infection while the other had growth disturbances resulting in limb length inequality at recent followup. Prompt and expeditious evacuation of pus from joints and antifungal therapy is imperative for treatment. Associated osteomyelitis leads to further difficulty in treatment. PMID:24932046

Sharma, Saurabh; Gangwal, Kapil

2014-01-01

311

Prologue: 2012 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).  

PubMed

The 2012 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) was held in June 2012 in Stockholm, Sweden, and attended by rheumatologists, dermatologists, and representatives of biopharmaceutical companies and patient groups from around the world. In this Prologue we introduce discussions that were held among meeting attendees. Prior to the 2012 meeting, 2 GRAPPA members organized a Fellows Symposium adjacent to the European Academy of Dermatology and Venerology meeting in Verona, where they discussed comorbidities and treatments of patients with psoriasis. The 2012 GRAPPA meeting began with a trainee symposium, where 30 rheumatology fellows and dermatology residents presented their research work. Other presentations and discussions included a review of arthritis mutilans; dermatology issues including screening tools for psoriatic arthritis (PsA) and the instruments to measure psoriasis severity; cardiovascular and other comorbidities of psoriasis and PsA; development of criteria to define inflammatory arthritis, enthesitis, dactylitis, and spondylitis; distinctions between peripheral spondyloarthritis and PsA; the status of an ultrasound outcome measure for dactylitis; and updates on several GRAPPA projects, including a study of biomarkers to predict structural damage in PsA, the ongoing video project, and several education initiatives. PMID:23908533

Mease, Philip J; Boehncke, Wolf-Henning; Gladman, Dafna D

2013-08-01

312

What Is Reactive Arthritis?  

MedlinePLUS

... NIAMS publication. To order Reactive Arthritis Q&A full-text version, please contact NIAMS using the contact information ... nih.gov Website: http://www.niams.nih.gov Full NIAMS Site NIH… Turning Discovery Into Health ® ... Comments Moderation Policy Site Map | Viewers and Players

313

What Is Rheumatoid Arthritis?  

MedlinePLUS

... publication. To order Rheumatoid Arthritis Handout on Health full-text version, please contact NIAMS using the contact information ... mailed to you? Visit our online order form. Full NIAMS Site NIH… Turning Discovery Into Health ® ... Comments Moderation Policy Site Map | Viewers and Players

314

78 FR 36305 - Proposed Information Collection (Non-Degenerative Arthritis (Including Inflammatory, Autoimmune...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Arthritis (Including Inflammatory, Autoimmune, Crystalline and Infectious Arthritis...Arthritis (including inflammatory, autoimmune, crystalline and infectious arthritis...Arthritis (including inflammatory, autoimmune, crystalline and infectious...

2013-06-17

315

78 FR 65450 - Agency Information Collection (Non-Degenerative Arthritis (Including Inflammatory, Autoimmune...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Arthritis (Including Inflammatory, Autoimmune, Crystalline and Infectious Arthritis...Arthritis (including inflammatory, autoimmune, crystalline and infectious arthritis...Arthritis (including inflammatory, autoimmune, crystalline and infectious...

2013-10-31

316

Evolving concepts of rheumatoid arthritis  

Microsoft Academic Search

Rheumatoid arthritis is the most common inflammatory arthritis and is a major cause of disability. It existed in early Native American populations several thousand years ago but might not have appeared in Europe until the 17th century. Early theories on the pathogenesis of rheumatoid arthritis focused on autoantibodies and immune complexes. T-cell-mediated antigen-specific responses, T-cell-independent cytokine networks, and aggressive tumour-like

Gary S. Firestein

2003-01-01

317

Treatment advances in psoriatic arthritis  

Microsoft Academic Search

Treatment of psoriatic arthritis, like the treatment of rheumatoid arthritis, now commonly includes the use of inhibitors\\u000a of tumor necrosis factor in addition to traditional synthetic disease-modifying antirheumatic drugs. This paper examines the\\u000a most recent data from therapeutic trials in psoriatic arthritis, with particular emphasis on the effectiveness of the tumor\\u000a necrosis factor inhibitors. Recent data on potential future therapies

Eric M. Ruderman

2005-01-01

318

Beaver fever arthritis.  

PubMed

Giardia lamblia, a flagellated protozoan and common cause of gastroenteritis, is a rare but previously reported cause of reactive arthritis (ReA). We report a case of inflammatory oligoarthritis in a young woman after infection with Giardia. Two weeks after being treated, she developed an inflammatory arthritis of her left knee and right elbow that was refractory to nonsteroidal antiinflammatory medication. Antinuclear antibody, rheumatoid factor, and HLA-B27 tests were negative. She had almost immediate relief with intraarticular injection of corticosteroids. We review the previously reported cases of ReA following giardiasis and discuss possible pathogenic mechanisms. Although ReA most commonly occurs after chlamydial urethritis or gastroenteritis associated with typical enteropathic bacteria, important historical clues could point to less common pathogens such as Giardia. Physicians should be aware of these less common causes of ReA, because this could have important diagnostic and therapeutic implications. PMID:17043473

Carlson, Daniel W; Finger, David R

2004-04-01

319

Apoptosis in rheumatoid arthritis  

Microsoft Academic Search

\\u000a Rheumatoid arthritis (RA) — a chronic inflammatory disease affecting synovial tissue in multiple joints — is associated with\\u000a long-term morbidity and early mortality despite considerable advances in understanding its pathogenesis. Although the identity\\u000a and role of specific inciting agents is uncertain, immune-mediated mechanisms are likely of crucial importance. The evidence\\u000a to support a role of CD4+T cells in the immune

Paul P. Tak; Gary S. Firestein

320

Genetics in rheumatoid arthritis  

Microsoft Academic Search

The data from the human genome project were published in 2001. Although this achievement will boost research in the genetics\\u000a of rheumatoid arthritis (RA), most of the work is in progress. Three of the four consortia that are performing linkage studies\\u000a to identify loci that are transmitted more often to patients than controls have published data on genome-wide searches in

Tom W. J. Huizinga

2002-01-01

321

An increase of blood squamous cell carcinoma antigen in Pseudomonas aeruginosa spondylitis  

Microsoft Academic Search

Squamous cell carcinoma antigen (SCCA) is traditionally engaged for detecting and following up malignancy from a squamous cell origin. We encountered an unusual increase of blood SCCA but no other cancer markers in a patient associated with an infective lumbar spondylitis due to Pseudomonas aeruginosa. An overshooting of Th1 expression, such as tumor necrosis factor alpha, bumped up by his

Tzu-Hui Li; Yi-Fen Kao; Chun-Chung Lui; Wei-Hsi Chen

2006-01-01

322

Literature Review and Clinical Presentation of Cervical Spondylitis Due to Salmonella Enteritidis in Immunocompetent  

PubMed Central

A 48-year-old woman was presented to our clinic with some fever and neck pains for about one month. Based on the symptoms and results of image, an empirical diagnosis of tuberculous cervical spondylitis was made. The pain was not significantly decreased after anti-tuberculosis therapy. And, 3 weeks later, she was re-admitted to our hospital for the unbearable pain. An exploration of the C4/5 by the anterior medial approach was recommended to evaluate the germ and debridement. Bacteriological tests showed that the pathogen was Salmonella Enteritidis. The pain was relieved significantly after operation and sensitive antibiotic treatments. Infections with Salmonella Typhi or Salmonella Paratyphi have been well-documented, while there are few reports of cervical spondylitis caused by Salmonella Enteritidis. We reported a case of a healthy woman with whom pyogenic cervical spondylitis of Salmonella Enteritidis was corroborated and treated and reviewed according to previous reports about spondylitis caused by Salmonella Enteritidis in the literature. PMID:24761205

Feng, Zhi-Yun; Guo, Fang

2014-01-01

323

Total Knee Arthroplasty in a Patient with an Ankylosing Knee after Previous Patellectomy  

PubMed Central

Patellectomized patients may have less satisfactory clinical outcomes following total knee arthroplasty (TKA) due to a decreased extensor mechanism efficiency and potential instability. Furthermore, the existing literature does not provide concrete guidance on the expected results of TKA or the type of implant that should be used in patellectomized patients. We present a case of a patient with an ankylosing knee who had undergone patellectomy due to gunshot injury 45 years ago and was treated with primary TKA using a posterior stabilized prosthesis at our institution. TKA using this prosthesis in the ankylosed knee with a previous history of patellectomy yielded good results in terms of postoperative clinical scores, range of motion and joint stability. PMID:25229049

Rhee, Seung Joon; Park, Shi Hwan; Hong, Sung Min

2014-01-01

324

The microbiome and psoriatic arthritis.  

PubMed

Psoriatic arthritis is a chronic inflammatory joint disease, seen in combination with the chronic inflammatory skin disease psoriasis and belonging to the family of spondylarthritides (SpA). A link is recognized between psoriatic arthritis and inflammatory bowel disease (IBD). Environmental factors seem to induce inflammatory disease in individuals with underlying genetic susceptibility. The microbiome is a subject of increasing interest in the etiology of these inflammatory immune-mediated diseases. The intestinal microbiome is able to affect extra-intestinal distant sites, including the joints, through immunomodulation. At this point, evidence regarding a relationship between the microbiome and psoriatic arthritis is scarce. However, we hypothesize that common immune-mediated inflammatory pathways seen in the "skin-joint-gut axis" in psoriatic arthritis are induced or at least mediated by the microbiome. Th17 has a crucial function in this mechanism. Further establishment of this connection may lead to novel therapeutic approaches for psoriatic arthritis. PMID:24474190

Eppinga, Hester; Konstantinov, Sergey R; Peppelenbosch, Maikel P; Thio, H Bing

2014-03-01

325

Surgical Treatment of Pyogenic Spondylitis with the Use of Freeze-Dried Structural Allograft  

PubMed Central

Objective Radical debridement and reconstruction is necessary for surgical treatment of pyogenic spondylitis to control infection and to provide segmental stability. The authors identified 25 patients who underwent surgery for pyogenic spondylitis using freeze-dried structural allograft for reconstruction. This study aimed to evaluate and demonstrate the effectiveness and safety of a freeze-dried structural allograft during the surgical treatment of pyogenic spondylitis. Methods From January 2011 to May 2013, we retrospectively reviewed 25 surgically treated patients of pyogenic spondylitis. Surgical techniques used were anterior radical debridement and reconstruction with a freeze-dried structural allograft and instrumentation. In these 25 patients, we retrospectively examined whether the symptoms had improved and the infection was controlled after surgery by evaluating laboratory data, clinical and radiological outcomes. The average follow-up period was 15.7 months (range, 12.2-37.5 months). Results The infection resolved in all of the patients and there were no cases of recurrent infection. The mean Visual Analog Scale score was 6.92 (range, 5-10) before surgery and 1.90 (range, 0-5) at the time of the last follow-up. Preoperatively, lower extremity motor deficits related to spinal infection were noted in 10 patients, and they improved in 7 patients after surgery. Follow-up computed tomographic scans were obtained from 10 patients, and osseous union between the vertebral body and the structural allograft was achieved in 2 patients. Conclusion The freeze-dried structural allograft can be a safe and effective alternative for surgical treatment of pyogenic spondylitis, and another option for vertebral reconstruction instead of using the other materials. PMID:25346759

Kim, Seung-Soo; Yoon, Jong-Won; Park, Hyun; Lee, Chul-Hee; Hwang, Soo-Hyun

2014-01-01

326

Macrophages in rheumatoid arthritis  

PubMed Central

The abundance and activation of macrophages in the inflamed synovial membrane/pannus significantly correlates with the severity of rheumatoid arthritis (RA). Although unlikely to be the 'initiators' of RA (if not as antigen-presenting cells in early disease), macrophages possess widespread pro-inflammatory, destructive, and remodeling capabilities that can critically contribute to acute and chronic disease. Also, activation of the monocytic lineage is not locally restricted, but extends to systemic parts of the mononuclear phagocyte system. Thus, selective counteraction of macrophage activation remains an efficacious approach to diminish local and systemic inflammation, as well as to prevent irreversible joint damage. PMID:11094428

Kinne, Raimund W; Bräuer, Rolf; Stuhlmüller, Bruno; Palombo-Kinne, Ernesta; Burmester, Gerd-R

2000-01-01

327

[Update in psoriatic arthritis treatment].  

PubMed

Psoriatic arthritis is a chronic inflammatory disease. It affects up to 40% of patients suffe- ring from skin psoriasis. Joint involvement is relatively heterogeneous. Some clinical manifestations are similar to those of rheumatoid arthritis, others are close to spondylarthritis manifestations and are therefore considered as part of this entity. Treatment depends on initial presentation (peripheral or axial) but often begins with non-steroidal anti-inflammatory drugs and methotrexate, followed by anti-TNFalpha if needed. New therapeutic op- tions are available or under evaluation, parti- cularly targeting cytokines involved in psoriatic arthritis (IL-12/IL-23 and IL-17). PMID:25799671

Berner, Jeanne; Zufferey, Pascal

2015-01-14

328

Handout on Health: Rheumatoid Arthritis  

MedlinePLUS

... osteoporosis with their doctors as part of their long-term, ongoing care. Osteoporosis is a condition in which bones become weakened and fragile. Having rheumatoid arthritis increases the risk of developing osteoporosis for both men and women, ...

329

Osteoarticular tuberculosis mimicking rheumatoid arthritis.  

PubMed

Tuberculosis (TB) remains a global burden despite extensive efforts to control it. TB arthritis commonly manifest as monoarthritis of weight-bearing joints. We report a rare presentation of osteoarticular TB involving multiple small joints of the hands, which mimicked rheumatoid arthritis (RA). Magnetic resonance imaging showed tenosynovitis. The patient was initially treated for seronegative RA but failed to respond. Subsequently, synovial biopsy led to the diagnosis. Antituberculosis treatment was given for 1 year. PMID:22399018

Seung, Ong Ping; Sulaiman, Wahinuddin

2012-11-01

330

Treatment recommendations for psoriatic arthritis  

Microsoft Academic Search

Objective:To develop comprehensive recommendations for the treatment of the various clinical manifestations of psoriatic arthritis (PsA) based on evidence obtained from a systematic review of the literature and from consensus opinion.Methods:Formal literature reviews of treatment for the most significant discrete clinical manifestations of PsA (skin and nails, peripheral arthritis, axial disease, dactylitis and enthesitis) were performed and published by members

C T Ritchlin; A Kavanaugh; D D Gladman; P J Mease; P Helliwell; W-H Boehncke; K de Vlam; D Fiorentino; O FitzGerald; A B Gottlieb; N J McHugh; P Nash; A A Qureshi; E R Soriano; W J Taylor

2009-01-01

331

Certolizumab for rheumatoid arthritis.  

PubMed

This is a review of the pharmacology of certolizumab pegol and its efficacy and safety in the treatment of patients with rheumatoid arthritis refractory to synthetic disease-modifying anti-rheumatic drugs (DMARDs). Certolizumab is a new anti-TNF-? biologic agent injected subcutaneously with an innovative molecular structure and unique pharmacodynamic and pharmacokinetic properties. Data from controlled clinical trials indicate that the drug is effective in reducing disease activity and disability. It also inhibits radiographic progression. Certolizumab administration has an acceptable safety profile. The clinical data available suggest that the nature of adverse events is generally comparable to that of other TNF-? blockers. Given its rapid onset of action certolizumab presents an attractive alternative therapeutic option for patients with moderate to severe RA refractory to DMARDs. PMID:24447441

Markatseli, T E; Papagoras, C; Nikoli, A; Voulgari, P V; Drosos, A A

2014-01-01

332

Methotrexate in psoriatic arthritis.  

PubMed

Methotrexate (MTX) is a folic acid analogue with antiproliferative and antiinflammatory effects. In the past several years, MTX has become the most commonly used agent in patients with severe, destructive psoriatic arthritis (PsA), with positive clinical results. Liver changes and serum enzyme level increases do not seem to be a major problem in PSA patients treated with MTX. In addition, PSA patients treated with low-dose MTX were not associated with pulmonary fibrosis as evaluated by means of sensitive imaging techniques and pulmonary function tests. The concomitant use of folic acid reduces both the frequency of serum liver enzyme level increases but also the efficacy of MTX by competing with the folate receptors. PMID:12463453

Cutolo, M; Seriolo, B; Pizzorni, C; Craviotto, C; Sulli, A

2002-01-01

333

Percutaneous Drainage Combined with Hyperbaric Oxygen Therapy for Pyogenic Spondylitis with Iliopsoas Abscess  

PubMed Central

Study Design A retrospective study. Purpose The purpose of this study was to evaluate outcomes in patients with pyogenic spondylitis accompanied by iliopsoas abscess who were treated by percutaneous drainage combined with hyperbaric oxygen (HBO) therapy. Overview of Literature To the best of our knowledge, there have been no previous reports of the use of percutaneous drainage combined with HBO therapy for the treatment of this condition. Methods Twenty-three patients (13 men, 10 women; mean age, 69.0 years; range, 45-85 years) were treated with percutaneous drainage combined with HBO therapy in addition to commonly used conservative therapy. Mean follow-up duration was 27.7 months (range, 12-48 months). Clinical outcomes and imaging examinations were retrospectively investigated. Results Symptoms such as low back pain, radicular pain, and hip pain resolved in all patients immediately after treatment. Mean time from the start of treatment to the return of C-reactive protein levels to normal or baseline values recorded before the onset of spondylitis was 28.3 days (range, 8-56 days). In the final set of follow-up radiographic studies, all patients were free from progressive destructive changes. Follow-up magnetic resonance images or computed tomography with contrast enhancement confirmed the disappearance or near-total resolution of the iliopsoas abscess cavity with healing of the pyogenic spondylitis in all 23 patients. No recurrences were observed during follow-up. Conclusions The present study suggests that patients with pyogenic spondylitis accompanied by iliopsoas abscess can be cured without a prolonged period of therapy or recurrence using this treatment. PMID:24967038

Koga, Hiroaki; Komiya, Setsuro

2014-01-01

334

Lumbosacral reconstruction for intractable pyogenic spondylitis using a total leg flap with a vascularized tibia graft.  

PubMed

This report describes an effective technique of using a total leg flap for treating a 57-year-old male paraplegic patient with intractable sacral pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus. Spondylitis was accompanied by severe instability of the lumbosacral area, a large lumbosacral ulcer, and a large bone and muscle defect, which made it difficult for the patient to maintain a sitting position. A total leg flap procedure, a modification of the total thigh flap procedure, was performed as a 1-stage salvage surgery. The vascularized tibia and fibula were grafted between the lumbar and sacral vertebrae, and a musculocutaneous flap was used to cover the extensive ulceration in the lumbosacral skin defect. The intractable lesion of the lumbosacral spine, which had not been cured for more than 2 years despite repeated debridement, intravenous antibiotic injections, sugar treatment, pyoktanin treatment, and hyperbaric O(2) treatment, subsided and stabilized within 1 year of surgery. The patient returned to activities of daily living using a wheelchair, and was very satisfied with the results. Use of a total leg flap with a vascularized tibia graft is an effective treatment for intractable pyogenic spondylitis accompanied by a large bone defect and large lumbosacral ulcers. PMID:18447694

Iwakiri, Kentaro; Miyauchi, Akira; Okuda, Shinya; Matsuda, Ken; Yamamoto, Tomio; Iwasaki, Motoki

2008-05-01

335

Rheumatological manifestations in inflammatory bowel disease  

PubMed Central

Rheumatological manifestations in inflammatory bowel disease (IBD) are frequent and include peripheral arthritis, axial involvement and peripheral enthesitis. Secondary osteoporosis and hypertrophic osteoarthropathy may also occur. Complications of IBD (e.g. septic arthritis) must be distinguished from sterile inflammation. Adverse effects of corticosteroid treatment, such as osteonecrosis, may also affect joints. Axial involvement ranges from low back pain to true ankylosing spondylitis. Human leukocyte antigen B27 is associated with axial involvement of IBD. Peripheral arthritis has been classified into two types. Type I is a pauciarticular, asymmetric usually non destructive arthritis affecting large joints and is usually associated with active bowel disease. Type II is a polyarthritis affecting small joints and tends to run a course independent of the bowel disease. Treatment of joint symptoms in IBD include sulphasalazine, azathioprine, methotrexate and glucocorticoids. Anti-tumor necrosis factor antibodies are effective in treating resistant or complicated Crohn’s disease as well as peripheral arthritis and axial involvement. PMID:24713717

Voulgari, Paraskevi V.

2011-01-01

336

Overview of Psoriasis and Psoriatic Arthritis  

MedlinePLUS

... of psoriasis + psoriatic arthritis Psoriasis ( ) and psoriatic arthritis ) symbols to determine if a treatment is indicated for ... capsaicin, tea tree oil, oats, dead sea salts, apple cider vinegar and others are also frequently used ...

337

Experimental Staphylococcus aureus arthritis in mice.  

PubMed Central

Staphylococcus aureus arthritis is usually caused by bacteremia and is highly destructive. Controlled studies on septic arthritis in humans are difficult to perform, because the time of onset of the infection is unknown. Animal models of bacterial arthritis make it possible to control important variables in experimental studies. We present a mouse model of S. aureus arthritis in which the intravenous administration of 10(7) cells of S. aureus LS-1 induced arthritis or osteitis or both within 3 weeks in 80 to 90% of the mice. Signs of arthritis emerged within the first few days after the injection. An interesting finding was that the S. aureus strain used in this study binds bone sialoprotein, a glycoprotein known to be specifically localized to bone tissue. This new model of S. aureus arthritis enables the study of the kinetics of joint destruction and the host-bacterium relationship as well as therapeutical approaches to septic arthritis and osteomyelitis. Images PMID:1855981

Bremell, T; Lange, S; Yacoub, A; Rydén, C; Tarkowski, A

1991-01-01

338

Arthritis of the Base of the Thumb  

MedlinePLUS

... Videos Hand Anatomy Find a Hand Surgeon Arthritis - Base of the Thumb Email to a friend * required ... spurs (osteophytes) (see Figure 1). Arthritis at the base of the thumb is a genetic predisposition: like ...

339

Management of patients with psoriatic arthritis.  

PubMed

Psoriatic arthritis is a chronic inflammatory arthritis condition. If left untreated, patients with psoriatic arthritis may suffer pain, reduced quality of life, joint damage, and disability. Understanding clinical presentation and comorbidities of the disease, as well as current guidelines for treatment, allows the nurse practitioner to provide comprehensive care for patients. PMID:25710245

Dewing, Kori A

2015-04-13

340

Prostaglandins and Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis (RA) is a chronic, autoimmune, and complex inflammatory disease leading to bone and cartilage destruction, whose cause remains obscure. Accumulation of genetic susceptibility, environmental factors, and dysregulated immune responses are necessary for mounting this self-reacting disease. Inflamed joints are infiltrated by a heterogeneous population of cellular and soluble mediators of the immune system, such as T cells, B cells, macrophages, cytokines, and prostaglandins (PGs). Prostaglandins are lipid inflammatory mediators derived from the arachidonic acid by multienzymatic reactions. They both sustain homeostatic mechanisms and mediate pathogenic processes, including the inflammatory reaction. They play both beneficial and harmful roles during inflammation, according to their site of action and the etiology of the inflammatory response. With respect to the role of PGs in inflammation, they can be effective mediators in the pathophysiology of RA. Thus the use of agonists or antagonists of PG receptors may be considered as a new therapeutic protocol in RA. In this paper, we try to elucidate the role of PGs in the immunopathology of RA. PMID:23193470

Fattahi, Mohammad Javad; Mirshafiey, Abbas

2012-01-01

341

The treatment of psoriatic arthritis.  

PubMed

Psoriatic arthritis (PsA) is a chronic, autoimmune, seronegative inflammatory arthritis characterized by varying degrees of axial and peripheral arthritis. Here, we review the literature on the pharmacological management of PsA and present a simple treatment algorithm based on the available information. Although PsA management must be individualized to the degree and type of joint pain and inflammation, in general, nonsteroidal antiinflammatory drugs (NSAIDs) still represent first-line treatment of mild PsA. Second-line therapy includes older agents such as gold salts, methotrexate, sulfasalazine, and cyclosporine. The tumor necrosis factor alpha (TNF-alpha) antagonists represent the most recent major advance in the clinical management of PsA. PMID:16428925

Manadan, Augustine M; Sequeira, Winston; Block, Joel A

2006-01-01

342

A customized distraction device for alveolar ridge augmentation and alignment of ankylosed teeth.  

PubMed

The purpose of this study was to develop an extraosseous, tooth-supported miniature intraoral device that could produce prosthetically driven bone distraction of small atrophic alveolar ridge segments. Extraosseous distraction requires that the distraction device be anchored to a dental implant previously placed into the ridge according to its anatomic axis. A distractor can also correct the position of implants placed in young patients before skeletal growth is completed. Similarly, it allows the alignment of ankylosed teeth not treatable by orthodontics. The device is made of (1) an engine consisting of an orthodontic micrometric screw; (2) a joint between the implant and the engine, ie, the ball attachment/o-ring system; and (3) an anchorage system to the oral cavity provided by an orthodontic appliance and a mini-implant for possible additional support. Surgery involves an osteotomy of the atrophic alveolar ridge segment, incorporating the implant, from the basal bone; afterward the device can be applied and distraction of the segment can be carried out. Distraction was successfully performed in 3 clinical cases: 2 bone-implant segments and 1 bone-ankylosed tooth segment. All cases were clinically uneventful. This mini-device for osteogenic distraction of small atrophic ridge segments can provide for accurate and precise ridge augmentation, as is required for ideal prosthetic rehabilitation. PMID:14982366

Nocini, Pier Francesco; De Santis, Daniele; Ferrari, Francesca; Bertele, Gian Paolo

2004-01-01

343

Cancer morbidity in rheumatoid arthritis.  

PubMed Central

A consecutive series of 489 patients with rheumatoid arthritis seen at the centre was studied to determine their cancer morbidity. Overall the 36 cancers diagnosed in the series between 1964 and 1981 were not significantly in excess of the expected number, but there was a highly significant excess of tumours of the reticuloendothelial system. The excess was mainly due to 6 observed cases of lymphoma. We conclude that there is a highly significant association between rheumatoid arthritis and the subsequent development of lymphoproliferative malignancy in this series. PMID:6712287

Prior, P; Symmons, D P; Hawkins, C F; Scott, D L; Brown, R

1984-01-01

344

[Understanding rheumatoid arthritis].  

PubMed

Rheumatoid arthritis is a common and severe inflammatory rheumatic disease, for which the immune mechanisms are being decoded little by little. The pathogenic ncludes significant cellular actors of innate immunity (fibroblastic synoviocytes, macrophages, mastocytes...) and adaptive immunity (T and B lymphocytes). These actors interact through the production of and response to specific (cytokines, chemokines and auto-antibodies) and non-specific (prostaglandins, nitrous oxide [NO], complement, proteases) mediators. The chronology of this rheumatoid synovitis is becoming progressively clearer. Its initiation could be the consequence of a precocious activation of the innate immunity, induced by bacterial agents or debris (PAMP). The activation of the synoviocytes and the macrophages via specific receptors (PPR) unleashes an intense inflammatory reaction that triggers a cascade of events. The ongoing nature of this synovitis leads to the intra-articular recruitment of different cells of immunity. This cellular afflux amplifies the macrophagic and synoviocytic activation and proliferation. All of these interactive phenomena end in the production of large quantities of pro-inflammatory cytokines (TNFa, IL1, IL6, IL15, IL17, IL18) but also other pathogenic mediators (auto-antibodies, complement, prostaglandins, nitrous oxide...). This synovitis persists, as it is no longer regulated by a sufficient production of physiological regulators (soluble receptors and inhibitors of cytokines). The consequence of this intense inflammation and synovial proliferation leads to osteo-articular destruction by the production of proteases and the activation of osteoclasts by the RANK/RANK-ligand pathway under the effect of cytokines (TNFa, IL5, IL1, IL6, IL17) and other mediators (prostaglandins) liberated by synoviocytes, macrophages and lymphocytes. The decryption of this puzzle has already created new therapeutic orientations. The identification of new targets is one of the major consequences of this progress in immuno-rheumatology. PMID:16544924

Sibilia, Jean; Sordet, Christelle; Mrabet, Dalila; Wachsmann, Dominique

2005-12-15

345

Eupatilin ameliorates collagen induced arthritis.  

PubMed

Eupatilin is the main active component of DA-9601, an extract from Artemisia. Recently, eupatilin was reported to have anti-inflammatory properties. We investigated the anti-arthritic effect of eupatilin in a murine arthritis model and human rheumatoid synoviocytes. DA-9601 was injected into collagen-induced arthritis (CIA) mice. Arthritis score was regularly evaluated. Mouse monocytes were differentiated into osteoclasts when eupatilin was added simultaneously. Osteoclasts were stained with tartrate-resistant acid phosphatase and then manually counted. Rheumatoid synoviocytes were stimulated with TNF-? and then treated with eupatilin, and the levels of IL-6 and IL-1? mRNA expression in synoviocytes were measured by RT-PCR. Intraperitoneal injection of DA-9601 reduced arthritis scores in CIA mice. TNF-? treatment of synoviocytes increased the expression of IL-6 and IL-1? mRNAs, which was inhibited by eupatilin. Eupatilin decreased the number of osteoclasts in a concentration dependent manner. These findings, showing that eupatilin and DA-9601 inhibited the expression of inflammatory cytokines and the differentiation of osteoclasts, suggest that eupatilin and DA-9601 is a candidate anti-inflammatory agent. PMID:25729243

Kim, Juryun; Kim, Youngkyun; Yi, Hyoju; Jung, Hyerin; Rim, Yeri Alice; Park, Narae; Jung, Seung Min; Park, Sung-Hwan; Ju, Ji Hyeon

2015-03-01

346

Bronchocentric granulomatosis and rheumatoid arthritis.  

PubMed

We report a 42-year-old patient with an 11-year history of rheumatoid arthritis (RA) who presented 8 years later with haemoptysis and was found to have multiple pulmonary opacities with histological features of bronchocentric granulomatosis (BCG). The association between BCG and RA is discussed and the literature is reviewed. PMID:3651314

Bonafede, R P; Benatar, S R

1987-04-01

347

Cytokine blockers in psoriatic arthritis  

Microsoft Academic Search

The cellular events underlying the pathogenesis of psoriatic arthritis (PsA) and psoriasis have not yet been fully elucidated. Nevertheless, some clues to these conditions are beginning to emerge. In particular, a growing body of data supports the role of proinflammatory cytokines, such as tumour necrosis factor (TNF), in the pathophysiology of PsA and psoriasis. Raised levels of these cytokines are

P J Mease

2001-01-01

348

Minimally invasive endoscopic treatment for lumbar infectious spondylitis: a retrospective study in a tertiary referral center  

PubMed Central

Background Spinal infections remain a challenge for clinicians because of their variable presentation and complicated course. Common management approaches include conservative administration of antibiotics or aggressive surgical debridement. The purpose of this study was to evaluate the efficacy of percutaneous endoscopic debridement with dilute betadine solution irrigation (PEDI) for treating patients with lumbar infectious spondylitis. Methods From January 2005 to July 2010, a total of 32 patients undergoing PEDI were retrospectively enrolled in this study. The surgical indications of the enrolled patients included single-level infectious spondylodiscitis, postoperative infectious spondylodiscitis, advanced infection with epidural abscess, psoas muscle abscess, pre-vertebral or para-vertebral abscess, multilevel infectious spondylitis, and recurrent infection after anterior debridement and fusion. Clinical outcomes were assessed by careful physical examination, Macnab criteria, regular serologic testing, and imaging studies to determine whether continued antibiotics treatment or surgical intervention was required. Results Causative bacteria were identified in 28 (87.5%) of 32 biopsy specimens. Appropriate parenteral antibiotics for the predominant pathogen isolated from infected tissue biopsy cultures were prescribed to patients. Twenty-seven (84.4%) patients reported satisfactory relief of their back pain after PEDI. Twenty-six (81.3%) patients recovered uneventfully after PEDI and sequential antibiotic therapy. No surgery-related major complications were found, except 3 patients with transient paresthesia in the affected lumbar segment. Conclusions PEDI was successful in obtaining a bacteriologic diagnosis, relieving the patient’s symptoms, and assisting in the eradication of lumbar infectious spondylitis. This procedure could be an effective alternative for patients who have a poor response to conservative treatment before a major open surgery. PMID:24669940

2014-01-01

349

[Citrobacter freundii spondylitis and sickle cell disease: a case in Morocco].  

PubMed

Infectious complications of sickle cell disease are common and can be serious and difficult to diagnose. Epidemiological aspects of these infections are well documented. The most common germ in children is pneumococcus followed by Haemophilus influenzae and minor salmonella. In adults gram-negative germs including minor salmonella are the most frequent. The purpose of this report is to describe a case of a Citrobacter freundii spondylitis with prevertebral abscess extending to dorsal and lumbar spinal areas. Diagnosis was made during work-up for persistent vaso-occlusive manifestations. Treatment consisted of percutaneous lumbar drainage associated with antibiotherapy. PMID:22368940

El Baaj, M; Lazrak, K; Tabache, F; Hassikou, H; Hadri, L

2010-08-01

350

Apremilast: first global approval.  

PubMed

Apremilast (Otezla(®)), an oral small molecule inhibitor of type-4 cyclic nucleotide phosphodiesterase (PDE-4), is under development with Celgene Corporation for the treatment of psoriatic arthritis, psoriasis, ankylosing spondylitis, Behçet's syndrome, atopic dermatitis, and rheumatoid arthritis. Apremilast is indicated for the treatment of active psoriatic arthritis in adults. Apremilast has received its first global approval for this indication in the USA. Regulatory submissions for approval in this indication are under review in Canada and Europe. Regulatory filings have also been submitted for apremilast in the treatment of plaque psoriasis in the USA and Europe. This article summarizes the milestones in the development of apremilast leading to its first approval for the treatment of psoriatic arthritis. PMID:24797159

Poole, Raewyn M; Ballantyne, Anita D

2014-05-01

351

Spondylo-arthropathies.  

PubMed

Spondylo-arthropathies are a broad group of inflammatory diseases that primarily involve the axial skeleton and the sacro-iliac joints. The pattern of peripheral joint involvement in spondylo-arthropathies differs from rheumatoid arthritis. Spondylo-arthropathies are known to include several conditions like ankylosing spondylitis, reactive arthritis (including Reiter's syndrome), arthritis associated with psoriasis and inflammatory bowel disease, juvenile and also undifferentiated spondylo-arthropathies. The characteristic features of spondylo-arthropathies are absence of rheumatoid factor, inflammatory low backache, sacro-iliitis, peripheral arthritis, enthesopathy, tendency to familial aggregation and association with HLA-B27. ESR may be elevated and patients may exhibit anaemia of chronic inflammation. HLA-B27 is a useful adjunctive test. The radiologic interpretation is very important. Non-steroidal anti-inflammatory drugs and spinal exercises are the cornerstone of therapy. Intra-articular corticosteroids are helpful. Patients may be benefited from, sulfasalazine, methotrexate or azathioprine. PMID:15168985

Handa, R

2003-09-01

352

Growing up with juvenile idiopathic arthritis.  

PubMed

Juvenile idiopathic arthritis (JIA) is the most common chronic pediatric illness in the United States. The disease encompasses a group of heterogeneous chronic arthritis conditions that begin before age 16 years and persist for more than 6 weeks. Formerly termed juvenile rheumatoid arthritis (JRA), JIA now includes polyarticular, oligoarticular, psoriatic, enthesitis-related arthritis, systematic arthritis, and undifferentiated arthritis. Diagnosis is based on clinical and laboratory features. Treatment includes immunosuppressant therapy, non-steroidal anti-inflammatory drug (NSAIDS), and biologic therapies. This can affect all aspects of an adolescent's life including physiologic, psychosocial, and spiritual components; therefore, this article discusses a comprehensive approach to care management with transition of care as a critical feature in adolescent healthcare. PMID:25333886

McKeever, Amy; Kelly, Michelle M

2015-01-01

353

Psoriatic arthritis: Epidemiology, diagnosis, and treatment  

PubMed Central

Our understanding of psoriatic arthritis has evolved as new knowledge of the disease has emerged. However, the exact prevalence of psoriatic arthritis is unknown, and its pathogenesis has not been fully elucidated. Genetic, environmental, and immunologic factors have all been implicated in disease development. Early diagnosis and treatment have become primary objectives in clinical rheumatology. Psoriatic arthritis not only causes functional impairment, but also increases mortality risk of patients. The advent of new therapeutic agents capable of arresting the progression of joint damage is expected. However, early psoriatic arthritis assessment remains limited. The objectives of this article are to outline the epidemiology, diagnosis, and treatment of psoriatic arthritis and to suggest a paradigm for identifying early psoriatic arthritis patients. PMID:25232529

Liu, Jung-Tai; Yeh, Horng-Ming; Liu, Shyun-Yeu; Chen, Kow-Tong

2014-01-01

354

Psoriatic arthritis: Epidemiology, diagnosis, and treatment.  

PubMed

Our understanding of psoriatic arthritis has evolved as new knowledge of the disease has emerged. However, the exact prevalence of psoriatic arthritis is unknown, and its pathogenesis has not been fully elucidated. Genetic, environmental, and immunologic factors have all been implicated in disease development. Early diagnosis and treatment have become primary objectives in clinical rheumatology. Psoriatic arthritis not only causes functional impairment, but also increases mortality risk of patients. The advent of new therapeutic agents capable of arresting the progression of joint damage is expected. However, early psoriatic arthritis assessment remains limited. The objectives of this article are to outline the epidemiology, diagnosis, and treatment of psoriatic arthritis and to suggest a paradigm for identifying early psoriatic arthritis patients. PMID:25232529

Liu, Jung-Tai; Yeh, Horng-Ming; Liu, Shyun-Yeu; Chen, Kow-Tong

2014-09-18

355

Acromioclavicular Septic Arthritis and Sternoclavicular Septic Arthritis with Contiguous Pyomyositis  

PubMed Central

Acromioclavicular (AC) and sternoclavicular (SC) septic arthritis with contiguous pyomyositis are rare, especially in immunocompetent individuals. We report a case of septic AC joint with pyomyositis of the deltoid and supraspinatus muscles and a separate case with septic SC joint with pyomysitis of the sternocleidomastoid muscle. Both patients had similar presentations of infections with Staphylococcus aureus and were successfully treated with surgical incision and drainage followed by prolonged antibiotic therapy. PMID:25729529

Corey, Sally A.; Saterbak, Andrew T.

2015-01-01

356

Coordinated individual education with an arthritis passport for patients with rheumatoid arthritis  

Microsoft Academic Search

Objective: To evaluate the effects of a program for individual education in combination with the use of an arthritis passport. - \\u000aMethods: We studied 3 groups of patients with rheumatoid arthritis. The first experimental group received educational materials and followed the program under the guidance of their regular providers of health care whose activities were coordinated through arthritis passports. The

Robert P. Riemsma; Erik Taal; Herman L. M. Brus; Johannes J. Rasker; Oene Wiegman

1997-01-01

357

Physical Activity in Older Adults with Arthritis  

Microsoft Academic Search

\\u000a Physical activity offers an effective, nonpharmacological means to improve the health of older adults, including those with\\u000a arthritis. Clinical practice guidelines identify a substantial therapeutic role for physical activity in osteoarthritis and\\u000a rheumatoid arthritis. For older adults, including those with arthritis, regular physical activity ­counteracts the reduction\\u000a in fitness, stamina, and loss of muscle strength associated with aging, prevents the

Dorothy D. Dunlop; Pamela A. Semanik; Rowland W. Chang

358

Treatment advances in systemic juvenile idiopathic arthritis  

PubMed Central

Systemic juvenile idiopathic arthritis (JIA) is an autoinflammatory condition that is distinct from other forms of childhood arthritis. Recently, biologic agents that specifically inhibit the cytokines interleukin (IL)-1 and IL-6 have demonstrated remarkable clinical effectiveness and confirmed the importance of these cytokines in the disease process. Future studies are likely to optimize the care of children with systemic arthritis and further elucidate the disease pathogenesis. PMID:24765526

2014-01-01

359

[A case of prostate abscess with sepsis, infectious endocarditis and pyogenic spondylitis].  

PubMed

A 65-year-old man with diabetes mellitus (DM) presented with an indwelling urethral catheter placed for urinary retention by his previous doctor. Thereafter, he had fever, vomiting and general fatigue. His blood examination showed severe inflammatory findings. He was diagnosed with acute prostatitis and immediately admitted to our hospital. Pelvic computerized tomography (CT) showed a prostate abscess. We performed transrectal ultrasonographic-guided puncture of the prostate abscess for drainage and blood culture was tested. Methicillin-sensitive Staphylococcus aureus (MSSA) was cultured from the puncture fluid and blood. We administered antibiotics with strict control of DM. After the prostate abscess improved and the urethral catheter was removed, the patient was systematically examined for potential sepsis-related disease caused by MSSA septic infection. Magnetic resonance imaging (MRI) of the head indicated multiple cerebral infarction, abdominal CT indicated splenetic infarction, ultrasonography of the heart indicated vegetation on the mitral valve and aortic valve, and chest X-ray indicated pulmonary congestion. Furthermore, MRI of the lumbar spine showed a high intensity lesion at the 4th and 5th lumbar spine, indicating pyogenic spondylitis. We diagnosed prostate abscess with sepsis, infectious endocarditis, congestive heart failure and pyogenic spondylitis. Aortic valve replacement, mitral annuloplasty, tricuspid valvuloplasty and ovale hole closure surgeries were performed to treat these conditions. PMID:23235281

Matsumoto, Minori; Shigemura, Katsumi; Yamamichi, Fukashi; Nakano, Yuzo; Miyake, Hideaki; Tanaka, Kazushi; Arakawa, Soichi; Fujisawa, Masato

2012-10-01

360

Atlanto-axial subluxation after pyogenic spondylitis of the atlanto-occipital joint.  

PubMed

This report presents a case of atlanto-axial subluxation after treatment of pyogenic spondylitis of the atlanto-occipital joint. A 60-year-old male had 1-month history of neck pain with fever. Magnetic resonance imaging showed inflammation around the odontoid process. Intravenous antibiotic therapy was administrated immediately. After 6 weeks, CRP had returned almost to normal. After 4 months, laboratory data was still normal, but the patient experienced increasing neck pain. Lateral cervical radiography in the neutral position showed instability between C1 and C2. Computed tomography showed a bony union of the atlanto-occipital joint and severe destruction of the atlanto-axial joint on the left side. Transarticular screw fixation for the atlanto-axial joint was performed. A lateral cervical radiograph in the neutral position after surgery showed a solid bony union. Neck pain improved following surgery. We speculate that spondylitis of the atlanto-occipital joint induced a loosening of the transverse ligament and articulation of the atlanto-axial joint. A bony fusion of the atlanto-occipital joint after antibiotic treatment resolved the pyogenic inflammation concentrated stress to the damaged atlanto-axial joint, resulting in further damage. The atlanto-axial instability was finally managed by the insertion of a transarticular screw. PMID:21140176

Tsunoda, Kazuhiko; Iizuka, Haku; Sorimachi, Yasunori; Ara, Tsuyoshi; Nishinome, Masahiro; Takechi, Yasuhiko; Takagishi, Kenji

2011-07-01

361

Septic arthritis of the sternoclavicular joint.  

PubMed

Septic arthritis is a medical emergency that requires immediate action to prevent significant morbidity and mortality. The sternoclavicular joint may have a more insidious onset than septic arthritis at other sites. A high index of suspicion and judicious use of laboratory and radiologic evaluation can help solidify this diagnosis. The sternoclavicular joint is likely to become infected in the immunocompromised patient or the patient who uses intravenous drugs, but sternoclavicular joint arthritis in the former is uncommon. This case series describes the course of 2 immunocompetent patients who were treated conservatively for septic arthritis of the sternoclavicular joint. PMID:23136331

Womack, Jason

2012-01-01

362

Arthritis - Multiple Languages: MedlinePlus  

MedlinePLUS

... Multiple Languages Arabic (???????) Chinese - Simplified (????) French (français) Hindi (??????) Japanese (???) Korean (???) Russian ( ... Chinese - Simplified) Bilingual PDF Health Information Translations French (français) Arthritis Arthrite - français (French) Bilingual PDF Health Information ...

363

Microbial Infection and Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis (RA) is a complex autoimmune disease affecting 1–2% of general worldwide population. The etiopathogenesis of RA involves the interplay of multiple genetic risk factors and environmental triggers. Microbial infections are believed to play an important role in the initiation and perpetuation of RA. Recent clinical studies have shown the association of microbial infections with RA. Accumulated studies using animal models have also found that microbial infections can induce and/or exaggerate the symptoms of experimental arthritis. In this review, we have identified the most common microbial infections associated with RA in the literature and summarized the current evidence supporting their pathogenic role in RA. We also discussed the potential mechanisms whereby infection may promote the development of RA, such as generation of neo-autoantigens, induction of loss of tolerance by molecular mimicry, and bystander activation of the immune system. PMID:25133066

Li, Song; Yu, Yangsheng; Yue, Yinshi; Zhang, Zhixin; Su, Kaihong

2014-01-01

364

Tyrosine kinases in rheumatoid arthritis  

PubMed Central

Rheumatoid arthritis (RA) is an inflammatory, polyarticular joint disease. A number of cellular responses are involved in the pathogenesis of rheumatoid arthritis, including activation of inflammatory cells and cytokine expression. The cellular responses involved in each of these processes depends on the specific signaling pathways that are activated; many of which include protein tyrosine kinases. These pathways include the mitogen-activated protein kinase pathway, Janus kinases/signal transducers and activators transcription pathway, spleen tyrosine kinase signaling, and the nuclear factor ?-light-chain-enhancer of activated B cells pathway. Many drugs are in development to target tyrosine kinases for the treatment of RA. Based on the number of recently published studies, this manuscript reviews the role of tyrosine kinases in the pathogenesis of RA and the potential role of kinase inhibitors as new therapeutic strategies of RA. PMID:21861931

2011-01-01

365

Ayurvedic medicine for rheumatoid arthritis.  

PubMed

Ayurvedic medicine is the traditional medicine of India, which originated over 5,000 years ago. Parts of this alternative medical system have become increasingly popular worldwide as patients seek approaches to medical care that they perceive as more holistic and less toxic than those offered by conventional Western medicine. Despite the advent of highly effective pharmacologic therapy, most individuals with rheumatoid arthritis (RA) continue to use alternative therapy at some point in the treatment of their disease. This report discusses some of the in-vitro data that suggest potential mechanisms through which Ayurvedic herbal medicines might have beneficial actions in rheumatoid arthritis, and the available clinical data evaluating the use of Ayurvedic medicine for RA. PMID:24938440

Basnyat, Shristi; Kolasinski, Sharon L

2014-08-01

366

Cell death in rheumatoid arthritis  

Microsoft Academic Search

Apoptosis plays a pivotal role in tissue homoeostasis both under physiological and pathological conditions and several studies\\u000a have shown that some characteristic changes in the composition and structure of the inflamed synovial membrane in rheumatoid\\u000a arthritis (RA) are linked to an altered apoptotic response of synovial cells. As a result, a hyperplastic synovial tissue\\u000a is generated that mediates the progressive

Adelheid Korb; Hermann Pavenstädt; Thomas Pap

2009-01-01

367

Methotrexate in refractory rheumatoid arthritis  

Microsoft Academic Search

Summary Fourteen patients with severe rheumatoid arthritis refractory to hydroxychloroquine, gold-thioglucose, D-penicillamine and azathioprine completed a 6-month open study with oral methotrexate (2.5 to 5 mg every 12 hours, three doses weekly). Twelve of them were followed up for 12 months. Compared with pretreatment values, there was a significant reduction in duration of morning stiffness (p<0.01), in the number of

A. M. Th. Boerbooms; M. E. C. Jeurissen; A. A. A. Westgeest; H. Theunisse; L. B. A. Putte

1988-01-01

368

The Management of Psoriatic Arthritis  

Microsoft Academic Search

The management of psoriatic arthritis (PsA) begins with education. Each consultation provides an opportunity for the physician\\u000a to counsel the patient and family about the disease and its clinical course that is unique to that individual. It is a chance\\u000a for the patient and family to learn and adapt. There are also a variety of further ways for instruction to

Philip J. Mease

369

Is juvenile rheumatoid arthritis\\/juvenile idiopathic arthritis different from rheumatoid arthritis?  

Microsoft Academic Search

CHAPTER SUMMARY: The chronic arthropathies of childhood share clinical and pathological features with rheumatoid arthritis (RA) in adults. Both are autoimmune diseases characterized by a destructive arthropathy. Both are likely to be complex genetic traits, with autoantibodies and with a type-1-T-helper-cell cytokine profile in disease tissues. In common with other autoimmune diseases, both have associations and linkage with human keukocyte

Sampath Prahalad; David N Glass

2002-01-01

370

Septic Arthritis Caused by Noncapsulated Haemophilus influenzae  

PubMed Central

Since the introduction of type b Haemophilus influenzae vaccination, noncapsulated H. influenzae has become responsible for most cases of invasive H. influenzae diseases. In our two cases of septic arthritis, we isolated strains with ?-lactamase-positive amoxicillin-clavulanate resistance (BLPACR). Thus, the increasing prevalence of BLPACR should be taken into account when empirical therapy is chosen for septic arthritis. PMID:23515545

Le Quellec, Sandra; Gaillot, Olivier; Chotel, Franck; Freydière, Anne-Marie; Laurent, Frédéric; Vandenesch, François

2013-01-01

371

The nail dystrophy of psoriatic arthritis  

Microsoft Academic Search

Nail abnormalities occur frequently in patients with psoriatic arthritis. This study of the finger nails of 46 patients with psoriatic arthritis, 100 nonpsoriatic rheumatism patients, and 100 nonpsoriatic general medical patients was designed to characterise these abnormalities with particular reference to the severity of nail pitting. The results of the study suggest: (1) Onycholysis alone in the absence of previous

C J Eastmond; V Wright

1979-01-01

372

Rheumatoid Arthritis and Complementary and Alternative Medicine  

MedlinePLUS

... botanicals in osteoarthritis and rheumatoid arthritis: a review. Evidence-Based Complementary and Alternative Medicine: e-CAM . 2005;2( ... Medicine Zhang C, Jiang M, Lü A-P. Evidence-based Chinese medicine for rheumatoid arthritis. Journal of Traditional ...

373

Ulceration of the cornea in rheumatoid arthritis.  

PubMed Central

Five patients with melting of the cornea in association with rheumatoid arthritis are described. The arthritis was often inactive and without systemic manifestations, in contrast to that seen in association with scleritis. In 3 there was evidence of reduced tear formation, but in none was tear production absent. In 3 patients the lesions healed during treatment with azathioprine or penicillamine. Images PMID:921342

Jayson, M I; Easty, D L

1977-01-01

374

Arthritis in Flemish paintings (1400-1700)  

Microsoft Academic Search

A close examination of the hands of people depicted in paintings of the Flemish school showed that in five paintings there were figures with hand lesions resembling those of rhematoid arthritis. Although none of the deformities or swellings are indisputable examples of rheumatoid arthritis, they do at least suggest that the painters must have been confronted with rheumatoid-like lesions in

J Dequeker

1977-01-01

375

Spondylitis in a humpback whale (Megaptera novaeangliae) from the southeast Pacific.  

PubMed

A 7.25 m long male humpback whale (Megaptera novaeangliae) with spondylitis was found beached on August 13, 1994 at Ancon, Ecuador (2 degrees 23' S, 80 degrees 47' W). The condition involved at least 11 vertebrae, 7 lumbar (L4 to L11) and 4 caudal (Ca1 to Ca4). Partial fusion of vertebrae was observed as a result of intervertebral bony proliferation, likely impeding full motion. The relatively young age of this specimen and the severity of the deformities suggest an infectious, rather than degenerative, process. The gross findings are most consistent with some type of spondyloarthritis. Although this condition has previously been identified in a number of cetacean species, the pathogenesis, population impact and ecologic implications have not been fully assessed. This is the third case described for humpback whales and the first for a humpback whale from the SE Pacific. PMID:17629121

Félix, Fernando; Haase, Ben; Aguirre, Windsor E

2007-05-01

376

Pulmonary miliary tuberculosis complicated with tuberculous spondylitis; an extraordinary rare association: a case report  

PubMed Central

In the last decade a significant rise in the prevalence of tuberculosis as well as in its extrapulmonary manifestations is detected worldwide. The central nervous system, the genitourinary tract, the organs of the abdomen and the skeletal system, are common sites of infection. Misdiagnosis and delay in treatment are common events. Herein, we present a case of a 78-year-old man non-smoker, with miliary tuberculosis complicated with tuberculous spondylitis. The patient presented with anemia and a left shoulder pain, accompanied by rigor and fever 37.5°C-38°C of one month duration. This entity is extremely rare, since only two similar cases have been reported in the English literature according to PubMed search. PMID:19918444

Palama, Eleni; Golias, Christos; Illiadis, Iosif

2009-01-01

377

Paralysis Developing as a Paradoxical Response During the Treatment for Tuberculous Spondylitis: A Case Report  

PubMed Central

It can be difficult for clinicians to distinguish a paradoxical response to antituberculous therapy, worsening of an existing lesion despite adequate treatment, treatment failure, and drug resistance. We report a case of a 69-year-old woman who experienced bilateral lower extremity paralysis secondary to a paradoxical response. She had been suffering for 1 month from low back pain, due to tuberculous spondylitis. Her low back pain improved after antituberculous therapy. The low back pain, however, reappeared 2 months after treatment, accompanied by newly developed lower extremity weakness. Imaging studies showed an increased extent of her previous lesions. Consequently, the patient underwent a vertebral corpectomy with interbody fusion of the thoracolumbar spine. Histopathological examination showed chronic inflamed granulation tissue with no microorganisms. Although the antituberculous medication was not changed, the patient's symptoms and signs, including the paralysis, resolved after surgery. PMID:25024967

Park, Jae Hyeon; Kim, Yeo Hyung; Kwon, Chan Hyuk

2014-01-01

378

Glucocorticoids in juvenile idiopathic arthritis.  

PubMed

Glucocorticoid (GC) drugs are a potent and rapidly effective therapeutic option for the treatment of juvenile idiopathic arthritis (JIA). These medications are mainly used for the management of the extra-articular features of systemic-onset disease. A course of low-dose prednisone may be considered for achieving a rapid disease control in patients with severe polyarthritis refractory to other therapies or while awaiting the full therapeutic effect of a recently initiated disease-modifying antirheumatic drug or biologic agent. Short-term systemic GC administration may also be indicated for chronic iridocyclitis unresponsive to topical therapy. The general objective of GC therapy is to limit the maximum dose and exposure to the highest doses to what is needed to achieve disease control, and then to gradually taper the dose until the minimum level sufficient to maintain disease quiescence over time is reached. High-dose intravenous 'pulse' methylprednisolone administration is sometimes chosen to treat the most severe or acute disease manifestations of systemic JIA, particularly macrophage activation syndrome. Intra-articular GC injection is a safe and rapidly effective treatment for synovitis in children with chronic arthritis. Triamcinolone hexacetonide is the optimal GC preparation for pediatric patients. Local injection therapy is used most frequently to treat oligoarthritis, but the strategy of performing multiple injections to induce disease remission, while simultaneously initiating therapy with second-line or biologic agents, has also been proposed for children with polyarticular JIA. Administration of GCs is associated with potentially deleterious adverse effects, some of which can be irreversible. This highlights the need of a judicious use of these medications and careful monitoring of their toxicity. The recently published recommendations for the management of JIA provide useful guidance to the clinicians for the administration of GCs in children with chronic arthritis. PMID:25227183

Schiappapietra, Benedetta; Varnier, Giulia; Rosina, Silvia; Consolaro, Alessandro; Martini, Alberto; Ravelli, Angelo

2015-01-01

379

Circadian rhythms: glucocorticoids and arthritis.  

PubMed

Circadian rhythms are driven by biological clocks and are endogenous in origin. Therefore, circadian changes in the metabolism or secretion of endogenous glucocorticoids are certainly responsible in part for the time-dependent changes observed in the inflammatory response and arthritis. More recently, melatonin (MLT), another circadian hormone that is the secretory product of the pineal gland, has been found implicated in the time-dependent inflammatory reaction with effects opposite those of cortisol. Interestingly, cortisol and MLT show an opposite response to the light. The light conditions in the early morning have a strong impact on the morning cortisol peak, whereas MLT is synthesized in a strictly nocturnal pattern. Recently, a diurnal rhythmicity in healthy humans between cellular (Th1 type) or humoral (Th2 type) immune responses has been found and related to immunomodulatory actions of cortisol and MLT. The interferon (IFN)-gamma/interleukin (IL)-10 ratio peaked during the early morning and correlated negatively with plasma cortisol and positively with plasma MLT. Accordingly, the intensity of the arthritic pain varies consistently as a function of the hour of the day: pain is greater after waking up in the morning than in the afternoon or evening. The reduced cortisol and adrenal androgen secretion, observed during testing in rheumatoid arthritis (RA) patients not treated with glucocoticoids, should be clearly considered as a "relative adrenal insufficiency" in the presence of a sustained inflammatory process, and allows Th1 type cytokines to be produced in higher amounts during the late night. In conclusion, the right timing (early morning) for the glucocorticoid therapy in arthritis is fundamental and well justified by the circadian rhythms of the inflammatory mechanisms. PMID:16855156

Cutolo, Maurizio; Sulli, Alberto; Pizzorni, Carmen; Secchi, Maria Elena; Soldano, Stefano; Seriolo, Bruno; Straub, Rainer H; Otsa, Kati; Maestroni, Georges J

2006-06-01

380

Prevalence of methotrexate intolerance in rheumatoid arthritis and psoriatic arthritis  

PubMed Central

Introduction The aim of this study was to determine the prevalence of gastrointestinal and behavioural symptoms occurring before (anticipatory/associative) and after methotrexate (MTX) administration, termed MTX intolerance, in rheumatoid (RA) and psoriatic arthritis (PsA). Methods Methotrexate Intolerance Severity Score (MISS), previously validated in juvenile idiopathic arthritis patients, was used to determine MTX intolerance prevalence in 291 RA/PsA patients. The MISS consisted of four domains: abdominal pain, nausea, vomiting and behavioural symptoms, occurring upon, prior to (anticipatory) and when thinking of MTX (associative). MTX intolerance was defined as ?6 on the MISS with ?1 point on anticipatory and/or associative and/or behavioural items. Results A total of 123 patients (42.3%) experienced at least one gastrointestinal adverse effect. The prevalence of MTX intolerance was 11%. MTX intolerance prevalence was higher in patients on parenteral (20.6%) than on oral MTX (6.2%) (p?

2013-01-01

381

Optical imaging of rheumatoid arthritis  

PubMed Central

Optical Imaging (OI) for rheumatoid arthritis is a novel imaging modality. With the high number of people affected by this disease, especially in western countries, the availability of OI as an early diagnostic imaging method is clinically highly relevant. In this article we describe the current techniques of OI and discuss potential future applications of this promising technology. Overall, we demonstrate that OI is a fast, inexpensive, noninvasive, nonionizing and accurate imaging modality. Furthermore, OI is a clinically applicable tool allowing for the early detection of inflammation and potentially facilitating the monitoring of therapy. PMID:21826190

Golovko, Daniel; Meier, Reinhard; Rummeny, Ernst; Daldrup-Link, Heike

2011-01-01

382

The Extended Posterior Circumferential Decompression Technique in the Management of Tubercular Spondylitis with and without Paraplegia  

PubMed Central

Study Design Retrospective clinical series. Purpose To study the clinical, functional and radiological results of patients with tuberculous spondylitis with and without paraplegia, treated surgically using the "Extended Posterior Circumferential Decompression (EPCD)" technique. Overview of Literature With the increasing possibility of addressing all three columns by a single approach, posterior and posterolateral approaches are gaining acceptance. A single exposure for cases with neurological deficit and kyphotic deformity requiring circumferential decompression, anterior column reconstruction and posterior instrumentation is helpful. Methods Forty-one patients with dorsal/dorsolumbar/lumbar tubercular spondylitis who were operated using the EPCD approach between 2006 to 2009 were included. Postoperatively, patients were started on nine-month anti-tuberculous treatment. They were serially followed up to thirty-six months and both clinical measures (including pain, neurological status and ambulatory status) and radiological measures (including kyphotic angle correction, loss of correction and healing status) were used for assessment. Results Disease-healing with bony fusion (interbody fusion) was seen in 97.5% of cases. Average deformity (kyphosis) correction was 54.6% in dorsal spine and 207.3% in lumbar spine. Corresponding loss of correction was 3.6 degrees in dorsal spine and 1.9 degrees in the lumbar spine. Neurological recovery in Frankel B and C paraplegia was 85.7% and 62.5%, respectively. Conclusions The EPCD approach permits all the advantages of a single or dual session anterior and posterior surgery, with significant benefits in terms of decreased operative time, reduced hospital stay and better kyphotic angle correction. PMID:25558312

Rathinavelu, Barani; Krishnan, Venkatesh; Amritanand, Rohit; Sundararaj, Gabriel David

2014-01-01

383

Orthodontic treatment of an ankylosed maxillary central incisor through single-tooth osteotomy by using interdental space regained from microimplant anchorage.  

PubMed

This case report describes the treatment of a boy, aged 13.6 years, whose ankylosed maxillary left central incisor had been avulsed and replanted 2.5 years earlier. Ankylosis of the tooth and adjacent alveolar process led to the development of infraocclusion, migration of adjacent teeth, midline deviation, and a vertical alveolar bone defect. Initially, distal tooth movement in the maxillary arch was performed with microimplant anchorage to gain space for repositioning the ankylosed tooth. Then a single-tooth osteotomy was performed in 1 surgical stage to allow for inferior repositioning of the tooth and bone. The ankylosed tooth was successfully leveled in the maxillary arch with a harmonic gingival margin. The total treatment period was 18 months, and the results were acceptable at 14 months after debonding. PMID:22284297

Chae, Jong-Moon; Paeng, Jun-Young

2012-02-01

384

Immunopathological features of rat Staphylococcus aureus arthritis.  

PubMed Central

Staphylococcus aureus is the most common bacterial species found in nongonococcal bacterial arthritis in humans. We present the first description, to our knowledge, of an outbreak of spontaneous staphylococcal arthritis in a rat colony. In a group of 10 rats, 9 displayed arthritis. Clinically, the most obvious findings were arthritis of one or both hindpaws and malaise. Bacteriophage typing showed the common phage type 85 in isolates recovered from the joints, blood, and bedding of rats and from the nose and cheeks of one person from the staff of the animal facility. The S. aureus strain proved to produce staphylococcal enterotoxin A and exhibited strong binding to collagen types I and II and bone sialoprotein, which are potentially important virulence factors. When the recovered S. aureus strain was injected intravenously into healthy rats, severe septic arthritis was induced in almost all of the animals. The arthritic lesions were characterized by infiltration of phagocytic cells and T lymphocytes into the synovium. Many of the synovial cells strongly expressed major histocompatibility complex class II molecules. Increased levels of interleukin 6 in serum as well as a prominent polyclonal B-cell activation were noted throughout the disease course. Pretreatment of S. aureus-injected rats in vivo with an antibody to the alpha beta T-cell receptor significantly decreased the severity of the arthritis. Our results indicate that alpha beta + T lymphocytes contribute to an erosive and persistent course of S. aureus arthritis. Images PMID:8188356

Bremell, T; Lange, S; Holmdahl, R; Rydén, C; Hansson, G K; Tarkowski, A

1994-01-01

385

Histopathological and ultrastructural modifications of the articular cartilage in ankylosing spondylarthritis.  

PubMed

The present study aims to analyse the articular cartilage in Ankylosing, Spondylarthritis (AS) versus the normal cartilage (18 cases altogether) by histopathological (HE, VG, Pas-Alcian, Gömöri, Safranine O), electronmicroscopic and histoenzymological techniques starting from the finding that the articular exudate in this affection is characterized cytomorphologically by cytosis (6,100/mm3), with polynucleosis (61%) and ragocytosis (25%). Histopathologically, the articular cartilage in AS evinced an alteration of safraninophilic areas and pale zones located in the neighbourhood of synovial lymphoplasmocytic infiltrates, pointing to the depletion of proteoglycans. The cartilage-synovia interference areas are relevant for the invasive nature of the inflammatory infiltrates which erode the cartilage. The histopathological modifications were confirmed ultrastructurally by the existence of some extended areas of revealed collagen, indicative of proteoglycans depletion. Functionally, chondrocytes have a high oxidative potential expressed by the presence of the peroxisomes and the positive reaction of peroxidase (PO), located near the nuclear membrane and the rough endoplasmic reticulum. The corroboration of histopathological, ultrastructural and histoenzymological data shows the alteration of the articular cartilage in AS, expressed morphologically at the level of the chondrocytes and of their synthesis products, collagen and proteoglycans. PMID:8032022

Ciobanu, A; Ciobanu, I R; H?l?l?u, F; Laky, D; Dinulescu, I; St?nculescu, M

1993-01-01

386

Synovial leukocytosis in infectious arthritis.  

PubMed

The clinical presentation of 41 adult patients with infectious arthritis has been reviewed with special emphasis on initial synovial fluid leukocytosis. Fifty percent of the patients with culture-proven joint-space infections had synovial fluid leukocyte counts below 28,000/mm3. Comparison of this investigation with previous studies of similar magnitude demonstrates a striking difference in the mean and median synovial fluid white cell counts. The population reviewed had a higher incidence of patients with potentially immunocompromising medical conditions than previous reports. Similarities between this and previous reports include predisposing conditions, the spectrum of pathogens cultured, associated clinical findings on admission, hospital course, and mortality. The data presented here document the magnitude of potential overlap between the synovial fluid leukocytosis in infected joints and in joints afflicted with other forms of inflammatory arthropathy. Three patients populations (malignant neoplasms, steroid use, and intravenous drug abuse) with positive cultures from synovial fluid aspirates but initial synovial fluid white cell counts averaging below 50,000 cells/mm3 were identified. Patients with moderate synovial fluid leukocytosis, especially those potentially immunocompromised, must be considered to have infectious arthritis unless other causes of inflammatory arthropathies are demonstrated. PMID:2379361

McCutchan, H J; Fisher, R C

1990-08-01

387

Conjunctival nodule in rheumatoid arthritis.  

PubMed

Conjunctival nodule is very rarely seen in patients with rheumatoid arthritis. Previously reported cases were associated with the use of methotrexate. Here, we report a conjunctival rheumatoid nodule without such prior treatment. A 49-year-old woman with seropositive rheumatoid arthritis, who was being treated only with oral steroids and hydroxychloroquine, developed diffuse anterior scleritis in the right eye. In addition, examination showed a focal raised yellow/tan conjunctival nodule. The nodule was within the bulbar conjunctiva with no attachments to the underlying tissue, which is different from nodular scleritis. The nodule was not tender on palpation. The patient underwent excisional biopsy of the nodule. Intraoperatively, the lesion was noted to be a firm nodule within substantia propria of the conjunctiva. Hematoxylin-eosin staining of the specimen revealed a central area of necrosis surrounded by palisades of histiocytes. Increased dosage of oral steroid after the biopsy resulted in resolution of the ocular symptoms and signs. In conclusion, rheumatoid nodules may be seen in the conjunctiva even without prior treatment with methotrexate. These nodules may show the severity of the underlying disease and the need for more aggressive treatment. PMID:22271069

Kheirkhah, Ahmad; Amoli, Fahimeh Asadi; Azari, Amir A; Molaei, Saber; Roozbahani, Mehdi

2012-02-01

388

Inhibition of Inflammatory Arthritis Using Fullerene Nanomaterials  

PubMed Central

Inflammatory arthritis (e.g. rheumatoid arthritis; RA) is a complex disease driven by the interplay of multiple cellular lineages. Fullerene derivatives have previously been shown to have anti-inflammatory capabilities mediated, in part, by their ability to prevent inflammatory mediator release by mast cells (MC). Recognizing that MC can serve as a cellular link between autoantibodies, soluble mediators, and other effector populations in inflammatory arthritis, it was hypothesized that fullerene derivatives might be used to target this inflammatory disease. A panel of fullerene derivatives was tested for their ability to affect the function of human skin-derived MC as well as other lineages implicated in arthritis, synovial fibroblasts and osteoclasts. It is shown that certain fullerene derivatives blocked Fc?R- and TNF-?-induced mediator release from MC; TNF-?-induced mediator release from RA synovial fibroblasts; and maturation of human osteoclasts. MC inhibition by fullerene derivatives was mediated through the reduction of mitochondrial membrane potential and Fc?R-mediated increases in cellular reactive oxygen species and NF-?B activation. Based on these in vitro data, two fullerene derivatives (ALM and TGA) were selected for in vivo studies using K/BxN serum transfer arthritis in C57BL/6 mice and collagen-induced arthritis (CIA) in DBA/1 mice. Dye-conjugated fullerenes confirmed localization to affected joints in arthritic animals but not in healthy controls. In the K/BxN moldel, fullerenes attenuated arthritis, an effect accompanied by reduced histologic inflammation, cartilage/bone erosion, and serum levels of TNF-?. Fullerenes remained capable of attenuating K/BxN arthritis in mast cell-deficient mice Cre-Master mice, suggesting that lineages beyond the MC represent relevant targets in this system. These studies suggest that fullerene derivatives may hold promise both as an assessment tool and as anti-inflammatory therapy of arthritis. PMID:25879437

Dellinger, Anthony L.; Cunin, Pierre; Lee, David; Kung, Andrew L.; Brooks, D. Bradford; Zhou, Zhiguo; Nigrovic, Peter A.; Kepley, Christopher L.

2015-01-01

389

Total Knee Arthroplasty in Rheumatoid Arthritis  

PubMed Central

The course of rheumatoid arthritis varies from mild disease to severe joint destructive variant that progresses rapidly, eventually leading to unremitting pain and joint deformity. In advanced disease, total knee arthroplasty has proven to be the most successful intervention that reduces knee pain and improves physical function in rheumatoid arthritis patients. However, as rheumatoid arthritis patients carry additional potential for late complications, many important considerations regarding preoperative evaluation and surgical technique must be taken into account in order to improve the results of total knee arthroplasty in this subgroup of patients. PMID:22570845

Lee, Jin Kyu

2012-01-01

390

Chemokines and angiogenesis in rheumatoid arthritis  

PubMed Central

In rheumatoid arthritis, chemokines mediate the migration of inflammatory leukocytes into the synovium. Among the four known chemokine families, CXC, CC chemokines and fractalkine seem to be of outstanding importance in this process. Angiogenesis, the formation of new vessels, is also important during the perpetuation of inflammation underlying rheumatoid arthritis. In this review, authors discuss the role of the most important chemokines and chemokine repetors in arthritis-associated neovascularization. The process and regulation of angiogenesis are described in this context as well. Apart from discussing the pathogenic role of chemokines and chemokine receptors in arthritic vessel formation, authors also review the important relevance of chemokines and angiogenesis for therapeutic intervention. PMID:19482623

Szekanecz, Zoltan; Pakozdi, Angela; Szentpetery, Agnes; Besenyei, Timea; Koch, Alisa E.

2010-01-01

391

Tropical Virus Symptoms Can Mimic Rheumatoid Arthritis  

MedlinePLUS

... features on this page, please enable JavaScript. Tropical Virus Symptoms Can Mimic Rheumatoid Arthritis: Study Similarities may ... 20, 2015 (HealthDay News) -- The mosquito-borne chikungunya virus causes joint pain and swelling similar to rheumatoid ...

392

Accommodation and Compliance Series: Employees with Arthritis  

MedlinePLUS

... handed keyboard, an articulating keyboard tray, speech recognition software, a trackball, and office equipment for a workstation ... space heater, additional window insulation, and speech recognition software. An insurance clerk with arthritis from systemic lupus ...

393

Management of melioidosis osteomyelitis and septic arthritis.  

PubMed

Little information is available about several important aspects of the treatment of melioidosis osteomyelitis and septic arthritis. We undertook a retrospective review of 50 patients with these conditions in an attempt to determine the effect of location of the disease, type of surgical intervention and duration of antibiotic treatment on outcome, particularly complications and relapse. We found that there was a 27.5% risk of osteomyelitis of the adjacent bone in patients with septic arthritis in the lower limb. Patients with septic arthritis and osteomyelitis of an adjacent bone were in hospital significantly longer (p = 0.001), needed more operations (p = 0.031) and had a significantly higher rate of complications and re-presentation (p = 0.048). More than half the patients (61%), most particularly those with multifocal bone and joint involvement, and those with septic arthritis and osteomyelitis of an adjacent bone who were treated operatively, needed more visits to theatre. PMID:25628295

Shetty, R P; Mathew, M; Smith, J; Morse, L P; Mehta, J A; Currie, B J

2015-02-01

394

The spondyloarthropathies.  

PubMed

The spondyloarthropathies occur with variable frequency in the tropics. Ankylosing spondylitis, in particular, is thought to be rare in tropical Africa, reflecting a low frequency of the HLA B27 gene. However, in the Melanesian populations of Papua New Guinea where there is a relatively high frequency of HLA B27, ankylosing spondylosis is infrequent. These diverse observations may be related to variations in B27 sub-types. Reactive arthritis is a common and important form of acute arthritis in the tropics and in Papua New Guinea at least has a strong association with HLA B27. In Africa an increasing prevalence of reactive arthritis may be related to the spread of HIV infection. Extra-articular features such as balanitis and enthositis are helpful pointers to the diagnosis. Disseminated gonococcal infection and tuberculosis must always be considered and treatment offered if doubt exists. The mainstay of treatment of reactive arthritis is, as always, an anti-inflammatory drug, supplemented by hydrocortisone injections; docycline is available for chlamydia-triggered arthritis and chloroquine or dapsone for more chronic, unresponsive cases. PMID:7728892

Richens, J; McGill, P E

1995-02-01

395

Septic arthritis: immunopathogenesis, experimental models and therapy  

PubMed Central

Septic arthritis is an inflammatory disease of the joints that is started by an infection whose most common agent is Staphylococcus aureus. In this review we discuss some of the most arthritogenic bacterial factors and the contribution of innate and specific immune mechanisms to joint destruction. Special emphasis is given to the induction of experimental arthritis by S. aureus in mice. The improvement of therapy by association of antibiotics with down-modulation of immunity is also included. PMID:24822058

2014-01-01

396

Bronchiectasis and rheumatoid arthritis: a clinical study  

Microsoft Academic Search

OBJECTIVES--To examine the relation between rheumatoid arthritis (RA) and bronchiectasis (BR). METHODS--Disease activity, outcome, extra-articular manifestations, and laboratory features were compared in 32 patients with BR and RA (RA-BR group), 32 matched patients with RA without BR (RA group), and 31 patients with BR but without arthritis (BR group). RESULTS--In 30 of the 32 (94%) patients with RA-BR, BR preceded

M J McMahon; D R Swinson; S Shettar; R Wolstenholme; C Chattopadhyay; P Smith; P Johns; N H Crosby

1993-01-01

397

Primary and Posttraumatic Arthritis of the Elbow  

PubMed Central

Whether degenerative joint disease of the elbow may be the result of primary or posttraumatic etiologies, arthritis of the elbow commonly leads to pain, loss of motion, and functional disability. A detailed history and focused physical examination, in combination with imaging modalities, can help localize the origin of symptoms and help direct treatment. Although nonoperative treatment is the initial therapy for arthritis of the elbow, surgical interventions may provide substantial relief to the appropriately selected patient. PMID:23781338

Biswas, Debdut; Wysocki, Robert W.; Cohen, Mark S.

2013-01-01

398

New agents for scintigraphy in rheumatoid arthritis  

Microsoft Academic Search

Radiopharmaceuticals have been used as investigative tools for the detection and treatment of arthritis activity in rheumatoid arthritis (RA) since the 1950s. Against the background of the pathophysiology of RA, the current status of joint scintigraphy and possible future developments are reviewed. Both non-specific (radiolabelled leucocytes and technetium-99m labelled human immunoglobulin) and specific targeting radiopharmaceuticals (including radiolabelled antibodies) are considered.

Marjolein H. W. Bois; Ernest K. J. Pauwels; Ferdinand C. Breedveld

1995-01-01

399

Rheumatoid arthritis in Saudi Arabia  

PubMed Central

The status of rheumatoid arthritis (RA) in Saudi Arabia (SA) was examined from various perspectives based on a systematic literature review and the authors’ personal experiences. In this regard, database and journal search were conducted to identify studies on RA in SA, yielding a total of 43 articles. Although efforts have been made to promote RA research in SA, current studies mostly represent only a few centers and may not accurately portray the national status of RA care. Notably, biological therapies were introduced early for almost all practicing rheumatologists in SA (government and private). However, no national guidelines regarding the management of RA have been developed based on local needs and regulations. Also, while efforts were made to establish RA data registries, they have not been successful. Taken together, this analysis can contribute to the planning of future guidelines and directives for RA care in SA. PMID:25491208

Almoallim, Hani M.; Alharbi, Laila A.

2014-01-01

400

Pharmacotherapy Options in Rheumatoid Arthritis  

PubMed Central

Drugs form the mainstay of therapy in rheumatoid arthritis (RA). Five main classes of drugs are currently used: analgesics, non-steroidal anti-inflammatories (NSAIDs), glucocorticoids, nonbiologic and biologic disease-modifying antirheumatic drugs. Current clinical practice guidelines recommend that clinicians start biologic agents if patients have suboptimal response or intolerant to one or two traditional disease modifying agents (DMARDs). Methotrexate, sulfasalazine, leflunomide and hydroxychloroquine are the commonly used DMARDs. Currently, anti-TNF is the commonly used first line biologic worldwide followed by abatacept and it is usually combined with MTX. There is some evidence that tocilizumab is the most effective biologic as a monotherapy agent. Rituximab is generally not used as a first line biologic therapy due to safety issues but still as effective as anti-TNF. The long term data for the newer oral small molecule biologics such as tofacitinib is not available and hence used only as a last resort. PMID:23997576

Kumar, Pradeep; Banik, Snehashish

2013-01-01

401

Rheumatoid arthritis affecting temporomandibular joint  

PubMed Central

Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT) has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT) in diagnosing the bony changes in the early phase of the disease. PMID:25684928

Sodhi, Amandeep; Naik, Shobha; Pai, Anuradha; Anuradha, Ardra

2015-01-01

402

Can Rheumatoid Arthritis Be Prevented?  

PubMed Central

The discovery of elevations of rheumatoid arthritis (RA)-related biomarkers prior to the onset of clinically apparent RA raises hopes that individuals who are at risk for future RA can be identified in a preclinical phase of disease that is defined as abnormalities of RA-related immune activity prior to the clinically apparent onset of joint disease. Additionally, there is a growing understanding of the immunologic processes that are occurring in preclinical RA, as well as a growing understanding of risk factors that may be mechanistically related to RA development. Furthermore, there are data supporting that treatment of early RA can lead to drug free remission. Taken as a whole, these findings suggest that it may be possible to use biomarkers and other factors to accurately identify the likelihood and timing of onset of future RA, and intervene with immunomodulatory therapies and/or risk factor modification to prevent the future onset of RA in at-risk individuals. Importantly, several clinical prevention trials for RA have already been tried, and one is underway. However, while our understanding of the growing understanding of the mechanisms and natural history of RA development may be leading us to the implementation of prevention strategies for RA, there are still several challenges to be met. These include developing sufficiently accurate methods of predicting those at high risk for future RA so that clinical trials can be developed based on accurate rates of development of arthritis and subjects can be adequately informed of their risk for disease, identifying the appropriate interventions and biologic targets for optimal prevention, and addressing the psychosocial and economic aspects that are crucial to developing broadly applicable prevention measures for RA. These issues notwithstanding, prevention of RA may be within reach in the near future. PMID:24315049

Deane, Kevin

2013-01-01

403

Burden of childhood-onset arthritis.  

PubMed

Juvenile arthritis comprises a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated morbidity, and life-long disability and risk for emotional and social dysfunction. In this article we will review the burden of juvenile arthritis for the patient and society and focus on the following areas: patient disability; visual outcome; other medical complications; physical activity; impact on HRQOL; emotional impact; pain and coping; ambulatory visits, hospitalizations and mortality; economic impact; burden on caregivers; transition issues; educational occupational outcomes, and sexuality.The extent of impact on the various aspects of the patients', families' and society's functioning is clear from the existing literature. Juvenile arthritis imposes a significant burden on different spheres of the patients', caregivers' and family's life. In addition, it imposes a societal burden of significant health care costs and utilization. Juvenile arthritis affects health-related quality of life, physical function and visual outcome of children and impacts functioning in school and home. Effective, well-designed and appropriately tailored interventions are required to improve transitioning to adult care, encourage future vocation/occupation, enhance school function and minimize burden on costs. PMID:20615240

Moorthy, Lakshmi N; Peterson, Margaret Ge; Hassett, Afton L; Lehman, Thomas Ja

2010-01-01

404

Burden of childhood-onset arthritis  

PubMed Central

Juvenile arthritis comprises a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated morbidity, and life-long disability and risk for emotional and social dysfunction. In this article we will review the burden of juvenile arthritis for the patient and society and focus on the following areas: patient disability; visual outcome; other medical complications; physical activity; impact on HRQOL; emotional impact; pain and coping; ambulatory visits, hospitalizations and mortality; economic impact; burden on caregivers; transition issues; educational occupational outcomes, and sexuality. The extent of impact on the various aspects of the patients', families' and society's functioning is clear from the existing literature. Juvenile arthritis imposes a significant burden on different spheres of the patients', caregivers' and family's life. In addition, it imposes a societal burden of significant health care costs and utilization. Juvenile arthritis affects health-related quality of life, physical function and visual outcome of children and impacts functioning in school and home. Effective, well-designed and appropriately tailored interventions are required to improve transitioning to adult care, encourage future vocation/occupation, enhance school function and minimize burden on costs. PMID:20615240

2010-01-01

405

Arthritis and pain. Psychosocial aspects in the management of arthritis pain  

Microsoft Academic Search

The purpose of this review is to summarize psychosocial factors associated with arthritis pain and highlight recent evidence for psychosocial approaches to managing arthritis pain. By definition, psychosocial factors refer to two dimensions of experience: the psychological (cognitive, affective) and social (interacting with others, engaging in life activities). Psychosocial factors influence the perception of pain and the presence of pain

Catherine L Backman

2006-01-01

406

Beaver fever--a rare cause of reactive arthritis.  

PubMed

Giardia lamblia infection is rarely associated with adult reactive arthritis. We report the first North American case and review the pediatric and adult literature to date. Antimicrobial treatment is essential to eradicate the parasite and control the arthritis. PMID:10606388

Tupchong, M; Simor, A; Dewar, C

1999-12-01

407

38 CFR 4.58 - Arthritis due to strain.  

Code of Federal Regulations, 2010 CFR

...of earlier, or more severe, arthritis in the injured extremity, including also arthritis of the lumbosacral joints and lumbar spine, if associated with the leg amputation or shortening, will be considered as service incurred, provided, however, that...

2010-07-01

408

38 CFR 4.58 - Arthritis due to strain.  

Code of Federal Regulations, 2012 CFR

...earlier, or more severe, arthritis in the injured extremity, including also arthritis of the lumbosacral joints and lumbar spine, if associated with the leg amputation or shortening, will be considered as service incurred, provided, however,...

2012-07-01

409

38 CFR 4.58 - Arthritis due to strain.  

Code of Federal Regulations, 2011 CFR

...earlier, or more severe, arthritis in the injured extremity, including also arthritis of the lumbosacral joints and lumbar spine, if associated with the leg amputation or shortening, will be considered as service incurred, provided, however,...

2011-07-01

410

38 CFR 4.58 - Arthritis due to strain.  

Code of Federal Regulations, 2014 CFR

...earlier, or more severe, arthritis in the injured extremity, including also arthritis of the lumbosacral joints and lumbar spine, if associated with the leg amputation or shortening, will be considered as service incurred, provided, however,...

2014-07-01

411

38 CFR 4.58 - Arthritis due to strain.  

Code of Federal Regulations, 2013 CFR

...earlier, or more severe, arthritis in the injured extremity, including also arthritis of the lumbosacral joints and lumbar spine, if associated with the leg amputation or shortening, will be considered as service incurred, provided, however,...

2013-07-01

412

Depression, illness perception and coping in rheumatoid arthritis  

Microsoft Academic Search

This study aimed to establish the relationship between depression, illness perception, coping strategies, and adverse childhood events in rheumatoid arthritis patients. Sixty-two out-patients with rheumatoid arthritis (RA) completed the Hospital Anxiety and Depression Scale, Illness Perception Questionnaire, London Coping with Rheumatoid Arthritis Questionnaire, and Childhood Development Questionnaire, and underwent a clinical assessment of their physical state. Depressed patients were more

Helen Murphy; Chris Dickens; Francis Creed; R. Bernstein

1999-01-01

413

Ustekinumab for the treatment of psoriatic arthritis: an update  

PubMed Central

Psoriatic arthritis occurs in 30% of psoriasis patients, and the treatment can be challenging in some patients. Recently, the US Food and Drug Administration approved ustekinumab, a fully human monoclonal antibody, for the management of psoriatic arthritis. In this article, we review large-scale randomized clinical trials addressing the efficacy and safety profile of ustekinumab for the treatment of psoriatic arthritis. PMID:25214798

Davari, Parastoo; Leo, Michael S; Kamangar, Faranak; Fazel, Nasim

2014-01-01

414

Pemetrexed ameliorates experimental arthritis in rats.  

PubMed

Pemetrexed (PMTX) is an anti-folate drug as methotrexate. The purpose of this study was to assess the efficacy of PMTX on collagen-induced arthritis (CIA). Forty Wistar albino rats were randomized into four groups. Arthritis was induced by intradermal injection of chicken type II collagen combined with incomplete Freund's adjuvant. Animals were sacrificed at the 15th day after the onset of arthritis. Tumor necrosis factor alpha (TNF-?), interleukin (IL)-17, and malondialdehyde (MDA) levels were increased, and superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) activities and the expressions of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) were decreased in the arthritis group. In the PMTX-treated (0.2 and 1 mg/kg/week i.p.) groups, the levels of TNF-?, IL-17, and MDA were decreased; the activities of SOD, CAT, and GPx and the expressions of Nrf2 and HO-1 were restored, and perisynovial inflammation and cartilage-bone destruction were decreased. PMTX has anti-arthritic potential in the CIA model and may be a therapeutic agent for rheumatoid arthritis. PMID:25129058

Karatas, Ahmet; Koca, Suleyman Serdar; Ozgen, Metin; Dagli, Adile Ferda; Erman, Fazilet; Sahin, Nuran; Sahin, Kazim; Isik, Ahmet

2015-02-01

415

Immunopathology of chronic lentivirus-induced arthritis.  

PubMed Central

This study evaluated histopathology and mononuclear cell phenotypes in synovial lesions of chronic arthritis induced by experimental infection of Saanen goats with caprine arthritis-encephalitis lentivirus. Histological examination of carpal joint synovium of three infected goats with clinical arthritis revealed progressive lesions consisting of membrane villus hypertrophy with extensive angiogenesis and mononuclear cell infiltration and degenerative changes of membrane villus necrosis associated with loss of vasculature and infiltrates. Changes in synovial tissue of five age-matched infected goats without clinical arthritis were limited to moderate synovial membrane hyperplasia also noted in an age-matched uninfected goat. Immunohistochemistry identified CD45R+ CD5- B lymphocytes as the principal component of most perivascular infiltrates in arthritic synovium. Other mononuclear cells included perivascular CD4+ and CD8+ T lymphocytes and macrophages with a prominent accumulation of CD8+ T lymphocytes at the lining surface of inflamed villi. T lymphocytes and macrophages as well as synovial lining cells were activated with respect to MHC class II but not for interleukin-2 receptors. Inflamed villi also contained lymphoid aggregates comprised of B cell germinal centers and activated T-cell mantles. B cells expressing immunoglobulin occurred around follicles and throughout inflamed villi. These findings indicate that memory immune responses that favor expansion and maturation of B cells and immunoglobulin production contribute to the immunopathology of chronic arthritis. Images Figure 1 Figure 2 Figure 3 Figure 5 Figure 6 PMID:7778682

Wilkerson, M. J.; Davis, W. C.; Baszler, T. V.; Cheevers, W. P.

1995-01-01

416

Interleukin 6 and Rheumatoid Arthritis  

PubMed Central

Interleukin-6 (IL-6) is a representative cytokine featuring pleiotropic activity and redundancy. A transient synthesis of IL-6 contributes to host defense against infectious agents and tissue injuries by inducing acute phase reactions and immunological and hematopoietic responses. However, uncontrolled persistent production of IL-6 may lead to the development of several immune-mediated diseases. Rheumatoid arthritis (RA) is a chronic disease with joint and systemic inflammation resulting from immunological abnormalities and it has been found that IL-6 plays a key role in the development of this disease. Clinical trials in various parts of the world of tocilizumab, a humanized anti-IL-6 receptor antibody, have proved its efficacy and tolerable safety either as monotherapy or in combination with disease-modifying antirheumatic drugs. As a result, it is currently used as a first-line biologic for the treatment of moderate-to-severe RA in more than 100 countries. Clarification of the mechanism(s) through which tocilizumab exerts its effect on RA and of the reason(s) why IL-6 is continuously produced in RA can be expected to lead to the best use of this agent for RA patients and aid in investigations into the pathogenesis of RA. PMID:24524085

Yoshida, Yuji

2014-01-01

417

[Atrioventricular blocks and rheumatoid arthritis].  

PubMed

Among 379 hospitalized cases of rheumatoid polyarthritis, 12 auriculo-ventricular blocks were detected between 1965 and 1975. The formation of a complete AV block is usually preceded by a branch block or a first degree block. During the installation of a pacemaker, hypoexcitability was usually noted. Four of the patients died. In the other 8 the evolution has been satisfactory over periods from 6 months to 4 years. Conduction disturbances were found in cases of polyarthritis of 10 years duration on the average. The articular lesions were normally diffuse with considerable lesions detectable radiologically. In many cases the frequency of extra-articular lesions indicated the severity of the rheumatic disease. From the anatomical point of view, histological lesions of rheumatoid polyarthritis were found : granuloma and arteritis in the myocardium. Only 8 authors have previously reported lesions of the donducting vessels at autopsies carried out on rheumatoid polyarthritis cases who had presented AV blocks. Except for Thery's case related to amylosis of the nodal tissue, rheumatoid granulomas occupied the whole or part of the nodal tissue. In elderly subjects suffering from rheumatoid arthritis, it was difficult to establish a strictly rheumatoid origin for the AV blocks observed, unless specific granulomas were discovered anatomically in the nodal tissue. PMID:1265414

David-Chaussé, J; Blanchot, P; Warin, J; Dehais, J; Bullier, R; Texier, J M

1976-03-01

418

HLA-linked rheumatoid arthritis  

SciTech Connect

Twenty-eight pedigrees were ascertained through pairs of first-degree relatives diagnosed with rheumatoid arthritis (RA). RA was confirmed in 77 pedigree members including probands; the absence of disease was verified in an additional 261 pedigree members. Pedigree members were serologically typed for HLA. We used likelihood analysis to statistically characterize the HLA-linked RA susceptibility locus. The genetic model assumed tight linkage to HLA. The analysis supported the existence of an HLA-linked RA susceptibility locus, estimated the lifetime penetrance as 41% in male homozygotes and as 48% in female homozygotes. Inheritance was recessive in males and was nearly recessive in females. In addition, the analysis attributed 78% of the variance within genotypes to genetic or environmental effects shared by siblings. The genetic model inferred in this analysis is consistent with previous association, linkage, and familial aggregation studies of RA. The inferred HLA-linked RA susceptibility locus accounts for approximately one-fifth of the RA in the population. Although other genes may account for the remaining familial RA, a large portion of RA cases may occur sporadically. 79 refs., 9 tabs.

Hasstedt, S.J.; Clegg, D.O.; Ingles, L.; Ward, R.H. [Univ. of Utah, Salt Lake City, UT (United States)

1994-10-01

419

Vitamin D in rheumatoid arthritis.  

PubMed

The discovery of the vitamin D receptor (VDR) in the cells of the immune system and the fact that activated dendritic cells produce the vitamin D hormone suggested that vitamin D could have immunoregulatory properties. VDR, a member of the nuclear hormone receptor superfamily, was identified in mononuclear cells, dendritic cells, antigen-presenting cells, and activated T-B lymphocytes. In synthesis, the most evident effects of the D-hormone on the immune system seem to be in the downregulation of the Th1-driven autoimmunity. Low serum levels of vitamin D3 might be partially related, among other factors, to prolonged daily darkness (reduced activation of the pre vitamin D by the ultra violet B sunlight), different genetic background (i.e. vitamin D receptor polymorphism) and nutritional factors, and explain to the latitute-related prevalence of autoimmune diseases such as rheumatoid arthritis (RA), by considering the potential immunosuppressive roles of vitamin D. 25(OH)D3 plasma levels have been found inversely correlated at least with the RA disease activity showing a circannual rhythm (more severe in winter). Recently, greater intake of vitamin D was associated with a lower risk of RA, as well as a significant clinical improvement was strongly correlated with the immunomodulating potential in vitamin D-treated RA patients. PMID:17967727

Cutolo, Maurizio; Otsa, Kati; Uprus, Maria; Paolino, Sabrina; Seriolo, Bruno

2007-11-01

420

Cricoarytenoid arthritis: a cause of acute upper airway obstruction in rheumatoid arthritis  

Microsoft Academic Search

Purpose  To report acute upper airway obstruction due to cricoarytenoid arthritis, a well known but uncommon complication of rheumatoid\\u000a arthritis.\\u000a \\u000a \\u000a \\u000a Clinical features  We report the case of a 70-yr-old female scheduled for a colostomy who had been suffering from rheumatoid arthritis for 17\\u000a years. Preoperative history and physical examination revealed no cardiopulmonary compromise. Anesthesia was induced while\\u000a an assistant immobilized the cervical

Jacelyn Kolman; Ian Morris

2002-01-01

421

The arthritis of mixed connective tissue disease.  

PubMed Central

Twenty patients with mixed connective tissue disease were followed for 5 years. Arthritis occurred in all 20 patients, being the presenting complaint in 11 patients. The joints most frequently involved were the proximal interphalangeal (PIP), metacarpophalangeal (MCP), wrists, metatarsophalangeal (MTP), and knee; the distribution tended to be symmetrical, mimicking early rheumatoid arthritis. Joint deformities occurred in 6 patients, but apart from 1 patient with arthritis mutilans, significant functional impairment was not encountered. Radiologically small punched out bone erosions, asymmetrically distributed, were the most characteristic finding; other notable changes were aseptic necrosis, tuft erosions, and periarticular calcification. Joint effusions were non-inflammatory, the cellular content was predominantly lymphocytic and the C3 level was normal. Most cases were controlled with non-steroidal anti-inflammatory agents and invariably responded to prednisone less than or equal to 7.5 mg/day. Images PMID:718271

Bennett, R M; O'Connell, D J

1978-01-01

422

Apremilast for the treatment of psoriatic arthritis.  

PubMed

Psoriatic arthritis occurs in about one-third of patients with psoriasis, and is a severely disabling, progressive inflammatory spondyloarthropathy typically treated with non-steroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs, TNF-? inhibitors and ustekinumab. These medications moderately improve the arthritis, dactylitis, and enthesitis that characterize psoriatic arthritis, however, they are associated with serious long-term adverse effects, issues with safety and tolerability, and high cost. Moreover, many patients do not respond or have resistant or recurrent manifestations to these agents. Apremilast is an orally available phosphodiesterase type 4 inhibitor that may block the pathogenic inflammatory Th17 and Th1 pathways upstream of current biologics, which target extracellular molecules of the immunological response. PMID:24702658

Varada, Sowmya; Tintle, Suzanne J; Gottlieb, Alice B

2014-05-01

423

Arthritis in Flemish paintings (1400-1700).  

PubMed

A close examination of the hands of people depicted in paintings of the Flemish school showed that in five paintings there were figures with hand lesions resembling those of rhematoid arthritis. Although none of the deformities or swellings are indisputable examples of rheumatoid arthritis, they do at least suggest that the painters must have been confronted with rheumatoid-like lesions in their models. In two other paintings there were signs of rheumatic fever and of temporal arteritis. No arthritic lesions were found in the works of painters of the Italian Renaissance, probably because they are less detailed. The finding of rheumatoid deformities in the Flemish paintings does, however, question the general belief that rheumatoid arthritis is a condition that has arisen relatively recently. PMID:324568

Dequeker, J

1977-05-01

424

Arthritis in Flemish paintings (1400-1700).  

PubMed Central

A close examination of the hands of people depicted in paintings of the Flemish school showed that in five paintings there were figures with hand lesions resembling those of rhematoid arthritis. Although none of the deformities or swellings are indisputable examples of rheumatoid arthritis, they do at least suggest that the painters must have been confronted with rheumatoid-like lesions in their models. In two other paintings there were signs of rheumatic fever and of temporal arteritis. No arthritic lesions were found in the works of painters of the Italian Renaissance, probably because they are less detailed. The finding of rheumatoid deformities in the Flemish paintings does, however, question the general belief that rheumatoid arthritis is a condition that has arisen relatively recently. Images FIGS 1-2 FIG 3 FIG 4 FIG 5 FIG 6 FIG 7 PMID:324568

Dequeker, J

1977-01-01

425

Mast cell involvement in rheumatoid arthritis.  

PubMed

Autoimmunity is a failure of self-tolerance resulting in immune reactions against autologous antigen. Rheumatoid arthritis is characterized by inflammation of synovium associated with destruction of the join cartilage and bone. A role of mast cell-mediated inflammation and antibodies are involved in this disease. Numerous cytokines such as IL-1, TNF, IL-8, IL-33 and IFN gamma have been implicated in rheumatoid arthritis and in particular in the synovial joint fluid. Since TNF is believed to activates resident synovial cells to produce collagenase that mediate destruction of cartilage, antagonists against the inflammatory cytokine TNF have a beneficial effects in this disease. Here we review the interrelationship between rheumatoid arthritis and mast cell activation. PMID:24152834

Kritas, S K; Saggini, A; Varvara, G; Murmura, G; Caraffa, A; Antinolfi, P; Toniato, E; Pantalone, A; Neri, G; Frydas, S; Rosati, M; Tei, M; Speziali, A; Saggini, R; Pandolfi, F; Theoharides, T C; Conti, P

2013-01-01

426

Radiosynovectomy in the Therapeutic Management of Arthritis  

PubMed Central

Radiosynovectomy is a well-established therapy in arthritis and involves an intra-articular injection of small radioactive particles to treat a synovitis. In Europe, frequent indications are rheumatoid and poly-arthritis. Especially in Germany radiosynovectomy is the second common therapy in Nuclear Medicine with about 40,000–60,000 treated joints per year. In Spain, USA, Turkey, Argentines and Philippines the therapy is more use in hemophilic arthritis with excellent results. Especially in developing countries with low availability of clotting factors, the radiosynovectomy represent a cost effective therapeutic option for repeated bleedings in hemophilic arthropathy. The special focus in these countries is maintaining of mobility and work ability. Often only the knee and medium joints (ankle, elbow and shoulder) are treated using yttrium-90, rhenium-186 or phosphorus-32. However, in rheumatoid arthritis most common affected joints are the fingers. For the treatment in these small joints, erbium-169 is necessary. Unfortunately, erbium-169 is only available in Europe. Further indications for radiosynovectomy are osteoarthritis and the articular effusion after joint replacement. The reported response rates in rheumatoid and poly-arthritis range from 60% to 80% depends from the stage of previous arthrosis. The best effectiveness of therapy was observed in hemophilic arthritis with response rate of 90% and significant reducing of bleeding frequency. The therapy is well-tolerated with low rate of side effects. In respect of the specific uptake of particles in the synovia and short range of beta radiation, the radiation exposure outside the joint is very low. The radiosynovectomy has efforts in comparison to surgical synovectomy: it's a minor intervention with low costs; and simultaneous treatments of multiple joints or treatment in short intervals are possible. The presented paper summarized the published papers and reports our own experiences in >15,000 treated joints. PMID:25709538

Knut, Liepe

2015-01-01

427

Radiosynovectomy in the therapeutic management of arthritis.  

PubMed

Radiosynovectomy is a well-established therapy in arthritis and involves an intra-articular injection of small radioactive particles to treat a synovitis. In Europe, frequent indications are rheumatoid and poly-arthritis. Especially in Germany radiosynovectomy is the second common therapy in Nuclear Medicine with about 40,000-60,000 treated joints per year. In Spain, USA, Turkey, Argentines and Philippines the therapy is more use in hemophilic arthritis with excellent results. Especially in developing countries with low availability of clotting factors, the radiosynovectomy represent a cost effective therapeutic option for repeated bleed