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1

Ankylosing Spondylitis  

MedlinePLUS

Ankylosing spondylitis is a type of arthritis of the spine. It causes swelling between your vertebrae, which are ... in the joints between your spine and pelvis. Ankylosing spondylitis is an immune disease. The disease is more ...

2

Ankylosing Spondylitis and Psoriatic Arthritis  

MedlinePLUS

... for the HLA-B27 genetic marker. More About PsA Our May / June 2003 issue of Spondylitis Plus ... and manage the pain and inflammation caused by PsA. Please see our PsA Treament and Medications sections ...

3

Coexisting ankylosing spondylitis and gouty arthritis  

Microsoft Academic Search

The aim of this study was to investigate the clinical characteristics of patients with coexisting ankylosing spondylitis (AS)\\u000a and gout. Between July 1987, and October 2004, sixty-five patients with coexisting AS and gout were enrolled. The clinical\\u000a manifestations of both AS and gout in these patients were studied. Of the 65 patients included in the study, 61 were men and

Huei-Huang Ho; Kuang-Hui Yu; Ji-Yih Chen; Ja-Liang Lin; Yeong-Jian Jan Wu; Shue-Fen Luo; Lieh-Bang Liou

2007-01-01

4

Infrared sauna in patients with rheumatoid arthritis and ankylosing spondylitis  

Microsoft Academic Search

To study the effects of infrared (IR) Sauna, a form of total-body hyperthermia in patients with rheumatoid arthritis (RA)\\u000a and ankylosing spondylitis (AS) patients were treated for a 4-week period with a series of eight IR treatments. Seventeen\\u000a RA patients and 17 AS patients were studied. IR was well tolerated, and no adverse effects were reported, no exacerbation\\u000a of disease.

Frederikus G. J. Oosterveld; Johannes J. Rasker; Mark Floors; Robert Landkroon; Bob van Rennes; Jan Zwijnenberg; Mart A. F. J. van de Laar; Gerard J. Koel

2009-01-01

5

[HLA B 27 uveitis in ankylosing spondylitis and reactive arthritis].  

PubMed

Clinical features of uveitis HLA B27 in patients with uveitis associated with ankylosing spondylitis and reactive arthritis. The study was made on 64 patients with uveitis treated in the municipal hospital between 2005-2008. The diagnosis was established after a complex ophthalmologic investigation. Histocompatibility HLA-B27 was determined in all groups of patients. Each patient was consulted by the rheumatologist. In the study were included 50 (78%) men and 14 (22%) women. The frequency of HLA B27+ was 72%. At HLA B27+ associated with ankylosing spondylitis and reactive arthritis is present in the anterior form in 85%, unilateral affection in 92%. Their evolution is chronic in 17% and has a tendency for recidivism in 11% of patients. HLA B27 is a genetic factor of uveitis associated with spondylarthropathies in 72%. The study determined the disease in 78% of men, 72% were acute, 85% were anterior and 92% were unilateral. The study of HLA B27 in patients with uveitis is one of the shortest ways for the earlier diagnosis of ankylosing spondylitis. PMID:20540366

Dumbr?veanu, Lilia; Cu?nir, V; Groppa, Liliana; Calinina, Liana

2010-01-01

6

Diagnosis of Ankylosing Spondylitis  

MedlinePLUS

Ankylosing Spondylitis (AS): Quick Links Overview >>> Symptoms >>> Diagnosis >>> Treatment >>> Medication >>> Doctor Q&A From Spondylitis Plus >>> ANKYLOSING SPONDYLITIS Overview A rheumatologist is commonly the type of ...

7

Ankylosing Spondylitis  

MedlinePLUS

... of this relatively new class of medications are genetically engineered to block proteins involved in the body’s inflammatory response. Four biologics—adalimumab, etanercept, golimumab, and infliximab—are approved by the Food and Drug Administration (FDA) for treating ankylosing spondylitis. ...

8

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

9

Ankylosing Spondylitis  

Microsoft Academic Search

Ankylosing spondylitis is the product of an interaction between environmental triggers, susceptibility and severity genes, gender, age and ethnic background. It is the prototypical disease of the spondyloarthropathies, a group of disorders characterized by:•involvement of the sacroiliac joints•peripheral arthropathy•absence of rheumatoid factor•pathological changes at the sites of insertion of ligaments or tendons (enthesopathy)•involvement of the heart, lung, skin and eye

Andrei Calin

2002-01-01

10

Surgery in the Treatment of Rheumatoid Arthritis and Ankylosing Spondylitis  

PubMed Central

The pain, deformities and disabilities resulting from rheumatoid arthritis and ankylosing spondylitis must be treated by a team composed of physician, physical medicine expert, orthopædic surgeon, and, in certain cases, deep X-ray therapist working simultaneously. The principle of “rest” in order to relieve pain has to be combined with methods designed to preserve and restore function. The multiple joint deformities in these cases may necessitate a long programme of reconstructive or functional treatment, which entails whole-hearted co-operation on the part of the patient in intensive post-operative exercise regime. Procedures advocated for the upper limb include excision of the acromion process together with the subacromial bursa to allow free movement between the central tendon of the deltoid and the tendinous shoulder cuff: arthrodesis of the shoulder in cases where there is more severe joint destruction: in certain cases of elbow-joint arthritis, excision of the radial head and sub-total synovectomy may preserve joint function and avoid or delay the necessity for arthroplasty which can be carried out in two ways: (a) similar to the formal joint excision, or (b) re-shaping the lower end of the humerus and upper end of the ulna lining these surfaces with fascia. The former method is preferable in cases of rheumatoid arthritis. To overcome wrist-joint deformity and restore pronation and supination excision of the lower end of the ulna together with radiocarpal fusion in position for optimum function is advocated. Finger and toe joints may be corrected by resection of the bone ends and capsulectomy. In the lower limbs bilateral involvement of the hip-joint is best treated by vitallium mould arthroplasty which may be carried out in four ways: (1) Routine arthroplasty; (2) Modified Whitman procedure; (3) Modified Colonna operation; and (4) The proximal shaft or intertrochanteric arthroplasty. It is essential in these operations to have knowledge of the operative technique, the use of special hip gouges and reamers, and detailed post-operative supervision. For dorsal kyphosis of the spine, spinal osteotomy at the lumbar level provides excellent correction but is an operation demanding care and skill in its execution. The author's remarks are based on experience gained when working with Dr. M. N. Smith-Petersen at the Massachusetts General Hospital, Boston, U.S.A.

Law, W. Alexander

1948-01-01

11

Measurement of pain threshold in patients with rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and healthy controls  

Microsoft Academic Search

Summary Pain threshold was measured using a pressure algometer in 126 subjects, of whom 54 were females and 72 males. These subjects included 18 males and 18 females with rheumatoid arthritis, 18 males and 18 females with osteoarthritis, 18 males with ankylosing spondylitis, and 18 male and 18 female healthy control volunteers. Six points were studied on each side of

E. M. Gerecz-Simon; E. R. Tunks; J.-A. Heale; W. F. Kean; W. W. Buchanan

1989-01-01

12

[Two faces of an illness: rheumatoid arthritis followed by ankylosing spondylitis].  

PubMed

Author presents the clinical history of a 35 years old female patient, who suffered from seronegative rheumatoid arthritis at the age of 29. Remission of the illness was followed by successful gravidity. Almost two years later spondylarthritis was diagnosed, showing only axial symptoms. The major histocompatibility complex analyzed by normal serological methods revealed the HLA B27 haplotype, typical for ankylosing spondylitis, and the HLA DR1 haplotype, typical for rheumatoid arthritis. During the examination of HLA DRB polymorphism, presence of DR B1 0101 allele was found, that plays role in the pathophysiology of rheumatoid arthritis. This case proves that a combination of HLA alleles typical for ankylosing spondylitis and rheumatoid arthritis can be found in the same patient. PMID:19812023

Varga, Eszter; Petró, Agnes; Jáger, Rita; Varga, László

2009-10-25

13

Ankylosing spondylitis  

PubMed Central

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.

Edavalath, Mukesh

2010-01-01

14

Common bone turnover markers in rheumatoid arthritis and ankylosing spondylitis: a literature review.  

PubMed

We studied the impact of inflammatory rheumatism and its treatment on the most common bone turnover markers, based on six previously defined questions in a systematic literature review in order to define their place in daily clinical practice. The role of bone is currently considered of particular importance concerning cartilage damage in inflammatory rheumatism (rheumatoid arthritis and ankylosing spondylitis) and the new concept of osteoimmunology has emerged. Some bone turnover markers are available in clinical practice. In spite of rich and extensive literature on bone turnover markers, their use in inflammatory rheumatism or even osteoporosis is not clear, and a systematic literature review became necessary. In spite of a large number of different markers used in literature, few of them that are useful in common practice have been studied in the field of inflammatory rheumatism such as rheumatoid arthritis and ankylosing spondylitis. Although their study enables understanding of the physiopathological mechanisms of osteoporosis in inflammatory rheumatism, their use in current common practice cannot be recommended. Interesting data on the forecast of the structural evolution of rheumatoid arthritis has been found within the framework of clinical research, without any real practical impact today. PMID:23142254

Coiffier, Guillaume; Bouvard, Béatrice; Chopin, Florance; Biver, Emmanuel; Funck-Brentano, Thomas; Garnero, Patrick; Guggenbuhl, Pascal

2013-05-01

15

Ultrasonographic evaluation of tendons and enthesal sites in rheumatoid arthritis: comparison with ankylosing spondylitis and healthy subjects  

Microsoft Academic Search

The objective of this study was to determine tendon involvements and enthesal abnormalities in patients with rheumatoid arthritis (RA) using high-resolution ultrasonographic images and to compare the findings with those seen in patients with ankylosing spondylitis (AS) and healthy controls. A total of 24 patients with RA, 18 with AS, and 20 healthy controls matched by age and body mass

Hakan Genc; Burcu Duyur Cakit; I??l Tuncbilek; Hatice Rana Erdem

2005-01-01

16

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

17

Imaging in ankylosing spondylitis  

PubMed Central

Imaging is an integral part of the management of patients with ankylosing spondylitis and axial spondyloarthritis. Characteristic radiographic and/or magnetic resonance imaging (MRI) findings are key in the diagnosis. Radiography and MRI are also useful in monitoring the disease. Radiography is the conventional, albeit quite insensitive, gold standard method for assessment of structural damage in spine and sacroiliac joints, whereas MRI has gained a decisive role in monitoring disease activity in clinical trials and practice. MRI may also, if ongoing research demonstrates a sufficient reliability and sensitivity to change, become a new standard method for assessment of structural damage. Ultrasonography allows visualization of peripheral arthritis and enthesitis, but has no role in the assessment of axial manifestations. Computed tomography is a sensitive method for assessment of structural changes in the spine and sacroiliac joints, but its clinical utility is limited due to its use of ionizing radiation and lack of ability to assess the soft tissues. It is exciting that with continued dedicated research and the rapid technical development it is likely that even larger improvements in the use of imaging may occur in the decade to come, for the benefit of our patients.

Lambert, Robert G.W.

2012-01-01

18

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

19

Correlation of immunoglobulin and C reactive protein levels in ankylosing spondylitis and rheumatoid arthritis.  

PubMed Central

Serum C reactive protein (CRP), IgG, and IgA levels were measured in 22 patients with ankylosing spondylitis (AS) and in 20 patients with rheumatoid arthritis (RA) to study the regulation of these proteins in inflammatory disease states. In both RA and AS the mean CRP, IgG, and IgA levels were raised above normal values. Although IgA and CRP levels showed a significant positive correlation in RA (r = 0.53, p = 0.02), there was no correlation between these values in AS (r = 0.24, p = 0.29). The difference in correlation coefficients between the AS and RA groups was significant at a p = 0.05 level. In RA the raised IgA levels may be another manifestation of the acute phase response, as shown by the good correlation between IgA and CRP in that disease. In AS, however, the IgA levels, although raised, do not correlate with CRP levels, suggesting that the mechanism of increase of IgA in the two diseases is different. Gut mediated immune stimulation has been proposed as a cause of raised IgA levels in AS.

Sanders, K M; Hertzman, A; Escobar, M R; Littman, B H

1987-01-01

20

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

21

Chronic bronchiolitis in ankylosing spondylitis.  

PubMed

The pleuro-pulmonary signs of ankylosing spondylitis are generally asymptomatic, typically represented by biapical lung fibrosis. To our knowledge, the severe bronchiolitis which is sometimes observed in other spondyloarthropathies has not been described in ankylosing spondylitis. We report two cases of severe chronic bronchiolitis in ankylosing spondylitis patients. Their clinical and radiological presentation were similar, characterized by progressive deterioration of stage III-IV dyspnea, non-reversible obstructive ventilatory defect, and CT scan showing air trapping with mosaic attenuation and ground-glass opacity in expiration. Lung biopsies confirmed the diagnosis of severe follicular bronchiolitis in one patient and constrictive bronchiolitis is suspected in the other. Only the patient with follicular bronchiolitis responded positively to treatment with low doses of macrolides. PMID:24284298

Marquette, David; Diot, Elisabeth; De Muret, Anne; Favelle, Olivier; Sonneville, Alain; Mammou, Saloua; Dumont, Pascal; Diot, Patrice; Marchand-Adam, Sylvain

2013-10-01

22

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

PubMed

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

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

2011-01-01

23

Ankylosing spondylitis: an overview  

PubMed Central

Ankylosing spondylitis (AS) is a complex, potentially debilitating disease that is insidious in onset, progressing to radiological sacroiliitis over several years. Patients with symptomatic AS lose productivity owing to work disability and unemployment, have a substantial use of healthcare resources, and reduced quality of life. The pathogenesis of AS is poorly understood. However, immune mediated mechanisms involving human leucocyte antigen (HLA)-B27, inflammatory cellular infiltrates, cytokines (for example, tumour necrosis factor ? and interleukin 10), and genetic and environmental factors are thought to have key roles. The detection of sacroiliitis by radiography, magnetic resonance imaging, or computed tomography in the presence of clinical manifestations is diagnostic for AS, although the presence of inflammatory back pain plus at least two other typical features of spondyloarthropathy (for example, enthesitis and uveitis) is highly predictive of early AS. Non-steroidal anti-inflammatory drugs (NSAIDs) effectively relieve inflammatory symptoms and are presently first line drug treatment. However, NSAID treatment has only a symptomatic effect and probably does not alter the disease course. For symptoms refractory to NSAIDs, second line treatments, including corticosteroids and various disease modifying antirheumatic drugs, are employed but are of limited benefit. Emerging biological therapies target the inflammatory processes underlying AS, and thus, may favourably alter the disease process, in addition to providing symptom relief.

Sieper, J; Braun, J; Rudwaleit, M; Boonen, A; Zink, A

2002-01-01

24

IgM, IgG and IgA class enterobacterial antibodies in serum and synovial fluid in patients with ankylosing spondylitis and rheumatoid arthritis  

Microsoft Academic Search

SUMMARY IgM, IgG and IgA class antibodies against three Klebsiella pneumoniae capsular types, Escherichia coli and Proteus mirabilis, as well as total immunoglobulin concentrations, were measured by enzyme immunoassay and radial immunodiÄusion tech- nique, respectively, in paired serum and synovial fluid samples from eight patients with ankylosing spondylitis and 10 with rheumatoid arthritis. No clear evidence for intra-articular antibody production

O. MAKI-IKOLA; M. PENTTINEN; R. VON ESSEN; C. GRIPENBERG-LERCHE; H. ISOMAKI; K. GRANFORS

1997-01-01

25

Ankylosing spondylitis and monoclonal gammopathies.  

PubMed Central

From 1960 to 1990, 557 patients with ankylosing spondylitis (428 men, 129 women) were diagnosed and indexed in the department of rheumatology. Monoclonal gammopathies were found in seven (five men, two women) patients (1.3%). With one exception, ankylosing spondylitis preceded monoclonal gammopathies by many years. The distribution of the isotypes of the mIg found in these seven patients was striking when compared either with previous reports of an association between ankylosing spondylitis and monoclonal gammopathies or with local data on the epidemiology of monoclonal gammopathies: five patients with IgG, four of them of the lambda (lambda) type, and two IgM, both of the kappa (kappa) type were found; no patients with mIgA were recorded. Two patients were HLA-B27 positive and had slight and transient monoclonal gammopathies, whereas three subjects were HLA-B27 negative and had important spikes, corresponding in two subjects to malignant diseases. This observation raises the question of whether the coexistence of HLA-B27 and ankylosing spondylitis might provide a protective action. Epidemiological studies are required to clarify such points.

Renier, G; Renier, J C; Gardembas-Pain, M; Chevailler, A; Boasson, M; Hurez, D

1992-01-01

26

Celecoxib: a review of its use for symptomatic relief in the treatment of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis.  

PubMed

Celecoxib (Celebrex®) was the first cyclo-oxygenase (COX)-2 selective inhibitor (coxib) to be introduced into clinical practice. Coxibs were developed to provide anti-inflammatory/analgesic activity similar to that of nonselective NSAIDs, but without their upper gastrointestinal (GI) toxicity, which is thought to result largely from COX-1 inhibition. Celecoxib is indicated in the EU for the symptomatic treatment of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis in adults. This article reviews the clinical efficacy and tolerability of celecoxib in these EU-approved indications, as well as overviewing its pharmacological properties. In randomized controlled trials, celecoxib, at the recommended dosages of 200 or 400?mg/day, was significantly more effective than placebo, at least as effective as or more effective than paracetamol (acetaminophen) and as effective as nonselective NSAIDs and the coxibs etoricoxib and lumiracoxib for the symptomatic treatment of patients with active osteoarthritis, rheumatoid arthritis or ankylosing spondylitis. Celecoxib was generally well tolerated, with mild to moderate upper GI complaints being the most common body system adverse events. In meta-analyses and large safety studies, the incidence of upper GI ulcer complications with recommended dosages of celecoxib was significantly lower than that with nonselective NSAIDs and similar to that with paracetamol and other coxibs. However, concomitant administration of celecoxib with low-dose cardioprotective aspirin often appeared to negate the GI-sparing advantages of celecoxib over NSAIDs. Although one polyp prevention trial noted a dose-related increase in cardiovascular risk with celecoxib 400 and 800?mg/day, other trials have not found any significant difference in cardiovascular risk between celecoxib and placebo or nonselective NSAIDs. Meta-analyses and database-derived analyses are inconsistent regarding cardiovascular risk. At recommended dosages, the risks of increased thrombotic cardiovascular events, or renovascular, hepatic or hypersensitivity reactions with celecoxib would appear to be small and similar to those with NSAIDs. Celecoxib would appear to be a useful option for therapy in patients at high risk for NSAID-induced GI toxicity, or in those responding suboptimally to or intolerant of NSAIDs. To minimize any risk, particularly the cardiovascular risk, celecoxib, like all coxibs and NSAIDs, should be used at the lowest effective dosage for the shortest possible duration after a careful evaluation of the GI, cardiovascular and renal risks of the individual patient. PMID:22141388

McCormack, Paul L

2011-12-24

27

Cardiopulmonary Manifestations of Ankylosing Spondylitis  

PubMed Central

Ankylosing spondylitis is a chronic inflammatory condition that usually affects young men. Cardiac dysfunction and pulmonary disease are well-known and commonly reported extra-articular manifestation, associated with ankylosing spondylitis (AS). AS has also been reported to be specifically associated with aortitis, aortic valve diseases, conduction disturbances, cardiomyopathy and ischemic heart disease. The pulmonary manifestations of the disease include fibrosis of the upper lobes, interstitial lung disease, ventilatory impairment due to chest wall restriction, sleep apnea, and spontaneous pneumothorax. They are many reports detailing pathophysiology, hypothesized mechanisms leading to these derangements, and estimated prevalence of such findings in the AS populations. At this time, there are no clear guidelines regarding a stepwise approach to screen these patients for cardiovascular and pulmonary complications.

Momeni, Mahnaz; Taylor, Nora; Tehrani, Mahsa

2011-01-01

28

Integrated population pharmacokinetics of etanercept in healthy subjects and in patients with rheumatoid arthritis and ankylosing spondylitis.  

PubMed

Etanercept pharmacokinetics in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriasis were assessed separately with distinct models using population pharmacokinetics methods of limited precision. The different model structures and associated significant covariates identified by these earlier methods made it difficult to compare etanercept pharmacokinetics among disease groups. This integrated analysis aimed to establish a framework to evaluate previously established population pharmacokinetic models of etanercept, and to identify consistent and important demographic and disease factors that affected etanercept pharmacokinetics in a diverse population of healthy subjects and patients with RA and AS. In this integrated analysis, cumulative rich and sparse etanercept concentration data from 53 healthy volunteers, 212 patients with RA, and 346 patients with AS were examined and compared using nonlinear mixed effect methodology implemented the in NONMEM VI software package. A more precise estimation method (FOCEi) was employed and compared with the first-order method in population pharmacokinetics model building and evaluation. The integrated analysis found that an optimal population pharmacokinetics model with a 2-compartment structure adequately characterized etanercept pharmacokinetics in all subject groups. Health status or disease type did not significantly affect etanercept pharmacokinetics. In adult patients with RA and AS, age and body weight do not significantly affect etanercept pharmacokinetics. PMID:20852002

Zhou, Simon Y; Shu, Cathye; Korth-Bradley, Joan; Raible, Donald; Palmisano, Maria; Wadjula, Joseph; Fatenejad, Saeed; Bjornsson, Thorir

2011-06-01

29

Immunogenicity of anti-tumour necrosis factor therapy in Korean patients with rheumatoid arthritis and ankylosing spondylitis.  

PubMed

The aim of this study was to investigate the prevalence of antidrug antibodies (ADAs) against tumour necrosis factor (TNF) inhibitors in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). ADAs were detected in 18 (9.8%) patients with RA and in 18 (10.2%) patients with AS of the 360 patients. Development of ADAs was significantly associated with treatment failure in RA patients (P=0.003). When classified by drugs, the prevalence of immunogenicity in descending order was 17 (28.8%) patients treated with infliximab, 17 (10.4%) with adalimumab, and 2 (1.4%) with etanercept. After adjustment for disease and duration of anti-TNF therapy, the odds ratio as a reference of adalimumab-treated patients was 9.159 (95% confidence interval [CI] 2.005-41.845) for infliximab and 0.280 (95% CI 0.128-0.611) for etanercept. The immunogenicity of anti-TNF therapy was highest in the infliximab-treated group and significantly lower in the etanercept-treated group. PMID:24752013

Jung, Seung Min; Kim, Hyun-Sook; Kim, Hae-Rim; Kim, Na Young; Lee, Jung-Hwa; Kim, Juryun; Kwok, Seung-Ki; Park, Kyung-Su; Park, Sung-Hwan; Kim, Ho-Youn; Ju, Ji Hyeon

2014-07-01

30

What Is Ankylosing Spondylitis?  

MedlinePLUS

... publication. To order the Ankylosing Spondylitiis Q&A full-text version, please contact the NIAMS using the contact information above. To view the complete text or to order online, visit ... updates and for any questions about any medications you are taking, please ...

31

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

32

Decreased central corneal thickness in ankylosing spondylitis.  

PubMed

Central corneal thickness and dry eye tests were evaluated in a study population consisting of 68 ankylosing spondylitis patients diagnosed according to the modified New York criteria, and 61 age-matched controls without ankylosing spondylitis. A full ophthalmological evaluation was performed on each subject. All subjects were screened for age, gender, HLA-B27, tear break-up time test, Schirmer test, and duration of disease. Central corneal thickness was measured under topical anesthesia with an ultrasonic pachymeter. The mean central corneal thickness was 537.3 ± 30.6 ?m, range 462-600 ?m, in ankylosing spondylitis patients, whereas it was 551.7 ± 25.2 ?m, range 510-620 ?m, in controls (p = 0.005). The Schirmer test result was 7.3 ± 5.9 mm for the ankylosing spondylitis patients and 11.7 ± 5.8 mm for the control group (p = 0.002). Tear break-up time was 7.3 ± 3.2 s for the ankylosing spondylitis patients and 14.0 ± 4.5 s for the control group (p < 0.001). The possibility of a thinner cornea should be taken into consideration in ankylosing spondylitis. In addition, attention must be given to lower dry eye tests in surgical interventions such as photorefractive keratectomy and laser in situ keratomileusis in ankylosing spondylitis patients. PMID:23846766

Ortak, Huseyin; Inan?r, Ahmet; Demir, Selim; Uysal, Alper; ?ahin, ?afak; Sa?can, Mustafa; Önder, Yalç?n; Alim, Sait; Demir, Ay?e Kevser

2014-04-01

33

Wnt signaling in ankylosing spondylitis.  

PubMed

The mechanisms that lead to bony fusion in ankylosing spondylitis (AS) are yet to be fully defined. In recent years, there have been several advances in our understanding of this complex disease. Here, the potential impact of the Wnt signaling pathway will be discussed. This pathway is involved in bone morphogenesis and homeostasis. Perturbations in the normal regulation have been implicated in abnormal bone formation (e.g., osteophytes). Levels of Wnt regulatory proteins like Dickkopf have been investigated as potential biomarkers of disease. This pathway might be involved in other aspects of this disease including T cell activation and differentiation, and in bone marrow adipogenesis. The pathways leading to the unique pathology and bony fusion in AS are complex and the Wnt pathway might play a critical contributing role. PMID:24820146

Corr, Maripat

2014-06-01

34

Immune complexes in ankylosing spondylitis.  

PubMed Central

Immune complexes have been reported in ankylosing spondylitis (AS) and may implicate infectious agents. Serum samples from 49 patients with AS were assayed for immune complexes by polyethylene glycol precipitation, followed by radial immunodiffusion and pepsinogen binding immunoassay. Both methods showed increases in IgA containing immune complexes, which correlated with serum IgA and with IgA rheumatoid factor concentrations, but did not show increases in other immune complex components. Increased immune complexes were associated with peripheral joint synovitis, but showed no correlation with other clinical or laboratory indices of disease activity. Immune complexes from nine AS serum samples and one AS synovial fluid were electrophoretically separated then probed with anti-Klebsiella pneumoniae, but AS specific antigens were not identified. This study did not suggest a major role for immune complexes in AS without peripheral disease, nor provide serological evidence for the involvement of klebsiella antigens. Images

MacLean, I L; Archer, J R; Cawley, M I; Kidd, B L; O'Hara, B P; Pegley, F S; Thompson, P W

1992-01-01

35

Ankylosing spondylitis in a military aviator: air medical considerations.  

PubMed

Rheumatologic diseases are a challenging diagnosis when it comes to air medical disposition decision making because many of these diseases overlap and their initial presentation is insidious and relapsing remitting in future scope. Many rheumatologic diseases have musculoskeletal and other organ complications. One of these diagnoses is spondyloarthritides. These disorders include ankylosing spondylitis (AS), reactive arthritis, psoriatic arthritis and spondylitis, enteropathic arthritis and spondylitis, juvenile-onset spondyloarthritis, and undifferentiated spondyloarthritis. The prevalence of spondyloarthropathy is estimated to be between 0.1% and 2.5%,(1) although figures vary from 1 study to another. In this article, we report the case of a military pilot diagnosed with AS who had a favorable response to treatment with etanercept therapy. PMID:24787516

Eslami, Reza; Momenzadeh, Mahmud; Ebadi, Ahmad

2014-01-01

36

Which clinical variables have the most significant correlation with quality of life evaluated by SF-36 survey in Croatian cohort of patient with ankylosing spondylitis and psoriatic arthritis?  

PubMed

The aim of our study was to assess clinical variables with the best correlation to quality of life (QOL) assessed by medical outcome survey Short-Form 36 (SF-36) in patients with spondyloarthritides, including ankylosing spondylitis (AS) and psoriatic arthritis (PsA). We analyzed the cohort of 54 patients (22 patients with PsA and 32 patients with AS), who filled the Croatian version of SF-36. For each type of arthritis, patients were clinically evaluated using the extensive list of clinical variables categorized into subjective and objective group. For AS patients, subjective and objective variables (spinal mobility measurements, clinical assessment of spinal pain, patient assessments of disease activity and pain) correlated mainly with the physical functioning concept of SF-36. Patients assessments of fatigue correlated with the energy/fatigue subscale, whereas patient assessment of enthesial pain correlated with the pain subscale. Correlations between clinical variables and SF-36 concepts of PsA patients showed more diverse distribution than for AS. Objective variables (spinal mobility measurements, a 76-joint score, clinical assessment of spinal pain) correlated with concepts concerning physical health and pain. Several subjective patient assessments correlated with energy/fatigue, emotional well-being, pain and general health subscales. Both patient and physician assessment of PsA activity correlated with the role limitations due to emotional problems. Bath ankylosing spondylitis functional index (BASFI) had the strongest correlation with the physical functioning concept of SF-36 in both diseases. Our findings provide important information to help selecting the variables with strongest impact on QOL, for better planning the management strategies and achieving better rehabilitation results. PMID:22065069

Jaji?, Zrinka; Rajnpreht, Ivana; Kova?i?, Nataša; Luki?, Ivan Krešimir; Velagi?, Vedran; Grubiši?, Frane; Maruši?, Ana; Gr?evi?, Danka

2012-11-01

37

ERAP1 and ankylosing spondylitis.  

PubMed

The strong genetic association of ERAP1 (endoplasmic reticulum aminopeptidase 1) with ankylosing spondylitis (AS), which is restricted to HLA-B27 positive cases, has profound pathogenetic implications. ERAP1 is involved in trimming peptides to optimal length for binding to HLA class 1 molecules, thereby not only affecting the stability and processing of HLA-B27 but also influencing the peptide repertoire presented to the immune system. This could have secondary effects on specific adaptive or autoimmune responses in AS. However, it appears increasingly likely that the pathogenic effect of ERAP1 may be mediated through effects on innate immunity, such as altering the interaction between HLA-B27 and immune receptors such as the killer immunoglobulin-like receptors (KIR) found on a range of innate immune cells or via the endoplasmic reticulum unfolded protein response. ERAP1 variants associated with reduced endopeptidase activity appear to be protective against AS, raising the possibility that ERAP1 inhibition could represent a future treatment strategy. PMID:23452840

Keidel, Sarah; Chen, Liye; Pointon, Jennifer; Wordsworth, Paul

2013-02-01

38

Conventional treatments for ankylosing spondylitis  

PubMed Central

Management of ankylosing spondylitis (AS) is challenged by the progressive nature of the disease. To date, no intervention is available that alters the underlying mechanism of inflammation in AS. Currently available conventional treatments are palliative at best, and often fail to control symptoms in the long term. Current drug treatment may perhaps induce a spurious state of "disease remission," which is merely a low level of disease activity. Non-steroidal anti-inflammatory drugs are first line treatment, but over time, the disease often becomes refractory to these agents. Disease modifying antirheumatic drugs are second line treatment and may offer some clinical benefit. However, conclusive evidence of the efficacy of these drugs from large placebo controlled trials is lacking. Additionally, these drugs can cause treatment-limiting adverse effects. Intra-articular corticosteroid injection guided by arthrography, computed tomography, or magnetic resonance imaging is an effective means of reducing inflammatory back pain, but controlled studies are lacking. A controlled study has confirmed moderate but significant efficacy of intravenous bisphosphonate (pamidronate) treatment in patients with AS; further evaluation of bisphosphonate treatment is warranted. Physical therapy and exercise are necessary adjuncts to pharmacotherapy; however, the paucity of controlled data makes it difficult to identify the best way to administer these interventions. Surgical intervention may be required to support severe structural damage. Thus, for patients with AS, the future of successful treatment lies in the development of pharmacological agents capable of both altering the disease course through intervention at sites of disease pathogenesis, and controlling symptoms.

Dougados, M; Dijkmans, B; Khan, M; Maksymowych, W; van der Linden, S.; Brandt, J

2002-01-01

39

Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome.  

PubMed

Ankylosing spondylitis is a chronic inflammatory disease characterized by inflammatory lower back pain and morning stiffness and accompanied by spine and sacroiliac joint involvement. Klinefelter's syndrome is a genetic condition that only affects males. Affected males have an extra X chromosome. This paper reports a 30-years-old male on followup with the diagnosis of Klinefelters syndrome. The patient admitted with complaints of inflammatory lower back, and neck pain and morning stiffness and was diagnosed with ankylosing spondylitis. Nonsteroidal anti-inflammatory drug and salazopyrine treatment resulted in significant regression in his complaints. PMID:23762731

Kobak, Senol; Yalçin, Murat; Karadeniz, Muamer; Oncel, Guray

2013-01-01

40

[Anti-TNF alfa therapy in ankylosing spondylitis].  

PubMed

Ankylosing spondylitis (AS) is an inflammatory chronic disease that affects young males and in more than 90% of cases is associated with HLA B27 antigen. Therapeutic options for those patients with spondyloarthropathies have been limited during the last decades. Infliximab and etanercept are both approved for the treatment of patients with active disease that does not respond to conventional therapies. Anti-TNF therapy is very effective in AS, and eventually can be more effective than in rheumatoid arthritis. In 2003 Assessments in Ankylosing Spondylitis Group (ASAS) published international recommendations about the use of these agents in AS, which can be used as guidance in taking decisions and elaborating guidelines. To define their utilization it is necessary more studies about efficacy, toxicity and about ways of use. PMID:17187716

Cravo, Ana Rita; Tavares, Viviana; Da Silva, José Canas

2006-01-01

41

Efficacy of cyclo-oxygenase-2 inhibition by etoricoxib and naproxen on the axial manifestations of ankylosing spondylitis in the presence of peripheral arthritis  

PubMed Central

Objective: The combined efficacy of selective and non-selective cyclo-oxygenase-2 (COX-2) inhibition on the axial manifestations of ankylosing spondylitis (AS) in the presence or absence of chronic peripheral arthritis was evaluated. Methods: In a post hoc subgroup analysis of a 6 week, randomised, double blind, placebo controlled trial, 387 patients with active axial AS were randomised to receive etoricoxib 90 mg or 120 mg once a day, naproxen 500 mg twice daily, or placebo. Randomisation was stratified by the presence or absence of chronic peripheral arthritis. The primary outcome measure was the time weighted average change from baseline of spine pain intensity. Efficacy data from the three groups receiving active treatment (the NSAID/COX-2 inhibitor group) were combined to improve precision. An analysis of covariance model was used to evaluate the effect of peripheral disease on treatment response. Results: 93 patients were allocated to receive placebo and 294 to active treatment (naproxen or etoricoxib). The combined NSAID/COX-2 inhibitor group had a significant treatment response compared with the placebo group for all efficacy measures, both in patients with and without peripheral arthritis. A significantly greater difference in mean patient assessment of spine pain was found between active and placebo treatments in patients without compared with those with peripheral arthritis (p = 0.005; –32.5 mm v –17.0 mm, respectively). Similar differences, although not statistically significant, were seen for other end points. Conclusion: NSAIDs and COX-2 inhibitors have a clinically relevant symptomatic effect on axial AS irrespective of the presence of peripheral arthritis. In this exploratory analysis spinal improvement appeared to be greater in patients without peripheral disease.

Gossec, L; van der Heijde, D; Melian, A; Krupa, D; James, M; Cavanaugh, P; Reicin, A; Dougados, M

2005-01-01

42

Radiation-induced leukemias in ankylosing spondylitis  

SciTech Connect

Three cases of leukemia occurred in patients with ankylosing spondylitis treated by radiotherapy. In each case, the leukemic process exhibited bizarre features suggesting that radiation is likely to induce atypical forms of leukemia possessing unusual attributes not shared by spontaneously developing leukemia. The likely distinctive aspects of radiation-induced leukemia are discussed.

Toolis, F. (Royal Infirmary, Edinburgh, UK); Potter, B.; Allan, N.C.; Langlands, A.O.

1981-10-01

43

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

44

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.

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

2013-01-01

45

Safety of tumor necrosis factor inhibitors use for rheumatoid arthritis and ankylosing spondylitis in Africa, the Middle East, and Asia: focus on severe infections and tuberculosis.  

PubMed

Multiple studies of patients in Western countries with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have indicated increased risk for active tuberculosis (TB) and other infections among these individuals. It has also been consistently reported that patients receiving tumor necrosis factor (TNF) inhibitors for these conditions have higher rates of active TB and other infections than RA or AS patients not receiving these medications. These issues have been studied less extensively in the Asia and Africa-Middle East regions, and information from these regions is important because of higher rates of TB in the general population. This paper reviews studies of RA and AS patients from Asia, Africa, and the Middle East who received TNF inhibitors. A literature search was conducted using http://www.ncbi.nlm.nih.gov/pubmed to collect and report these data. The years included in the PubMed literature search ranged from January 2000 to October 2011. Additionally, information from the China Hospital Knowledge Database was used to report data from Chinese patients with RA and AS treated with TNF inhibitors. Results from these studies indicate that the risk for active TB and other infections in AS and RA patients from Asia, Africa, and the Middle East are increased in patients receiving TNF inhibitors and that the risk is higher among those treated with monoclonal antibodies versus soluble TNF receptor. PMID:23242389

Hammoudeh, Mohammed; Alarfaj, Abdurhman; Chen, Der-Yuan; Djoudi, Hachemi; Youseif, Ehab; Zhu, Jian

2013-03-01

46

Ankylosing Spondylitis and Rheumatoid Arthritis: Serum Levels of TNF-? and Its Soluble Receptors during the Course of Therapy with Etanercept and Infliximab  

PubMed Central

The effects of the TNF-? blockers infliximab or etanercept on the levels of TNF-?, TNF-receptor 1 (TNF-R1), and TNF-receptor 2 (TNF-R2), as well as the levels of the inflammation markers CRP and IL-6, were measured in ankylosing spondylitis (AS) and rheumatoid arthritis (RA) patients receiving treatment with either compound. We found that RA patients tend to have higher levels of TNF-? than both healthy individuals and AS patients prior to treatment (P < 0.05). We measured greatly increased levels of TNF-? in both the AS and RA etanercept patient groups during the course of treatment, while in the infliximab treated patients, the amount of TNF-? measured remained unchanged. Elevated TNF-? in the etanercept treated patients does not appear to be a significant risk factor for the spontaneous development of further autoimmune diseases in our study group. Increased levels of TNF-R1 were determined in both AS (P < 0.05) and RA (P < 0.001) patients when compared to healthy controls. In AS patients, the levels of TNF-R1 dropped significantly when treated with either infliximab (P < 0.01) or etanercept (P < 0.001). In contrast, the levels of this receptor remained unchanged in RA patients treated with either compound.

2014-01-01

47

Spinal fractures in patients with ankylosing spondylitis  

Microsoft Academic Search

Thirty-one consecutive patients with ankylosing spondylitis and spinal fractures were reviewed. There were 6 women and 25 men with a mean age of 60±11 years; 19 had cervical and 12 had thoracolumbar injuries. Of the patients with cervical fracture, two had an additional cervical fracture and one had an additional thoracic fracture. Three trauma mechanisms were identified: high-energy trauma in

C. Olerud; A. Frost; J. Bring

1996-01-01

48

Treatment of ankylosing spondylitis: focus on etanercept  

PubMed Central

Ankylosing spondylitis is a chronic inflammatory condition which preferentially affects the axial skeleton, often beginning in the sacroiliac joints. The etiology of the pathologic lesions of this condition including enthesitis, erosive articular changes, osteitis, and fibrous ankylosis, as well as changes which occur in the eye, gastrointestinal tract, cardiovascular system, and lungs is unknown; however, there is a strong association with HLA-B27, which indicates altered immunity. One of the major mediators of the immune response is TNF-?, which functions as a pleiotrophic soluble messenger primarily from macrophages. TNF-? is principally involved with activation of both normal and transformed cells, including endothelium, synoviocytes, osteoclasts, chondrocytes, and fibroblasts. The cornerstone of medical management of ankylosing spondylitis includes intensive physical therapy and nonsteroidal anti-inflammatories for symptomatic relief. However, it is becoming increasingly recognized that TNF-? blockade has an important role in the reduction of spine and joint inflammation. This review discusses the data that supports use of etanercept in the treatment of ankylosing spondylitis.

Frech, Tracy

2007-01-01

49

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.

Ozgocmen, Salih; Akgul, Ozgur; Ak?nc?, Aysen; Ataman, Sebnem; Birtane, Murat; Bodur, Hatice; Gunayd?n, Rezan; Kuru, Omer; Rezvani, Aylin; Sendur, Omer Faruk; Senel, Kaz?m; Tuncer, Tiraje

2012-01-01

50

Idiopathic retroperitoneal fibrosis and ankylosing spondylitis. A new case report  

Microsoft Academic Search

The case of a 52-year-old man with retroperitoneal fibrosis and ankylosing spondylitis is described. Inflammatory low back pain and acute renal insufficiency prompted a computed tomography scan of the abdomen with contrast agent injection. A fibrous sheath surrounding the aorta and attracting the ureters toward the midline was seen, strongly suggesting retroperitoneal fibrosis. The diagnosis of ankylosing spondylitis was based

A Bezza; A El Maghraoui; M Ghadouane; F Tabache; A Abouzahir; M Abbar; D Ghafir; V Ohayon; M. I Archane

2002-01-01

51

Ankylosing spondylitis assessment group preliminary definition of short-term improvement in ankylosing spondylitis  

Microsoft Academic Search

Objective. To develop criteria for symptomatic improvement in patients with ankylosing spondylitis (AS), using outcome domain data from placebo- controlled clinical trials of nonsteroidal antiinflamma- tory drugs (NSAIDs). Methods. Patient data from 5 short-term, ran- domized, controlled trials were used to assess equiva- lence, reliability, and responsiveness of multiple items in the 5 outcome domains for AS treatment: physical function,

Jennifer J. Anderson; Gabriel Baron; Desiree Van Der Heijde; David T. Felson; Maxime Dougados

2001-01-01

52

Increased Frequencies of Th22 Cells as well as Th17 Cells in the Peripheral Blood of Patients with Ankylosing Spondylitis and Rheumatoid Arthritis  

PubMed Central

Background T-helper (Th) 22 is involved in the pathogenesis of inflammatory diseases. The roles of Th22 cells in the pathophysiological of ankylosing spondylitis (AS) and rheumatoid arthritis (RA) remain unsettled. So we examined the frequencies of Th22 cells, Th17 cells and Th1 cells in peripheral blood (PB) from patients with AS and patients with RA compared with both healthy controls as well as patients with osteoarthritis. Design and Methods We studied 32 AS patients, 20 RA patients, 10 OA patients and 20 healthy controls. The expression of IL-22, IL-17 and IFN-? were examined in AS, RA, OA patients and healthy controls by flow cytometry. Plasma IL-22 and IL-17 levels were examined by enzyme-linked immunosorbent assay. Results Th22 cells, Th17 cells and interleukin-22 were significantly elevated in AS and RA patients compared with OA patients and healthy controls. Moreover, Th22 cells showed positive correlation with Th17 cells as well as interleukin-22 in AS and RA patients. However, positive correlation between IL-22 and Th17 cells was only found in AS patients not in RA patients. In addition, the percentages of both Th22 cells and Th17 cells correlated positively with disease activity only in RA patients not in AS patients. Conclusions The frequencies of both Th22 cells and Th17 cells were elevated in PB from patients with AS and patients with RA. These findings suggest that Th22 cells and Th17 cells may be implicated in the pathogenesis of AS and RA, and Th22 cells and Th17 cells may be reasonable cellular targets for therapeutic intervention.

Qi, Lei; Liu, Xin-guang; Yuan, Cun-zhong; Hu, Nai-wen; Ma, Dao-xin; Li, Zhen-feng; Yang, Qiang; Li, Wei; Li, Jian-min

2012-01-01

53

Neurological complications of ankylosing spondylitis: neurophysiological assessment.  

PubMed

Studies examined the neurological involvement of ankylosing spondylitis (AS) are limited. This study aimed to assess the frequency of myelopathy, radiculopathy and myopathy in AS correlating them to the clinical, radiological and laboratory parameters. Included were 24 patients with AS. Axial status was assessed using bath ankylosing spondylitis metrology index (BASMI). Patients underwent (a) standard cervical and lumbar spine and sacroiliac joint radiography, (b) somatosensory (SSEP) and magnetic motor (MEP) evoked potentials of upper and lower limbs, (c) electromyography (EMG) of trapezius and supraspinatus muscles. Patients' mean age and duration of illness were 36 and 5.99 years. Bath ankylosing spondylitis metrology index mean score was 4.6. Twenty-five percent (n = 6) of patients had neurological manifestations, 8.3% of them had myelopathy and 16.7% had radiculopathy. Ossification of the posterior (OPLL) and anterior (OALL) longitudinal ligaments were found in 8.3% (n = 2) and 4.2% (n = 1). About 70.8% (n = 17) had >or=1 neurophysiological test abnormalities. Twelve patients (50%) had SSEP abnormalities, seven had prolonged central conduction time (CCT) of median and/or ulnar nerves suggesting cervical myelopathy. Six had delayed peripheral or root latencies at Erb's or interpeak latency (Erb's-C5) suggesting radiculopathy. Motor evoked potentials was abnormal in 54% (n = 13). Twelve (50%) and five (20.8%) patients had abnormal MEP of upper limbs and lower limbs, respectively. About 50% (n = 12) had myopathic features of trapezius and supraspinatus muscles. Only 8.3% (n = 2) had neuropathic features. We concluded that subclinical neurological complications are frequent in AS compared to clinically manifest complications. Somatosensory evoked potential and MEP are useful to identify AS patients prone to develop neurological complications. PMID:19153738

Khedr, Eman M; Rashad, Sonia M; Hamed, Sherifa A; El-Zharaa, Fatma; Abdalla, Abdel Karim H

2009-07-01

54

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.

Senabre-Gallego, Jose Miguel; Santos-Ramirez, Carlos; Santos-Soler, Gregorio; Salas-Heredia, Esteban; Sanchez-Barrioluengo, Mabel; Barber, Xavier; Rosas, Jose

2013-01-01

55

Focal sialadenitis in patients with ankylosing spondylitis and spondyloarthropathy: a comparison with patients with rheumatoid arthritis or mixed connective tissue disease  

PubMed Central

OBJECTIVES—To investigate the occurrence of and risk factors for focal sialadenitis in patients with rheumatoid arthritis (RA), mixed connective tissue disease (MCTD), ankylosing spondylitis (AS), and spondyloarthropathy (SpA).?METHODS—A total of 85 patients (25 with RA, 19 with MCTD, 19 with AS, 22 with SpA) participated in the study. Each patient filled out a questionnaire for eye and oral symptoms and for the use of medication, and was interviewed; other tests included Schirmer's test, laboratory tests, collection of unstimulated and stimulated whole saliva, and minor salivary gland biopsy. A focus score of ?1 was regarded as an indicator of focal sialadenitis.?RESULTS—Focal sialadenitis was observed in 68% (57/84) of all patients. It affected 80% (20/25) of the patients with RA, 94% (17/18) of those with MCTD, 58% (11/19) of those with AS, and 41% (9/22) of those with SpA (?2 test, p=0.0013). Salivary secretion correlated negatively with the focus scores—that is, severity of focal sialadenitis. Patients with focal sialadenitis had both decreased salivary secretion and decreased tear secretion significantly more often than did patients without (?2 test, p=0.0074 and p=0.048 respectively). Patients with positive rheumatoid factor (RF), antinuclear antibodies (ANA), or SSA or SSB antibodies had sialadenitis significantly more often than did patients with negative antibodies. In the subgroup of patients with AS or SpA, no associations were found between focal sialadenitis and the presence of these antibodies.?CONCLUSION—In addition to patients with RA or MCTD, focal sialadenitis also affects a very high proportion of patients with AS or SpA. Focus scores are significantly higher in patients with RA or MCTD than in those with AS or SpA. A significant association exists between focal sialadenitis and RF, ANA, SSA and SSB. However, in the subgroup of patients with AS or SpA, no associations were found between focal sialadenitis and serological markers or clinical symptoms.??

Helenius, L; Hietanen, J; Helenius, I; Kautiainen, H; Piirainen, H; Paimela, L; Lappalainen, M; Suuronen, R; Lindqvist, C; Leirisalo-Repo, M

2001-01-01

56

Intravenous methylprednisolone pulse therapy in ankylosing spondylitis.  

PubMed

For several years the medical treatment of active ankylosing spondylitis (AS) has been NSAID because gold, penicillamine, antimalarials and steroids have been without efficacy. In 1981, Mintz et al reported that methylprednisolone pulse therapy (MPPT) had an excellent effect in patients with AS. Seven patients with active AS and insufficient efficacy of NSAID for three months were treated with one gram methylprednisolone daily given intravenously for three successive days. Mobility and pain were recorded before, during, and after treatment. Significant pain relief and improvement of mobility of the spine for at least six weeks were clearly demonstrated (p less than 0.05). Finger to floor distance and chin manubrium distance improved significantly for at least six months (p less than 0.05). We conclude that intravenous MPPT is a useful treatment in patients with active AS when NSAID is insufficient. PMID:4042697

Ejstrup, L; Peters, N D

1985-08-01

57

Socioeconomic impact of ankylosing spondylitis in Morocco.  

PubMed

The goal of this study was to determine the impact of ankylosing spondylitis (AS) on the socioeconomic well-being of Moroccan patients. One hundred (100) consecutive AS patients (71 men, 29 women) were included. The socioeconomic consequences were studied by measuring direct costs, indirect costs (consequences on work capacity), and intangible costs (social impact) of AS. The mean age at AS onset was 26.85 years +/- 11.71 (7-64). The mean disease duration of AS was 12.05 years +/- 8.32 (0.5-39). Financial difficulties due to AS were observed in 82% of the patients. In 28% of them, these conditions explained a bad observance to treatments. In 14% of the cases, they led children to leave school to support their handicapped parents. Work disability occurred in 22.9% of initially employed patients. Withdrawal from work was correlated to bad social conditions at work, higher scores of Bath ankylosing spondylitis functional index (BASFI), and absence of adherence to a social security system. Sexual problems were present in 64.2% of the patients and were correlated to higher scores of BASFI. There were also disturbances in housekeeping (65.8%) and in leisure time activities (72.2%). Patients received a financial and a psychological familial support in, respectively, 66 and 87% of the cases. Despite the great familial support, Moroccan AS patients suffer from important socioeconomic consequences because of the illness, the bad socioeconomic conditions, the insufficiency of state help, and the social security problems. PMID:17457657

Rkain, Hanan; Allali, Fadoua; Bentalha, Aziza; Lazrak, Noufissa; Abouqal, Redouane; Hajjaj-Hassouni, Najia

2007-12-01

58

[Respiratory manifestations of ankylosing spondylitis (50 cases)].  

PubMed

Fifty patients with ankylosing spondylitis underwent radiography of the chest. In addition, 2 of them had bronchography, 3 had computerized tomography (CT) of the chest, 9 had respiratory function tests and 8 head ventilation/perfusion study by the Xenon method. Seven thoracic images were questionably specific of spondylitis, showing plural symphysis, strips of atelectasis, pleural thickening, apical pulmonary sclerosis and opacities of the diaphragmatic hilum. CT proved valuable in 1 case to confirm pulmonary fibrosis and in 2 cases to reveal that pleural thickening was continuous with an opacity ensheathing the vertebral body. In 7 out of 9 cases the functional restrictive deficit was accompanied by normal or supranormal functional residual capacity and increased residual volume. In all patients explored by the Xenon method, there was apical-caudal inversion of the ventilation/perfusion ratio. These findings suggest 3 pathogenic hypotheses: mere sequelae of hypoventilation, specific lung tissue fibrosis, extension by continuity of the vertebra-ensheathing process to the subpleural spaces. PMID:3589343

Leménager, J; L'Hirondel, J L; Sauvajon, H; Sesboue, B

1987-01-01

59

Hypothalamic-pituitary-adrenal axis function in ankylosing spondylitis  

PubMed Central

Objective: To assess basal function and responsiveness of the hypothalamic-pituitary-adrenal (HPA) axis in patients with ankylosing spondylitis during dynamic testing. Methods: Insulin induced hypoglycaemia (IIH) (Actrapid HM 0.1 IU/kg, as intravenous bolus) was induced in 17 patients and 11 healthy controls matched for age, sex, and body mass index. Concentrations of glucose, adrenocorticotrophic hormone (ACTH), cortisol, insulin, dehydroepiandrosterone sulphate (DHEAS), 17?-hydroxyprogesterone, interleukin 6 (IL-6), and tumour necrosis factor ? (TNF?) were determined in plasma. Results: Comparable basal cortisol levels were found in the two groups, with a trend to be lower in ankylosing spondylitis. In the ankylosing spondylitis group, there were higher concentrations of IL-6 (mean (SEM): 16.6 (2.8) pg/ml v 1.41 (0.66) pg/ml in controls; p<0.001) and TNF? (8.5 (1.74) pg/ml v 4.08 (0.42) pg/ml in controls; p<0.01). Glucose, insulin, ACTH, DHEAS, and 17?-hydroxyprogesterone did not differ significantly from control. The IIH test was carried out successfully in 11 of the 17 patients with ankylosing spondylitis, and the ACTH and cortisol responses were comparable with control. General linear modelling showed a different course of glycaemia (p = 0.041) in the ankylosing spondylitis patients who met the criteria for a successful IIH test compared with the controls. Conclusions: The results suggest there is no difference in basal HPA axis activity and completely preserved responsiveness of the HPA axis in patients with ankylosing spondylitis. The interpretation of the different course of glycaemia during IIH in ankylosing spondylitis requires further investigation.

Imrich, R; Rovensky, J; Zlnay, M; Radikova, Z; Macho, L; Vigas, M; Koska, J

2004-01-01

60

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.

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

2014-01-01

61

Ankylosing spondylitis monocytes show upregulation of proteins involved in inflammation and the ubiquitin proteasome pathway  

Microsoft Academic Search

Objectives:To determine if peripheral blood monocytes from patients with ankylosing spondylitis (AS) differed in protein expression compared to rheumatoid arthritis (RA) and healthy controls (HC).Methods:Monocyte protein expression was characterised by 2D gel electrophoresis and by label-free quantitative expression profiling, using nano-ultra performance liquid chromatography coupled to electrospray ionisation mass spectrometry (ESI-MSE, where E refers to low\\/high collision energy switching). Data

C Wright; M Edelmann; K diGleria; S Kollnberger; H Kramer; S McGowan; K McHugh; S Taylor; B Kessler; P Bowness

2009-01-01

62

Treatment trials in ankylosing spondylitis: current and future considerations  

PubMed Central

Emerging treatment options in ankylosing spondylitis (AS) are giving new hope to patients with this chronic and potentially disabling disease. Clinical development of new treatments requires that rigorous and well controlled trials be conducted to demonstrate safety and efficacy. A number of classification systems have been developed in recent years as a result of enhanced understanding of the pathogenesis of AS. Although new outcome measures have been developed and a consensus has been reached on the use of assessment instruments in clinical trials, there is still need for improvement and implementation. The ASsessments in Ankylosing Spondylitis (ASAS) Working Group has addressed some of these dilemmas by establishing a core set of domains for the evaluation of AS and by selecting specific assessment methods for each domain. They have also published improvement criteria for assessing short term improvement with symptom modifying antirheumatic drugs and are presently in the process of developing response criteria for disease controlling antirheumatic treatment. Various experts are also currently examining discrepancies and inadequacies of classification systems for AS. Imaging studies, magnetic resonance imaging, in particular, may provide better classification criteria in the near future. In addition to consensus on outcome assessment and classification of AS, lessons learnt from clinical trials in rheumatoid arthritis (RA) may serve as a template for AS. Guidance provided by the United States Food and Drug Administration (FDA) for clinical trials in RA may be of particular use. The FDA has defined the claims that sponsors can receive for RA products and the clinical trial data that would be expected to be submitted to support such claims.

van der Heijde, D; Braun, J; McGonagle, D; Siegel, J

2002-01-01

63

Ankylosing spondylitis: from cells to genes.  

PubMed

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

64

Ankylosing spondylitis in sub-Saharan Africa.  

PubMed

Ankylosing spondylitis (AS) represents a chronic inflammatory bone disease of the axial skeleton that manifests as chronic back pain and progressive stiffness of the spine. It characteristically affects young adults with a peak age of onset between 20-30 years. In contrast to Western Europe and North America, the disease is rare in Sub-Saharan Africa where the majority of the population is HLA-B27 negative. Even in some African populations where HLA-B27 is prevalent (for example, in Gambia and Senegal, where 3-6% of the general population has HLA-B27), the disease is also said to be rare. However, some other genetic markers may be involved in the causation of AS in the HLA-B27 negative population, and when it occurs in this subgroup of patients it has a similar manifestation with HLA-B27 negative white patients and these patients rarely develop anterior uveitis. The clinical presentation of the disease in Africa is generally milder; most affected individuals do not have a family history of AS, the patients are older at onset of the disease, and the majority of them lack extra-articular manifestations such as anterior uveitis compared with the situation in Western Europe and North America. In conclusion, AS in sub-Saharan Africa seems to represent a subgroup of the disease, which may open the window to a greater understanding of the pathophysiology of the condition. PMID:19581245

Belachew, D A; Sandu, N; Schaller, B; Guta, Z

2009-07-01

65

Coexistence of ankylosing spondylitis and hereditary multiple exostoses:coincidence or association.  

PubMed

Coexisting ankylosing spondylitis and hereditary multiple exostoses have rarely been reported (three patients) previously. A 27-year-old man with hereditary multiple exostoses is presented as a fourth report. At the age of 15 years, the patient had multiple exostoses around the knee, ankle and shoulder joints. He was diagnosed with ankylosing spondylitis 3 years ago. The patient's sister and his 3 brothers also have multiple exostoses without any family history of spondyloarthropathy or inflammatory arthritis. The aim of this report is to discuss an interesting coexistence of these two diseases. The increasing number of reported patients who have a coexistence of these two diseases might suggest that the association of these two diseases is stronger than a coincidence. PMID:24693299

Rostamian, Abdolrahman; Mazoochy, Hamed; Movassaghi, Shafieh; Mortazavi, Seyed Mohammad Javad; Sadeghzadeh, Elham; Shahbazi, Fatemeh; Ghanaati, Hossein

2014-01-01

66

Coexistence of Ankylosing Spondylitis and Hereditary Multiple Exostoses:Coincidence or Association  

PubMed Central

Coexisting ankylosing spondylitis and hereditary multiple exostoses have rarely been reported (three patients) previously. A 27-year-old man with hereditary multiple exostoses is presented as a fourth report. At the age of 15 years, the patient had multiple exostoses around the knee, ankle and shoulder joints. He was diagnosed with ankylosing spondylitis 3 years ago. The patient’s sister and his 3 brothers also have multiple exostoses without any family history of spondyloarthropathy or inflammatory arthritis. The aim of this report is to discuss an interesting coexistence of these two diseases. The increasing number of reported patients who have a coexistence of these two diseases might suggest that the association of these two diseases is stronger than a coincidence.

Rostamian, Abdolrahman; Mazoochy, Hamed; Movassaghi, Shafieh; Mortazavi, Seyed Mohammad Javad; Sadeghzadeh, Elham; Shahbazi, Fatemeh; Ghanaati, Hossein

2014-01-01

67

Testicular Sertoli cell function in ankylosing spondylitis.  

PubMed

To assess the testicular Sertoli cell function according to inhibin B levels in ankylosing spondylitis (AS) patients and the possible effect of anti-TNF therapy on this hormone production, 20 consecutive AS patients and 24 healthy controls were evaluated. At study entry, AS patients were not receiving sulfasalazine/methotrexate and never have used biological/cytotoxic agents. They were assessed by serum inhibin B levels, hormone profile, urological examination, testicular ultrasound, seminal parameters, and clinical features. Ten of these patients received anti-TNF treatment and they were reevaluated for Sertoli function and disease parameters at 6 months. Four of them agreed to repeat sperm analysis. At study entry, the median of inhibin B (68 vs. 112.9 pg/mL, p = 0.111), follicle-stimulating hormone levels (3.45 vs. 3.65 IU/L, p = 0.795), and the other hormones was comparable in AS patients and controls (p > 0.05). Sperm analysis was similar in AS patients and controls (p > 0.05) with one AS patient presenting borderline low inhibin B levels. Further analysis at 6 months of the 10 patients referred for anti-TNF therapy, including one with borderline inhibin B, revealed that median inhibin B levels remained stable (116.5 vs. 126.5 pg/mL, p = 0.431) with a significant improvement in C-reactive protein (27.8 vs. 2.27 mg/L, p = 0.039). Sperm motility and concentration were preserved in the four patients who repeated this analysis after TNF blockage. In conclusion, this was the first study to report, using a specific marker, a normal testicular Sertoli cell function in AS patients with mild to moderate disease activity. PMID:23417428

Almeida, Breno Pires; Saad, Carla Gonçalves Schahin; Souza, Fernando Henrique Carlos; Moraes, Julio Cesar Bertacini; Nukumizu, Lucia Akemi; Viana, Vilma Santos Trindade; Bonfá, Eloísa; Silva, Clovis Artur

2013-07-01

68

Autoimmune thyroid disease in ankylosing spondylitis.  

PubMed

Although autoimmune thyroid disease is well known to be associated with primary Sjögren's syndrome (SjS) and with various autoimmune diseases, it is less clear whether a similar association also exists for ankylosing spondylitis (AS). Therefore, we investigated the frequency of autoimmune thyroid disease in patients with AS. In this cross sectional study, 80 patients with AS fulfilling the 1984 Modified New York Criteria and 80 healthy subjects, age and sex-matched with AS patients, were included. As the positive control group, 62 female patients with primary SjS were also studied. All cases underwent thyroid ultrasonography (USG) by a single endocrinologist. Thyroid function tests and thyroid autoantibodies were measured. The diagnosis of Hashimoto's thyroiditis (HT) was made if the patient had thyroid autoantibody positivity plus at least one of the following criteria: diffuse goiter with physical examination, abnormality in thyroid function tests, and parenchymal heterogeneity with USG. The chi-squared test and Fisher's exact test were used to compare cases and controls. The p values <0.05 were considered statistically significant. The frequencies of parenchymal heterogeneity with USG (30 vs 11.3 %, p?=?0.045), thyroid autoantibody positivity (13.8 vs 2.5 %, p?=?0.017), and concomitant diagnosis of HT (10 vs 1.3 %, p?=?0.034) were significantly higher in AS group compared to healthy controls. Among AS patients having HT, subclinical hypothyroidism was detected only in a single patient. Frequency of autoimmune thyroid disease was significantly higher in AS group, compared to healthy controls. Prospective studies are needed to see the clinical relevance of these findings and outcome in the long term. PMID:24384825

Emmungil, Hakan; Erdogan, Mehmet; Kalfa, Melike; Karabulut, Gonca; Kocanaogullar?, Hayriye; Inal, Vedat; Aksu, Kenan; Oksel, Fahrettin; Kabasakal, Yasemin; Keser, Gokhan

2014-07-01

69

Functional disability predicts total costs in patients with ankylosing spondylitis  

Microsoft Academic Search

Objective. To describe the composition and distri- bution of total costs of ankylosing spondylitis (AS), and to identify predictors of high total costs among patients with AS. Methods. In a prospective longitudinal study, 241 patients with AS reported information on health status, health care utilization, treatments, and work limitations on biannually mailed questionnaires. Annual direct costs were estimated on the

Michael M. Ward

2002-01-01

70

Effect of Pilates training on people with ankylosing spondylitis.  

PubMed

The objective of this study was to investigate the effects of Pilates on pain, functional status, and quality of life in patients with ankylosing spondylitis. The study was performed as a randomized, prospective, controlled, and single-blind trial. Fifty-five participants (30 men, 25 women) who were under a regular follow-up protocol in our Rheumatology Clinic with the diagnosis of AS according to the modified New York criteria were included in the study. The participants were randomly assigned into two groups: in group I, Pilates exercise program of 1 h was given by a certified trainer to 30 participants 3 times a week for 12 weeks, and in group II, designed as the control group, 25 participants continued previous standard treatment programs. In groups, pre-(week 0) and post treatment (week 12 and week 24) evaluation was performed by one of the authors who was blind to the group allocation. Primary outcome measure was functional capacity. Evaluation was done using the Bath Ankylosing Spondylitis Functional Index (BASFI). Exploratory outcome measures were Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Chest expansion, and ankylosing spondylitis quality of life (ASQOL) questionnaire. In group I, BASFI showed significant improvement at week 12 (P = 0.031) and week 24 (P = 0.007). In group II, this parameter was not found to have significantly changed at week 12 and week 24. Comparison of the groups showed significantly superior results for group I at week 24 (P = 0.023). We suggest Pilates exercises as an effective and safe method to improve physical capacity in AS patients. Our study is the first clinical study designed to investigate the role of Pilates method in AS treatment. We believe that further research with more participants and longer follow-up periods could help assess the therapeutic value of this popular physical exercise method in AS. PMID:21499876

Altan, L; Korkmaz, N; Dizdar, M; Yurtkuran, M

2012-07-01

71

Multiple sclerosis during adalimumab treatment in a case with ankylosing spondylitis.  

PubMed

Ankylosing spondylitis is a chronic and progressive inflammatory disease involving the sacroiliac joints with HLA-B27 positivity in 85% of the patients and radiologically evidence of sacroiliitis. It is associated with several extraarticular manifestations, but neurological complications are rare. Occurrence of multiple sclerosis in patients with ankylosing spondylitis has been reported in limited cases. Adalimumab, a TNF-? antagonist, offers a significant improvement in ankylosing spondylitis and is considered to be less immunogenic and more tolerable than other TNF-? blockers. A case of multiple sclerosis coexisted with HLA-B27 positive ankylosing spondylitis after treated with adalimumab was reported. PMID:23269571

Uyguno?lu, U?ur; Uluduz, Derya; Ta?ç?lar, Koray; Saip, Sabahattin

2014-01-01

72

Infrared sauna in patients with rheumatoid arthritis and ankylosing spondylitis. A pilot study showing good tolerance, short-term improvement of pain and stiffness, and a trend towards long-term beneficial effects.  

PubMed

To study the effects of infrared (IR) Sauna, a form of total-body hyperthermia in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients were treated for a 4-week period with a series of eight IR treatments. Seventeen RA patients and 17 AS patients were studied. IR was well tolerated, and no adverse effects were reported, no exacerbation of disease. Pain and stiffness decreased clinically, and improvements were statistically significant (p < 0.05 and p < 0.001 in RA and AS patients, respectively) during an IR session. Fatigue also decreased. Both RA and AS patients felt comfortable on average during and especially after treatment. In the RA and AS patients, pain, stiffness, and fatigue also showed clinical improvements during the 4-week treatment period, but these did not reach statistical significance. No relevant changes in disease activity scores were found, indicating no exacerbation of disease activity. In conclusion, infrared treatment has statistically significant short-term beneficial effects and clinically relevant period effects during treatment in RA and AS patients without enhancing disease activity. IR has good tolerability and no adverse effects. PMID:18685882

Oosterveld, Fredrikus G J; Rasker, Johannes J; Floors, Mark; Landkroon, Robert; van Rennes, Bob; Zwijnenberg, Jan; van de Laar, Mart A F J; Koel, Gerard J

2009-01-01

73

A systematic medline analysis of therapeutic approaches in ankylosing spondylitis  

Microsoft Academic Search

Ankylosing spondylitis (AS) is a chronic inflammatory disorder involving the sacroiliac joints (SIJs), spine and less frequently\\u000a the peripheral joints. Traditionally, it is well recognised that AS is a challenging disease to manage due to the lack of\\u000a effective therapeutic options. Current evidence would suggest this has changed and there are now a number of therapies available\\u000a that provide persistent

L. Goh; A. Samanta

2009-01-01

74

The involvement of NK cells in ankylosing spondylitis  

Microsoft Academic Search

A role for NK cells in the regulation of autoimmunity has been demonstrated. Since there is a strong association between Ankylosing Spondylitis (AS) and HLA-B27, which is specifically recognized by the NK-inhibitory receptor KIR3DL1, this study evaluated the potential involvement of NK cells in AS. We studied 19 AS patients and 22 healthy volunteer donors and assessed the percentage, activity

Niva Azuz-Lieberman; Gal Markel; Roi Gazit; Jacob Hanna; Hagit Achdout; Raizy Gruda; Gil Katz; Tal I. Arnon; Shosh Battat; Ehud Zamir; Muhammed Adawi; Reuven Mader; Ofer Mandelboim

2005-01-01

75

Ankylosing spondylitis in an athlete with chronic sacroiliac joint pain.  

PubMed

Ankylosing spondylitis is a disease in which inflammation of joints, most often in the axial skeleton, can lead to reactive fibrosis and eventual joint fusion with associated immobility and kyphosis. The disease often involves extra-articular features, such as uveitis and aortic regurgitation, as well as associated inflammatory conditions of the intestines. Its etiology is unknown. Ankylosing spondylitis most commonly presents in young males (15-30 years old) as persistent low back pain and stiffness that is worse in the morning and at night and improves with activity. The authors report the case of a young male athlete whose symptoms were initially incorrectly diagnosed as sacroiliac joint instability and dysfunction and later as a sacroiliac stress fracture before further workup revealed a seronegative spondyloarthropathy and the diagnosis of ankylosing spondylitis. The patient was prescribed oral indomethacin daily by the attending rheumatologist and started on a slow progression of return to running, jumping, and weight lifting. Within 4 weeks of beginning this treatment, the patient had complete cessation of pain with the medication. At follow-up 1 year after graduation from his university, the patient was nearly symptom free and working in a non-heavy labor job. The purpose of this case report is to remind sports medicine physicians of the prevalence of rheumatologic diseases in general and ankylosing spondylitis in particular and of the various ways in which spondyloarthropathies may present in athletes. Increased suspicion may lead to earlier diagnosis and treatment, potentially reducing illness severity and duration and improving the performance of athletes with this condition. PMID:24679210

Miller, Timothy L; Cass, Nathan; Siegel, Courtney

2014-02-01

76

Diffuse idiopathic skeletal hyperostosis: Differentiation from ankylosing spondylitis  

Microsoft Academic Search

Diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) share involvement of the axial skeleton and\\u000a peripheral entheses. Both diseases produce bone proliferations in the later phases of their course. Although the aspect of\\u000a these bone proliferations is dissimilar, confusion of radiologic differential diagnosis between the two diseases exists mostly\\u000a as a consequence of a lack of awareness of their

Ignazio Olivieri; Salvatore D’Angelo; Carlo Palazzi; Angela Padula; Reuven Mader; Muhammad A. Khan

2009-01-01

77

99mTc-MDP scintigraphy in ankylosing spondylitis.  

PubMed

99mTechnetium-MDP bone scintigrams in 11 patients with ankylosing spondylitis were reviewed. Increased activity in sacroiliac joints was present in five of 11 cases, all of whom had symptoms of less than 5 years duration. Patients with longstanding disease had normal or low sacroiliac joint activity. In the spine, appearances included diffuse symmetrical, unifocal or multifocal asymmetrical increased uptake involving the costovertebral, costotransverse and facet joints as well as the spinous processes. In advanced disease with extensive ankylosis, the lumbar spine was featureless on scintigraphy, except for focal increased activity at the site of previous fracture in one patient. Of six available views of the sternum, increased uptake was present in five at the manubriosternal joint and five at the sternoclavicular joints. Increased peripheral uptake was mainly in the hips and knees in advanced cases. Plain radiographic changes correlated poorly with scintigraphic changes, scintigraphy detecting considerably more lesions than radiography. Awareness of the scintigraphic appearances of ankylosing spondylitis may lead to diagnosis before the development of radiographic changes and avoid confusion with other pathology. Clinical indications for bone scintigraphy in ankylosing spondylitis are suggested. PMID:8293644

Collie, D A; Smith, G W; Merrick, M V

1993-12-01

78

Defining disease activity in ankylosing spondylitis: is a combination of variables (Bath Ankylosing Spondylitis Disease Activity Index) an appropriate instrument?  

Microsoft Academic Search

Objective. Disease activity has been defined using a self-administered instrument, focusing on fatigue, axial pain, peripheral pain, enthesopathy and morning stiVness (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI )). This validated instrument is simple and takes 40 s to complete, but whether the index is an accurate expression of the component parts, or whether additional weighting would enhance its eYcacy,

A. Calin; P. Nakache; A. Gueguen; H. Zeidler; H. Mielants; M. Dougados

1999-01-01

79

Ankylosing spondylitis associated with Sweet's syndrome: a case report  

PubMed Central

Introduction Sweet’s syndrome is an acute neutrophilic dermatosis characterized by a diffuse dermal infiltrate of mature neutrophils. In most cases, it occurs as an isolated phenomenon (idiopathic Sweet’s syndrome) but it can be drug induced or associated with a variety of underlying diseases such as infections, neoplasms, and chronic inflammatory diseases. The association between Sweet’s syndrome and ankylosing spondylitis is rare. Only a few cases have been reported in the literature. We report a new case in which we describe an outbreak of acute neutrophilic dermatosis revealing ankylosing spondylitis. Case presentation A 33-year-old Moroccan man presented with large-joint polyarthralgia, inflammatory pain in his buttocks and lower lumbar spine, fever and skin lesions. On examination, the patient had a low-grade fever, six tender but not swollen joints, limitation of motion of the lumbar spine, and painful erythematous maculopapules over his face, neck, and hands. Laboratory tests showed hyperleukocytosis, and elevated erythrocyte sedimentation rate and C-reactive protein. The immunological tests and infectious disease markers were negative. Investigations for an underlying neoplastic disease remained negative. Magnetic resonance imaging showed a bilateral sacroiliitis. Skin biopsy findings were consistent with Sweet’s syndrome. The diagnosis of Sweet’s syndrome associated with ankylosing spondylitis was established. Nonsteroid anti-inflammatory drugs were started and the patient showed rapid clinical and biological improvement. Conclusion Three observations of the association between Sweet’s syndrome and spondylarthropathy have been reported in the literature. The cause of this association remains unclear. Some hypotheses have been developed, but further studies are needed to confirm or refute them.

2013-01-01

80

Surgical Treatment of Lumbar Hyperextension Injury in Ankylosing Spondylitis  

PubMed Central

Ankylosing spondylitis (AS) is a chronic systemic and inflammatory rheumatic disease with a variable course of the axial skeleton. Spinal involvement may accompany ossification of the ligaments, intervertebral disc, end-plates and apophyseal structures, and seems to be "bamboo spine". Because of these natures of the spine in AS, a spinal fracture can be occurred with minor trauma or spontaneously. The fracture of the AS can cause neurological complications extremely high, so special attention to prevent neurological deterioration. Operative management of the injured spine with AS is difficult, and associated with a high complication rate. Extreme care must be taken for surgery to prevent secondary neurological deterioration.

Lee, Jung Keun; Park, Moon Sun; Kim, Seong Min; Chung, Seung Young; Lee, Do Sung

2013-01-01

81

Simultaneous presentation of upper lobe fibrobullous disease and spinal pseudarthrosis in a patient with ankylosing spondylitis.  

PubMed Central

A 51 year old man with a 20 year history of ankylosing spondylitis and pronounced thoracic gibbus presented with two simultaneous complications of longstanding ankylosing spondylitis, upper lobe fibrobullous disease, and spinal pseudarthrosis. No neurological sequelae developed and treatment was conservative. Both these lesions mimic tuberculosis, and so it is important to determine them accurately to avoid unnecessary antituberculosis treatment. Both of these complications are reported to occur in longstanding ankylosing spondylitis and their simultaneous presentation may be more common than is realised. This case is believed to be the first such report of their association. Images

Hakala, M; Kontkanen, E; Koivisto, O

1990-01-01

82

Pulmonary involvement in ankylosing spondylitis assessed by multidetector computed tomography  

PubMed Central

Summary Background Ankylosing spondylitis (AS) may present with extra-articular involvement in the lungs. We aimed to evaluate the abnormal pulmonary multidetector computed tomography findings of patients with AS and compare them with the clinical symptoms, duration of illness, laboratory results and pulmonary function tests (PFT). Material/Methods We evaluated the chest multidetector computed tomography (MDCT) findings of 41 patients with ankylosing spondylitis (AS) and compared them with pulmonary function test (PFT) results, demographic characteristics, duration of illness and laboratory findings that we were able to obtain. Results The most common abnormalities were nodules, peribronchial thickening, pleural thickening and bronchiectasis. Abnormalities occurred in 96.87% of patients in the early AS group and 77.8% of patients in the late AS group. Patients with early AS included asymptomatic individuals with normal PFT results and abnormal MDCT findings. Conclusions The use of MDCT in AS patients may be beneficial for the evaluation of pulmonary disease, even in asymptomatic patients without any PFT abnormalities and those in the early stages of the disease.

Yuksekkaya, Ruken; Almus, Ferdag; Cel?kyay, Fatih; Cel?kel, Serhat; Inan?r, Ahmet; Almus, Eda; Ozmen, Zafer

2014-01-01

83

Suppression of Inflammation and Effects on New Bone Formation in Ankylosing Spondylitis  

MedlinePLUS

... ankylosing spondylitis (AS) is sometimes known as "fusing". Fusion of the spine and other joints, such as ... The authors of the study conclude that "Our data supports the hypothesis that new bone formation is ...

84

Prevalence of vertebral compression fractures due to osteoporosis in ankylosing spondylitis  

Microsoft Academic Search

OBJECTIVE--To determine the prevalence of vertebral compression fractures due to osteoporosis in patients with ankylosing spondylitis. DESIGN--Prospective study of 111 consecutive patients; patients with vertebral compression fractures were entered into a case-control study. SETTING--Outpatient clinic at the centre for rheumatic diseases, Glasgow. PATIENTS--111 Consecutive patients with ankylosing spondylitis. Patients with compression fractures were matched for age and sex with two

S H Ralston; G D Urquhart; M Brzeski; R D Sturrock

1990-01-01

85

Assessment of outcome in ankylosing spondylitis: an extended radiographic scoring system  

Microsoft Academic Search

Objective: To develop and validate an extensive radiographic scoring system for ankylosing spondylitis (AS).Methods: The Stoke Ankylosing Spondylitis Spinal Score (SASSS) was modified by adding a score for the cervical spine and defining squaring. This modified SASSS (mSASSS) is the sum of the lumbar and cervical spine score (range 0–72). 370 lateral views of the lumbar and cervical spine were

M. C. W. Creemers; M. J. A. M. Franssen; M A van ’t Hof; F. W. J. Gribnau

2005-01-01

86

Ankylosing spondylitis in West Africans--evidence for a non-HLA-B27 protective effect  

PubMed Central

OBJECTIVE—To determine the prevalence of ankylosing spondylitis in the Fula ethnic group in The Gambia, and relate the disease prevalence to the B27 frequency and subtype distribution of that population.?METHODS—215 first degree relatives of 48 B27 positive Fula twin pairs, and 900 adult Fula males were screened for ankylosing spondylitis by clinical and, where appropriate, radiographic means. The B27 prevalence was determined by PCR/sequence specific oligonucleotides on finger prick samples from 100 unrelated Fula, and B27 subtype distribution by SSCP on unrelated B27 positive individuals. This data were then compared with the prevalence of ankylosing spondylitis among B27 positive Caucasians.?RESULTS—No case of ankylosing spondylitis was seen. Six per cent of Fula are B27 positive, of which 32% are B*2703 and 68% B*2705. Assuming the penetrance of ankylosing spondylitis in B27 positive Fula is the same as in B27 positive Caucasians, the probability of not observing any cases of ankylosing spondylitis among the Fula examined is remote (P = 6.7 × 10-6). Similarly, the chance of not seeing any cases among those expected to be either B*2705 or B*2703 was small (P = 3.2 × 10-4 for B*2705, and P = 0.02 for B*2703).?CONCLUSIONS—The risk of developing ankylosing spondylitis in B27 positive Fula is lower than in B27 positive Caucasians. This is not explained by the B27 subtype distribution among Fula, and suggests the presence of some non-B27 protective factor reducing the prevalence of ankylosing spondylitis in this population.??

Brown, M; Jepson, A; Young, A; Whittle, H; Greenwood, B; Wordsworth, B

1997-01-01

87

Golimumab administered subcutaneously every 4 weeks in ankylosing spondylitis: 104-week results of the GO-RAISE study  

PubMed Central

Objective To assess the efficacy and safety of golimumab over 104 weeks in patients with active ankylosing spondylitis. Methods At baseline, patients with active ankylosing spondylitis (n=356) were randomly assigned (1:1.8:1.8) to subcutaneous injections of placebo (group 1), golimumab 50 mg (group 2) or golimumab 100 mg (group 3) every 4 weeks. At week 16, patients in groups 1 and 2 with <20% improvement in total back pain and morning stiffness entered early escape to 50 or 100 mg, respectively. At week 24, patients still receiving placebo crossed over to golimumab 50 mg. Findings through week 24 were previously reported; those through week 104 are presented herein. Results At week 104, 38.5%, 60.1% and 71.4% of patients in groups 1, 2 and 3, respectively, had at least 20% improvement in the Assessment in SpondyloArthritis international Society response criteria (ASAS20); 38.5%, 55.8% and 54.3% had an ASAS40 response and 21.8%, 31.9% and 30.7% were in ASAS partial remission. Mean Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index scores were <3 at week 104 for all the treatment regimens. Golimumab safety through week 104 was similar to that through week 24. Conclusion Clinical response that was achieved by patients receiving golimumab through 24 weeks was sustained through 52 and 104 weeks. The golimumab safety profile appeared to be consistent with the known safety profile of tumour necrosis factor inhibitors.

Braun, Jurgen; Deodhar, Atul; Inman, Robert D; van der Heijde, Desiree; Mack, Michael; Xu, Stephen; Hsu, Benjamin

2012-01-01

88

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

89

Immunoglobulin A in the skin of patients with ankylosing spondylitis.  

PubMed Central

Cutaneous immunofluorescence studies were carried out in 21 patients with ankylosing spondylitis (AS) and the results compared with those for 18 healthy subjects. The most prominent finding was the presence of IgA in dermal vessels of patients with AS (71% compared with 17% of the control group). IgG and IgM cutaneous deposits were also observed in patients with AS, but these results did not differ from those of the control group. A renal biopsy was performed in three of the patients presenting with unexplained microscopic haematuria. One of them had an IgA nephropathy, but no correlation was found between kidney and skin deposits of IgA. These findings suggest that IgA cutaneous deposits in AS are not a marker of IgA nephropathy but stress the role of immunoglobulin A in the pathogenesis of this disease. Images

Collado, A; Sanmarti, R; Bielsa, I; Castel, T; Kanterewicz, E; Canete, J D; Brancos, M A; Rotes-Querol, J

1988-01-01

90

[Total hip replacement in patients with ankylosing spondylitis.].  

PubMed

The authors present their experience with total hip replacement in patients with ankylosing spondylitis. In the period of 1985-1997 they performed in total 66 total hip replacements in 41 patients. Of the total number of the used implants 24 were fully cemented (the average follow-up - 13 years), 3 were hybrid and 39 cementless (the average follow-up - 6 years). The results of total hip replacements were assessed on the basis of Harris score (HS). The outcomes of the two subgroups, i. e. cemented and cementless implants, were statistically evaluated and compared. The group of hybrid implants was not statistically evaluated due to a small size of the subgroup. In both evaluated groups of implants the results were very favourable (the average HS value in cemented: 86,2 in cementless: 86,4). The occurrence of periarticular ossifications was minimal in both groups. Of the post-operative complications we recorded one case of displacement of the implant which was solved by closed reduction under general anesthesia. Two cases required re-operation of the loosened cementless cup. There occurred no infect. On the basis of the evaluation of the average 13-year results of cemented implants the use of this type of total hip replacement in patients with M. Bechterev is recommended. The question remains whether the same positive values will be produced after the same time interval also by cementless implants as we still do not have results from a 10-year follow-up. Key words: ankylosing spondylitis, total hip replacement. PMID:20478223

Jezek, V; Vavrík, P; Popelka, S; Urbanová, Z

2000-01-01

91

Therapy of ankylosing spondylitis and other spondyloarthritides: established medical treatment, anti-TNF-? therapy and other novel approaches  

PubMed Central

Therapeutic options for patients with more severe forms of spondyloarthritis (SpA) have been rather limited in recent decades. There is accumulating evidence that anti-tumor-necrosis-factor (anti-TNF) therapy is highly effective in SpA, especially in ankylosing spondylitis and psoriatic arthritis. The major anti-TNF-? agents currently available, infliximab (Remicade®) and etanercept (Enbrel®), are approved for the treatment of rheumatoid arthritis (RA) in many countries. In ankylosing spondylitis there is an unmet medical need, since there are almost no disease-modifying antirheumatic drugs (DMARDs) available for severely affected patients, especially those with spinal manifestations. Judging from recent data from more than 300 patients with SpA, anti-TNF therapy seems to be even more effective in SpA than in rheumatoid arthritis. However, it remains to be shown whether patients benefit from long-term treatment, whether radiological progression and ankylosis can be stopped and whether long-term biologic therapy is safe.

Braun, Juergen; Sieper, Joachim

2002-01-01

92

Focal spinal abnormalities on bone scans in ankylosing spondylitis: a clue to the presence of fracture or pseudarthrosis  

Microsoft Academic Search

Four cases of ankylosing spondylitis are presented in which radionuclide bone studies indicated focal abnormalities of the spine. In three patients, the area of abnormal nuclide uptake corresponded to a site of pseudarthrosis, and in the fourth an acute fracture was present. As such focal lesions on bone scans are unusual in cases of chronic ankylosing spondylitis in which a

DONALD RESNICK; SUSAN WILLIAMSON; NAOMI ALAZRAKI

1981-01-01

93

Is there a relationship between endothelial nitric oxide synthase gene polymorphisms and ankylosing spondylitis?  

PubMed Central

OBJECTIVE: Nitric oxide is produced by endothelial nitric oxide synthase, and its production can be influenced by polymorphisms of the endothelial nitric oxide synthase gene. Because candidate genes responsible for susceptibility to ankylosing spondylitis are mostly unknown and available data suggest that there may be problems related to the nitric oxide pathway, such as endothelial dysfunction and increased asymmetric dimethylarginine, this study aimed to assess the association of common endothelial nitric oxide synthase gene polymorphisms with ankylosing spondylitis. METHODS: One hundred ninety-four unrelated Turkish ankylosing spondylitis patients and 113 healthy without apparent cardiovascular disease, hypertension or diabetes mellitus were included. All individuals were genotyped by PCR-RFLP for two single-nucleotide polymorphisms, namely 786T>C (rs2070744, promoter region) and 786 Glu298Asp (rs1799983, exon 7). Variable numbers of tandem repeat polymorphisms in intron 4 were also studied and investigated by direct electrophoresis on agarose gel following polymerase chain reaction analysis. The Bath ankylosing spondylitis metrology index of the patients was calculated, and human leukocyte antigen B27 was studied. RESULTS: All studied polymorphisms satisfied Hardy-Weinberg equilibrium. Sex distributions were similar between the patient and control groups. No significant differences were found in the distributions of allele and genotype frequencies of the studied endothelial nitric oxide synthase polymorphisms between patients and controls. There were no correlations between endothelial nitric oxide synthase polymorphisms, disease duration, Bath ankylosing spondylitis metrology index or human leukocyte antigen B27. CONCLUSION: The results presented in this study do not support a major role of common endothelial nitric oxide synthase polymorphisms in Turkish ankylosing spondylitis patients.

Sari, Ismail; Igci, Yusuf Ziya; Can, Gercek; Taylan, Ali; Solmaz, Dilek; Gogebakan, Bulent; Akar, Servet; Eslik, Zeynep; Bozkaya, Giray; Akkoc, Nurullah

2013-01-01

94

Economic Considerations of the Treatment of Ankylosing Spondylitis  

PubMed Central

Ankylosing spondylitis (AS)is associated with both significant direct and indirect costs,which vary by country, and have generally increased dramatically since the introduction of anti-TNF therapy. The cost-effectiveness of biologic agents is controversial, although cost-effectiveness studies need to consider the potential impact of anti-TNF treatments on work ability. Alternatives to reduce costs associated with biologics have been examined, including on-demand dosing and lower dose alternatives. Other treatment measures, such as total hip arthroplasty and physical therapy, are also effective in reducing pain and improving function in patients with AS, although the optimal type or combination of physical therapy treatment modalities, the optimal frequency and duration of treatment, and whether therapy is equally effective in stable disease and uncontrolled AS needs to be determined. No studies have examined differences in patient outcomes based on subspecialty care. Establishing an evidence base for these questions would help inform policy decisions to design the most cost-effective measures to treat AS.

Reveille, John D.; Ximenes, Antonio; Ward, Michael M.

2012-01-01

95

Visceral fat reflects disease activity in patients with ankylosing spondylitis.  

PubMed

Purpose: Response to infliximab treatment diminishes as body mass index (BMI) increases in patients with ankylosing spondylitis (AS). The purpose of the study was to determine if diminished response to infliximab treatment in patients with AS could be associated with increased visceral adipose tissue rather than increased BMI. Methods: Twenty six AS patients (21 males and five females) who fulfilled the modified New York criteria and who were currently receiving infliximab treatment were enrolled in the study. Pain was measured by the visual analogue scale (VAS). The disease activity and functional status were assessed by the Bath AS Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI). The Bath AS Metrology Index (BASMI) was used to evaluate mobility restrictions. Weight and visceral body composition were measured without shoes in light indoor clothes using a bio-impedance meter. Results: There was a significant correlation between visceral adipose tissue amount and disease activity under infliximab treatment. In correlation analysis, visceral fat showed significant correlations between BASDAI (r=0.545, p=0.004) and VAS (r=0.458, p=0.019). Total body fat also showed a significant correlation with BASDAI (r=0.463, p=0.017). Conclusion: A significant correlation was found between visceral adipose tissue amount and disease activity in patients with AS. PMID:24895992

Aydin, Mesut; Aydin, Fatma; Yuksel, Murat; Yildiz, Abdulkadir; Polat, Nihat; Akil, Mehmet A; Bilik, Mehmet Z; Akyuz, Abdurrahman; Batmaz, Ibrahim; Alan, Sait

2014-01-01

96

Population pharmacokinetics of infliximab in patients with ankylosing spondylitis.  

PubMed

The population pharmacokinetics of infliximab were characterized in patients with active ankylosing spondylitis (n = 274). Serum infliximab concentration data, from a 2-year period, were analyzed using NONMEM. A 2-compartment linear pharmacokinetic model was chosen to describe the pharmacokinetic characteristics of infliximab in serum. Population estimates (typical value +/- standard error) were obtained from the final covariate model: clearance (CL: 0.273 +/- 0.007 L/day), volume of distribution in the central compartment (V(1): 3.06 +/- 0.057 L), intercompartment clearance (Q: 1.72 +/- 0.48 L/day), and volume of distribution in the peripheral compartment (V(2): 2.94 +/- 0.17 L). Interindividual variability for CL and V(1) was 34.1% and 17.5%, respectively. White blood cell count at baseline and the antibody-to-infliximab status were significant covariates to CL; body surface area and sex were significant covariates to V(1). The CL for patients with a positive antibody-to-infliximab status was estimated to be 41.9% to 76.7% higher than for the remaining patients. Other covariates (baseline disease activity and the concomitant medication use of prednisolone, omeprazole, nonsteroidal anti-inflammatory drugs, or analgesics) did not affect infliximab pharmacokinetics. The development of antibodies to infliximab was associated with accelerated infliximab clearance and may represent a potential underlying mechanism for an inadequate response, or loss of response, to infliximab treatment. PMID:18401017

Xu, Zhenhua; Seitz, Kathleen; Fasanmade, Adedigbo; Ford, Joyce; Williamson, Paul; Xu, Weichun; Davis, Hugh M; Zhou, Honghui

2008-06-01

97

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.

Popescu, C; Trandafir, M; Badica, AM; Morar, F; Predeteanu, D

2014-01-01

98

Ankylosing spondylitis: recent breakthroughs in diagnosis and treatment  

PubMed Central

Ankylosing spondylitis (AS) is generally easy to diagnose when the characteristic findings of the “bamboo” spine and fused sacroiliac joints are present on radiographs. Unfortunately, these changes are usually seen late in the disease after tremendous suffering has been incurred by the patient. Diagnostic delay averages seven to ten years. Historically, once the diagnosis was made, the treatment options were often inadequate or poorly tolerated in many individuals. This condition most often starts in early adulthood when people are typically in the earlier stages of their careers, resulting in diminished workforce participation and decreased quality of life. If an individual has a family physician, this might be the first encounter with a healthcare provider. Quite often, the initial practitioner is sought at a public walk-in clinic or chiropractic office. In recent years, there have been two major developments in the management of AS that make earlier diagnosis possible and offer the hope of alleviating pain and preventing structural changes that result in loss of function. These developments include the use of magnetic resonance imaging (MRI) to visualize the inflammatory changes in the sacroiliac joint and the axial spine, and the demonstration that tumor necrosis factor (TNF) blocking agents are highly efficacious in reducing spinal inflammation and possibly in slowing radiographic progression. This review outlines diagnostic strategies that can help identify AS in its earlier stages. Special attention is focused on treatment advances, including the use of anti-TNF agents, and how these medications have been incorporated into clinical recommendations for daily use.

Shaikh, Saeed A.

2007-01-01

99

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.

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

2008-01-01

100

Critical appraisal of the guidelines for the management of ankylosing spondylitis: disease-modifying antirheumatic drugs.  

PubMed

Surprisingly, little data are available for the use of disease-modifying antirheumatic drugs in ankylosing spondylitis. Sulfasalazine has been the best studied. Efficacy data for individual agents (including pamidronate) and combinations of agents are detailed in this review. Intriguingly, these agents continue to be used with some frequency, even in the absence of efficacy data. To answer these questions, additional systematic studies of these agents in ankylosing spondylitis are needed and will likely need to be done by interested collaborative groups such as SPARTAN. PMID:22543537

Soriano, Enrique R; Clegg, Daniel O; Lisse, Jeffrey R

2012-05-01

101

Lung parenchymal changes in patients with ankylosing spondylitis  

PubMed Central

AIM: To assess lung parenchymal changes in ankylosing spondylitis (AS) using high resolution computed tomography (HRCT). METHODS: We included 78 AS patients whose average age was 33.87 (18-56) years with a ratio of 53 males to 25 females who were followed up for 3.88 (1-22) years on average. Pneumonia and tuberculosis were excluded. In a detailed examination of lung HRCT findings, we investigated the presence of parenchymal micronodules, parenchymal bands, subpleural bands, interlobular and intralobular septal thickening, irregularity of interfaces, ground-glass opacity, consolidation, mosaic pattern, bronchial wall thickening, bronchial dilatation, tracheal dilatation, pleural thickening, emphysema, thoracic cage asymmetry, honeycomb appearance, structural distortion, apical fibrosis and other additional findings. RESULTS: In detailed HRCT evaluations, lung parenchymal changes were found in 46 (59%) of all patients. We found parenchymal bands in 21 (27%) cases, interlobular septal thickening in 9 (12%), emphysema in 9 (12%), apical fibrosis in 8 (10%), ground-glass opacities in 7 (9%), parenchymal micronodules in 5 (6%), irregularity in interfaces in 3 (4%), bronchial dilatation in 3 (4%), mosaic pattern in 2 (3%), pleural thickening in 2 (3%), consolidation in 1 (1%), bronchial wall thickening in 1 (1%) and a subpleural band in 1 (1%) case. Furthermore, we detected subsegmental atelectasis in 2 patients and a cavitary lesion in 1 patient. CONCLUSION: Our study had the highest number of AS cases of all previous studies in evaluating lung parenchymal changes. The rate of lung parenchymal changes was slightly lower than that reported in recent literature.

Hasiloglu, Zehra Isik; Havan, Nuri; Rezvani, Aylin; Sariyildiz, Mustafa Akif; Erdemli, Halil Eren; Karacan, Ilhan

2012-01-01

102

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

103

Leukemia mortality after X-ray treatment for ankylosing spondylitis  

SciTech Connect

Leukemia mortality has been studied in 14,767 adult ankylosing spondylitis patients diagnosed between 1935 and 1957 in the United Kingdom, of whom 13,914 patients received X-ray treatment. By 1 January 1992, there were 60 leukemia deaths among the irradiated patients, almost treble that expected from national rates. Among those irradiated, the ratio of observed to expected deaths for leukemia other than chronic lymphocytic leukemia was greatest in the period 1-5 years after the first treatment (ratio = 11.01, 95% confidence interval 5.26-20.98) and decreased to 1.87 (95% confidence interval 0.94-3.36) in the 25+ year period. There was no significant variation in this ratio with sex or age at first treatment. The ratio for chronic lymphocytic leukemia was slightly but not significantly raised (ratio=1.44, 95% confidence interval 0.62-2.79). Most irradiated patients received all their exposure within a year. Based on 1 in 15 random sample, the mean total marrow dose was 4.38 Gy. Doses were nonuniform, with heaviest doses to the lower spine. The risk for nonchronic lymphocytic leukemia was adequately described by a linear-exponential model that allowed for cell sterilization in heavily exposed parts of the marrow and time since exposure. Ten years after first exposure, the linear component of excess relative risk was 12.37 per Gy (95% confidence interval 2.25-52.07), and it was estimated that cell sterilization reduced the excess relative risk by 47% at 1 Gy (95% confidence interval 17%-79%). The average predicted relative risk in the period 1-25 years after exposure to a uniform dose of 1 Gy was 7.00. 20 refs., 2 figs., 8 tabs.

Weiss, H.A.; Darby, S.C. [Univ. of Oxford (United Kingdom); Fearn, T. [Univ. College London (United Kingdom)] [and others

1995-04-01

104

An Epidemiological Study on Ankylosing Spondylitis in Southern Albania  

PubMed Central

Objectives: To evaluate the incidence and prevalence of ankylosing spondylitis (AS) in southern Albania and to assess the association of various demographic risk factors with the severity of disease. Material and methods: This is an observational study with cross-sectional analyses, conducted in the region of Gjirokaster, between 1995 until 2011. The diagnosis of AS was based on the modified New York criteria. Data on population are obtained from the reports of the National Institute of Statistics. Results: Between 1995 and 2011, there were 54 patients diagnosed with AS. Of them, 48 subjects were males (88.9%) and 6 subjects females (11.1%). The AS prevalence in adult population (?14 years of age), in December 2010, was 0.061%. The 5-year incidence (2006–2010) in adult population was 0.006 %. The mean age at the onset of disease was 29.7±8.4 years. The mean age in 2011 (n=50 subjects) was 51.6±12.7 years. The duration of the disease was 22.7±11.2 years. More than two thirds of the patients (70.3%) were in the advanced radiological stages of the disease. A younger age at the onset of the disease, longer delay in diagnosis, lower educational level and smoking were significant independent factors associated with the advanced forms of the disease. Conclusion: In southern Albania, the AS prevalence in 2010 was 0.061% and the 5-year incidence (2006-2010) was 6 new cases per 105 adults. The incidence and prevalence of AS in Southern Albania are close to the respective regional epidemiological data.

Koko, Vjollca; Ndrepepa, Ana; Skenderaj, Skender; Ploumis, Avraam; Backa, Teuta; Tafaj, Argjend

2014-01-01

105

Arthritis Today.  

National Technical Information Service (NTIS)

Dr. Plotz discusses the symptoms, diagnosis and treatment of arthritis, including osteoarthritis, gout, ankylosing spondylitis and systemic lupus erythematosus. He describes the degenerative processes, immune abnormalities, genetic factors, and infectious...

1994-01-01

106

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

107

Outcomes of a multicentre randomised clinical trial of etanercept to treat ankylosing spondylitis  

Microsoft Academic Search

OBJECTIVE: A double blind, randomised, placebo controlled study to evaluate the safety and efficacy of etanercept to treat adult patients with ankylosing spondylitis (AS). METHODS: Adult patients with AS at 14 European sites were randomly assigned to 25 mg injections of etanercept or placebo twice weekly for 12 weeks. The primary efficacy end point was an improvement of at least

A. Calin; B. A. C. Dijkmans; P Emery; M Hakala; J Kalden; M Leirisalo-Repo; EM Mola; C Salvarani; R Sanmarti; J Sany; J Sibilia; J. Sieper; Linden de S. venr; E Veys; AM Appel; S Fatenejad

2004-01-01

108

Two year maintenance of efficacy and safety of infliximab in the treatment of ankylosing spondylitis  

Microsoft Academic Search

Objective: To obtain results of the second year extension of an original 3 month randomised, placebo controlled trial (and the 1 year extension study) assessing the use of infliximab, a monoclonal antibody to tumour necrosis factor ?, for the treatment of patients with ankylosing spondylitis (AS).Methods: Of the 54 patients with AS who completed the first year of the study,

J Braun; J Brandt; J Listing; A Zink; R Alten; G Burmester; E Gromnica-Ihle; H Kellner; M Schneider; H So?rensen; H Zeidler; J Sieper

2005-01-01

109

Studies with an enthesis index as a method of clinical assessment in ankylosing spondylitis  

Microsoft Academic Search

The histopathological characteristic of ankylosing spondylitis (AS) is the presence of chronic enthesitis. Our aim was to develop a clinical measurement of the severity of tenderness over entheses. The scoring system was based on the patients' response to palpation over entheses easily accessible to examination. The enthesis index (EI) correlated with pain (r = 0.67, p less than 0.01) and

M Mander; J M Simpson; A McLellan; D Walker; J A Goodacre; W C Dick

1987-01-01

110

Ankylosing spondylitis, HLA-B27 positivity and the need for biologic therapies  

Microsoft Academic Search

ObjectivesHLA-B27 positivity strongly influences Ankylosing spondylitis (AS) disease susceptibility and phenotype. The aim of this study was to analyse an AS cohort with respect to quality of life (ASQoL), extra-articular disease, markers of disease activity (BASDAI), functional capacity (BASFI), biologic requirement, and the influence of HLA-B27 on these parameters.

Jane Freeston; Nick Barkham; Elizabeth Hensor; Paul Emery; Alexander Fraser

2007-01-01

111

Successful catheter-directed venous thrombolysis in an ankylosing spondylitis patient with phlegmasia cerulea dolens.  

PubMed

Ankylosing spondylitis (AS) is an inflammatory rheumatic disease. Phlegmasia cerulea dolens is a severe form of deep vein thrombosis characterized by swelling, pain, and bluish discoloration. Treatment delay may cause venous gangrene, tissue ischemia, limb loss or death. Here, we present an AS case who presented with phlegmasia cerulea dolens and treated by catheter-directed thrombolysis. PMID:24046784

Rokni Yazdi, Hadi; Rostami, Nematollah; Hakimian, Homa; Mohammadifar, Mehdi; Ghajarzadeh, Mahsa

2013-06-01

112

Successful Catheter-Directed Venous Thrombolysis in an Ankylosing Spondylitis Patient with Phlegmasia Cerulea Dolens  

PubMed Central

Ankylosing spondylitis (AS) is an inflammatory rheumatic disease. Phlegmasia cerulea dolens is a severe form of deep vein thrombosis characterized by swelling, pain, and bluish discoloration. Treatment delay may cause venous gangrene, tissue ischemia, limb loss or death. Here, we present an AS case who presented with phlegmasia cerulea dolens and treated by catheter-directed thrombolysis.

Rokni Yazdi, Hadi; Rostami, Nematollah; Hakimian, Homa; Mohammadifar, Mehdi; Ghajarzadeh, Mahsa

2013-01-01

113

A co-occurrence of sarcoidosis and ankylosing spondylitis: a case report  

Microsoft Academic Search

Sarcoidosis is an inflammatory multi-system disease, which may cause articular involvement. By causing sacroiliitis, it may\\u000a mimic spondyloarthropathies. A case with a co-occurrence of sarcoidosis and late-onset of typical ankylosing spondylitis was\\u000a presented and a possible association between these two entities was discussed.

Ilhan Sezer; Meltem Alkan Melikoglu; H. Fatih Cay; Hilal Kocabas; Cahit Kacar

2008-01-01

114

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

115

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

116

The inadequate anti-tumour necrosis factor (anti-TNF) therapy in patients with ankylosing spondylitis  

Microsoft Academic Search

Dear editor, Ankylosing spondylitis (AS) is a chronic progressive inflammatory disease of axial and peripheral joints associated with serious disability and a significant reduction in quality of life [1]. The prevalences of AS and related spondyloarthritis in most of the Meditterenean countries including ours have been determined as 0.5?1% and seems to be higher than the observed prevalences in other

Pinar Borman; Figen Ayhan; Esma Ceceli

2010-01-01

117

Carotid Intima Media Thickness as a Marker of Atherosclerosis in Ankylosing Spondylitis  

PubMed Central

Aim. Increased cardiovascular morbidity and mortality have been observed in ankylosing spondylitis because of accelerated atherosclerosis. We measured carotid intima media thickness (CIMT) as a surrogate marker of atherosclerosis in this study. Methods. In this study 37 cases of AS and the same number of matched individuals were recruited. CIMT measurements were done using B-mode ultrasound. Disease activity was assessed using Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), and Bath ankylosing spondylitis metrological index (BASMI) scores and C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels. Results. Mean age of the study groups was 29.43?±?9.00 years. Average disease duration was 65.62?±?54.92 months. Twenty-eight (75.68%) of cases were HLA B-27 positive. A significantly increased CIMT was observed in cases as compared to control group (0.62?±?0.12 versus 0.54?±?0.04; P < 0.001). CIMT in the cases group positively correlated with age (r = 0.357;?P < 0.05), duration of disease (r = 0.549;?P < 0.01), and BASMI (r = 0.337;?P < 0.05) and negatively correlated with ESR (r = ?0.295;?P < 0.05). Conclusions. Patients of AS had a higher CIMT than those of the control group. CIMT correlated with disease chronicity.

Gupta, Naveen; Goyal, Laxmikant; Agrawal, Abhishek; Bhargava, Rajat; Agrawal, Arun

2014-01-01

118

ICF based comparison of disease specific instruments measuring physical functional ability in ankylosing spondylitis  

PubMed Central

Objectives: To link validated and widely used instruments measuring physical functional ability in ankylosing spondylitis to the International Classification of Functioning, Disability, and Health (ICF) and to compare their contents, based on the results of the linking process. Methods: The Bath Ankylosing Spondylitis Functional Index (BASFI), the Dougados Functional Index (DFI), the Health Assessment Questionnaire modified for the spondylarthropathies (HAQ-S), and the Revised Leeds Disability Questionnaire (RLDQ) were linked to the ICF separately by two trained health professionals according to 10 linkage rules. Results: All concepts contained in the items of the selected instruments could be successfully linked to the ICF except for "illness" included in the HAQ-S. Altogether 55 different ICF categories were linked. Seven belonged to "body functions", 43 to "activities and participation", and five to "environmental factors". The component "body structure" was not contained in any of the four instruments. Only two ICF categories were common to all selected questionnaires, but there was a high level of concordance on the concepts represented in them. However, especially in terms of "activities and participation", the emphasised aspects differed. Conclusions: The ICF provides an excellent common framework for the comparison of disease specific instruments for ankylosing spondylitis. For a future revision of the ICF, a specification of major limitations in patients with ankylosing spondylitis is suggested.

Sigl, T; Cieza, A; van der Heijde, D; Stucki, G

2005-01-01

119

Breast cancer in a male with ankylosing spondylitis treated with TNFalpha antagonists.  

PubMed

A 72-year-old male with a 4-year history of TNFalpha antagonist therapy (infliximab and etanercept) for ankylosing spondylitis was diagnosed with breast cancer. He had a family history of breast cancer. The low incidence and considerable severity of breast cancer in males, genetic risk factors, and potential role for TNFalpha antagonist therapy are discussed. PMID:19457692

El Mansouri, Laila; Couchouron, Tifenn; Le Roux, Guillaume; Dugast, Catherine; Burtin, Françoise; Albert, Jean-David; Perdriger, Aleth; Hassouni, Najia Hajjaj; Chalès, Gérard

2009-07-01

120

Lung parenchyma changes in ankylosing spondylitis: demonstration with high resolution CT and correlation with disease duration  

Microsoft Academic Search

Objective: To analyze the spectrum of the lung parenchyma changes in ankylosing spondylitis (AS) with high resolution computed tomography (HRCT) and correlate the findings with disease duration. Material and methods: Twenty patients (18 male, 2 female) with the diagnosis of AS according to New York criteria were included in the study. None of the patients had history of tuberculosis, prolonged

Özlem ?enocak; Metin Manisal?; Dinç Özaksoy; Can Sevinç; Elif Akal?n

2003-01-01

121

Focal spinal abnormalities on bone scans in ankylosing spondylitis: a clue to the presence of fracture or pseudarthrosis  

SciTech Connect

Four cases of ankylosing spondylitis are presented in which radionuclide bone studies indicated focal abnormalities of the spine. In three patients, the area of abnormal nuclide uptake corresponded to a site of pseudarthrosis, and in the fourth an acute fracture was present. As such focal lesions on bone scans are unusual in cases of chronic ankylosing spondylitis in which a complication is not apparent, their presence can be a useful finding.

Resnick, D.; Williamson, S.; Alazraki, N.

1981-05-01

122

[The reliability and validity of a Croatian version of the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in patients with ankylosing spondylitis].  

PubMed

The aim of the study was to investigate the reliability and the validity of the Croatian version of the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity index (BASDAI) in patients with ankylosing spondylitis (AS). Patients with established diagnosis of AS participated in the study. Fifty-two and 48 patients were included for the evaluation of BASFI and BASDAI, respectively. For translation international translation steps were followed. For reliability patients recompleted both indices on the following day. To assess validity following parameters were obtained: spinal mobility in sagittal plane, chest expansion index, erythrocyte sedimentation rate, serum C-reactive protein, level of pain and patient's global health. Apart from descriptive statistics Spearman's rho coefficient was used. Correlation between BASFI and BASDAI score was 0.621. The mean BASFI scores on two occasions (within 24 hours) were 4.82 +/- 2.67 versus 4.88 +/- 2.52 (r = 0.961; p < 0.01), and for BASDAI scores were 5.46 +/- 2.30 versus 5.32 +/- 2.19, respectively (r = 0.959; p < 0.01). Stability index for both indices was 0.98. High correlation was found for each repeated question of BASFI and BASDAI. For both indices congruent validity demonstrated the best correlation with cervical and thoracic mobility. Also, the correlation was observed for BASFI with spinal mobility in lumbar region and with chest expansion index, and for BASDAI with the level of pain. Our findings indicate that Croatian version ofBASFI and BASDAI is reliable and valid. Therefore, it can be used in clinical research as well as in clinical practice. PMID:20429263

Grazio, Simeon; Grubisi?, Frane; Nemci?, Tomislav; Matijevi?, Valentina; Skala, Hana

2009-01-01

123

Symptomatic improvement in function and disease activity in a patient with ankylosing spondylitis utilizing a course of chiropractic therapy: a prospective case study  

PubMed Central

Background There is limited outcome measure support for chiropractic manipulative therapy in the management of ankylosing spondylitis. An improvement in specific indices for both function and disease activity during chiropractic therapy for ankylosing spondylitis has not previously been reported. Objective To measure changes in function and disease activity in a patient with ankylosing spondylitis during a course of chiropractic therapy. The clinical management of ankylosing spondylitis, including chiropractic manipulative therapy and the implications of this case study are discussed. Clinical Features A 34-year-old male with a 10 year diagnosis of ankylosing spondylitis sought chiropractic treatment for spinal pain and stiffness. His advanced radiographic signs included an increased atlantodental interspace and cervical vertebral ankylosis. Intervention and outcome The Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), finger-tip-to-floor distance and chest expansion were assessed during an 18 week course of chiropractic spinal manipulation and mobilization therapy. There was a 90% improvement in the disease activity index and an 85% improvement in the functional index from the pre-treatment baseline, as measured by the BASDAI and BASFI respectively. Spinal flexibility and chest expansion also improved. Conclusion To the authors knowledge this is the first study to incorporate ankylosing spondylitis specific indices, for both disease activity and function, to objectively support the use of chiropractic manipulative therapy in the management of ankylosing spondylitis. More intensive research is suggested.

Rutherford, Susan M; Nicolson, Cameron F; Crowther, Edward R

2005-01-01

124

Monitoring ankylosing spondylitis therapy by dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging  

Microsoft Academic Search

Objective  The effects of different therapies on enthesitis\\/osteitis in active ankylosing spondylitis (AS) were evaluated by magnetic\\u000a resonance imaging (MRI). The aim was to assess the role of quantitative MRI in the evaluation of AS treatment efficacy.\\u000a \\u000a \\u000a \\u000a Materials and methods  Thirty patients with active spondylitis or bilateral sacroilitis were selected and followed up for 1 year. Ten of the patients\\u000a were treated only

Nataša Gašperši?; Igor Serša; Vladimir Jevti?; Matija Tomši?; Sonja Praprotnik

2008-01-01

125

Valvular heart disease associated with juvenile onset ankylosing spondylitis: a case report and review of the literature.  

PubMed

Aortitis with associated aortic insufficiency is a well-known extra-articular manifestation of ankylosing spondylitis and other HLA-B27 associated spondyloarthropathies in adults. The cardiovascular histopathology is distinct from other forms of inflammatory and degenerative valve disease. Clinical cardiac involvement may be slowly progressive or fulminant and life-threatening. Mitral valve involvement associated with juvenile onset ankylosing spondylitis has rarely been reported. This article discusses a case of juvenile onset spondylitis in which associated aortic, and possibly mitral, valve disease dominated the clinical course for many years before axial joint disease required total replacement of the right hip. PMID:6288151

Gregersen, P K; Gallerstein, P; Jaffe, W; Enlow, R W

1982-01-01

126

Thalidomide reduces recurrence of ankylosing spondylitis in patients following discontinuation of etanercept.  

PubMed

A previous study showed that most ankylosing spondylitis (AS) patients presented recurrence within 6 months post-discontinuation of etanercept. How to reduce recurrence following discontinuation of etanercept should be further researched. In this study, 111 ankylosing spondylitis patients meeting the Assessment in AS 20 % response (ASAS20) criteria after 12-week administration of etanercept were randomized into three groups: Group I, 150 mg thalidomide once/day; Group II, 1 g sulfasalazine, twice/day; Group III, NSAIDs for the maintenance treatment. The patients were regularly followed up once a month, and AS recurrence was evaluated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the patient global assessment (PGA), and rachialgia. The follow-up lasted for 1 year, and AS recurrence was considered as the end of a visit. Finally, 100 patients completed the follow-up study, of whom 30 were in Group I, 33 in Group II, and 37 in Group III. The average follow-up period was 5.1 ± 3.9 months and the longest lasted for 12 months. At the end of the follow-up study, the recurrence rates in Groups I, II, and III were, respectively, 60.0 % (18/30), 84.8 % (28/33), and 89.2 % (33/37). The recurrence rates of Group I were statistically significantly lower than that of Group II and III (P = 0.0265; P = 0.0053), while there was no significant difference between Group II and Group III. In addition, we found that PGA, C-reactive protein (CRP), and spinal inflammation could be regarded as predictive factors for AS recurrence by analysis with the Cox proportional hazard model. This study points to a new way for maintenance therapy of AS following discontinuation of etanercept and reveals several useful indicators for prediction of AS recurrence. PMID:23143621

Deng, Xiaohu; Zhang, Jianglin; Zhang, Jie; Huang, Feng

2013-06-01

127

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

128

Bone mineral density and vertebral compression fracture rates in ankylosing spondylitis  

Microsoft Academic Search

OBJECTIVE--To examine the relationship between disease severity and bone density as well as vertebral fracture risk in patients with ankylosing spondylitis (AS). METHODS--Measurements were taken for bone mineral density (BMD) and vertebral fracture rates in 87 patients with AS. BMD was measured at the hip (femoral neck -FN), lumbar spine (L1-L4-LS) and for the whole body using a hologic-QDR-1000\\/W absorptiometer.

S Donnelly; D V Doyle; A Denton; I Rolfe; E V McCloskey; T D Spector

1994-01-01

129

The use of the GlideScope(R) for tracheal intubation in patients with ankylosing spondylitis  

Microsoft Academic Search

Background. The GlideScopeVideo Laryngoscope is a new intubating device. The aim of the study was to investigate the use of the GlideScopefor tracheal intubation in patients with ankylosing spondylitis (AS) undergoing general anaesthesia. Methods. Twenty AS patients were chosen to undergo tracheal intubation by the GlideScope? . Preoperative airway assessments were carried out to predict the difficulty of tracheal intubation.

H. Y. Lai; I. H. Chen; A. Chen; F. Y. Hwang; Y. Lee

2006-01-01

130

Mortality and causes of death in 398 patients admitted to hospital with ankylosing spondylitis  

Microsoft Academic Search

The mortality and causes of death in 398 patients (47 women, 351 men) with definite ankylosing spondylitis, admitted to hospital for the first time between 1961 and 1969, were investigated. The mean age at first admission was 36.5 years (SD 11.8). After a mean follow up time of 25.7 years, a total of 152 patients (12 women, 140 men) had

K Lehtinen

1993-01-01

131

Transpedicular wedge resection osteotomy for the treatment of a kyphotic Andersson lesion-complicating ankylosing spondylitis  

Microsoft Academic Search

Two cases with a long-standing thoracolumbar kyphosis due to ankylosing spondylitis are presented with a symptomatic localized destructive kyphotic lesion of the spine. Clinical and radiographic findings demonstrated a progressive vertebral and discovertebral kyphotic pseudarthrosis, known as an Andersson lesion, at the L1 and L1-2 level, respectively. Surgical correction and stabilization was performed by an extending transpedicular wedge resection osteotomy

B. J. Van Royen; R. C. A. Kastelijns; D. P. Noske; F. C. Oner; T. H. Smit

2006-01-01

132

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

Microsoft Academic Search

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

Mark D Atkinson; Sinead Brophy; Stefan Siebert; Mike B Gravenor; Ceri J Phillips; David V Ford; Kerina H Jones; Ronan A Lyons

2010-01-01

133

Transforming growth factor beta-1 and gene polymorphisms in oriental ankylosing spondylitis  

Microsoft Academic Search

Objectives. To study serum levels of transforming growth factor beta-1 (TGFb1) and the expression of TGFb 1i nin vitro peripheral blood mononuclear cell (PBMC) cultures in oriental ankylosing spondylitis (AS) patients, and to determine their association with codon 10 and 25 TGFB1 gene polymorphisms. Methods. Serum levels of TGFb1 were measured by enzyme-linked immunosorbent assay (ELISA). The ability of PBMCs

H. S. Howe; P. L. Cheung; K. O. Kong; H. Badsha; B. Y. H. Thong; K. P. Leong; E. T. Koh; T. Y. Lian; Y. K. Cheng; S. Lam; D. Teo; T. C. Lau; B. P. Leung

2005-01-01

134

Disease activity assessment in ankylosing spondylitis in a Chinese cohort: BASDAI or ASDAS?  

PubMed

Recently, the Ankylosing Spondylitis Disease Activity Score (ASDAS), a new index, has been shown to be validated and highly discriminatory in assessing ankylosing spondylitis (AS) disease activity. This study is to evaluate the performance of ASDAS in a local Chinese cohort of AS in a cross-sectional setting and to compare it with the existing instrument, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Consecutive patients with AS were recruited from a local rheumatology clinic. Data, including BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI), Visual Analogue Scale (VAS) for spinal pain, and patient and physician global assessments were gathered during clinic visit. Inflammatory markers, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and high-sensitivity (hs)-CRP were collected. ASDAS was calculated accordingly. The discriminatory capacity of BASDAI and ASDAS was compared by: (1) standardized mean difference statistics, (2) R (2) in linear regressions, and (3) area under receiver operating characteristic curve (AUC) in logistic regression models. Both ASDAS and BASDAI showed satisfactory predictive value on disease activity with reference to patient and physician global assessment. R (2) in linear regression models ranged from 0.6-0.7. Both indices also demonstrated good discriminatory capacity as evidenced by a relatively high AUC (> 0.8) under the logistic regression models using either patient or physician global assessment score ?4 and <4 as cut off of high and low disease activity status, respectively. Although we could not demonstrate significant differences in the performance between them, subgroup analysis suggested better discriminatory ability of ASDAS in the high inflammatory marker subgroup. ASDAS and BASDAI showed similarly good performance in a cross-sectional setting in a local Chinese AS cohort. ASDAS performed better in subgroup with raised inflammatory markers. PMID:24981160

Au, Yuen Ling Elaine; Wong, Woon Sing Raymond; Mok, Mo Yin; Chung, Ho Yin; Chan, Eric; Lau, Chak Sing

2014-08-01

135

Multiple organ tuberculosis of lung, pleura, and peritoneum in ankylosing spondylitis during adalimumab therapy  

Microsoft Academic Search

A case of multiple organ tuberculosis (TBc) involving lung, pleura, and peritoneum in a 39-year-old man with long-standing\\u000a ankylosing spondylitis (AS) treated with adalimumab was presented. The relationship between antitumor necrosis factor-? (anti-TNF-?)\\u000a therapy and TBc was also reviewed. This case illustrates that TBc can develop in multiple organs during adalimumab therapy,\\u000a and thus, the awareness of serious complications of

Wan-Hee Yoo

136

Treatment of ankylosing spondylitis with TNF blockers: a meta-analysis.  

PubMed

Biological agents directed against tumor necrosis factor (TNF) represent therapeutic options for patients with ankylosing spondylitis with high disease activity despite use of non-steroidal anti-inflammatory drugs. To evaluate the efficacy and safety of the anti-TNF agents infliximab, etanercept, adalimumab, golimumab, and certolizumab for the treatment of ankylosing spondylitis, we performed a systematic review of randomized clinical trials on adult patients with ankylosing spondylitis using articles culled from the EMBASE, MEDLINE, Cochrane Controlled Trials Register and LILACS databases (September/2012), manual literature search, and the gray literature. Study selections and data collection were performed by two independent reviewers, with disagreements solved by a third reviewer. The following outcomes were evaluated: ASAS 20 response, disease activity, physical function, vertebral mobility, adverse events, and withdraws. The meta-analysis was performed using the Review Manager(®) 5.1 software by applying the random effects model. Eighteen studies were included in this review. No study of certolizumab was included. Patients treated with anti-TNF agents were more likely to display an ASAS 20 response after 12/14 weeks (RR 2.21; 95 % CI 1.91; 2.56) and 24 weeks (RR 2.68; 95 % CI 2.06; 3.48) compared with controls, which was also true for several other efficacy outcomes. Meta-analysis of safety outcomes and withdraws did not indicate statistically significant differences between treatment and control groups after 12 or 30 weeks. Adalimumab, infliximab, etanercept, and golimumab can effectively reduce the signs and symptoms of the axial component of ankylosing spondylitis. Safety outcomes deserve further study, especially with respect to long-term follow-ups. PMID:23686218

Machado, Marina Amaral de Ávila; Barbosa, Mariana Michel; Almeida, Alessandra Maciel; de Araújo, Vânia Eloisa; Kakehasi, Adriana Maria; Andrade, Eli Iola Gurgel; Cherchiglia, Mariangela Leal; Acurcio, Francisco de Assis

2013-09-01

137

Therapy of ankylosing spondylitis with 224 Ra-radium chloride: dosimetry and risk considerations  

Microsoft Academic Search

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease which reduces the quality of life and leads to disability in approximately one-third of the patients. The spectrum of therapeutic modalities is limited. The renaissance of the use of 224Ra-radium chloride for AS treatment, however, gives rise to concern which should result in the reconsideration of 224Ra dosimetry and in the

Michael Lassmann; Dietmar Nosske; Christoph Reiners

2002-01-01

138

Chromosomal aberrations in peripheral lymphocytes of patients treated with radium-224 for ankylosing spondylitis  

Microsoft Academic Search

The aim of this study was to investigate the in vivo frequency of chromosomal aberrations (primarily dicentric chromosomes and chromatid breaks) potentially induced by 224Ra a-radiation in peripheral lymphocytes. The study was designed to serve as a cytogenetic analysis along with the therapeutic procedure of ankylosing spondylitis patients who were undergoing a treatment with 224Ra-chloride. The total administered activity was

G. Stephan; W. U. Kampen; D. Noßke; H. Roos

2005-01-01

139

Efficacy and safety of adalimumab in a patient with ankylosing spondylitis on peritoneal dialysis  

Microsoft Academic Search

The most commonly used treatments in patients with ankylosing spondylitis include nonsteroidal anti-inflammatory and disease\\u000a modifying anti-rheumatic drugs (DMARDs), but most of these have nephrotoxic effects. In patients who undergo chronic hemodialysis,\\u000a DMARDs are not widely preferred due to the chance of increased adverse effect incidence and the risk on patient survival,\\u000a in addition to already present immunosuppression. The efficacy

Senol Kobak

140

Tramadol/acetaminophen combination as add-on therapy in the treatment of patients with ankylosing spondylitis.  

PubMed

This study aimed to determine the safety and efficacy of tramadol 37.5 mg/acetaminophen 325 mg combination tablets (Ultracet®) in patients with ankylosing spondylitis (AS). This was a 12-week, randomized, double-blind, placebo-controlled study. Sixty patients with active AS according to the Modified New York Criteria were enrolled. Active disease was defined by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for more than 3 at randomization. Subjects were randomized equally into two groups: the treatment group received aceclofenac plus Ultracet® one tablet twice a day, and the control group received aceclofenac plus placebo for 12 weeks. The primary endpoint was a difference of Assessment in Ankylosing Spondylitis (ASAS20) response criteria between two groups at week 12. At week 12, ASAS20 was achieved by 53.3 % of the aceclofenac plus Ultracet group and 31 % of the aceclofenac alone group (p?=?0.047). For the pain visual analogue scale at week 12, there was a reduction of 45.6 % in aceclofenac plus Ultracet group and 25.7 % in the aceclofenac alone group (p?=?0.087). There was no statistically significant difference between two groups in BASDAI, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Global Index, Physician Global Assessment, spinal mobility, ESR, hs-CRP, and Ankylosing Spondylitis Quality of Life Questionnaire. A slight increase in total adverse events was noted with dizziness (7.5 vs 1.5 %), vertigo (4.5 vs 1.5 %), and nausea/vomiting (6 vs 0 %) in the Ultracet arm compared to placebo. The tramadol 37.5 mg/acetaminophen 325 mg combination tablet (Ultracet®) might has additional effect to nonsteroidal anti-inflammatory drugs in the treatment of patients with ankylosing spondylitis. It showed marginal benefit in pain and disease activity. However, a slight increase in minor adverse events was noted. PMID:23192419

Chang, Jhi-Kai; Yu, Chen-Tung; Lee, Ming-Yung; Yeo, Kj; Chang, I-Chang; Tsou, Hsi-Kai; Wei, James Cheng-Chung

2013-03-01

141

Influence of methotrexate on infliximab pharmacokinetics and pharmacodynamics in ankylosing spondylitis  

PubMed Central

AIMS Infliximab, an anti-tumour necrosis factor ? monoclonal antibody, has profoundly modified the treatment of several inflammatory diseases. The objective was to assess the influence of methotrexate on the variability of infliximab pharmacokinetics and concentration–effect relationship in axial ankylosing spondylitis (AAS) patients. METHODS Twenty-six patients with AAS were included in a prospective study. They were treated by infliximab 5 mg kg?1 infusions at weeks 0, 2, 6, 12 and 18. Infliximab concentrations were measured before, and 2 and 4 h after each infusion, and at each intermediate visit (weeks 1, 3, 4, 5, 8, 10 and 14). Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was measured at each visit. Infliximab pharmacokinetics was described using a two-compartment model with first-order distribution and elimination constants. A population approach was used. Infliximab pharmacodynamics was described using the area under the BASDAI curve. RESULTS A total of 507 blood samples and 329 BASDAI measurements were collected. The following pharmacokinetic parameters were obtained (interindividual coefficient of variation): volumes of distribution for the central compartment = 2.4 l (9.6%) and peripheral compartment = 1.8 l (26%), systemic clearance = 0.23 l day?1 (22%) and intercompartment clearance = 2.3 l day?1. Methotrexate influenced neither pharmacokinetic nor BASDAI variability. CONCLUSIONS Using the present dosage, the clinical efficacy of infliximab is only weakly influenced by its serum concentrations. The results do not support the combination of methotrexate with infliximab in ankylosing spondylitis.

Ternant, David; Mulleman, Denis; Lauferon, Francine; Vignault, Celine; Ducourau, Emilie; Wendling, Daniel; Goupille, Philippe; Paintaud, Gilles

2012-01-01

142

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

143

Discovery of Candidate Serum Proteomic and Metabolomic Biomarkers in Ankylosing Spondylitis*  

PubMed Central

Ankylosing Spondylitis (AS) is a common inflammatory rheumatic disease with a predilection for the axial skeleton, affecting 0.2% of the population. Current diagnostic criteria rely on a composite of clinical and radiological changes, with a mean time to diagnosis of 5 to 10 years. In this study we employed nano liquid-chromatography mass spectrometry analysis to detect and quantify proteins and small compounds including endogenous peptides and metabolites in serum from 18 AS patients and nine healthy individuals. We identified a total of 316 proteins in serum, of which 22 showed significant up- or down-regulation (p < 0.05) in AS patients. Receiver operating characteristic analysis of combined levels of serum amyloid P component and inter-?-trypsin inhibitor heavy chain 1 revealed high diagnostic value for Ankylosing Spondylitis (area under the curve = 0.98). We also depleted individual sera of proteins to analyze endogenous peptides and metabolic compounds. We detected more than 7000 molecular features in patients and healthy individuals. Quantitative MS analysis revealed compound profiles that correlate with the clinical assessment of disease activity. One molecular feature identified as a Vitamin D3 metabolite—(23S,25R)-25-hydroxyvitamin D3 26,23-peroxylactone—was down-regulated in AS. The ratio of this vitamin D metabolite versus vitamin D binding protein serum levels was also altered in AS as compared with controls. These changes may contribute to pathological skeletal changes in AS. Our study is the first example of an integration of proteomic and metabolomic techniques to find new biomarker candidates for the diagnosis of Ankylosing Spondylitis.

Fischer, Roman; Trudgian, David C.; Wright, Cynthia; Thomas, Gethin; Bradbury, Linda A.; Brown, Matthew A.; Bowness, Paul; Kessler, Benedikt M.

2012-01-01

144

Evaluating the reliability of Persian version of ankylosing spondylitis quality of life (ASQoL) questionnaire and related clinical and demographic parameters in patients with ankylosing spondylitis.  

PubMed

Ankylosing spondylitis quality of life (ASQoL) is an instrument for assessing quality of life (QoL). The aims of this study were to assess the reliability of Persian version of ASQoL questionnaire and evaluation of QoL status and related factors in ankylosing spondylitis (AS). One hundred and sixty-three Iranian patients with AS who fulfilled modified New York criteria were enrolled. Patients were evaluated using questionnaires including demographic and clinical variables, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), fatigue, Bath AS Metrology Index, pain and ASQoL. Reliability and validity of Persian version of ASQoL were evaluated by test-re-test agreement, internal consistency and correlation with specific scales. Relationship of parameters with ASQoL was analyzed by multiple regression. Age, disease duration and ASQoL score (mean ± SD) were 37.74 ± 9.88, 14.49 ± 8.47 and 8.02 ± 5.28 years, respectively. Test-re-test reproducibility for ASQoL was good as assessed by intra-class correlation coefficient (ICC: 0.97, P < 0.001). Internal consistency was high (Cronbach's alpha: 0.91). Convergent validity was confirmed by correlation of ASQoL score with specific scales (BASFI, r = 0.74, BASDAI, r = 0.6, fatigue, r = 0.56, depression, r = 0.24, intermalleolar distance, r = -0.44 and educational level, r = -0.37). Persian version of ASQoL is a valid and reliable scale to assess QoL in AS. Function, fatigue, mood, hip mobility and education are the factors which should be noted to achieve the best QoL. PMID:24170319

Fallahi, Sasan; Jamshidi, Ahmad Reza; Bidad, Katayoon; Qorbani, Mostafa; Mahmoudi, Mahdi

2014-06-01

145

[A missed unstable cervical vertebra fracture in a patient with ankylosing spondylitis].  

PubMed

A 53-year-old man with a 13-year history ofankylosing spondylitis presented to the emergency clinic of another hospital because of neck pain after a fall from a low stepladder. The patient was put at ease and discharged after physical examination and X-ray of the cervical spine revealed nothing out of the ordinary. Because his neck pain persisted, the patient contacted his rheumatologist. New cervical X-rays revealed fractures of the body and articular process of CVI and CVII. The patient was referred to our hospital for orthopaedic treatment. The fractures healed during 2.5 months' treatment with halotraction and a halovest. All patients with ankylosing spondylitis with neck pain after trauma have an unstable cervical fracture until proven otherwise. Cervical fractures should be excluded in all cases and other diagnostic tools (CT-scan or MRI) must be used whenever necessary. PMID:16136744

Graat, H C A; van Bommel, E; Pöll, R G

2005-08-20

146

The Interleukin 1 Gene Cluster Contains a Major Susceptibility Locus for Ankylosing Spondylitis  

PubMed Central

Ankylosing spondylitis (AS) is a common and highly heritable inflammatory arthropathy. Although the gene HLA-B27 is almost essential for the inheritance of the condition, it alone is not sufficient to explain the pattern of familial recurrence of the disease. We have previously demonstrated suggestive linkage of AS to chromosome 2q13, a region containing the interleukin 1 (IL-1) family gene cluster, which includes several strong candidates for involvement in the disease. In the current study, we describe strong association and transmission of IL-1 family gene cluster single-nucleotide polymorphisms and haplotypes with AS.

Timms, Andrew E.; Crane, Alison M.; Sims, Anne-Marie; Cordell, Heather J.; Bradbury, Linda A.; Abbott, Aaron; Coyne, Mark R. E.; Beynon, Owen; Herzberg, Ibi; Duff, Gordon W.; Calin, Andrei; Cardon, Lon R.; Wordsworth, B. Paul; Brown, Matthew A.

2004-01-01

147

Opinion of patients with ankylosing spondylitis on risk factors impairing their quality of life.  

PubMed

We studied 54 patients with ankylosing spondylitis with questionnaire in order to determine their view on threat to quality of their life related to the disease. We have show that pain and significant disability are the main threats associated with the disease in view of the patients. Social aspects (losing of job or decreasing of income) are also important for the patients, while management of the disease is not considered as arduous. The results of patients' opinion may be helpful in designing of educational programs for them. PMID:22983136

Kucharz, Eugene J; Kotulska, Anna; Kope?-M?drek, Magdalena; Widuchowska, Ma?gorzata

2013-11-01

148

[Advance of research on HLA-B27 and the immunological mechanism of ankylosing spondylitis].  

PubMed

Ankylosing spondylitis (AS) is an autoimmune disease which has a strong association with HLA-B27. Its pathogenesis includes the interaction between microorganism and host, the recognition of MHC class I molecule by immune cells and the imbalance of the cytokine network and so on. Unfolded protein response (UPR) participates in the development of AS. And the activation of the IL-23/IL-17 axis, which is in the downstream of UPR, may make a critical contribution to the pathogenesis. UPR and IL-23/IL-17 axis open new avenues of investigation as well as identifying new therapeutic target in this disease. PMID:21595182

Li, Meng-Yuan; Yao, Zhong-Qiang; Liu, Xiang-Yuan

2011-02-01

149

Markers of intestinal inflammation in patients with ankylosing spondylitis: a pilot study  

PubMed Central

Introduction Inflammatory bowel disease (IBD) and ankylosing spondylitis (AS) are similar chronic inflammatory diseases whose definitive etiology is unknown. Following recent clinical and genetic evidence supporting an intertwined pathogenic relationship, we conducted a pilot study to measure fecal calprotectin (fCAL) and IBD-related serologies in AS patients. Methods Consecutive AS patients were recruited from a long-term prospectively collected longitudinal AS cohort at Cedars-Sinai Medical Center. Controls were recruited from Cedars-Sinai Medical Center employees or spouses of patients with AS. Sera were tested by ELISA for IBD-associated serologies (antineutrophil cytoplasmic antibodies (ANCA), anti-Saccharomyces cerevisiae antibody IgG and IgA, anti-I2, anti-OmpC, and anti-CBir1). The Bath Ankylosing Spondylitis Disease Activity Index, the Bath Ankylosing Spondylitis Functional Index, and the Bath Ankylosing Spondylitis Radiology Index were completed for AS patients. Results A total of 81 subjects (39 AS patients and 42 controls) were included for analysis. The average age of AS patients was 47 years and the average disease duration was 22 years. AS patients were predominantly male; 76% were HLA-B27-positive. Median fCAL levels were 42 ?g/g and 17 ?g/g in the AS group and controls, respectively (P < 0.001). When using the manufacturer's recommended cutoff value for positivity of 50 ?g/g, stool samples of 41% of AS patients and 10% of controls were positive for fCAL (P = 0.0016). With the exception of ANCA, there were no significant differences in antibody levels between patients and controls. Median ANCA was 6.9 ELISA units in AS patients and 4.3 ELISA units in the controls. Among AS patients stratified by fCAL level, there were statistically significant differences between patients and controls for multiple IBD-associated antibodies. Conclusion Calprotectin levels were elevated in 41% of patients with AS with a cutoff value for positivity of 50 ?g/g. fCAL-positive AS patients displayed higher medians of most IBD-specific antibodies when compared with healthy controls or fCAL-negative AS patients. Further studies are needed to determine whether fCAL can be used to identify and characterize a subgroup of AS patients whose disease might be driven by subclinical bowel inflammation.

2012-01-01

150

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

151

Clinical and Radiographic Features of Adult-onset Ankylosing Spondylitis in Korean Patients: Comparisons between Males and Females  

PubMed Central

The objective of this study was to investigate clinical and radiographic features and gender differences in Korean patients with adult-onset ankylosing spondylitis. Multicenter cross-sectional studies were conducted in the rheumatology clinics of 13 Korean tertiary referral hospitals. All patients had a confirmed diagnosis of ankylosing spondylitis according to the modified New York criteria. Clinical, laboratory, and radiographic features were evaluated and disease activities were assessed using the Bath ankylosing spondylitis disease activity index. Five hundred and five patients were recruited. The male to female ratio was 6.1:1. Average age at symptom onset was 25.4±8.9 yr and average disease duration was 9.6±6.8 yr. Males manifested symptoms at a significantly earlier age. HLA-B27 was more frequently positive in males. Hips were more commonly affected in males, and knees in females. When spinal mobility was measured using tragus-to-wall distance and the modified Schober's test, females had significantly better results. Radiographic spinal changes, including bamboo spine and syndesmophytes, were more common in males after adjustment of confounding factors. In conclusion, we observed significant gender differences in radiographic spinal involvement as well as other clinical manifestations among Korea patients with adult-onset ankylosing spondylitis. These findings may influence the timing of the diagnosis and the choice of treatment.

Jung, Young-Ok; Kim, Inje; Kim, Suho; Suh, Chang-Hee; Park, Han Jung; Park, Won; Kwon, Seoung Ryul; Jeong, Jae Cheon; Lee, Yun Jong; Ryu, Hee Jung; Park, Young Bae; Lee, Jisoo; Lee, You-Hyun; Seo, Young Il; Chung, Won Tae; Hong, Seung-Jae; Hong, Yeon-Sik; Baek, Han Joo; Choi, Hyo Jin; Kang, Hyo-Jong; Lee, Chan-Hee; Kim, Sang-Hyon

2010-01-01

152

IgA serum levels and disease activity in ankylosing spondylitis: a prospective study.  

PubMed Central

We investigated the possible association between serum IgA, IgM, and IgG and disease activity in a longitudinal study of 48 weeks' duration in 38 male patients with active ankylosing spondylitis receiving regular treatment with either phenylbutazone or diflunisal. Throughout the study serum IgA levels correlated most frequently with chest expansion and lumbar flexion index, and patients with extensive radiological changes also had the highest serum IgA levels. Likewise, changes in IgA, but not in IgM and IgG, correlated with changes in a composite index of disease activity (IDA). Changes in erythrocyte sedimentation rate (ESR) showed a similar correlation with changes in IDA, whereas changes in serum IgA and ESR showed no consistent correlation, suggesting that both parameters reflect different aspects of disease. Serum IgA, ESR, and IDA values all decreased during regular drug treatment, suggesting a disease modifying effect of the non-steroidal anti-inflammatory drugs (NSAIDs) studied. Regular measurement of serum IgA may be useful in the assessment of disease activity of ankylosing spondylitis.

Franssen, M J; van de Putte, L B; Gribnau, F W

1985-01-01

153

IgA serum levels and disease activity in ankylosing spondylitis: a prospective study.  

PubMed

We investigated the possible association between serum IgA, IgM, and IgG and disease activity in a longitudinal study of 48 weeks' duration in 38 male patients with active ankylosing spondylitis receiving regular treatment with either phenylbutazone or diflunisal. Throughout the study serum IgA levels correlated most frequently with chest expansion and lumbar flexion index, and patients with extensive radiological changes also had the highest serum IgA levels. Likewise, changes in IgA, but not in IgM and IgG, correlated with changes in a composite index of disease activity (IDA). Changes in erythrocyte sedimentation rate (ESR) showed a similar correlation with changes in IDA, whereas changes in serum IgA and ESR showed no consistent correlation, suggesting that both parameters reflect different aspects of disease. Serum IgA, ESR, and IDA values all decreased during regular drug treatment, suggesting a disease modifying effect of the non-steroidal anti-inflammatory drugs (NSAIDs) studied. Regular measurement of serum IgA may be useful in the assessment of disease activity of ankylosing spondylitis. PMID:4062389

Franssen, M J; van de Putte, L B; Gribnau, F W

1985-11-01

154

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.

Hennigan, Stephanie; Ackermann, Christoph; Kavanaugh, Arthur

2007-01-01

155

Thoracic aortic pseudoaneurysm after spine trauma in ankylosing spondylitis. Case report.  

PubMed

Ankylosing spondylitis (AS) is a rheumatic disease characterized by consolidation of the articulating surfaces and inflammation of the vertebral column. Because of its associated spine stiffness and secondary osteoporosis, patients with this disorder are at increased risk of vertebral fractures. Ankylosing spondylitis presents a significant challenge to spine surgeons because of its complex effects on the spine, extraarticular organ manifestations, and potential neurological and functional sequelae. Traumatic thoracic and lumbar spine injuries in this patient population may be associated with injury to the aorta either due to direct mechanical trauma or to blunt forces associated with the spine fracture. This complication and association is thought to be the result of pathophysiological changes that cause the aorta to become firmly adherent to the anterior longitudinal ligament. The authors present a case of AS in a patient with a thoracic spine fracture and in whom a delayed thoracic aortic pseudoaneurysm ruptured. To the best of the authors' knowledge, only five cases of this complex condition have been reported since 1980. Recognition of the potential for aortic injury in patients with AS should prompt early investigation of the aorta in cases involving numerous fractures and assist in surgical planning to avoid this lethal injury. PMID:15739538

Lifshutz, Jason; Lidar, Zvi; Maiman, Dennis

2005-02-01

156

The serum levels of resistin in ankylosing spondylitis patients: a pilot study.  

PubMed

Resistin is a recently described adipokine which is a member of cysteine-rich secretory protein family. Although it has been primarily defined in human adipocytes, it has been identified that its level was higher in mononuclear leukocytes, macrophages, spleen, and bone marrow cells. Because ankylosing spondylitis is an inflammatory disease, it is suspected that upregulation of proinflammatory cytokines is effective in its immunopathogenesis. The aim of our study is to determine the serum resistin levels in patients with AS and to research the relationship with disease activity markers. A total of 30 patients with AS and 30 healthy controls were included in this study. Serum resistin concentrations, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Bath AS Disease Activity Index (BASDAI) were evaluated. In results resistin levels in ankylosing spondylitis group were significantly higher than in control group. But, there was no correlation between resistin and ESR, CRP, BASDAI. In conclusion, higher serum resistin levels in patients with AS compared to healthy subjects give clues that resistin could have a role in the pathogenesis of AS. PMID:21140266

Kocabas, Hilal; Kocabas, Volkan; Buyukbas, Sad?k; Mel?koglu, Meltem Alkan; Sezer, Ilhan; Butun, Bulent

2012-03-01

157

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

158

Pulmonary manifestations of ankylosing spondylitis treated as pulmonary tuberculosis: a case report and review of literature.  

PubMed

A 45 year old trader presented with history of persistent productive cough, progressively increasing dyspnoea, malaise and fever of 6 months prior to presentations. He also complained of severe lower backache and stiffness that radiated to both legs of 5 years duration. Chest radiograph revealed left apical fibrosis, coarse, linear shadows with cavities. There was also super infection with aspergilloma in the left apical region. The sputum AAFB was negative. Despite the fact that the patient complained of lower backache and stiffness, the plain radiograph of the affected spine was not requested for by the attending physician. Rather, the patient was commenced on antituberculous therapy based on pulmonary changes on chest radiograph. But after completing the treatment (nine months regimen), there were no improvement in patient's clinical conditions and pulmonary changes on repeated chest radiograph. The plain radiographs of the lumbosacral spine, pelvis and both hips were suggested by the author (Radiologist) who reviewed the patient's chest radiographs. The radiographs of the lumbosacral spine, as well as pelvis and both hips showed features of ankylosing spondylitis with pulmonary complication. His treatment was later reviewed based on the above new findings. This report highlights the fact that pulmonary manifestation in ankylosing spondylitis, a rare entity in our environment can present the same pattern as pulmonary tuberculosis which is far more common in this environment. A high index of suspicion will enhance early proper diagnosis. PMID:20037624

Ibinaiye, P O; Salawu, F

2009-12-01

159

Is magnetotherapy applied to bilateral hips effective in Ankylosing spondylitis patients? A randomized, double-blind, controlled study.  

PubMed

This double-blind, randomized controlled study was conducted with the aim to investigate the effect of magnetic field therapy applied to the hip region on clinical and functional status in ankylosing spondylitis (AS) patients. Patients with AS (n = 66) who were diagnosed according to modified New York criteria were enrolled in this study. Patients were randomly divided in two groups. Participants were randomly assigned to receive magnetic field therapy (2 Hz) (n = 35), or placebo magnetic field therapy (n = 31) each hip region for 20 min. Patients in each group were given heat pack and short-wave treatments applied to bilateral hip regions. Both groups had articular range of motion and stretching exercises and strengthening exercises for surrounding muscles for the hip region as well as breathing and postural exercises by the same physical therapist. These treatment protocols were continued for a total of 15 sessions (1 session per day), and patients were examined by the same physician at months 1, 3 and 6. Visual analogue scale (VAS) pain, VAS fatigue, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrologic Index (BASMI), DFI, Harris hip assessment index and Ankylosing Spondylitis Quality of Life scale (ASQOL) were obtained at the beginning of therapy and at month 1, month 3 and month 6 for each patient. There were no significant differences between groups in the VAS pain, VAS fatigue, morning stiffness, BASDAI, BASFI, BASMI, DFI, Harris hip assessment index and ASQoL at baseline, month 1, month 3 or month 6 (p > 0.05). Further randomized, double-blind controlled studies are needed in order to establish the evidence level for the efficacy of modalities with known analgesic and anti-inflammatory action such as magnetotherapy, particularly in rheumatic disorders associated with chronic pain. PMID:24399455

Turan, Yasemin; Bayraktar, Kevser; Kahvecioglu, Fatih; Tastaban, Engin; Aydin, Elif; Kurt Omurlu, Imran; Berkit, Isil Karatas

2014-03-01

160

Efficacy of sulfasalazine in patients with inflammatory back pain due to undifferentiated spondyloarthritis and early ankylosing spondylitis: a multicentre randomised controlled trial  

PubMed Central

Objectives To assess the effect of sulfasalazine (SSZ) on inflammatory back pain (IBP) due to active undifferentiated spondyloarthritis (uSpA) or ankylosing spondylitis in patients with symptom duration <5?years. Methods Patients with IBP and a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) >3 from 12 centres were randomly assigned to 24?weeks' treatment with SSZ 2?g/day or placebo. The primary outcome variable was the change in BASDAI over 6?months. Secondary outcomes included measures of spinal pain, physical function and inflammation. Results 230 patients (50% men, age range 18–64?years, 67% human leucocyte antigen B27 positive) were treated with either SSZ 2×1?g/day or placebo for 6?months. Enthesitis was found in 50%, and peripheral arthritis in 47% of the patients. The mean (SD) BASDAI dropped markedly in both groups: by 3.7 (2.7) and 3.8 (2.4), respectively, as did most secondary outcome measures. No noticeable difference in treatment was observed between groups. Patients with IBP and no peripheral arthritis had significantly (p?=?0.03) more benefit with SSZ (BASDAI 5.1 (1.3) to 2.8 (2.3)) than with placebo (5.2 (1.6) to 3.8 (2.4)). Spinal pain (p?=?0.03) and morning stiffness (p?=?0.05) improved with SSZ in these patients, but other secondary outcomes were not markedly different. Conclusion SSZ was no better than placebo for the treatment of the signs and symptoms of uSpA; however, SSZ was more effective than placebo in the subgroup of patients with IBP and no peripheral arthritis.

Braun, J; Zochling, J; Baraliakos, X; Alten, R; Burmester, G; Grasedyck, K; Brandt, J; Haibel, H; Hammer, M; Krause, A; Mielke, F; Tony, H-P; Ebner, W; Gomor, B; Hermann, J; Zeidler, H; Beck, E; Baumgaertner, M; Sieper, J

2006-01-01

161

[Characteristics of the early phase of ankylosing spondylitis].  

PubMed

100 patients with several clinical and suspicious radiological symptoms of Bechterev's disease (Institute of Rheumatology Moscow) and 100 patients with the clinical symptoms of Bechterev's disease without radiological symptoms of a sacroiliacal arthritis (Medico-Policlinical Institute Leipzig) have been examined within a common research programme since 1976 and analysed concerning the frequency of the complaints as well as of clinical symptoms at the beginning of the disease. The main complaints at the beginning of Bechterev's disease are nocturnal pains in the lumbosacral region, pains in the joints, in which cases 50% of the patients spoke of swellings of the joints. 42% of the patients complained of the feeling of the morning rigidity in the lumbar spinal column and 22% spoke of increased temperatures. In 9--10% of our patients an iritis was diagnosed at the beginning of the disease. PMID:7257453

Häntzchel, H; Otto, W; Römhild, N; Treutler, H; Beenken, O; Reinelt, D; Astapenko, M; Tschepoi, V; Poljanskaja, I; Mylov, N; Gasian-Anatolevitzsch, R

1981-03-15

162

Palisaded neutrophilic and granulomatous dermatitis associated with ankylosing spondylitis.  

PubMed

Palisaded neutrophilic granulomatous dermatitis (PNGD) is a rare neutrophilic dermatosis that shows a broad clinical and histopathological spectrum. The clinical presentation of PNGD varies from asymptomatic papules, to nodules, to annular plaques. The most common clinical presentation is erythematous papules on the extensor surface of extremities, especially fingers and elbows. Histopathological findings demonstrate a spectrum of changes that reflect the evolution of the lesions, from only sparse mixed perivascular infiltrates to interstitial or palisaded granuloma formation with dermal fibrosis. The cause of PNGD is unknown, but there is a prominent association with systemic conditions, particularly with autoimmune diseases, representing rheumatoid arthritis and systemic lupus erythematosus, the most common associations. It has also been described associated to systemic sclerosis, sarcoidosis, systemic vasculitis, inflammatory bowel disease, and lymphoproliferative disorders, and also drugs have been implicated. Recently, it has been described the potential association with tumor necrosis factor alpha inhibitors. This dermatosis should be considered as a marker of systemic disease and particularly it should be considered in patients with history of autoimmune disorders who present with papular eruptions on the extremities. PMID:23974221

de Unamuno Bustos, Blanca; Rabasco, Ana García; Sánchez, Rosa Ballester; de Miquel, Víctor Alegre

2013-12-01

163

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

164

Gastric outlet obstruction due to gastric amyloidosis mimicking malignancy in a patient with ankylosing spondylitis.  

PubMed

Amyloidosis is a group of disorders characterized by the extracellular accumulation of insoluble, fibrillar proteins in various organs and tissues. It is classified, on the basis of the identity of the precursor protein, as primary, secondary, or familial amyloidosis. Gastrointestinal amyloidosis usually presents as bleeding, ulceration, malabsorption, protein loss, and diarrhea. However, gastric amyloidosis with gastric outlet obstruction mimicking linitis plastica is rare. We report a case of gastrointestinal amyloidosis with gastric outlet obstruction in a patient with ankylosing spondylitis. The patient was indicated for subtotal gastrectomy because of the aggravation of obstructive symptoms, but refused the operation and was transferred to another hospital. Three months later, the patient died of aspiration pneumonia during medical treatment. PMID:24340260

Seon, Choon Sik; Park, Young Sook; Jung, Yu Min; Choi, Jeong Ho; Son, Byoung Kwan; Ahn, Sang Bong; Kim, Seong Hwan; Jo, Yun Ju

2013-11-01

165

Cauda equina syndrome and dural ectasia: rare manifestations in chronic ankylosing spondylitis  

PubMed Central

Cauda equina syndrome (CES) is a rare manifestation in patients with long-standing ankylosing spondylitis (AS). We report a 57-year-old male patient with a 30-year history of AS who developed CES in the past 4 years. The CT and MRI examinations showed unique appearances of dural ectasia, multiple dorsal dural diverticula, erosion of the vertebral posterior elements, tethering of the conus medullaris to the dorsal aspect of the spinal canal and adhesion of the nerve roots of the cauda equina to the wall of the dural sac. A large dural defect was found at surgery. De-adhesion of the tethered conus medullaris was performed but without significant clinical improvement. The possible aetiologies of CES and dural ectasia in patients with chronic AS are discussed and the literature is reviewed.

Liu, C-C; Lin, Y-C; Lo, C-P; Chang, T-P

2011-01-01

166

Regression analysis of multivariate current status data with dependent censoring: application to ankylosing spondylitis data.  

PubMed

Multivariate current-status failure time data consist of several possibly related event times of interest, in which the status of each event is determined at a single examination time. If the examination time is intrinsically related to the event times, the examination is referred to as dependent censoring and needs to be taken into account. Such data often occur in clinical studies and animal carcinogenicity experiments. To accommodate for possible dependent censoring, this paper proposes a joint frailty model for event times and dependent censoring time. We develop a likelihood approach using Gaussian quadrature techniques for obtaining maximum likelihood estimates. We conduct extensive simulation studies for investigating finite-sample properties of the proposed method. We illustrate the proposed method with an analysis of patients with ankylosing spondylitis, where the examination time may be dependent on the event times of interest. PMID:24122926

Chen, Chyong-Mei; Wei, James Cheng-Chung; Hsu, Chao-Min; Lee, Ming-Yung

2014-02-28

167

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.

Ometto, Francesca; Botsios, Costantino; Punzi, Leonardo

2014-01-01

168

Airway management in cervical spine ankylosing spondylitis: Between a rock and a hard place  

PubMed Central

We report the perioperative course of a patient with long standing ankylosing spondylitis with severe dysphagia due to large anterior cervical syndesmophytes at the level of the epiglottis. He was scheduled to undergo anterior cervical decompression and the surgical approach possibly precluded an elective pre-operative tracheostomy. We performed a modified awake fibreoptic nasal intubation through a split nasopharyngeal airway while adequate oxygenation was ensured through a modified nasal trumpet inserted in the other nares. We discuss the role of nasal intubations and the use of both the modified nasopharyngeal airways we used to facilitate tracheal intubation. This modified nasal fibreoptic intubation technique could find the application in other patients with cervical spine abnormalities and in other anticipated difficult airways.

Eipe, Naveen; Fossey, Susan; Kingwell, Stephen P

2013-01-01

169

Gastric Outlet Obstruction Due to Gastric Amyloidosis Mimicking Malignancy in a Patient with Ankylosing Spondylitis  

PubMed Central

Amyloidosis is a group of disorders characterized by the extracellular accumulation of insoluble, fibrillar proteins in various organs and tissues. It is classified, on the basis of the identity of the precursor protein, as primary, secondary, or familial amyloidosis. Gastrointestinal amyloidosis usually presents as bleeding, ulceration, malabsorption, protein loss, and diarrhea. However, gastric amyloidosis with gastric outlet obstruction mimicking linitis plastica is rare. We report a case of gastrointestinal amyloidosis with gastric outlet obstruction in a patient with ankylosing spondylitis. The patient was indicated for subtotal gastrectomy because of the aggravation of obstructive symptoms, but refused the operation and was transferred to another hospital. Three months later, the patient died of aspiration pneumonia during medical treatment.

Seon, Choon Sik; Jung, Yu Min; Choi, Jeong Ho; Son, Byoung Kwan; Ahn, Sang Bong; Kim, Seong Hwan; Jo, Yun Ju

2013-01-01

170

Relation between chest expansion, pulmonary function, and exercise tolerance in patients with ankylosing spondylitis.  

PubMed Central

Thirty three patients with definite ankylosing spondylitis (AS) were examined to establish the relation between restriction of chest expansion, limitation of lung function, and working capacity or exercise tolerance. As in previous studies there was a significant association between chest expansion and lung vital capacity. There was also a significant association between vital capacity and exercise tolerance as measured by a subject's maximum oxygen capacity (VO2max). Both vital capacity and VO2max were expressed as a percentage of predicted normal values using patients' height before disease. In this study chest expansion did not have a significant effect on exercise tolerance. The results suggested that patients who took a modest amount of exercise regularly could maintain a satisfactory work capacity despite very restricted spinal and chest wall mobility. It is recommended that greater emphasis should be given to encouraging patients with AS to maintain cardiorespiratory fitness as well as spinal mobility.

Fisher, L R; Cawley, M I; Holgate, S T

1990-01-01

171

Retrograde intubation in a case of ankylosing spondylitis posted for correction of deformity of spine  

PubMed Central

Ankylosing spondylitis (AS) patients are most challenging. These patient present the most serious array of intubation and difficult airway imaginable, secondary to decrease or no cervical spine mobility, fixed flexion deformity of thoracolumbar spine and possible temporomandibular joint disease. Sound clinical judgment is critical for timing and selecting the method for airway intervention. The retrograde intubation technique is an important option when fiberoptic bronchoscope is not available, and other method is not applicable for gaining airway access for surgery in prone position. We report a case of AS with fixed flexion deformity of thoracic and thoracolumbar spine, fusion of posterior elements of cervical spine posted for lumbar spinal osteotomy with anticipated difficult intubation. An awake retrograde oral intubation with light sedation and local block is performed.

Raval, Chetankumar; Patel, Heena; Patel, Pranoti; Kharod, Utpala

2010-01-01

172

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.

2013-01-01

173

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.

2012-01-01

174

The Impact of TNF-inhibitors on radiographic progression in Ankylosing Spondylitis  

PubMed Central

Introduction We studied the effect of Tumor Necrosis Factor-Alpha (TNF)-inhibitors on progressive spine damage in Ankylosing Spondylitis (AS) patients. Methods All AS patients (satisfying the modified New York criteria) prospectively followed and with at least two sets of spinal radiographs at a minimum gap of 1.5 years were included (n=334). Patients received clinical standard of care, which included non-steroidal anti-inflammatory drugs and TNF-inhibitors. Radiographic severity was assessed by the modified Stokes Ankylosing Spondylitis Spine Score (mSASSS). Patients with a rate of progression more than 1 mSASSS unit/year were considered progressors. Univariable and multivariable regression analyses were done. Propensity score matching (PSM) and sensitivity analysis were performed. A zero-inflated negative binomial (ZINB) model was used to analyze the effect of TNF-inhibitor on change in mSASSS with varying follow-up periods. Potential confounders like Bath AS Disease Activity Index (BASDAI), ESR, CRP, HLA-B27, gender, age of onset, smoking and baseline damage were included in the model. Results TNF-inhibitor treatment was associated with a 50% reduction in the odds of progression (OR: 0.52; CI: 0.30-0.88; p=0.02). Patients with a delay in starting therapy of more than 10 years were more likely to progress compared to those who started earlier (OR=2.4; 95% CI: 1.09-5.3; p=0.03). In the ZINB model TNF-inhibitor use significantly reduced progression when the gap between x-rays was more than 3.9 years. The protective effect of TNF-inhibitors was stronger after propensity score matching. Conclusions TNF-inhibitors appear to reduce radiographic progression in AS, especially with early initiation and longer duration of follow up.

Haroon, Nigil; Inman, Robert D.; Learch, Thomas J.; Weisman, Michael H.; Lee, MinJae; Rahbar, Mohammad H.; Ward, Michael M.; Reveille, John D; Gensler, Lianne S.

2014-01-01

175

Osteoporosis, spinal mobility and chest expansion index in patients with ankylosing spondylitis.  

PubMed

To determine the correlation between the bone mineral density (BMD) and spinal mobility and chest expansion index in patients with ankylosing spondylitis. Eighty patients with confirmed diagnosis of ankylosing spondylitis were included in this study. In all of them physical examination was performed including assessment of spinal mobility and chest expansion index. Bone mineral density of the lumbar spine (L1-L4, anteroposterior view) and at the left hip was measured by dual X-ray absorptiometry (DXA) in standard manner According to the WHO classification of osteoporosis, patients were classified in three groups (normal, osteopenic or osteoporotic) depending on the osteoporotic status in lumbar spine, hip and femoral neck region. Eighty patients (46 men and 34 women; age 25-73 years) were included. Mean BMD for lumbar spine was 1.104 +/- 1.043 (T score: 0.67 +/- 2.15) and for total hip was 1.057 +/- 0.899 (T score: -0.28 +/- 2.34). Significant difference in the mobility of thoracic spine was observed in patients in regard to the WHO classification of osteoporosis in lumbar and femoral region (p = 0.031, Oneway Anova for osteoporosis of lumbar region; p = 0.022, Oneway Anova for osteoporosis of total hip region). Mean value for the chest expansion index was 3.07 +/- 1.66 cm. Chest expansion index was significantly reduced in patients having osteoporosis in lumbar and total hip region (p = 0.015, Oneway Anova for osteoporosis of lumbar region; p = 0.038, Oneway Anova for osteoporosis of total hip region). The observation that reduced mobility of thoracic and lumbar spine and chest expansion index occured in patients with low BMD in lumbar and total hip region suggest that osteoporosis should be monitored more frequently in patients with AS. PMID:24851598

Grubisi?, Frane; Grazio, Simeon; Balenovi?, Antonija; Nemci?, Tomislav; Kusi?, Zvonko

2014-03-01

176

The genetic basis of ankylosing spondylitis: new insights into disease pathogenesis  

PubMed Central

Ankylosing spondylitis (AS) is a complex disease involving multiple risk factors, both genetic and environmental. AS patients are predominantly young men, and the disease is characterized by inflammation and ankylosis, mainly at the cartilage–bone interface and enthesis. HLA-B27 has been known to be the major AS-susceptibility gene for more than 40 years. Despite advances made in the past few years, progress in the search for non-human leukocyte antigen susceptibility genes has been hampered by the heterogeneity of the disease. Compared to other complex diseases, such as inflammatory bowel disease (IBD), fewer susceptibility loci have been identified in AS. Furthermore, non-major histocompatibility-complex susceptibility loci discovered, such as ERAP1 and IL23R, are likely contributors to joint inflammation. Identification and confirmation of functional variants remains a significant challenge of investigations involving genome-wide association studies (GWAS). It remains unclear why none of the AS-susceptibility genes identified in GWAS appear to be directly involved in the ankylosing process. Numerous reviews have recently been published on the genetics of AS. Therefore, aside from a brief summary of what AS GWAS has successfully achieved thus far, this review will focus on directions that could address unanswered questions raised by GWAS.

Tsui, Florence WL; Tsui, Hing Wo; Akram, Ali; Haroon, Nigil; Inman, Robert D

2014-01-01

177

Efficacy evaluation of methotrexate in the treatment of ankylosing spondylitis using meta-analysis.  

PubMed

The aim of this study was to evaluate the efficacy of methotrexate (MTX) in the treatment of ankylosing spondylitis (AS). The literature on controlled clinical trials was searched from MEDLINE, EMBASE, OVID, and Cochrane Library databases up to November 2012. The quality of the studies included was evaluated publicly by two reviewers. A meta-analysis was conducted to the homogeneous studies using Cochrane systematic review. Three trials involving 116 patients compared treatment with MTX against placebo. No statistically significant differences (p < 0.05) were found in the primary outcome measures of withdrawal rate, bath ankylosing spondilitis active index (BASDAI), C-reactive protein (CRP), patient global assessment, and side effects such as nausea and vomiting. Two trials involving 142 patients compared treatment with MTX plus infliximab (IFX) against IFX alone in the effect of treatment of AS. No statistically significant differences (p < 0.05) were found in the primary outcome measures of ASAS20 and withdrawal rate. Thus, we should choose the right drugs based on the specific situation in clinical applications. Randomized controlled trials designed rationally and implemented strictly with multi-center, large sample size and enough follow-up time are needed in future research. PMID:24618070

Yang, Zibin; Zhao, Wei; Liu, Weihua; Lv, Qiao; Dong, Xiliang

2014-05-01

178

Prevalence of ankylosing spondylitis in males and females in a young middle-aged population of Tromsø, northern Norway  

Microsoft Academic Search

In an epidemiological survey in Tromsø, northern Norway a prevalence of definite ankylosing spondylitis (AS) of between 1.1% and 1.4% was found (males: 1.9-2.2% and females: 0.3-0.6%). The ratio of male to female was between 3.9 and 6.1 in favour of the male sex. It was calculated that 6.7% of the B27 positive individuals had AS, and that 22.5% of

J T Gran; G Husby; M Hordvik

1985-01-01

179

Age at disease onset and diagnosis delay in HLA-B27 negative vs. positive patients with ankylosing spondylitis  

Microsoft Academic Search

Objective. To investigate differences between HLA-B27- and HLA-B27+ patients with ankylosing spondylitis (AS). Methods. A total of 1080 patients with AS responded to a questionnaire containing 30 questions; 945 (87.5%) knew their HLA-B27 status, 10% of them being B27-. Results. The average age at disease onset was 27.7 years in B27- and 24.8 years in B27+ AS (P- (standard deviation

Ernst Feldtkeller; Muhammad Asim Khan; Désirée van der Heijde; Sjef van der Linden; Jürgen Braun

2003-01-01

180

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

Microsoft Academic Search

OBJECTIVETo evaluate employment status, work disability, and work days lost in patients with ankylosing spondylitis (AS).METHODSA questionnaire was sent to 709 patients with AS aged 16–60. The results of 658 of the patients could be analysed.RESULTSAfter 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.

A Boonen; A Chorus; H Miedema; D van der Heijde; H van der Tempel; Sj van der Linden

2001-01-01

181

Persistent clinical response to the anti-TNF-  antibody infliximab in patients with ankylosing spondylitis over 3 years  

Microsoft Academic Search

Objective. Infliximab, a monoclonal antibody against tumour necrosis factor a (TNF-a), is approved in Europe for the treatment of patients with active ankylosing spondylitis (AS) who have responded inadequately to conventional therapy. This report provides analyses from a 3-yr extension study, as a follow-up to both the 1- and 2-yr open label extensions of the original 3-month randomized controlled trial

J. Braun; X. Baraliakos; J. Brandt; J. Listing; A. Zink; R. Alten; G. Burmester; E. Gromnica-Ihle; H. Kellner; M. Schneider

2005-01-01

182

Evidence for a specific B27-associated cell surface marker on lymphocytes of patients with ankylosing spondylitis  

Microsoft Academic Search

THE strong association of HLA-B27 with ankylosing spondylitis (AS) as well as an increased frequency of B27 in other seronegative arthropathies is well documented1-4. Nevertheless, the significance and the molecular basis of this remarkable association is still unknown. Ebringer et al.5-7 reported that Klebsiella pneumoniae was present in the faeces of patients with AS more frequently than in those of

Kerri Seager; Helen V. Bashir; A. F. Geczy; J. EDMONDS; A. DE VERE-TYNDALL

1979-01-01

183

Translation and validation of non-English versions of the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire  

Microsoft Academic Search

BACKGROUND: The Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire is a unidimensional, disease-specific measure developed in the UK and the Netherlands. This study describes its adaptation into other languages. METHODS: The UK English ASQOL was translated into US English; Canadian French and English; French; German; Italian; Spanish; and Swedish (dual-panel methods). Cognitive debriefing interviews were conducted with AS patients. Psychometric\\/scaling

Lynda C Doward; Stephen P McKenna; David M Meads; James Twiss; Dennis Revicki; Robert L Wong; Michelle P Luo

2007-01-01

184

Relative value of the lumbar spine and hip bone mineral density and bone turnover markers in men with ankylosing spondylitis  

Microsoft Academic Search

The purpose of this study is to evaluate bone mineral density (BMD) and bone turnover markers in men with ankylosing spondylitis\\u000a (AS) and to determine their relationship with clinical features and disease activity. Serum carboxi terminal cross-linked\\u000a telopeptide of type I collagen (CTX), osteocalcin (OC) levels, and BMD of lumbar spine and proximal femur were evaluated in\\u000a 44 males with

Laura Muntean; Marena Rojas-Vargas; Siao-Pin Simon; Simona Rednic; Ruxandra Schiotis; Simona Stefan; Maria M. Tamas; Horatiu D. Bolosiu; Eduardo Collantes-Estévez

2011-01-01

185

Distribution of HLA-DRB1 genes in patients with sporadic ankylosing spondylitis in the south of Spain  

Microsoft Academic Search

Objective. To evaluate the relationship between the presence of different HLA-DRB1 genes and predisposition to develop a sporadic form of ankylosing spondylitis (AS) in a demographically well-defined population. Methods. One hundred fifteen selected patients with sporadic (non-familial) forms of AS from six different cities and 748 bone marrow donors as control group. All individuals were typed for HLA-B27 by flow

V Perez-Guijo; E Muñoz; A Escudero; R Veroz; M Sánchez; M. C Muñoz-Villanueva; R González; J Peña; E Collantes-Estevez

2002-01-01

186

Robotic-Assisted Device in Posterior Spinal Fusion for a High Risk Thoraculombar Fracture in Ankylosing Spondylitis  

PubMed Central

Fractures in ankylosing spondylitis (AS) are often difficult to treat and surgical treatment may be fraught with complications. We describe the use of a robotic-assisted device in the surgical treatment of an unstable L1 fracture in an elderly patient with chronic lymphocytic leukemia and AS. The postoperative course was uneventful and the patient was discharged after 3 days. The use of a robotic-assisted device in spine surgery is particularly indicated in difficult high risk cases.

Suliman, Ali; Bernfeld, Benjamin; Bruskin, Alexander

2014-01-01

187

Lumbar Stiffness but not Thoracic Radiographic Changes Relate to Alteration of Lung Function Tests in Ankylosing Spondylitis  

Microsoft Academic Search

:   Involvement of the costovertebral (CV) and costotransverse (CT) as well as the sacroiliac (SI) joints is known to occur in\\u000a patients with ankylosing spondylitis (AS). The functional significance of these changes is not clear. We have performed clinical\\u000a and radiological evaluations and assessed the effect of joint involvement on pulmonary function. We detected radiologic evidence\\u000a of involvement of the

L. Cerrahoglu; Z. Unlu; C. Goktan; P. Celik

2002-01-01

188

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.

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

2012-01-01

189

Ankylosing spondylitis  

MedlinePLUS

... Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology . 9th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap ... systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising ...

190

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

PubMed

In ankylosing spondylitis, inflammatory activity probably plays a key role in the pathophysiology of bone loss. The aim of the study was to investigate the relationship of bone mineral density (BMD) at the lumbar spine and hip region with some measures of disease activity and functional ability in patients with ankylosing spondylitis. In 80 patients with established ankylosing spondylitis, disease activity and functional ability were determined by C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI). Spinal pain and patient global health were assessed using horizontal visual analog scale. BMD was measured by dual-energy X-ray absorptiometry. There was a significant negative correlation of bone density T scores with acute-phase reactants (i.e., patients with lower T scores had higher level of CRP and ESR). That relationship was reflected more reliably at proximal femur sites than at the lumbar spine. There were also significant differences in ESR, BASDAI, BASFI, spinal pain and global health between three groups of patients according to WHO classification of osteoporosis (normal, osteopenic and osteoporotic). Significantly, more patients with osteopenia at the lumbar spine had lower BASDAI index than those with normal BMD (P = 0.030). Our results indicate an association of low BMD with high disease activity in patients with AS. Femoral BMD seems to be more associated with disease activity and functional ability than lumbar spine BMD. PMID:21858541

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

2012-09-01

191

Attenuated insulin response and normal insulin sensitivity in lean patients with ankylosing spondylitis.  

PubMed

Chronic low-grade inflammation is associated with insulin resistance. The aim of this study was to determine insulin response to intravenous glucose load and insulin sensitivity in patients with ankylosing spondylitis (AS). Fourteen nonobese male patients with AS and 14 matched healthy controls underwent frequent-sampling intravenous glucose tolerance test (FSIVGTT). Insulin secretion and insulin sensitivity were calculated using the computer-minimal and homeostasis-model assessment 2 (HOMA2) models. Fasting glucose, insulin, cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol, triglyceride levels, HOMA2, glucose effectiveness, insulin sensitivity and insulin response to FSIVGTT did not differ between patients and controls. Tumor necrosis factor-alpha and interleukin (IL)-6 concentrations tended to be higher in AS patients than in controls. Second-phase beta-cell responsiveness was 37% lower (p = 0.05) in AS patients than in controls. A negative correlation was found between the percentage of beta-cell secretion and IL-6 in all subjects (r = -0.54, p = 0.006). We found normal insulin sensitivity but attenuated glucose utilization in the second phase of FSIVGTT in AS patients. Our results indicate that elevated IL-6 levels may play a pathophysiological role in attenuating beta-cell responsiveness, which may explain the association between elevated IL-6 levels and increased risk for type 2 diabetes. PMID:16366418

Penesova, A; Rovensky, J; Zlnay, M; Dedik, L; Radikova, Z; Koska, J; Vigas, M; Imrich, R

2005-01-01

192

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

193

Phenotype Difference between Familial and Sporadic Ankylosing Spondylitis in Korean Patients.  

PubMed

Clustered occurrences of ankylosing spondylitis (AS) in family have been noticed. We evaluated patients with AS confirmed by the modified New York criteria for familial history of AS (one or more first to third degree relatives). The clinical characteristics and the recurrence risks (number of AS patients/number of familial members) of the familial AS compared to sporadic AS were investigated. Out of a total of 204 AS patients, 38 patients (18.6%) reported that they had a familial history of AS. The recurrence risks in the familial AS patients for first, second and third degree family members were 14.5%, 5.2%, and 4.4% respectively. Erythrocyte sedimentation rate (ESR) (22.6±22.2 vs 35.4±34.4, P=0.029) and C-reactive protein (CRP) (1.24±1.7 vs 2.43±3.3, P=0.003) at diagnosis, body mass index (21.9±2.7 vs 23.7±3.3, P=0.002) and frequency of oligoarthritis (13.2% vs 33.7%, P=0.021) were significantly lower in the familial form. The presence of HLA-B27 (97.4% vs 83.1%, P=0.044) was significantly higher in familial AS. In conclusion, Korean familial AS patients show a lower frequency of oligoarthritis, lower BMI, lower ESR and CRP at diagnosis and higher presence of HLA-B27. PMID:24932078

Kim, Hye Won; Choe, Hye Rim; Lee, Su Bin; Chang, Won Ik; Chae, Hyun Jun; Moon, Jin Young; Kang, Jisue; Lee, Sungim; Song, Yeong Wook; Lee, Eun Young

2014-06-01

194

Level set based vertebra segmentation for the evaluation of Ankylosing Spondylitis  

NASA Astrophysics Data System (ADS)

Ankylosing Spondylitis is a disease of the vertebra where abnormal bone structures (syndesmophytes) grow at intervertebral disk spaces. Because this growth is so slow as to be undetectable on plain radiographs taken over years, it is necessary to resort to computerized techniques to complement qualitative human judgment with precise quantitative measures on 3-D CT images. Very fine segmentation of the vertebral body is required to capture the small structures caused by the pathology. We propose a segmentation algorithm based on a cascade of three level set stages and requiring no training or prior knowledge. First, the noise inside the vertebral body that often blocks the proper evolution of level set surfaces is attenuated by a sigmoid function whose parameters are determined automatically. The 1st level set (geodesic active contour) is designed to roughly segment the interior of the vertebra despite often highly inhomogeneous and even discontinuous boundaries. The result is used as an initial contour for the 2nd level set (Laplacian level set) that closely captures the inner boundary of the cortical bone. The last level set (reversed Laplacian level set) segments the outer boundary of the cortical bone and also corrects small flaws of the previous stage. We carried out extensive tests on 30 vertebrae (5 from each of 6 patients). Two medical experts scored the results at intervertebral disk spaces focusing on end plates and syndesmophytes. Only two minor segmentation errors at vertebral end plates were reported and two syndesmophytes were considered slightly under-segmented.

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

2006-03-01

195

Association between cytokines and methylation of SOCS-1 in serum of patients with ankylosing spondylitis.  

PubMed

In this study, we aim to determine the relationship between methylation level of an inflammatory-related gene, SOCS-1 in serum samples of patients with ankylosing spondylitis (AS) and their degree of inflammation as well as serum cytokine level. Quantitative real time methylation specific PCR was performed to examine the promoter methylation of SOCS-1 in serum samples of 43 HLA-B27+ AS patients and 6 B27+ healthy controls. Degree of inflammation was accessed by spondylopathy, sacroiliitis as well as acute phase reactant, erythrocyte sedimentation rate and C-reactive protein (CRP). Serum IL-6 and TNF-? level was determined by ELISA assay. SOCS-1 methylation can only be found in serums samples from patients but not normal control. Methylation of SOCS-1 significantly associated with severity of patient's spondylopathy (P < 0.005), sacroiliitis (P < 0.005) and acute phase reactant CRP (P = 0.0278). AS patients also exhibited higher serum IL-6 (P < 0.001) and TNF-? level (P < 0.001). Importantly, patients with high serum IL-6 or TNF-? level demonstrated a significantly higher SOCS-1 methylation (P < 0.001). In conclusion, this proof-of-principle study suggested that methylation of SOCS-1 can be detected in serum of HLA-B27+ AS patients but not in B27+ controls. The pathogenic potential of SOCS-1 methylation in AS deserves further investigation. PMID:24532142

Lai, Ning-Sheng; Chou, Jian-Liang; Chen, Gary C W; Liu, Su-Qin; Lu, Ming-Chi; Chan, Michael W Y

2014-06-01

196

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.

2010-01-01

197

Comparison of Venous Thromboembolism after Total Hip Arthroplasty between Ankylosing Spondylitis and Osteoarthritis  

PubMed Central

Objective. Ankylosing spondylitis (AS), an inflammatory rheumatic disease, will gradually lead to severe hip joint dysfunction. Total hip arthroplasty is a useful method to improve patients' quality of life. The aim of this study was to compare the incidence and risk factors of deep vein thrombosis (DVT) between AS and hip osteoarthritis. Methods. In a retrospective study, a total of 149 subjects who underwent cementless THA were studied. Clinical data, biochemical data, and surgery-related data were measured between AS and OA groups. Results. The incidence of DVT in AS group was lower than that of OA group, although no significant difference was detected (P = 0.89). The patients of AS group were much younger (P < 0.0001) and thinner (P = 0.018) compared with those of OA group. AS patients had higher ejection fraction (EF) (P = 0.016), higher platelet counts (P < 0.0001), and lower hypertension rate (P = 0.0004). The values of APTT, PT, and INR in AS patients were higher than those in OA patients (all P < 0.0001). The values of D-dimer and APTT were both significantly higher in DVT subjects than those in non-DVT subjects. Conclusion. AS patients potentially had a lower incidence of DVT compared with OA patients.

Shi, Dongquan; Xu, Xingquan; Song, Kai; Xu, Zhihong; Dai, Jin; Chen, Dongyang; Jiang, Qing

2014-01-01

198

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.

Jimenez-Balderas, Francisco-Javier; Garcia-Jaimes, Janete; Rios, Rita; Zonana-Nacach, Abraham; Tapia-Romero, Raquel; Villanueva, Nayeli; Mendez-Samperio, Patricia

2014-01-01

199

Correlations among enthesitis, clinical, radiographic and quality of life parameters in patients with ankylosing spondylitis.  

PubMed

Abstract Objectives. To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS). Methods. A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated. Results. Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue (p < 0.05). MASES was not correlated with BASRI, BASMI, ASQoL and ESR. The mean MASES score was 1.1 ± 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively. Conclusions. Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS. PMID:24252034

Rezvani, Aylin; Bodur, Hatice; Ataman, Sebnem; Kaya, Taciser; Bu?dayc?, Derya Soy; Demir, Saliha Ero?lu; Koçyi?it, Hikmet; Altan, Lale; U?urlu, Hatice; K?rnap, Mehmet; Gür, Ali; Kozano?lu, Erkan; Ak?nc?, Ay?en; Tekeo?lu, Ibrahim; Sahin, Gün?ah; Bal, Ajda; Sivrio?lu, Konçuy; Yazgan, Pelin; Ayd?n, Gülümser; Hepgüler, Simin; Olmez, Ne?e; Sendur, Omer Faruk; Yener, Mahmut; Altay, Zühal; Ayhan, Figen; Durmu?, O?uz; Duruöz, Mehmet Tuncay; Günendi, Zafer; Nac?r, Bar??; Oken, Oznur; Tokta?, Hasan; Delialio?lu, Sibel Ünsal; Evcik, Deniz; Sertpoyraz, Filiz Meryem

2014-07-01

200

A retrospective study of treating thoracolumbar spine fractures in ankylosing spondylitis.  

PubMed

Spinal fractures are commonly encountered in ankylosing spondylitis (AS) patients. This study compares the outcome of early surgical treatment with initial conservative treatment for thoracolumbar fractures in patients with AS. From 1996 to 2008, 28 patients with AS were treated either operatively or conservatively for thoracolumbar fractures; however, only 25 patients met the inclusion criteria with a minimum follow-up of 2 years. For surgically treated patients, posterior spinal instrumentation was performed using a transpedicle screw system. Nonsurgically treated patients wore a fracture brace. The demographic data, diagnosis, mechanism of injury, and neurological status were recorded, and fracture healing was assessed radiographically. The mean age was 54.2 ± 13.8 years (range 30-80 years). Six patients (Group A) received surgical intervention within 1 month. All of these fractures healed, and two of five patients showed neurologic improvement after surgery. Eight patients (Group B) had fractures that were missed. The delay in diagnosis resulted in pseudoarthrosis in all cases, and progressive neurologic deficits were identified in four cases. Eleven patients (Group C) received conservative treatment with bracing. Fracture union was achieved in three cases, and pseudoarthrosis occurred in eight cases. Operative treatment can achieve solid fusion and improve the neurological status, while conservative treatment may result in pseudoarthrosis and progressive neurologic deficit. The results suggest that AS patients with unstable spinal fractures should receive early surgical management to prevent further sequelae. PMID:24306166

Lu, Meng-Ling; Tsai, Tsung-Ting; Lai, Po-Liang; Fu, Tsai-Sheng; Niu, Chi-Chien; Chen, Lih-Huei; Chen, Wen-Jer

2014-07-01

201

A systematic literature review of the economic impact of ankylosing spondylitis.  

PubMed

This article reviews the last decade studies on the economic impact of ankylosing spondylitis (AS). Interestingly, a common observation is that in AS indirect costs are higher than the use of direct healthcare resources. Country, age, gender, and severity of the diseases impact on per patient annual costs AS related. Different payment and reimbursement regimes may impact on the amount and distribution of indirect costs. The differences observed among countries on absolute and relative (compared with direct costs) amounts of indirect costs can be explained with the capability of a country of actually measure productivity losses and indirect costs. Low indirect costs without other indicators should not be considered as a sign of efficiency in AS care, but may be due to an underestimation of AS-related costs; as a consequence, indirect costs may be a net loss for patients that nobody can repay. A private insurance reimbursement regime has the highest capability of inducing players to define, select and actually identify indirect costs better than in different reimbursement regimes. Therefore indirect costs may become very high in case of private insurance regimes because of their more detailed identification. PMID:23072824

Palla, Ilaria; Trieste, Leopoldo; Tani, Chiara; Talarico, Rosaria; Cortesi, Paolo A; Mosca, Marta; Turchetti, Giuseppe

2012-01-01

202

Comparison of Venous Thromboembolism after Total Hip Arthroplasty between Ankylosing Spondylitis and Osteoarthritis.  

PubMed

Objective. Ankylosing spondylitis (AS), an inflammatory rheumatic disease, will gradually lead to severe hip joint dysfunction. Total hip arthroplasty is a useful method to improve patients' quality of life. The aim of this study was to compare the incidence and risk factors of deep vein thrombosis (DVT) between AS and hip osteoarthritis. Methods. In a retrospective study, a total of 149 subjects who underwent cementless THA were studied. Clinical data, biochemical data, and surgery-related data were measured between AS and OA groups. Results. The incidence of DVT in AS group was lower than that of OA group, although no significant difference was detected (P = 0.89). The patients of AS group were much younger (P < 0.0001) and thinner (P = 0.018) compared with those of OA group. AS patients had higher ejection fraction (EF) (P = 0.016), higher platelet counts (P < 0.0001), and lower hypertension rate (P = 0.0004). The values of APTT, PT, and INR in AS patients were higher than those in OA patients (all P < 0.0001). The values of D-dimer and APTT were both significantly higher in DVT subjects than those in non-DVT subjects. Conclusion. AS patients potentially had a lower incidence of DVT compared with OA patients. PMID:24995324

Shi, Dongquan; Xu, Xingquan; Song, Kai; Xu, Zhihong; Dai, Jin; Chen, Dongyang; Jiang, Qing

2014-01-01

203

ETS1 variants confer susceptibility to ankylosing spondylitis in Han Chinese  

PubMed Central

Introduction ETS1 is a negative regulator of the Th17 differentiation gene and plays a central role in the pathogenesis of autoimmune diseases. We aimed to investigate whether polymorphisms in ETS1 confer susceptibility to ankylosing spondylitis (AS) in Han Chinese. Methods We selected seven single nucleotide polymorphisms (SNPs) within ETS1 based on HapMap data and previous genome-wide association study. Genotyping involved the TaqMan method in 1,015 patients with AS and 1,132 healthy controls from Shandong Province, and 352 AS patients and 400 healthy controls from Ningxia, a northwest region in China. Gene expression was determined by real-time PCR. Results The SNP rs1128334 was strongly associated with AS (odds ratio 1.204, 95% confidence interval 1.06-1.37; P?=?0.005). This association was confiexrmed in the Ningxia population (P?=?0.015). Carriers of the haplotype TAT for rs12574073, rs1128334 and rs4937333 were associated with increased risk of AS and haplotype CGC with reduced risk as compared to controls. In addition, ETS1 expression was lower in AS patients than controls. The risk allele A of rs1128334 and haplotype A-T of rs1128334 and rs4937333 were associated with decreased expression of ETS1. Conclusions Common variants in ETS1 may contribute to AS susceptibility in Han Chinese people.

2014-01-01

204

Associations of the PTPN22 and CTLA-4 genetic polymorphisms with Taiwanese ankylosing spondylitis.  

PubMed

Ankylosing spondylitis (AS) is an autoimmune disease, and the imbalance of peripheral tolerance is involved in its pathogenesis. Importantly, the negative signal of activated T cells plays a crucial role in the balance of peripheral tolerance. It has been postulated that human protein tyrosine phosphatase nonreceptor 22 (PTPN22) and cytotoxic T-lymphocyte antigen-4 (CTLA-4) genes encode proteins that are actively involved in regulating T-cell activation. Therefore, we evaluated the effects of PTPN22 and CTLA-4 genotypes on the occurrence of AS. Genetic polymorphisms of PTPN22 -1123G/C and CTLA-4 +49A/G were identified by polymerase chain reaction for 391 AS patients and 391 healthy controls. Subjects with PTPN22 CC and GC genotypes had a greater risk of AS occurrence than those with PTPN22 GG genotype [relative risk = 1.39, 95 % confidence interval (95 % CI) 1.03-1.88]. Further, subjects with PTPN22 CC/CTLA-4 AA or PTPN22 GC/CTLA-4 AA genotypes had 1.90-fold (95 % CI 1.02-3.49) greater risk of AS development than those with other combinations of PTPN22 and CTLA-4 genotypes. Our findings indicated that PTPN22 -1123G/C and CTLA-4 +49A/G genetic polymorphisms have a combined effect on the development of AS. PMID:24212676

Huang, Chun-Huang; Wei, James Cheng-Chung; Chen, Chun-Chieh; Chuang, Chih-Shien; Chou, Chia-Hsuan; Lin, Yu-Jie; Wang, Ming-Fuu; Wong, Ruey-Hong

2014-05-01

205

Low doses of etanercept can be effective to maintain remission in ankylosing spondylitis patients.  

PubMed

We wanted to do a prospective open-label study to evaluate if ankylosing spondylitis (AS) patients in clinical remission with twice weekly etanercept (ETN) 25 mg therapy could be changed to weekly regimen or even to every other week regimen without increased dose for injection. Thirty-eight AS patients self-administered 25 mg of ETN (Wyett) subcutaneously. According to the protocol, patients who were in clinical partial remission with twice weekly ETN 25 mg at week 12 and 16 changed to a weekly regimen without a change of the dose. If clinical remission, despite the reduction of the dose, persists at week 24 and 28, patients changed to an every-other-week regimen, continuing with this administration schedule for the entire duration of the study if at week 36 and 46 clinical remission was maintained. At the end of the study, 18 patients (47 %) were still in remission, 4 (10 %) with a weekly regimen, and 14 (37 %) with an every-other-weekly regimen. Our study indicates that a consistent percentage of subjects with AS, treated with ETN 25 mg twice weekly, achieved clinical remission within the first 3 months of therapy, and also, a substantial percentage of these patients maintains the partial remission with an every other week regimen. PMID:24062201

De Stefano, Renato; Frati, Elena; De Quattro, Davide; Menza, Luana; Manganelli, Stefania

2014-05-01

206

Association of the MSX2 gene polymorphisms with ankylosing spondylitis in Japanese.  

PubMed

Several genes have been implicated in the etiology of ankylosing spondylitis (AS); however, the significance of these genes except HLA-B27 remains to be elucidated. In this study, we examined the association of AS with novel candidate genes and previously reported genes other than HLA-B27. We examined a total of 45 single nucleotide polymorphisms (SNPs) in 15 genes by a sequential screening. We first genotyped 170 Japanese AS patients and 896 controls for the SNPs (first screen). Then, we genotyped eight SNPs with P < 0.05 in the first screen for 108 additional Japanese patients (second screen). We checked the replication of the association of the most significant SNP by genotyping 219 Taiwanese AS patients and 185 controls. When the first and second screens were combined, four SNPs showed nominal significance of P < 0.05. An intronic SNP (IVS1 + 996G > A) in MSX2, a novel candidate gene, showed the most significant association (P = 0.0030). The association was not replicated in our Taiwanese population; however, there was the same trend with the Japanese population in the allelic frequency distribution of the SNP. In the genes previously reported to have association with AS, only one synonymous SNP, c.963T > G in ANKH, showed a marginal association in the Japanese population (P = 0.045). PMID:18299954

Furuichi, Tatsuya; Maeda, Koichi; Chou, Chung-Tei; Liu, Yu-Fen; Liu, Ting-Chun; Miyamoto, Yoshinari; Takahashi, Atsushi; Mori, Kanji; Ikari, Katsunori; Kamatani, Naoyuki; Kurosawa, Hisashi; Inoue, Hisashi; Tsai, Shih-Feng; Ikegawa, Shiro

2008-01-01

207

The relationship between plasma homocysteine level and different treatment modalities in patients with ankylosing spondylitis.  

PubMed

To determine plasma homocysteine levels in ankylosing spondylitis (AS) and their correlation with disease activity measurements. To examine the effects of different treatment modalities on homocysteine levels. One hundred eight patients diagnosed with AS according to New York criteria and 65 healthy individuals matched in terms of age and gender were enrolled in the study. Patients were given detailed physical examinations. The Bath AS Disease Activity Index (BASDAI) was used for disease activity, the Bath AS Metrology Index (BASMI) for spinal mobility, the Bath AS Functional Index (BASFI) to determine functional status and the Bath AS Radiological Index (BASRI) for radiological analysis. Sedimentation rate (ESR) and C reactive protein (CRP) levels, acute phase reactants, were measured. Plasma homocysteine levels, serum interleukin (IL) -6 and serum tumor necrosis factor- ? (TNF- ?) levels were investigated using the enzyme-linked immunosorbent assay (ELISA) method. Plasma homocysteine levels in AS patients were statistically significantly lower compared with those in the healthy control group (P = 0.0001). There was no significant difference among sub-groups established on the basis of medical treatments and disease activity (BASDAI ?4 and >4). No statistically significant correlation was determined between homocysteine level and disease activity parameters, radiological score and functional indices. A significant negative correlation was, however, established between age and homocysteine level in the AS group (P < 0.05, r = -0.426). Plasma homocysteine was lower in AS patients compared with the control group. This is not correlated with disease activation and medical treatment employed. PMID:21644039

Capkin, Erhan; Karkucak, Murat; Akyüz, Ay?e; Alver, Ahmet; Turkyilmaz, Aysegul Kucukali; Zengin, Elif

2012-08-01

208

Profiling of HLA-B Alleles for Association Studies with Ankylosing Spondylitis in the Chinese Population  

PubMed Central

Human leucocyte antigen (HLA) B*27 is a susceptibility allele to ankylosing spondylitis (AS). However, major AS-associated subtypes of HLA-B*27 and other HLA-B alleles vary in different ethnic populations. Herein, we examined HLA-B alleles in a total of 360 AS patients and 350 controls of Chinese Han ancestry. The HLA-B genotyping was performed with sequence-based typing (SBT) method. Six HLA-B*27 subtypes B*27:04, B*27:05, B*27:07, B*27:08, B*27:10 and B*27:15 were observed in the cohorts. HLA-B*27:04:01 and -B*27:05:02 appeared significantly increased in AS patients, which indicated as two major susceptibility alleles to AS. Homozygous B*27 was observed only in AS patients. There are 30 HLA-B alleles identified in the studies. HLA-B*15, especially B*15:01:01:01, appeared as the major allele type in the Chinese controls. Some common HLA-B alleles such as HLA-B*15, B*13, B*46 and B*51 were significantly reduced in Chinese AS patients. In conclusion, the studies profiled the HLA-B alleles, and identified major susceptibility subtypes of B27 to AS in Han Chinese population

Yi, Lin; Wang, Jiucun; Guo, Xinjian; Espitia, Maribel G.; Chen, Enuo; Assassi, Shervin; Jin, Li; Zou, Hejian; Reveille, John D.; Zhou, Xiaodong

2013-01-01

209

Pulmonary, renal and neurological comorbidities in patients with ankylosing spondylitis; implications for clinical practice.  

PubMed

Ankylosing spondylitis (AS) is associated with several comorbidities which contribute significantly to morbidity and mortality and add to the complexity of management. In addition to the well known extra-articular manifestations and increased cardiovascular risk, several pulmonary, renal, and neurological complications which have been associated with AS deserve equal attention. Whereas a clear link has been established for some manifestations, the evidence for other associations is less clear. Interstitial lung disease, apical fibrosis, secondary infection, and ventilatory restriction from reduced chest wall movement are well known pulmonary complications; more recently an association with sleep apnoea has been suggested. Renal amyloidosis and IgA nephropathy remain a treatment challenge which may respond to anti-TNF therapy. Atlanto axial subluxation and vertebral fractures can result in serious neurological complications and are notoriously difficult to diagnose unless a high level of suspicion is maintained. Despite several reports linking AS with demyelination a true link remains to be proved. This review discusses the prevalence, pathophysiology, and management of pulmonary, renal, and neurological complications, and implications for clinical practice. PMID:24925589

Mercieca, Cecilia; van der Horst-Bruinsma, Irene E; Borg, Andrew A

2014-08-01

210

Adipokines, Biomarkers of Endothelial Activation, and Metabolic Syndrome in Patients with Ankylosing Spondylitis  

PubMed Central

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease associated with accelerated atherosclerosis and increased risk of cardiovascular (CV) disease. AS patients also display a high prevalence of features clustered under the name of metabolic syndrome (MeS). Anti-TNF-? therapy was found to be effective to treat AS patients by suppressing inflammation and also improving endothelial function. Previously, it was demonstrated that a short infusion of anti-TNF-? monoclonal antibodyinfliximab induced a rapid and dramatic reduction in serum insulin levels and insulin resistance along with a rapid improvement of insulin sensitivity in nondiabetic AS patients. The role of adipokines, MeS-related biomarkers and biomarkers of endothelial cell activation and inflammation seem to be relevant in different chronic inflammatory diseases. However, its implication in AS has not been fully established. Therefore, in this review we summarize the recent advances in the study of the involvement of these molecules in CV disease or MeS in AS. The assessment of adipokines and biomarkers of endothelial cell activation and MeS may be of potential relevance in the stratification of the CV risk of patients with AS.

Lopez-Mejias, Raquel; Miranda-Filloy, Jose A.; Ubilla, Begona; Carnero-Lopez, Beatriz; Blanco, Ricardo; Pina, Trinitario; Gonzalez-Juanatey, Carlos; Llorca, Javier; Gonzalez-Gay, Miguel A.

2014-01-01

211

Early response to adalimumab predicts long-term remission through 5 years of treatment in patients with ankylosing spondylitis  

PubMed Central

Objectives To describe the efficacy and safety through 5 years of adalimumab treatment in patients with ankylosing spondylitis (AS), and to identify predictors of remission. Methods Patients with active AS were followed up to 5 years during a 24-week randomised, controlled period, followed by an open-label extension. Disease activity and clinical improvement were evaluated by Assessment in Spondyloarthritis International Society (ASAS) responses, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score (ASDAS). Kaplan–Meier was used to identify patients with sustained ASAS partial remission (PR) or ASDAS inactive disease (ID) for three or more consecutive visits spanning ?6 months. Logistic regression was used to identify factors associated with remission. Explanatory variables included baseline demographic and disease characteristics and week 12 responses. Results Of the 311 patients who received at least one dose of adalimumab, 202 (65%) completed the 5-year study. Among 125 patients who received 5 years of adalimumab, 70%, 77%, 51% and 61% achieved ASAS40, BASDAI 50, ASAS PR and ASDAS ID, respectively. Of 311 adalimumab-treated patients, 45% and 55% achieved sustained ASAS PR and ASDAS ID at any time during study participation. The strongest predictor of remission at years 1 and 5 and of sustained remission was achieving remission at 12 weeks of treatment; baseline characteristics showed weaker associations. Adverse events were comparable with previous reports on adalimumab safety. Conclusions In patients with active AS, the efficacy and safety of adalimumab were maintained through 5 years with about half of the patients experiencing sustained remission at any time during the study. Early achievement of remission was the best predictor of long-term and sustained remission.

Sieper, Joachim; van der Heijde, Desiree; Dougados, Maxime; Brown, L Steve; Lavie, Frederic; Pangan, Aileen L

2012-01-01

212

Inflammatory bowel disease and ankylosing spondylitis associated with cutaneous vasculitis, glomerulonephritis, and circulating IgA immune complexes.  

PubMed Central

Two patients both with inflammatory bowel disease (IBD) and ankylosing spondylitis (AS) developed leucocytoclastic vasculitis of the skin and nephropathy. Immunofluorescence studies showed that there was perivascular deposition of immunoglobulin A in the skin biopsy specimens of both patients and in the renal mesangium of one patient. Serum samples of the two patients contained IgA immune complexes. The absence of previous reports on such a combination of symptoms in IBD or AS suggests that these patients may have a disease entity which is distinct from uncomplicated IBD or AS, and which may combine the immunopathological features of both underlying disorders.

Peeters, A J; van den Wall Bake, A W; Daha, M R; Breeveld, F C

1990-01-01

213

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.

2012-01-01

214

Prevalence of ankylosing spondylitis in males and females in a young middle-aged population of Troms?, northern Norway.  

PubMed Central

In an epidemiological survey in Tromsø, northern Norway a prevalence of definite ankylosing spondylitis (AS) of between 1.1% and 1.4% was found (males: 1.9-2.2% and females: 0.3-0.6%). The ratio of male to female was between 3.9 and 6.1 in favour of the male sex. It was calculated that 6.7% of the B27 positive individuals had AS, and that 22.5% of the B27 positive subjects with back pain or stiffness suffered from AS.

Gran, J T; Husby, G; Hordvik, M

1985-01-01

215

Carbonic anhydrase I (CA1) is involved in the process of bone formation and is susceptible to ankylosing spondylitis  

PubMed Central

Introduction Ankylosing spondylitis (AS) is characterized by abnormal bone formation in the spine and the sacroiliac joints. In vitro assays demonstrate that carbonic anhydrase I (CA1) promotes calcium precipitation. This study investigated the function of CA1 for bio-mineralization and determined if common polymorphisms in the CA1 gene might contribute to AS risk. Methods Calcification was induced in Saos-2 cells, a human osteosarcoma cell line, with ascorbic acid and ?-glycerophosphate. Calcification was determined by Alizarin Red-S (AR-S) staining. Expressions of CA1, alkaline phosphatase (ALP), bone sialoprotein (BSP), osteocalcin (OCN), osterix (OSX) and runt-related transcription factor-2 (Runx2) were determined by real-time PCR and western blotting. The cells were also treated with acetazolamide, an anti-carbonic anhydrase drug. Genotyping was performed using Illumina VeraCode microarray in a case-control study including 51 AS patients, 267 rheumatoid arthritis (RA) patients and 160 healthy controls. The result was confirmed by Taqman assay, including 258 AS patients, 288 RA patients and 288 healthy controls. Results Following the induction of calcification, Saos-2 cells produced large amounts of calcium-rich deposits. Increased transcriptions of CA1, ALP, BSP, OCN, OSX and Runx2, essential genes for ossification, were detected in the cultured cells. Following treatmen with acetazolamide, the expression of CA1 obviously declined and mineralized nodule formation was also decreased. Illumina microarray indicates that SNP at rs7841425 also showed significant differences in allelic frequency (P = 0.01396) and genotypic frequency (P = 0.005902) between AS cases and controls. In addition, SNP at rs7827474 showed significant differences in allelic frequency (P = 5.83E-04) and genotypic frequency (P = 0.000186) between RA cases and controls (P values were adjusted to multiple comparisons). The Taqman assay revealed that rs725605 demonstrated statistically significant evidence of allele frequency (P = 0.022307) and gene frequency (P = 0.007731) for association with AS. This SNP did not show significant differences in allelic frequencies and gene frequencies between RA patients and controls. Conclusions CA1 may play an essential role in bio-mineralization and new bone formation. The gene encoding CA1 is susceptible to AS.

2012-01-01

216

Incidence and predictors of morphometric vertebral fractures in patients with ankylosing spondylitis  

PubMed Central

Introduction Ankylosing spondylitis (AS) is associated with an increased incidence of vertebral fractures (VFs); however the actual incidence and predictors of morphometric VFs are unknown. The present study examined the incidence and predictors of new VFs in a large AS cohort. Methods In total, 298 AS patients who fulfilled the modified New York criteria were enrolled and spinal radiographs were evaluated biennially. Clinical and laboratory data and radiographic progression were assessed according to the Bath AS Disease Activity Index, erythrocyte sedimentation rate, C-reactive protein (CRP), and the Stoke AS spine score (SASSS). VF was defined according to the Genant criteria. The incidence of VFs at 2 and 4 years was evaluated using the Kaplan-Meier method. The age-specific standardized prevalence ratio (SPR) for AS patients in comparison with the general population was calculated. Results Of 298 patients, 31 (10.8%) had previous VFs at baseline. A total of 30 new VFs occurred in 26 patients over 4 years. The incidence of morphometric VFs was 4.7% at 2 years and 13.6% at 4 years. Multivariate logistic regression analysis showed that previous VFs at baseline and increased CRP levels at 2 years were predictors of new VFs (odds ratio (OR) =12.8, 95% confidence interval (CI)?=?3.6-45.3 and OR?=?5.4, 95% CI?=?1.4–15.9). The age-specific specific standardized prevalence ratio of morphometric VFs in AS was 3.3 (95% CI 2.1–4.5). Conclusions The incidence of morphometric VFs increased in AS. Previous VFs and increased CRP levels predicted future VFs. Further studies are needed to identify the effects of treatment interventions on the prevention of new VFs.

2014-01-01

217

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.

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

2013-01-01

218

Assessment of quality of life and depression in spouses of patients with ankylosing spondylitis.  

PubMed

The objective of this study is to investigate the quality of life and the rates of depression in spouses/partners of patients with AS compared with spouses/partners of healthy controls". Twenty-five persons with AS and their 25 spouses (21 women and 4 men) and 25 healthy controls were recruited consecutively. All the subjects completed 36-item Short Form Health Survey (SF-36) questionnaire forms and 17-item Hamilton Depression Rating Scale (HAM-D17). Mean age was 35 ± 6.47 years in spouse group (SG) and 36.26 ± 5.93 in control group (CG). In SG and CG, the SF-36 subscale scores were compared using Mann-Whitney U test. Social functioning, mental health, emotional role, and general health were significantly (P < 0.05) lower in SG compared with CG. The average score of social functioning was found to be 65.41 in spouses of patients compared with healthy controls (90.75). Depression scores were significantly (P < 0.001) higher in SG compared with CG. Among SF-36 subgroups in spouses, general health perception had a negatively significant correlation with depression scores (P < 0.05) and duration of ankylosing spondylitis (P < 0.05). A positively significant correlation has been identified between bodily pain and depression scores in spouses (P < 0.05). Therefore, female partners of male patients were found to be more depressive. Being a spouse of a patient with AS significantly interferes with quality of life and increases the depression frequency. PMID:22071688

Uludag, Murat; Unalan, Halil; Tuzun, Sans?n; Kocabasoglu, Nese; Aydin, Filiz Y?ld?z; Palamar, Deniz; Ozdemir, Samuray; Akarirmak, Ulku

2012-11-01

219

Clinical characteristics and medical management of Iranian patients with ankylosing spondylitis.  

PubMed

Abstract Objectives. Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease with variable clinical expression. Ethnic, racial and geographical factors have been associated with disease occurrence and expression. We intended to describe the clinical characteristics and assess the disease severity and treatment status in Iranian AS patients. Methods. A total of 320 AS patients were assessed for demographic variables, clinical manifestations, human leukocyte antigen (HLA) status, disease severity, functional capacities, quality of life and treatment status. Results. A gender ratio of 3.8:1, an average age onset of 27 ± 7.3 and a mean diagnostic delay of 8 years were observed. Eleven percent had juvenile onset AS. Positive family history was higher than that observed in most other countries. Enthesitis was a very common finding involving more than two-thirds of our patients. Uveitis was the leading extra-articular manifestation. We found an HLA-B27 prevalence of 73% and four HLA-B27 subtypes. Disease activity was high and the functional status was poor as indicated by mean Bath AS Disease Activity, Functional and Metrology indices. Quality of life was considerably impaired in our patients. We found a low percentage of patients on biological medications and a relatively higher percentage on disease modifying anti-rheumatic drugs and corticosteroids. Conclusions. Our results demonstrate a broad characterization of Iranian AS patients providing a better understanding of this disease. A national multicenter registry would enable larger- scale prospective studies to be carried out further evaluating the disease burden on patients and society. PMID:24251997

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

2014-05-01

220

The economic burden of the ankylosing spondylitis in the Czech Republic: comparison between 2005 and 2008.  

PubMed

To investigate the burden of ankylosing spondylitis in the Czech Republic as a baseline for future health economic evaluations. Data were obtained from two cross-sectional studies Beda I (2005) and Beda II (2008), performed in 1,008 and 509 patients, respectively. Methodology used was Cost-of-Illness prevalence-based analysis bottom-up approach. Analysis was performed from payer (health insurance companies) and societal perspective (including productivity costs using friction cost approach). Mean age of sample in Beda I and Beda II was 50.2 and 52.5 years, male were present by 61.0 and 62.7 %; average disease duration was 23.0 and 26.4 years, respectively. Mean total annual costs per patient in the sample were €4,782 in Beda I and €5806 in Beda II. Average direct costs per patient in the sample per year are estimated at €1,812 (Beda I) and €2,588 (Beda II) with the average productivity costs €2,970 (Beda I) and €3,218 (Beda II). We observed a small decrement in percentage (6.7 %) of productivity costs for Beda II as an influence of higher consumption of biologic drugs, hence higher direct costs and possible productivity preservation. The largest direct cost burdens were spa procedures (45.3 %, Beda I) and biological drugs (52.8 %, Beda II). Unique analysis of the burden of the AS in the Central-Eastern Europe presents health care resource and cost consumption by comparing two cross-sectional prevalence-based studies. Further analysis should be carried to obtain data connecting health status with costs consumption in order to analyse the AS from this perspective. PMID:23314983

Pet?íková, Alena; Doležal, Tomáš; Klimeš, Ji?í; Vocelka, Milan; Sedová, Liliana; Kolá?, Jozef

2013-07-01

221

Tumor necrosis factor receptor-II nt587 polymorphism in Chinese Han patients with ankylosing spondylitis.  

PubMed

We aimed to explore the association between the onset of ankylosing spondylitis (AS) and nt587 polymorphisms of the tumor necrosis factor receptor II (TNFRII) gene in the Han population of Hunan Province, China. Correlation analysis was performed in a case-control study involving 100 AS cases and 100 healthy controls. The nt587 single nucleotide polymorphism of the TNFRII gene was examined by polymerase chain reaction-restriction fragment length polymorphism. The relationship between AS and the frequencies of genotypes and alleles in TNFRII nt587 were analyzed using the SPSS software. There were 43 cases with the TNFRII nt587 T/T genotype, 32 cases with the TNFRII nt587 T/G genotype, and 25 cases with the TNFRII nt587 G/G genotype. In the 100 healthy controls, 56 subjects had the TNFRII nt587 T/T genotype, 34 had the TNFRII nt587 T/G genotype, and 10 had the TNFRII nt587 G/G genotype. The G allele frequency of the AS group was significantly higher (?(2) = 8.734, P = 0.003) than that in the control group (41.0 vs 27.0%). The odds ratio (OR) in AS cases with the TNFRII nt587 G/G genotype was 3.256, which was obviously higher than in those with T/G (OR = 1.226) and T/T (OR = 1.0) genotype. The polymorphism at position nt587 of the TNFRII gene was found to be associated with AS, and the TNFRII nt587 G allele may play an important role in AS susceptibility. The TNFRII nt587 G/G genotype may increase the risk of developing AS in the Hunan population. PMID:25061744

Li, X; Wang, M; Ma, R; Zhang, T; Liu, J; Chen, J W; Peng, W

2014-01-01

222

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

223

[Clinical, radiographic and biologic particularities of ankylosing spondylitis in Tunisian patients according to the presence or the absence of the HLA B27 and its sub-types].  

PubMed

To assess the clinical, radiographic and biologic particularities of ankylosing spondylitis (AS) in Tunisian patients according to HLA B27 and its sub-types statute. This was a case-control study that included 100 patients (85 males/15 females) with AS according to the modified New York criteria. Demographic, clinical, AS specific indexes, radiographic and biologic parameters were determined. HLA-B and B27 subtypes typing of all subjects were performed by PCR-SSP. Patients mean age was 38.4 years +/- 12.6 HLA-B27 was found in 62% of patients. The comparison of B27 positive and B27 negative patients revealed a correlation of B27 with age, male gender, family history of spondylarthropathies, age at disease onset, acute onset of the disease, inaugural spinal involvement, uveitis, bilateral and destructive hip arthritis as well as a high score of mSASSS. The most frequent sub-types of HLA B27 were B*2702 (49.2%) and B*2705 (36.3%). No significant difference of the clinical presentation of the disease or severity factors was found among these patients. This study confirmed the contribution of the HLA B27 to the determination of the clinical presentation of AS. The variability of factors linked to B27 may be explained by the polygenic model of the disease. PMID:22984764

Hamdi, W; Kaffel, D; Ghannouchi, M M; Laadhar, L; Makni, S; Kchir, M Montacer

2012-01-01

224

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

225

HLA-E gene polymorphism associates with ankylosing spondylitis in Sardinia  

PubMed Central

Introduction Ankylosing spondylitis (AS) is a severe, chronic inflammatory disease strongly associated with HLA-B27. The presence of additional HLA risk factors has been suggested by several studies. The aim of the current study is to assess the occurrence of an additional HLA susceptibility locus in the region between HLA-E and HLA-C in the Sardinian population. Methods 200 random controls, 120 patients with AS and 175 HLA-B27 positive controls were genotyped for six single nucleotide polymorphisms (SNPs) spanning the HLA region between HLA-E and HLA-C loci previously shown to harbour an additional susceptibility locus for AS. Allele, genotype and haplotype frequencies were compared. Results The data confirm our previous finding of a significant increase in patients with AS of allele A at SNP rs1264457 encoding for an Arg at the functional HLA-E polymorphism (Arg128/Gly128). This was due to a remarkable increase in the frequency of genotype A/A in patients vs HLA-B27-matched controls (51% vs 29%; P for trend: 5 × 10-5). Genotype distribution of three other SNPs mapping in genes (GNL1, PRR3 and ABCF-1) close to HLA-E and showing high LD with it, was also significantly skewed. Accordingly, haplotype distribution was also remarkably different. The frequency of the haplotype AAGA, is 42% in random controls, increases to 53% in the HLA-B27-positive controls, and reaches 68% in patients with AS (P values: 2 × 10-11 vs random and 3 × 10-4 vs HLA-B27 controls). Conclusions There is a strong association between the presence of a haplotype in genes mapping between HLA-E and HLA-C and AS due to an increase of homozygous markers in patients. The strongest association however, is with the HLA-E functional polymorphism rs1264457. Since HLA-E is the ligand for the NKG2A receptor, these data point to the natural killer (NK) activity as possible player in the pathogenesis of AS.

2009-01-01

226

Vertebral Osteotomies in Ankylosing Spondylitis--Comparison of Outcomes Following Closing Wedge Osteotomy versus Opening Wedge Osteotomy: A Systematic Review  

PubMed Central

Study Design?Systematic review. Study Rationale?To seek out and assess the best quality evidence available comparing opening wedge osteotomy (OWO) and closing wedge osteotomy (CWO) in patients with ankylosing spondylitis to determine whether their results differ with regard to several different subjective and objective outcome measures. Objective?The aim of this study is to determine whether there is a difference in subjective and objective outcomes when comparing CWO and OWO in patients with ankylosing spondylitis suffering from clinically significant thoracolumbar kyphosis with respect to quality-of-life assessments, complication risks, and the amount of correction of the spine achieved at follow-up. Methods?A systematic review was undertaken of articles published up to July 2012. Electronic databases and reference lists of key articles were searched to identify studies comparing effectiveness and safety outcomes between adult patients with ankylosing spondylitis who received closing wedge versus opening wedge osteotomies. Studies that included pediatric patients, polysegmental osteotomies, or revision procedures were excluded. Two independent reviewers assessed the strength of evidence using the GRADE criteria and disagreements were resolved by consensus. Results?From a total of 67 possible citations, 4 retrospective cohorts (class of evidence III) met our inclusion criteria and form the basis for this report. No differences in Oswestry Disability Index, visual analog scale for pain, Scoliosis Research Society (SRS)-24 score, SRS-22 score, and patient satisfaction were reported between the closing and opening wedge groups across two studies. Regarding radiological outcomes following closing versus opening osteotomies, mean change in sagittal vertical axis ranged from 8.9 to 10.8 cm and 8.0 to 10.9 cm, respectively, across three studies; mean change in lumbar lordosis ranged from 36 to 47 degrees and 19 to 41 degrees across four studies; and mean change in global kyphosis ranged from 38 to 40 degrees and 28 to 35 degrees across two studies. Across all studies, overall complication risks ranged from 0 to 16.7% following CWO and from 0 to 23.6% following OWO. Conclusion?No statistically significant differences were seen in patient-reported or radiographic outcomes between CWO and OWO in any study. The risks of dural tear, neurological injury, and reoperation were similar between groups. Blood loss was greater in the closing wedge compared with the opening wedge group, while the risk of paralytic ileus was less. The overall strength of evidence for the conclusions is low.

Ravinsky, Robert A.; Ouellet, Jean-Albert; Brodt, Erika D.; Dettori, Joseph R.

2013-01-01

227

Is It Real False Negative Finding in Motor Evoked Potential Monitoring during Corrective Surgery of Ankylosing Spondylitis? A Case Report  

PubMed Central

We performed L1 posterior vertebral columnar resection and posterior correction for Andersson's lesion and thoracolumbar kyphosis in an ankylosing spondylitis patient during motor evoked potential (MEP) monitoring. We checked MEP intra-operatively, whenever a dangerous procedure for neural elements was performed, and no abnormal findings were seen during surgery. After the operation, we examined neurologic function in the recovery room; the patient showed a progressive neurologic deficit and no response to MEP. After emergency neural exploration and decompression surgery, the neurologic deficit was recovered. We questioned whether to acknowledge the results of this case as a false negative. We think the possible reason for this result may be delayed development of paralysis. So, we recommend that MEP monitoring should be performed not only after important operative steps but also after all steps, including skin suturing, for final confirmation.

Kim, Ki-Tack; Lee, Sang-Hun; Son, Eon-Seok

2012-01-01

228

The effect of etanercept on a case of amyloidosis secondary to ankylosing spondylitis: results of 2-year follow-up.  

PubMed

Secondary amyloidosis (type AA) is rarely encountered but can be a significant complication of ankylosing spondylitis (AS) and may lead to proteinuria and renal dysfunction. Anti-tumor necrosis factor-alpha (anti-TNF?) agents may be used to induce clinical remission by suppressing systemic inflammation in secondary amyloidosis. The patient described , with the diagnosis of AS, was diagnosed with secondary amyloidosis, despite treatment with disease modifying anti-rheumatic medication. He developed marked proteinuria, renal dysfunction and low levels of serum albumin. Diagnosis of amyloidosis was confirmed by renal biopsy. During a 2-year treatment period with etanercept, an anti-TNF? agent, a definite improvement was determined in all parameters. This case illustrates that in the treatment of secondary amyloidosis related to AS, etanercept, an anti-TNF ? agent, can be considered an effective therapeutic option. PMID:24435036

Yilmaz, Halim; Kocabas, Hilal; Erkin, Gulten

2013-01-01

229

Prologue: 2009 Joint Meeting of Spondyloarthritis Research and Therapy Network (SPARTAN) and International Genetics of Ankylosing Spondylitis (IGAS).  

PubMed

In July 2009, a 3-day conference was held in Houston, Texas, USA, by members of several groups: the Spondyloarthritis Research and Therapy Network (SPARTAN); the International Genetics of Ankylosing Spondylitis (IGAS); and interested members of the Pan American League of Associations of Rheumatology (PANLAR). The purpose of this meeting was to bring together physician scientists, clinicians, and educators from around the world who are working together to improve their understanding of spondyloarthritis (SpA). In addition to the annual educational and Fellows sessions for SPARTAN members, the conference included a one-day international meeting dedicated to the role of HLA-B27, along with a series of sessions that summarized advances among various collaborative groups and defined opportunities for future genetic initiatives. This supplement provides a review of the SPARTAN and IGAS meetings. PMID:21123332

Reveille, John D; Clegg, Daniel O

2010-12-01

230

[Radiologic changes in the costovertebral and costotransverse joints and functional changes in the thoracic spine in ankylosing spondylitis].  

PubMed

Radiological, morphological and functional changes of the thoracic spine together with costovertebral and costotransversal joint involvement were studied in patients with ankylosing spondylitis. While radiological changes were found in all patients, in 74% they were of inflammatory origin. Radiological abnormalities were more prominent in patients with a more severe clinical course and a relatively short duration of the disease. As many as 95% of patients exhibited functional impairment of the thoracic spine. No significant difference was observed between the duration of disease and functional impairment of the thoracic spine (t = 1.4, P > 0.05) but there was a highly significant correlation between radiological changes and functional impairment of the thoracic spine (r = 0.577, P < 0.001). PMID:1366139

Jelci?, A; Jaji?, I; Fürst, Z

1992-01-01

231

Lumbar stiffness but not thoracic radiographic changes relate to alteration of lung function tests in ankylosing spondylitis.  

PubMed

Involvement of the costovertebral (CV) and costotransverse (CT) as well as the sacroiliac (SI) joints is known to occur in patients with ankylosing spondylitis (AS). The functional significance of these changes is not clear. We have performed clinical and radiological evaluations and assessed the effect of joint involvement on pulmonary function. We detected radiologic evidence of involvement of the CV joint in 80% of patients and of the CT joint in 60 %. We found a direct relation between the severity of CV, CT and SI joint affliction, and the severity of CV and SI joints were related to time of evolution of the disease. Pulmonary function tests revealed neither restrictive nor obstructive defects. No relation was found between pulmonary function and CV and CT joint affliction. Patients with stiffer spines had a tendency to have pulmonary function tests within the lower limit of the normal range. In patients with AS diaphragmatic breathing might compensate the chest respiration to some extent. PMID:12189452

Cerrahoglu, L; Unlu, Z; Can, M; Goktan, C; Celik, P

2002-08-01

232

Both Baseline Clinical Factors and Genetic Polymorphisms Influence the Development of Severe Functional Status in Ankylosing Spondylitis  

PubMed Central

Functional severity in ankylosing spondylitis (AS) patients is variable and difficult to predict early. The aim of our study was to assess whether a combination of baseline clinical factors and genetic markers may predict the development of severe functional status in AS. We performed a cross-sectional association study on AS patients included in the Spanish National Registry of Spondyloarthropathies—REGISPONSER. Bath Ankylosing Spondylitis Functional Index (BASFI) was standardized by adjusting for disease duration since the first symptoms (BASFI/t). We considered as severe functional status the values of BASFI/t in the top of the 60th (p60), 65th (p65), 70th (p70), and 75th (p75) percentile. We selected 384 single nucleotide polymorphisms (SNPs) distributed in 190 genes to be analyzed. The study cohort included 456 patients with mean age 50.8(±10.5) years and with mean disease duration since first symptoms 24.7 (±10.1) years. Older age at disease onset and neck pain at baseline showed statistical significant association with severe BASFI/t. Polymorphisms associated in the allele frequencies test with severe BASFI/t in all classifications were: rs2542151 (p60 [P?=?.04], p65 [P?=?.04], p70 [P?=?.001] and p75 [P?=?.001]) and rs2254441 (p60 [P?=?.004], p65 [P?=?.02], p70 [P?=?.01] and p75 [P<.001]).. Genotype association, after adjustment for covariates, found an association in three of the four patients' classifications for rs2542151 and in two of the classifications for rs2254441.Forward logistic regression did not identify any model with a good predictive power for severe functional development. In our study we identified clinical factors and 24 polymorphisms associated with development of severe functional status in AS patients. Validation of these results in other cohorts is required.

Schiotis, Ruxandra; Bartolome, Nerea; Sanchez, Alejandra; Szczypiorska, Magdalena; Sanz, Jesus; Cuende, Eduardo; Collantes Estevez, Eduardo; Martinez, Antonio; Tejedor, Diego; Artieda, Marta; Buzoianu, Anca; Mulero, Juan

2012-01-01

233

Immune interferon in serum and synovial fluid in rheumatoid arthritis and related disorders  

Microsoft Academic Search

Moderate titres of antiviral activity were demonstrated in 48-58% of sera obtained from patients suffering from seropositive and seronegative rheumatoid arthritis (RA), psoriatic arthritis, Reiter's syndrome, ankylosing spondylitis, and juvenile rheumatoid arthritis. Sera from blood donors and from patients with various noninflammatory diseases were positive in 16% of cases. The activity was species-specific, mediated by the homologous cells, and destroyed

M DeGré; O J Mellbye; O Clarke-Jenssen

1983-01-01

234

Assessment of acute spinal inflammation in patients with ankylosing spondylitis by magnetic resonance imaging: a comparison between contrast enhanced T1 and short tau inversion recovery (STIR) sequences  

Microsoft Academic Search

Objectives: To compare the performance of two different MRI sequences—T1 weighted, fat saturated, spin echo after application of contrast medium, and short ? inversion recovery (STIR) sequences—to detect spinal inflammation in patients with ankylosing spondylitis (AS).Methods: Both MRI sequences were performed in 38 patients with active AS and compared using the MRI activity scoring system, ASspiMRI-a. One vertebral unit (VU)

X Baraliakos; K-G A Hermann; R Landewe?; J Listing; W Golder; J Brandt; M Rudwaleit; M Bollow; J Sieper; D van der Heijde; J Braun

2005-01-01

235

Clinical symptoms and signs useful in the early diagnosis of ankylosing spondylitis  

Microsoft Academic Search

Summary  Seventy patients between the ages of 18 to 30 with early spondylitis (eAS), with bilateral grade II–III sacroiliitis without syndesmophytes were examined. The control group comprised 32 patients of the same age range with lumbar disc disease (LDD) confirmed by radiculography, without changes in the sacroiliac joints. In both groups the same clinical parameters were evaluated, calculating for each the

M. Sadowska-Wróblewska; A. Filipowicz; H. Garwolinska; J. Michalski; B. Rusiniak; T. Wróblewska

1983-01-01

236

Comparison of PA spine, lateral spine, and femoral BMD measurements to determine bone loss in ankylosing spondylitis.  

PubMed

To evaluate bone loss in the early- and late-stage ankylosing spondylitis (AS) patients using posteroanterior (PA) and lateral lumbar and femoral bone mineral density (BMD) measurement methods. Eighty-six AS patients and 50 control subjects were enrolled. PA spine, lateral spine, and femur BMD values of patients and controls were measured. The presence of any syndesmophytes or compression fractures was determined. Patients were divided as early (<10 years) and late stage (?10 years) according to the onset of the inflammatory pain. Mean PA spinal BMD was similar in patients and controls (p = 0.460). Femoral and lateral spine BMD values were significantly lower in patients (p = 0.012 and p = 0.001). When comparing early- and late-stage AS groups, mean PA spinal BMD was found to be lower in the early group (p = 0.005), while femoral and lateral spinal values were lower (although statistically not significant) in the late group. At least one compression fracture was present in 28 % of patients. Although not statistically significant, mean PA spinal BMD was higher in those with fractures. Femoral and lateral spinal BMD values were significantly lower in the fracture group (p = 0.034 and p = 0.004). Lateral spinal BMD values were significantly lower in patients with syndesmophytes (p = 0.004). Bone loss is increased in AS compared with control subjects. The BMD measurement at the lateral lumbar spine reflects bone loss and fracture risk better than PA spine and femoral measurements. PMID:23274443

Ulu, Mehmet Ali; Çevik, Remzi; Dilek, Banu

2013-07-01

237

Improved precision of syndesmophyte measurement for the evaluation of ankylosing spondylitis using CT: a phantom and patient study  

NASA Astrophysics Data System (ADS)

Ankylosing spondylitis is a disease characterized by abnormal bone formation (syndesmophyte) at the margins of inter-vertebral disc spaces. Syndesmophyte growth is currently typically monitored by the visual inspection of radiographs. The limitations inherent to the modality (2D projection of a 3D object) and rater (qualitative human judgment) may compromise sensitivity. With newly available treatments, more precise measures of syndesmophytes are needed to determine whether treatment can slow rates of syndesmophyte growth. We previously presented a computer algorithm measuring syndesmophyte volumes and heights in the 3D space of CT scans. In this study, we present improvements to the original algorithm and evaluate the gain in precision as applied to an anthropomorphic vertebral phantom and patients. Each patient was scanned twice in one day, thus providing two syndesmophyte volume and height measures. The difference between those two measures (ideally zero) determines our algorithm's precision. The technical improvements to the algorithm decreased the mean volume difference (standard deviation) between scans from 3.01% (2.83%) to 1.31% (0.95%) and the mean height difference between scans from 3.16% (2.99%) to 1.56% (1.13%). The high precision of the improved algorithm holds promise for application to longitudinal clinical studies.

Tan, Sovira; Yao, Jianhua; Yao, Lawrence; Ward, Michael M.

2012-07-01

238

Candidate's single-nucleotide polymorphism predictors of treatment nonresponse to the first anti-TNF inhibitor in ankylosing spondylitis.  

PubMed

The objective of this study is to identify single-nucleotide polymorphisms (SNPs) predictors of treatment nonresponse to the first anti-TNF-alpha agent in ankylosing spondylitis (AS). Patients were classified as "nonresponders" if they failed to achieve improvement ?50 % of the initial BASDAI. We selected candidate SNPs previously reported, associated with susceptibility or pathogenesis of AS and with other spondylarthropaties (SpAs). The predictors of nonresponse were modeled with multiple logistic regression. The predictive power of the genetic model of nonresponse to treatment was tested with AUC-ROC. One hundred and twenty-one (121) AS patients fulfilled the inclusion criteria. Of the candidate SNPs tested for association with treatment effectiveness, five independent predictors were identified: rs917997, rs755622, rs1800896, rs3740691, and rs1061622. The genetic model of nonresponse to treatment had a predictive power of 0.77 (95 % CI 0.68-0.86). Our study identified several polymorphisms which could be the useful genetic biomarkers in predicting nonresponse to anti-TNF-alpha therapy. PMID:24337767

Schiotis, Ruxandra; Sánchez, Alejandra; Escudero, Alejandro; Bartolomé, Nerea; Szczypiorska, Magdalena; Font, Pilar; Martínez, Antonio; Tejedor, Diego; Artieda, Marta; Mulero, Juan; Buzoianu, Anca; Collantes-Estévez, Eduardo

2014-06-01

239

Ankylosing spondylitis, HLA-B27, and Klebsiella: a study of lymphocyte reactivity of anti-Klebsiella sera.  

PubMed Central

Twenty three anti-Klebsiella antisera were tested for their cytotoxic activity and four for their binding capacity for peripheral blood lymphocytes (PBL) from patients with HLA-B27 positive ankylosing spondylitis (AS+B27+) and from B27 positive (AS-B27+) and B27 negative (AS-B27-) healthy individuals. None of the antisera showed specific activity against PBL from any particular group. The antisera tested included two anti-Klebsiella K43 sera provided by an Australian group, who have reported them to be specifically cytotoxic for AS+B27+ PBL, four antisera raised against a Klebsiella K43 strain provided by this group, and an antiserum from another group, who have reported it as having increased binding capacity for AS+B27+ and AS-B27+ PBL compared with AS-B27- PBL. The results of other workers who have attempted to reproduce the results of either group are reviewed and the possible reasons for the repeated failure to confirm the reported findings are discussed.

Singh, B; Milton, J D; Woodrow, J C

1986-01-01

240

Adaptive Immunity in Ankylosing Spondylitis: Phenotype and Functional Alterations of T-Cells before and during Infliximab Therapy  

PubMed Central

Our aim was to assess the phenotype of T-cell subsets in patients with ankylosing spondylitis (AS), a chronic inflammatory rheumatic disease. In addition, we also tested short-term T-cell activation characteristics. Measurements were done in 13 AS patients before and during the intravenous therapy with anti-TNF agent infliximab (IFX). Flow cytometry was used to determine T-cell subsets in peripheral blood and their intracellular signaling during activation. The prevalence of Th2 and Th17 cells responsible for the regulation of adaptive immunity was higher in AS than in 9 healthy controls. Although IFX therapy improved patients' condition, immune phenotype did not normalize. Cytoplasmic and mitochondrial calcium responses of CD4+ and CD8+ cells to a specific activation were delayed, while NO generation was increased in AS. NO generation normalized sooner upon IFX than calcium response. These results suggest an abnormal immune phenotype with functional disturbances of CD4+ and CD8+ cells in AS.

Szalay, Balazs; Meszaros, Gergo; Cseh, Aron; Acs, Lilla; Deak, Magdolna; Kovacs, Laszlo; Vasarhelyi, Barna; Balog, Attila

2012-01-01

241

Low Body Mass Index and Blood Loss in Primary Total Hip Arthroplasty: Results from 236 Consecutive Ankylosing Spondylitis Patients  

PubMed Central

Objective. To evaluate the effect of low body mass index (BMI) on blood loss during primary total hip arthroplasty (THA) in ankylosing spondylitis (AS) patients. Methods. Two hundred seventy-seven consecutive AS patients who underwent primary THA were retrospectively studied. The patients were divided by BMI into an underweight group (BMI < 18.5?kg/m2) and a normal weight group (18.5?kg/m2 < BMI < 25?kg/m2). Demographics, perioperative laboratory values, intraoperative data, blood loss, transfusion rate, transfusion reactions, surgical complications, hospitalization cost, and length of stay (LOS) were collected and analyzed. Results. Of 277 AS patients, 236 were eligible for inclusion in the study. A total of 91 (39%) patients were underweight. The hidden blood loss, transfusion rate, transfusion reactions, and hospitalization cost in the underweight group were significantly higher than those in the normal weight group. Conclusions. For AS patients, BMI appears to be correlated with blood loss during primary THA. Compared with patients of normal weight, low BMI patients have the potential to suffer more postoperative hidden blood loss and to require a higher transfusion rate.

Zhao, Jinzhu; Li, Jia; Zheng, Wei; Liu, Denghui; Sun, Xiaofeng; Xu, Weidong

2014-01-01

242

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.

Chunco, Rosemary

2011-01-01

243

Genetic variations in the KIR gene family may contribute to susceptibility to ankylosing spondylitis: a meta-analysis.  

PubMed

The present meta-analysis of relevant case-control studies was conducted to investigate the possible relationships between genetic variations in the killer cell immunoglobulin-like receptor (KIR) gene clusters of the human KIR gene family and susceptibility to ankylosing spondylitis (AS). The following electronic databases were searched for relevant articles without language restrictions: the Web of Science, the Cochrane Library Database, PubMed, EMBASE, CINAHL, the Chinese Biomedical Database (CBM) and Chinese National Knowledge Infrastructure (CNKI) databases, covering all papers published until 2013. STATA statistical software was adopted in this meta-analysis as well. We also calculated the crude odds ratios (OR) and its 95 % confidence intervals (95 % CI). Seven case-control studies with 1,004 patients diagnosed with AS and 2,138 healthy cases were implicated in our meta-analysis, and 15 genes in the KIR gene family were also evaluated. The results of our meta-analysis show statistical significance between the genetic variations in the KIR2DL1, KIR2DS4, KIR2DS5 and KIR3DS1 genes and an increased susceptibility to AS (KIR2DL1: OR 7.82, 95 % CI 3.87-15.81, P< 0.001; KIR2DS4: OR 1.91, 95 % CI 1.16-3.13, P = 0.010; KIR2DS5: OR1.51, 95 % CI 1.14-2.01, P = 0.004; KIR3DS1: OR 1.58, 95 % CI 1.34-1.86, P< 0.001; respectively). However, we failed to found positive correlations between other genes and susceptibility to AS (all P >0.05). The current meta-analysis provides reliable evidence that genetic variations in the KIR gene family may contribute to susceptibility to AS, especially for the KIR2DL1, KIR2DS4, KIR2DS5 and KIR3DS1 genes. PMID:24880650

Zuo, Hai-Ning; Wang, Zhi-Long; Cui, Dao-Ran; Xin, Da-Jiang

2014-08-01

244

Health-related Quality of Life Assessment on 100 Tunisian Patients with Ankylosing Spondylitis using the SF-36 Survey  

PubMed Central

Objectives The main objective of the study was to examine the self reported health status in patients with ankylosing spondylitis (AS) compared with the general population and the secondary objective (in the AS group) was to study the association between health status, demographic parameters, and specific disease instruments in AS. Methods A cross sectional study of 100 AS patients recruited between 2006 and 2009 at the Department of Rheumatology. Health status was assessed by using the SF-36 health questionnaire in patients with AS. Demographic characteristics and disease-specific instruments were also examined by the questionnaire. A sample of 112 healthy individuals was also surveyed using the SF-36 health questionnaire. Results This study showed a great impairment in the quality of life of patients with AS involving all scales. All male patients with AS reported significantly impaired health-related quality of life on all items of the SF-36 compared with the general population whereas female patients reported poorer health on three items only, namely physical functioning, general health and bodily pain. Mental health was mostly affected than physical role. The physical role was significantly higher in patients with high education level than in patients with low education level (p=0.01). Physical functioning was better in employed patients. All scales of SF-36 were correlated with BASFI, BASDAI and BAS-G. Only physical functioning and general health were correlated with BASMI. Conclusion Impairment in the quality of life can be significant when suffering from AS, affecting mental health more than physical health. Among disease parameters, functional impairment, disease activity, mobility limitation, and spinal pain were the most associated factors resulting to the deterioration of quality of life.

Azzouz, Dhouha; Ghannouchi, Mohamed Mehdi; Haouel, Manel; Kochbati, Samir; Saadellaoui, Kaouthar; Ben Hmida, Abdelmajid; Zouari, Bechir; Kchir, Mohamed Montacer

2012-01-01

245

Increased Risk of Ischemic Stroke in Young Patients with Ankylosing Spondylitis: A Population-Based Longitudinal Follow-Up Study  

PubMed Central

Background Prospective data on the association between ischemic stroke and ankylosing spondylitis (AS) in the young are sparse. The purpose of this population-based, age- and sex-matched longitudinal follow-up study was to investigate the risk of developing ischemic stroke in young patients with AS. Methods A total of 4562 patients aged 18- to 45-year-old with at least two ambulatory visits in 2001 with a principal diagnosis of AS were enrolled in the AS group. The non-AS group consisted of 22810 age- and sex-matched, randomly sampled subjects without AS. The two-year ischemic stroke-free survival rate for each group were calculated using the Kaplan-Meier method. Cox proportional hazards regression analysis was used to estimate the hazard ratio of ischemic stroke after adjusting for demographic and clinical covariates. Results During follow-up, 21 patients in the AS group and 53 in the non-AS group developed ischemic stroke. The ischemic stroke-free survival rate over the 2 year follow-up was lower in the AS group than the non-AS group (p?=?0.0021). The crude hazard ratio of ischemic stroke for the AS group was 1.98 (95% CI, 1.20–3.29; p?=?0.0079) and the adjusted hazard ratio after controlling for demographic and comorbid medical disorders was 1.93 (95% CI, 1.16–3.20; p?=?0.0110). Conclusion Our study showed an increased risk of developing ischemic stroke in young patients with AS.

Lin, Chia-Wei; Huang, Ya-Ping; Chiu, Yueh-Hsia; Ho, Yu-Tsun; Pan, Shin-Liang

2014-01-01

246

Whole-blood Gene Expression Profiling in Ankylosing Spondylitis Shows Upregulation of Toll-like Receptor 4 and 5  

PubMed Central

Objective To identify differentially expressed genes in peripheral blood cells (PBC) of patients with ankylosing spondylitis (AS) relative to healthy controls and controls with systemic inflammation. Methods We investigated PBC samples of 16 patients with AS and 14 matched controls, in addition to systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) samples utilizing Illumina Human Ref-8 BeadChips. Candidate genes were confirmed using quantitative PCR. Subsequently, these genes were also validated in a separate sample of 27 patients with AS [before and after antitumor necrosis factor (anti-TNF) treatment] and 27 matched controls. Results We identified 83 differentially expressed transcripts between AS patients and controls. This gene list was filtered through the lists of differentially expressed transcripts in SLE and SSc, which resulted in identification of 52 uniquely dysregulated transcripts in AS. Many of the differentially expressed genes belonged to Toll-like receptor (TLR) and related pathways. TLR4 and TLR5 were the only dysregulated TLR subtypes among AS patients. We confirmed the overexpression of TLR4 and TLR5 in AS patients in comparison to controls (p = 0.012 and p = 0.006, respectively) and SLE (p = 0.002, p = 0.008) using quantitative PCR in the same sample. Similarly, TLR4 (p = 0.007) and TLR5 (p = 0.012) were significantly upregulated among the AS patients before anti-TNF treatment in the confirmatory sample. TLR4 (p = 0.002) and TLR5 (p = 0.025) decreased significantly after anti-TNF treatment. Conclusion PBC gene expression profiling in AS shows an upregulation of TLR4 and TLR5. This supports the importance of TLR subtypes in the pathogenesis of AS that are responsible for the immune response to Gram-negative bacteria.

ASSASSI, SHERVIN; REVEILLE, JOHN D.; ARNETT, FRANK C.; WEISMAN, MICHAEL H.; WARD, MICHAEL M.; AGARWAL, SANDEEP K.; GOURH, PRAVITT; BHULA, JITEN; SHARIF, ROOZBEH; SAMPAT, KEERAN; MAYES, MAUREEN D.; TAN, FILEMON K.

2010-01-01

247

A Functional Variant of PTPN22 Confers Risk for Vogt-Koyanagi-Harada Syndrome but Not for Ankylosing Spondylitis  

PubMed Central

Background Protein tyrosine phosphatase non-receptor 22 (PTPN22) is a key negative regulator of T lymphocytes and has emerged as an important candidate susceptibility factor for a number of immune-related diseases. This study aimed to examine the predisposition of PTPN22 SNPs to Vogt-Koyanagi-Harada (VKH) syndrome and acute anterior uveitis (AAU) associated with ankylosing spondylitis (AS). Methods A total of 1005 VKH syndrome, 302 AAU+AS+ patients and 2010 normal controls among the Chinese Han population were enrolled in the study. Genotyping, PTPN22 expression, cell proliferation, cytokine production and cell activation were examined by PCR-RFLP, Real-time PCR, CCK8, ELISA and Flow cytometry. Results The results showed significantly increased frequencies of the rs2488457 CC genotype and C allele but a decreased frequency of the GG genotype in VKH syndrome patients (PBonferroni correction (Pc)?=?3.47×10?7, OR?=?1.54; Pc?=?3.83×10?8, OR?=?1.40; Pc?=?6.35×10?4, OR?=?0.62; respectively). No significant association of the tested SNPs with AAU+AS+ patients was observed. Functional studies showed a decreased PTPN22 expression, impaired cell proliferation and lower production of IL-10 in rs2488457 CC cases compared to GG cases (Pc?=?0.009, Pc?=?0.015 and Pc?=?0.048 respectively). No significant association was observed concerning T cell activation and rs2488457 genotype. Conclusions The study showed that a functional variant of PTPN22 confers risk for VKH syndrome but not for AAU+AS+ in a Chinese Han population, which may be due to a modulation of the PTPN22 expression, PBMC proliferation and IL-10 production.

Hou, Shengping; Du, Liping; Yu, Hongsong; Cao, Qingfeng; Zhou, Yan; Liao, Dan; Kijlstra, Aize; Yang, Peizeng

2014-01-01

248

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.??

Van Royen, B J; De Gast, A

1999-01-01

249

Association of HLA-B27 and ERAP1 with ankylosing spondylitis susceptibility in Beijing Han Chinese.  

PubMed

This study investigated the genetic polymorphisms of HLA-B27, together with polymorphisms on endoplasmic reticulum aminopeptidase 1 (ERAP1), and susceptibility for ankylosing spondylitis (AS) in the Beijing Han population. A case-control study was carried out for 602 AS patient samples and 619 matched controls of Han Chinese. HLA-B27 genotyping was performed by polymerase chain reaction-sequence specific primers (PCR-SSP), and four ERAP1 SNPs (rs27037, rs27980, rs27582, and rs27434) were selected and genotyped on the Sequenom iPlex platform (Sequenom, San Diego, CA). Association analysis was performed using the likelihood ratio ?(2) test. This study identified four HLA-B27 alleles in Beijing Han AS patients, B*27:02, B*27:04, B*27:05, and B*27:07, of which B*27:05 was the most significant geographical different subtype among AS patients in Chinese. Our results confirmed that HLA-B27 was strongly associated with AS (P=1.9 × 10(-150) ), and the most strongly associated alleles were B*27:04, B*27:05, and B*27:02. Our study also confirmed a weak association between ERAP1 (rs27434) and AS. We also observed that for HLA-B*27:02 and HLA-B*27:04 positive AS patients, rs27434 and rs27582 were associated with AS. In contrast, for HLA-B27-negative and HLA-B*27:05-positive AS patients, this association was not observed. This is the first study to show that both B27 and ERAP1 are AS genetic susceptibility genes in Beijing Han. Interactions between ERAP1 and HLA-B*27:02 and B*27:04 may play an important role in the AS pathogenesis. PMID:24666027

Zhang, Z; Dai, D; Yu, K; Yuan, F; Jin, J; Ding, L; Hao, Y; Liang, F; Liu, N; Zhao, X; Long, J; Xi, Y; Sun, Y-Y

2014-05-01

250

Daily physical activity in ankylosing spondylitis: validity and reliability of the IPAQ and SQUASH and the relation with clinical assessments  

PubMed Central

Introduction The aim of this study was to investigate the construct validity and test-retest reliability of the International Physical Activity Questionnaire (IPAQ; long form) and the Short QUestionnaire to Assess Health-enhancing physical activity (SQUASH) and to investigate the relation between daily physical activity and clinical assessments in patients with ankylosing spondylitis (AS). Methods For validity, the self-report questionnaires IPAQ and SQUASH were compared with daily physical activity assessed with the ActiGraph accelerometer during 7 consecutive days in 63 AS outpatients. For reliability, the IPAQ and SQUASH were administered twice approximately 1 week apart in 52 AS outpatients. In all 115 patients, clinical assessments were performed at the outpatient clinic. Results IPAQ and SQUASH total scores correlated significantly with accelerometer outcome: ? = 0.38 and r = 0.35, respectively. Intraclass correlation coefficients between first and second assessments of the IPAQ and SQUASH were 0.83 and 0.89, respectively. Bland-Altman analyses showed no systemic bias, but in particular for the IPAQ the 95% limits of agreement were wide. Daily physical activity assessed by accelerometer, IPAQ, and SQUASH correlated significantly with disease activity, physical activity, and quality of life. A relation with spinal mobility was found only for the accelerometer and SQUASH. The direction of these correlations indicates that higher daily physical activity is related to lower disease activity and better physical function, spinal mobility and quality of life. Conclusions Both physical activity questionnaires showed modest construct validity. The SQUASH showed good test-retest reliability, superior to the IPAQ. These results indicate that the SQUASH is more suitable than the IPAQ to assess daily physical activity in AS population studies. However, it is desirable to add questions on AS-specific physical activity. Further studies are needed to investigate the causality of the relation between daily physical activity and clinical assessments.

2013-01-01

251

HLA alleles and HLA-B27 haplotypes associated with susceptibility and severity of ankylosing spondylitis in a Portuguese population.  

PubMed

Human leukocyte antigen (HLA)-B27 is the mostly known major histocompatibility complex (MHC) gene associated with ankylosing spondylitis (AS). Nonetheless, there is substantial evidence that other MHC genes appear to be associated with the disease, although it has not yet been established whether these associations are driven by direct associations or by linkage disequilibrium (LD) mechanisms. We aimed to investigate the contributions of HLA class I and II alleles and B27-haplotypes for AS in a case-control study. A total of 188 HLA-B27 AS cases and 189 HLA-B27 healthy controls were selected and typed for HLA class I and II by the Luminex polymerase chain reaction-sequence specific oligonucleotide probe (PCR-SSOP) method. Allelic and haplotypic distributions were estimated by maximum likelihood method using Arlequin v3.11 and statistical analysis were performed by Stata10.1. No associations were found between non-HLA-B27 loci and AS susceptibility, but several associations were observed for phenotypic features of the disease. DRB1*08 was identified as a risk factor for uveitis and DQB1*04 seems to provide protection for AS severity (functional, metrological and radiological indexes). A*02/B27/C*02/DRB1*01/DQB1*05 [P<0.0001; odds ratio (OR)?=?39.06; 95% confidence interval (CI) (2.34-651)] is the only haplotype that seems to confer susceptibility to AS. Moreover, the haplotype A*02/B27/C*01/DRB1*08/DQB1*04 seems to provide protection for disease functional and radiological repercussions. Our findings are compatible with the hypothesis that other genes within the HLA region besides HLA-B27 might play some role in AS susceptibility and severity. PMID:24498993

Pimentel-Santos, F M; Matos, M; Ligeiro, D; Mourão, A F; Ribeiro, C; Costa, J; Santos, H; Barcelos, A; Pinto, P; Cruz, M; Sousa, E; Santos, R A; Fonseca, J E; Trindade, H; Guedes-Pinto, H; Branco, J C

2013-12-01

252

Spectrum of ankylosing spondylitis in Portugal. Development of BASDAI, BASFI, BASMI and mSASSS reference centile charts.  

PubMed

The availability of population-specific normative data regarding disease severity measures is essential for patient assessment. The goals of the current study were to characterize the pattern of ankylosing spondylitis (AS) in Portuguese patients and to develop reference centile charts for BASDAI, BASFI, BASMI and mSASSS, the most widely used assessment tools in AS. AS cases were recruited from hospital outpatient clinics, with AS defined according to the modified New York criteria. Demographic and clinical data were recorded. All radiographs were evaluated by two independent experienced readers. Centile charts for BASDAI, BASFI, BASMI and mSASSS were constructed for both genders, using generalized linear models and regression models with duration of disease as independent variable. A total of 369 patients (62.3% male, mean?±?(SD) age 45.4?±?13.2 years, mean?±?(SD) disease duration 11.4?±?10.5 years, 70.7% B27-positive) were included. Family history of AS in a first-degree relative was reported in 17.6% of the cases. Regarding clinical disease pattern, at the time of assessment 42.3% had axial disease, 2.4% peripheral disease, 40.9% mixed disease and 7.1% isolated enthesopatic disease. Anterior uveitis (33.6%) was the most common extra-articular manifestation. The centile charts suggest that females reported greater disease activity and more functional impairment than males but had lower BASMI and mSASSS scores. Data collected through this study provided a demographic and clinical profile of patients with AS in Portugal. The development of centile charts constitutes a useful tool to assess the change of disease pattern over time and in response to therapeutic interventions. PMID:22009195

Pimentel-Santos, Fernando M; Mourão, Ana Filipa; Ribeiro, Célia; Costa, José; Santos, Helena; Barcelos, Anabela; Pinto, Patricia; Godinho, Fátima; Cruz, Margarida; Vieira-Sousa, Elsa; Santos, Rui André; Rabiais, Sara; Félix, Jorge; Fonseca, João Eurico; Guedes-Pinto, Henrique; Brown, Matthew A; Branco, Jaime C

2012-03-01

253

Are clinical measures influenced by various ethnic origins in Iranian patients with ankylosing spondylitis?A pilot study  

PubMed Central

Background: Ankylosing spondylitis (AS) may manifest with heterogeneous patterns according to ethnic origins. The purpose of this study was to describe the influence of various Iranian ethnic origins on clinical measures in patients with AS. Methods: 0ne hundred sixty-three AS patients diagnosed by modified New York 1984 criteria were enrolled consecutively. The patients were classified into Fars, Turk, Kord, Lor and other ethnic origins. Several clinical measures were described and compared between the ethnic origins. Results: The highest and the lowest finger to floor distance was observed for Fars ethnicity (20.4±14.8) and other ethnicities (5.9±8.1), respectively (P=0.04). The frequency of severe decrease in cervical slope was significantly different between various ethnicities (P=0.025). The most and the least frequency of severe decrease in cervical slope was observed in Fars patients (61.3%) and other ethnicities (20%), respectively. The frequency of severe thoracic kyphosis was significantly dissimilar between various ethnicities (P=0.006). The most and the least frequency of severe increase in thoracic kyphosis was observed in Fars (68.8%) and Lor patients (25%), respectively. A significant relationship was seen only between other ethnicities and finger to floor distance, lateral lumbar flexion, chest expansion and BASDAI (P<0.05). Conclusion: Clinical expression variations in AS disease might be influenced by various Iranian ethnic origins. A larger sample size with other Iranian ethnicities (Baluch, Arab, etc) is required to clear the definite relationship between Iranian ethnicities and clinical expression.

Fallahi, Sasan; Jamshidi, Ahmad Reza; Mahmoudi, Mahdi; Qorbani, Mostafa

2014-01-01

254

OMERACT magnetic resonance imaging initiative on structural and inflammatory lesions in ankylosing spondylitis--report of a special interest group at OMERACT 10 on sacroiliac joint and spine lesions  

Microsoft Academic Search

The ASAS\\/OMERACT MRI group recently described and defined magnetic resonance imaging (MRI) findings in sacroiliac joints (SIJ) that are essential for the diagnosis of sacroiliitis in patients with axial spondyloarthritis, including ankylosing spondylitis (AS). At the Outcome Measures in Rheumatology Clinical Trials (OMERACT) 2010 meeting, a special interest group (SIG) was formed to design a research agenda for the definition

X. Baraliakos; Heijde van der D; J. Braun; R. B. M. Landewé

2011-01-01

255

Genetic Polymorphisms of Stromal Interaction Molecule 1 Associated with the Erythrocyte Sedimentation Rate and C-Reactive Protein in HLA-B27 Positive Ankylosing Spondylitis Patients  

PubMed Central

Ankylosing spondylitis (AS) is a chronic inflammation of the sacroiliac joints, spine and peripheral joints. The development of ankylosing spondylitis is still unclear. Genetics factors such as human leukocyte antigen HLA-B27 and ERAP1 have been widely reported to associate to AS susceptibility. In this study, we enrolled 361 AS patients and selected four tagging single nucleotides polymorphisms (tSNPs) at STIM1 gene. The correlation between STIM1 genetic polymorphisms and AS activity index (BASDAI, BASFI, BAS-G) as well as laboratory parameters of inflammation (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)) were tested. Our results indicated that HLA-B27 positive AS patients who are carrying the minor allele homozygous G/G genotype of SNP rs3750996 significantly associated with a higher level of ESR in serum. Furthermore, rs3750996/rs3750994 pairwise allele analysis indicated that G-C haplotypes also significantly correlated with higher level of ESR as well as CRP. These findings provide a better understanding of STIM1 genetic contribution to the pathogenesis of AS.

Wei, James Cheng-Chung; Hung, Kuo-Sheng; Hsu, Yu-Wen; Wong, Ruey-Hong; Huang, Chun-Huang; Jan, Ming-Shiou; Wu, Shyh-Jong; Juan, Yung-Shun; Chang, Wei-Chiao

2012-01-01

256

[Can thermal therapy of ankylosing spondylitis induce an activation of the disease?].  

PubMed

A randomized, open, controlled study was carried out in eight patients with spondylitis ankylosans, in a cross-over procedure including total body cryotherapy and whole spine paraffin mud packs. The effect of both therapies on clinical status and different laboratory data was investigated. No clinical changes were seen after either therapy; in contrast, in answering the spine function questionnaire patients reported an improvement after cryotherapy and a worsening after thermotherapy, but because of the small number of patients no positive conclusion was possible. The acute phase proteins (alpha-1-AGP, alpha-1-ACT, alpha-2-haptoglobin and alpha-2-coeruloplasmin) did not show any changes, only CRP increased after thermotherapy and declined after cryotherapy. Interesting changes were seen in the glycosylation profile of alpha-1-AGP: after thermotherapy an increase of bi-antennary oligosaccharides occurred, observed as appearance of a third peak in the affinity immunoelectrophoresis with con A and an increase of reactivity-coefficient of alpha-1 and glycoprotein which was also seen in the exacerbation of AS. This shows, that an activation of the inflammatory process may be possible by thermotherapy (perhaps because of an amplification of Il-6 production), but not by cryotherapy. Similar studies should be conducted in larger numbers of patients. PMID:1380197

Samborski, W; Sobieska, M; Mackiewicz, T; Stratz, T; Mennet, M; Müller, W

1992-01-01

257

A modified method for intubation of a patient with ankylosing spondylitis using intubating laryngeal mask airway (LMA-Fastrach)--a case report.  

PubMed

We present an instance of successful use of an intubating laryngeal mask airway (LMA-Fastrach) and a Cook airway exchanger (CAE) for ventilation and intubation in a patient with severe ankylosing spondilitis (AS) receiving total hip arthroplasty. This measure may serve as an effective alternative for airway management in patients with difficult airway. A 61-year-old male was scheduled for right total hip arthroplasty because of degenerative osteoarthritis. He had been suffering from extensive ankylosing spondylitis, with the cervical spine markedly fixed in anterior flexion. Besides he could not open his mouth widely (35 mm when fully open) also because of ankylosis of jaw. Although we advised an awake fiberoptic tracheal intubation for anesthesia but he refused owing to a previous painful experience. After induction of anesthesia with glycopyrrolate, fentanyl, thiamylal sodium and succinylcholine, we inserted a # 5 Fastrach ILMA for primary airway maintenance. Then through the lumen of the ILMA we introduced the CAE as a guide for endotracheal tube (ETT) intubation. After applying the RAPI-FIT adapter to the CAE, we connected it to the capnography monitor for the confirmation of airway. We finally inserted an endotracheal tube into the trachea using the CAE as a guide. The whole procedure was uneventful and smooth. In sum, the modified Fastrach intubation method may facilitate tracheal intubation in patients with severe ankylosing spondilitis. It may be an alternative way for successful airway management in patients with difficult airway. PMID:11840584

Hsin, S T; Chen, C H; Juan, C H; Tseng, K W; Oh, C H; Tsou, M Y; Tsai, S K

2001-12-01

258

Combined effects of ankylosing spondylitis-associated ERAP1 polymorphisms outside the catalytic and peptide-binding sites on the processing of natural HLA-B27 ligands.  

PubMed

ERAP1 polymorphism involving residues 528 and 575/725 is associated with ankylosing spondylitis among HLA-B27-positive individuals. We used four recombinant variants to address the combined effects of the K528R and D575N polymorphism on the processing of HLA-B27 ligands. The hydrolysis of a fluorogenic substrate, Arg-528/Asp-575 < Lys-528/Asp-575 < Arg-528/Asn-575 < Lys-528/Asn-575, indicated that the relative activity of variants carrying Arg-528 or Lys-528 depends on residue 575. Asp-575 conferred lower activity than Asn-575, but the difference depended on residue 528. The same hierarchy was observed with synthetic precursors of HLA-B27 ligands, but the effects were peptide-dependent. Sometimes the epitope yields were variant-specific at all times. For other peptides, concomitant generation and destruction led to similar epitope amounts with all the variants at long, but not at short, digestion times. The generation/destruction balance of two related HLA-B27 ligands was analyzed in vitro and in live cells. Their relative yields at long digestion times were comparable with those from HLA-B27-positive cells, suggesting that ERAP1 was a major determinant of the abundance of these peptides in vivo. The hydrolysis of fluorogenic and peptide substrates by an HLA-B27 ligand or a shorter peptide, respectively, was increasingly inhibited as a function of ERAP1 activity, indicating that residues 528 and 575 affect substrate inhibition of ERAP1 trimming. The significant and complex effects of co-occurring ERAP1 polymorphisms on multiple HLA-B27 ligands, and their potential to alter the immunological and pathogenetic features of HLA-B27 as a function of the ERAP1 context, explain the epistatic association of both molecules in ankylosing spondylitis. PMID:24352655

Martín-Esteban, Adrian; Gómez-Molina, Patricia; Sanz-Bravo, Alejandro; López de Castro, José A

2014-02-14

259

Responsiveness of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and clinical and MRI measures of disease activity in a 1-year follow-up study of patients with axial spondyloarthritis treated with tumour necrosis factor ? inhibitors  

Microsoft Academic Search

ObjectivesTo investigate construct validity and responsiveness of the novel ankylosing spondylitis (AS) disease activity score (ASDAS) in patients with spondyloarthritis (SpA).MethodsIn a 46-week prospective longitudinal multicentre study of 60 patients with SpA (80% men, median age 40 years (range 21–62)) treated with tumour necrosis factor ? (TNF?) inhibitors (infliximab, n=41; etanercept, n=13; adalimumab, n=6), the responsiveness of ASDAS, conventional clinical

Susanne Juhl Pedersen; Inge Juul Sørensen; Kay-Geert A Hermann; Ole Rintek Madsen; Niels Tvede; Michael Sejer Hansen; Gorm Thamsborg; Lis Smedegaard Andersen; Ole Majgaard; Anne Gitte Loft; Jon Erlendsson; Karsten Asmussen; Julia S Johansen; Anne Grethe Jurik; Jakob Møller; Maria Hasselquist; Dorrit Mikkelsen; Thomas Skjødt; Annette Hansen; Mikkel Østergaard

2010-01-01

260

Circulating hyaluronate in rheumatoid arthritis: relationship to inflammatory activity and the effect of corticosteroid therapy  

Microsoft Academic Search

The mean serum hyaluronate concentration in a group of patients with rheumatoid arthritis (n = 37) was 232 +\\/- 182 (SD) microgram\\/l and significantly greater (p less than 0.001) than that of age and sex matched healthy controls (mean level 42 +\\/- 25 micrograms\\/l) as well as that of patients with ankylosing spondylitis (mean level 58 +\\/- 33 micrograms\\/l). In

A Engström-Laurent; R Hällgren

1985-01-01

261

Symptoms of Ankylosing Spondylitis  

MedlinePLUS

... may only be felt on one side, or alternate sides. The pain is usually dull and diffuse, ... inflammation caused by AS. The body must expend energy to deal with the inflammation, thus causing fatigue. ...

262

GlideScope video laryngoscopy use tracheal intubation in patients with ankylosing spondylitis: a series of four cases and literature review.  

PubMed

Airway management in patients with ankylosing spondylitis (AS) is a challenging problem for anesthesiologists. The GlideScope video laryngoscope (GVL) is designed to assist tracheal intubation for patients with a difficult airway. The aim of the study was to report the successful intubation by GVL of four AS patients, and to discuss the use of GVL for tracheal intubation in patients with AS by performing a review of the literature. Four patients with chronic, severe AS were evaluated preoperatively; all had features associated with a difficult direct laryngoscopy. We performed the necessary preparations for difficult airway and intubation. Patients were kept in supine position, with their head and neck supported on pillows. Following sufficient preoxygenation, patients received i.v. remifentanil at 1 ?g kg(-1), propofol at 2 mg kg(-1), and succinylcholine at 1 mg kg(-1). GVL intubation was provided after full muscle relaxation. GVL is reasonable alternative to awake fiberoptic bronchoscopy or any other device, as it appears that less training and skill is involved in the actual intubation process. Adequate laryngeal exposure was obtained in all patients were successfully intubated in the first attempt. As with any challenging airway management, it is essential to have a rescue strategy. We believe that GVL can be a good alternative for oral endotracheal intubation in patients with AS. This series is very small and the reader should be very cautious about drawing broad conclusions regarding the GVL and patients with AS. PMID:24046099

Saricicek, Vahap; Mizrak, Ayse; Gul, Rauf; Goksu, Sitki; Cesur, Mehmet

2014-04-01

263

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.

Lopez-Mejias, Raquel; Rueda-Gotor, Javier; Miranda-Filloy, Jose A.; Ubilla, Begona; Carnero-Lopez, Beatriz; Palmou-Fontana, Natalia; Gomez-Acebo, Ines; Blanco, Ricardo; Pina, Trinitario; Ochoa, Rodrigo; Gonzalez-Juanatey, Carlos; Gonzalez-Gay, Miguel A.

2014-01-01

264

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

265

Double-blind, placebo-controlled randomized trial with adalimumab for treatment of juvenile onset ankylosing spondylitis (JoAS): significant short term improvement  

PubMed Central

Introduction While adalimumab is licensed for ankylosing spondylitis (AS), open uncontrolled studies suggest therapeutic efficacy of TNF-inhibitors in juvenile onset AS (JoAS). Methods A total of 32 patients aged 12 to 17 years with severe, active and refractory JoAS were enrolled in a multicenter, randomized, double-blind, placebo-controlled parallel study of 12 weeks, followed by open-label adalimumab until week 24 for all patients. ASAS40 was used as the primary, and ASAS20, PedACR and single items were used as the secondary outcome measures for the intention to treat population. Results A total of 17 patients were randomized to receive adalimumab 40 mg/2 weeks and 15 patients received placebo. Two patients (one of each group) discontinued prematurely due to insufficient efficacy and were labeled as non-responders. In the double-blind part, more patients on adalimumab achieved an ASAS40 at week 4 (41%), week 8 (53%) and week 12 (53%) than on placebo (20%, 33%, 33%), while differences at week 8 only reached borderline significance (P = 0.05). Also, at 4, 8 and 12 weeks ASAS20/PedACR30/70 response rates were higher in the adalimumab group (53%/53%/29%; 59%/76%/41%; 53%/65%/53%) compared to placebo (27%/27%/7%; 27%/33%/13%; 33%/40%/27%). In the adalimumab group a significant decrease of all disease activity parameters was noted at week 12 and was even more pronounced at week 24. At week 12 the Bath Ankylosing Spondylitis Disease activity spinal inflammation score decreased by 65% (P <0.001), the back pain score decreased by 50% (P <0.005), the Bath AS Functional Index (BASFI) score decreased by 47% (P <0.02), while the Childhood Health Assessment Questionnaire-Disability Index (CHAQ-DI) score improved by 65% (P <0.005). ANCOVA analysis demonstrated superiority of adalimumab over placebo for the physician global assessment of disease activity, parents' global assessment of subject's overall well-being, active joint count (all P <0.05) and erythrocyte sedimentation rate (ESR) (P <0.01). During the 12-week controlled phase, 29 AEs occurred in 10 patients on placebo compared to 27 AEs in 11 patients on adalimumab. Injection site reactions were the most common adverse events. There were 17 various infections occurring in the double-blind phase, 8 on placebo, 9 on adalimumab and a further 19 in the open label period. Conclusions Adalimumab was well tolerated and highly effective in a double-blind randomized trial in patients with JoAS. Treatment effects rapidly occurred and persisted for at least 24 weeks of treatment. Trial registration EudraCT 2007-003358-27.

2012-01-01

266

Survival of disease-modifying antirheumatic drugs used as the first antirheumatic medication in the treatment of ankylosing spondylitis in Finland. A nationwide population-based register study.  

PubMed

The tight national drug reimbursement regulations in the treatment of ankylosing spondylitis (AS) in Finland lead to the practice that at least one traditional disease-modifying antirheumatic drug (DMARD), if not contraindicated, has been tried and has failed before a patient can be eligible for reimbursement of anti-tumour necrosis factor (TNF) treatment. The aim of the present study is to evaluate drug survival of the firstly prescribed DMARDs in patients with AS. All AS patients from January 1, 2000 to December 31, 2007 were collected from the nationwide drug reimbursement registry maintained by the Social Insurance Institution (SII). Data on antirheumatic medication came from the prescription registry of SII. A total of 2,890 AS patients (60 % males) were identified. Sulfasalazine (SSA) monotherapy was the most common first antirheumatic treatment (2,319 patients, 87 %), followed by methotrexate (MTX) monotherapy (230 patients, 9 %) and by hydroxychloroquine monotherapy (77 patients, 3 %). A combination of two or more DMARDs was used by 44 patients (2 %). Only seven patients (0.3 %) had biological (etanercept or adalimumab) started as the first antirheumatic drug. Median survival time of SSA monotherapy was 4.5 years (95 % CI 4.2 to 4.8) and that of MTX was 1.9 years (95 % CI 1.5 to 2.1). SSA is almost the standard as the first antirheumatic treatment of AS in Finland. Although the clinical efficiency of SSA was not evaluable in the present study, these data suggest that the use of SSA can at least postpone the need and start of TNF inhibitors with marked economic consequences. PMID:24907035

Relas, Heikki; Kautiainen, Hannu; Puolakka, Kari; Virta, Lauri J; Leirisalo-Repo, Marjatta

2014-08-01

267

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.

2011-01-01

268

Endoplasmic reticulum aminopeptidase-1 alleles associated with increased risk of Ankylosing Spondylitis reduce HLA-B27 mediated presentation of multiple antigens  

PubMed Central

Ankylosing spondylitis (AS) is a chronic systemic arthritic disease that leads to significant disability and loss of quality of life in the ~0.5% of the worldwide human population it affects. There is currently no cure for AS and mechanisms underlying its pathogenesis remain unclear. AS is highly genetic, with over 70% of the genetic risk being associated with the presence of HLA-B27 and endoplasmic reticulum aminopeptidase-1 (ERAP1) alleles. Furthermore, gene-gene interactions between HLA-B27 and ERAP1 AS risk alleles have recently been confirmed. Here, we demonstrate that various ERAP1 alleles can differentially mediate surface expression of antigens presented by HLA-B27 on human cells. Specifically, for all peptides tested, we found that an ERAP1 variant containing high AS risk SNPs reduced the amount of the peptide presented by HLA-B27, relative to low AS risk ERAP1 variants. These results were further validated using peptide catalysis assays in vitro, suggesting that high AS risk alleles have an enhanced catalytic activity that more rapidly destroys many HLA-B27-destined peptides, a result that correlated with decreased HLA-B27 presentation of the same peptides. These findings suggest that one mechanism underlying AS pathogenesis may involve an altered ability for AS patients harboring both HLA-B27 and high AS risk ERAP1 alleles to correctly display a variety of peptides to the adaptive arm of the immune system, potentially exposing such individuals to higher AS risk due to abnormal display of pathogen or self derived peptides by the adaptive immune system.

Seregin, Sergey S.; Rastall, David P.W.; Evnouchidou, Irini; Aylsworth, Charles F.; Quiroga, Dionisia; Kamal, Ram P.; Godbehere-Roosa, Sarah; Blum, Christopher F.; York, Ian A.; Stratikos, Efstratios; Amalfitano, Andrea

2014-01-01

269

Spondylitis: Frequently Asked Questions  

MedlinePLUS

... the primary disease in the spondylitis family of diseases and is a form of chronic arthritis that primarily affects the spine, although other joints can become involved. Occurring primarily in young adults, (age of onset ...

270

ERAP1 genetic variations associated with HLA-B27 interaction and disease severity of syndesmophytes formation in Taiwanese ankylosing spondylitis  

PubMed Central

Introduction Ankylosing spondylitis (AS) is a familial, heritable disease specified by syndesmophyte formation leading to an ankylosed spine. Endoplasmic reticulum aminopeptidase 1 (ERAP1) genetic variations have been widely proved to be associated with AS in several ethnic populations. The aim of this study was to investigate whether ERAP1 single nucleotide polymorphisms (SNPs) are associated with AS susceptibility and disease severity in Taiwanese. Methods Four ERAP1 SNPs (rs27037, rs27980, rs27044 and rs30187) were genotyped in 797 Taiwanese AS patients and 1,150 healthy controls. Distributions of genotype and alleles were compared between AS patients and healthy controls, and among AS patients stratified by clinical parameters. Results The SNP rs27037T allele appeared to be a risk factor for AS susceptibility (P = 5.5 × 10-5, OR 1.30, 95% CI: 1.15 to 1.48; GT+TT vs. GG P = 9.3 × 10-5, OR 1.49, 95% CI: 1.22 to 1.82). In addition, the coding SNP (cSNP) rs27044G allele (P = 1.5 × 10-4, OR 1.28, 95% CI: 1.13 to 1.46; CG+GG vs. CC, P = 1.7 × 10-3, OR 1.44, 95% CI: 1.15 to 1.81) and the cSNP rs30187T allele (P = 1.7 × 10-3, OR 1.23, 95% CI: 1.08 to 1.40; CT+TT vs. CC P = 6.1 × 10-3, OR 1.38, 95% CI: 1.10 to 1.74) were predisposing factors for AS. Notably, the rs27044G allele carriers (CG+GG vs. CC, P = 0.015, OR 1.59, 95% CI: 1.33 to 2.30) and rs30187T allele carriers (CT+TT vs. CC, P = 0.011, OR 1.63, 95% CI: 1.12 to 2.38) were susceptible to syndesmophyte formation in AS patients. Furthermore, two cSNPs (rs27044 and rs30187) strongly associated with HLA-B27 positivity in AS patients. Finally, the ERAP1 SNP haplotype TCG (rs27037T/rs27980C/rs27044G) is a major risk factor for AS (adjusted P <0.00001, OR 1.38, 95% CI: 1.12 to 1.58) in Taiwanese. Conclusions This study provides the first evidence of ERAP1 SNPs involving syndesmophyte formation. The interactions between ERAP1 SNPs and HLA-B27 play critical roles in pMHC I pathway processing contributing to the pathogenesis of AS in multiple populations.

2012-01-01

271

Higher Bone Turnover Is Related to Spinal Radiographic Damage and Low Bone Mineral Density in Ankylosing Spondylitis Patients with Active Disease: A Cross-Sectional Analysis  

PubMed Central

Introduction Ankylosing spondylitis (AS) is characterized by excessive bone formation and bone loss. Our aim was to investigate the association of bone turnover markers (BTM) with spinal radiographic damage and bone mineral density (BMD) in AS patients with active disease. Methods 201 consecutive AS outpatients of the Groningen Leeuwarden AS (GLAS) cohort were included. Serum markers of bone resorption (C-telopeptides of type-I collagen, sCTX) and bone formation (procollagen type-I N-terminal peptide, PINP; bone-specific alkaline phosphatase, BALP) were measured. Z-scores were used to correct for the normal influence that age and gender have on bone turnover. Radiographs were scored by two independent readers according to modified Stoke AS Spinal Score (mSASSS). The presence of complete bridging (ankylosis of at least two vertebrae) was considered as measure of more advanced radiographic damage. Low BMD was defined as lumbar spine and/or hip BMD Z-score ? ?1. Results Of the 151 patients with complete data, 52 (34%) had ?1 complete bridge, 49 (33%) had ?1 syndesmophyte (non-bridging), and 50 (33%) had no syndesmophytes. 66 (44%) had low BMD. Patients with bridging had significantly higher sCTX and PINP Z-scores than patients without bridging (0.43 vs. ?0.55 and 0.55 vs. 0.04, respectively). Patients with low BMD had significantly higher sCTX Z-score than patients with normal BMD (?0.08 vs. ?0.61). After correcting for gender, symptom duration, and CRP, sCTX Z-score remained significantly related to the presence of low BMD alone (OR: 1.60), bridging alone (OR: 1.82), and bridging in combination with low BMD (OR: 2.26). Conclusions This cross-sectional study in AS patients with active and relatively long-standing disease demonstrated that higher serum levels of sCTX, and to a lesser extent PINP, are associated with the presence of complete bridging. sCTX was also associated with low BMD. Longitudinal studies are needed to confirm that serum levels of sCTX can serve as objective marker for bone-related outcome in AS.

Efde, Monique; Bos, Reinhard; Leijsma, Martha K.; Bootsma, Hendrika; Veeger, Nic J. G. M.; Brouwer, Elisabeth; van der Veer, Eveline

2014-01-01

272

Contribution of KIR3DL1/3DS1 to ankylosing spondylitis in human leukocyte antigen-B27 Caucasian populations  

PubMed Central

Killer cell immunoglobulin-like receptors (KIRs) and human leukocyte antigen (HLA) loci are both highly polymorphic, and some HLA class I molecules bind and trigger cell-surface receptors specified by KIR genes. We examined whether the combination of KIR3DS1/3DL1 genes in concert with HLA-B27 genotypes is associated with susceptibility to ankylosing spondylitis (AS). Two HLA-B27-positive Caucasian populations were selected, one from Spain (71 patients and 105 controls) and another from the Azores (Portugal) (55 patients and 75 controls). All were typed for HLA-B and KIR (3DS1 and 3DL1) genes. Our results show that in addition to B27, the allele 3DS1 is associated with AS compared with B27 controls (p < 0.0001 and p < 0.003 in the Spanish population and Azoreans, respectively). We also observed that the association of KIR3DS1 to AS was found in combination with HLA-B alleles carrying Bw4-I80 in trans position in the Spanish population (30.9% in AS versus 15.2% in B27 controls, p = 0.02, odds ratio (OR) = 2.49) and in Azoreans (27.2% in AS versus 8.7% in B27 controls, p = 0.01, OR = 4.4 in Azoreans). On the other hand, 3DL1 was decreased in patients compared with B27 controls (p < 0.0001 in the Spanish population and p < 0.003 in Azoreans). The presence of this allele in combination with Bw4-I80 had a protective effect against the development of AS in the Spanish population (19.7% in AS, 35.2% in B27 controls; p = 0.03, OR = 0.45). The presence of KIR3DS1 or KIR3DL1 in combination with HLA-B*27s/HLA-B Bw4-I80 genotypes may modulate the development of AS. The susceptibility to AS could be determined by the overall balance of activating and inhibitory composite KIR-HLA genotypes.

Lopez-Larrea, Carlos; Blanco-Gelaz, Miguel Angel; Torre-Alonso, Juan Carlos; Armas, Jacome Bruges; Suarez-Alvarez, Beatriz; Pruneda, Laura; Couto, Ana Rita; Gonzalez, Segundo; Lopez-Vazquez, Antonio; Martinez-Borra, Jesus

2006-01-01

273

Differences in HLA-B27 positive and negative patients with ankylosing spondylitis: study of clinical disease activity and concentrations of serum IgA, C reactive protein, and haptoglobin.  

PubMed Central

To find out whether disease activity and B27 status were associated with serum concentrations of IgA, C reactive protein (CRP), and haptoglobin in ankylosing spondylitis (AS) multivariate analysis of variance was used to study 101 patients with AS whose disease was clinically classified as active or inactive, and who were HLA-B27 typed. It was found that B27 and disease activity do interact significantly to affect the serum concentrations of IgA, CRP, and haptoglobin. When the 77 B27+ patients were examined, however, it was found that disease activity was significantly associated with serum concentrations IgA. In contrast, in the 24 B27- patients concentrations of serum IgA were significantly associated with disease activity, but not. These results emphasise the known difference between B27+ and B27- AS and suggest different pathogenic mechanisms in the two forms of AS.

Reynolds, T L; Khan, M A; van der Linden, S; Cleveland, R P

1991-01-01

274

Development of simple clinical criteria for the definition of inflammatory arthritis, enthesitis, dactylitis, and spondylitis: a report from the GRAPPA 2012 annual meeting.  

PubMed

Dermatologist and primary care clinicians are in an ideal position to identify the emergence of psoriatic arthritis (PsA) in patients with psoriasis. Yet these clinicians are not well trained to distinguish inflammatory musculoskeletal disease from other more common problems such as osteoarthritis, traumatic or degenerative tendonitis and back pain, or fibromyalgia. A simple set of clinical criteria to identify inflammatory disease would aid recognition of PsA. At its 2012 annual meeting, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) discussed development of evidence-based, practical, and reliable definitions of inflammatory arthritis, enthesitis, dactylitis, and spondylitis. This project will be a sequential process of expert clinician nominal-group technique, patient surveys and focus groups, and Delphi exercises to identify core features of inflammatory disease, testing these in a small group of patients with and without inflammatory disease, and finally validating these criteria in larger groups of patients. PMID:23908542

Mease, Philip J; Garg, Amit; Gladman, Dafna D; Helliwell, Philip S

2013-08-01

275

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.

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

2013-01-01

276

Undifferentiated Spondyloarthropathy (uSpA)  

MedlinePLUS

... a well-defined form of spondylitis such as ankylosing spondylitis. Some doctors consider USpA a "cousin" to ankylosing spondylitis, psoriatic arthritis, spondylitis associated with inflammatory bowel/Crohn's ...

277

Effects of Tripterygium glycosides on interleukin-17 and CD4+CD25+CD127low regulatory T-cell expression in the peripheral blood of patients with ankylosing spondylitis  

PubMed Central

The aim of this study was to investigate the possible mechanisms of action of Tripterygium glycosides (TG) in the treatment of ankylosing spondylitis (AS). In total, 20 patients with active AS received treatment with 20 mg TG tablet (TGT) 3 times per day for 6 weeks. In addition, 20 healthy age- and gender-matched individuals were recruited as the control group. The efficacy measures included the Bath AS disease activity index (BASDAI), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels. The serum interleukin (IL)-17 levels were measured using ELISA. The expression of CD4+CD25+CD127low regulatory T cells (Tregs) in the peripheral blood was evaluated by flow cytometry. A bivariate correlation analysis was used to determine the association of IL-17 levels with BASDAI, ESR, CRP and CD4+CD25+CD127low Tregs in AS patients. Prior to treatment, the BASDAI, ESR and CRP levels in AS patients were found to be elevated compared to those in healthy controls and were significantly reduced following TGT treatment (P<0.05, P<0.05 and P<0.05, respectively). Prior to treatment, the AS patients exhibited significantly higher IL-17 levels compared to those in healthy controls (P<0.05). Following TGT treatment, the IL-17 levels were significantly reduced in AS patients (P<0.01) but were not significantly different in the control subjects (P>0.05). In addition, prior to treatment, the ratio of CD4+CD25+CD127low Tregs in AS patients was significantly lower compared to that in healthy controls (P<0.05) and it was significantly increased following TGT treatment (P<0.05). The correlation analysis between the BASDAI, ESR or CRP levels and IL-17 revealed a positive linear correlation (P<0.001, P<0.001 and P<0.01, respectively), whereas CD4+CD25+CD127low Tregs were found to be negatively correlated with IL-17 (P<0.01). In conclusion, TGT is efficient for the treatment of AS patients and its mechanism of action may be correlated with the upregulation of CD4+CD25+CD127low Tregs and the downregulation of IL-17 in the peripheral blood.

JI, WEI; LI, HONGGANG; GAO, FENG; CHEN, YAJUN; ZHONG, LINGYU; WANG, DAN

2014-01-01

278

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.

2013-01-01

279

Clinical efficacy and adverse effects of golimumab in the treatment of rheumatoid arthritis.  

PubMed

Golimumab is a fully human monoclonal antibody targeting tumor necrosis factor-alpha (TNFalpha), an important cytokine in the pathogenesis of rheumatoid arthritis (RA) and other arthritides. Golimumab was approved for the treatment of rheumatoid arthritis with methotrexate (MTX) and with or without MTX for psoriatic arthritis and ankylosing spondylitis. Administration is by monthly subcutaneous injection. In this review we present some of the major clinical trials evaluating the efficacy of golimumab with or without concomitant MTX in RA patients, including patients resistant to previous biologic treatments. In addition, we collected data on safety and adverse effects encountered in clinical trials. Current data show golimumab to be an effective and safe choice for the treatment of various inflammatory arthritides. PMID:22891404

Chovel-Sella, Aluma; Karplus, Rebekah; Sella, Tal; Amital, Howard

2012-06-01

280

Serum metabolic signatures of four types of human arthritis.  

PubMed

Similar symptoms of the different types of arthritis have continued to confound the clinical diagnosis and represent a clinical dilemma making treatment choices with a more personalized or generalized approach. Here we report a mass spectrometry-based metabolic phenotyping study to identify the global metabolic defects associated with arthritis as well as metabolic signatures of four major types of arthritis--rheumatoid arthritis (n = 27), osteoarthritis (n = 27), ankylosing spondylitis (n = 27), and gout (n = 33)--compared with healthy control subjects (n = 60). A total of 196 metabolites were identified from serum samples using a combined gas chromatography coupled with time-of-flight mass spectrometry (GC-TOF MS) and ultraperformance liquid chromatography quadrupole-time-of-flight mass spectrometry (UPLC-QTOF MS). A global metabolic profile is identified from all arthritic patients, suggesting that there are common metabolic defects resulting from joint inflammation and lesion. Meanwhile, differentially expressed serum metabolites are identified constituting an unique metabolic signature of each type of arthritis that can be used as biomarkers for diagnosis and patient stratification. The results highlight the applicability of metabonomic phenotyping as a novel diagnostic tool for arthritis complementary to existing clinical modalities. PMID:23819623

Jiang, Miao; Chen, Tianlu; Feng, Hui; Zhang, Yinan; Li, Li; Zhao, Aihua; Niu, Xuyan; Liang, Fei; Wang, Minzhi; Zhan, Junping; Lu, Cheng; He, Xiaojuan; Xiao, Lianbo; Jia, Wei; Lu, Aiping

2013-08-01

281

Microbes, the gut and ankylosing spondylitis  

PubMed Central

It is increasingly clear that the interaction between host and microbiome profoundly affects health. There are 10 times more bacteria in and on our bodies than the total of our own cells, and the human intestine contains approximately 100 trillion bacteria. Interrogation of microbial communities by using classic microbiology techniques offers a very restricted view of these communities, allowing us to see only what we can grow in isolation. However, recent advances in sequencing technologies have greatly facilitated systematic and comprehensive studies of the role of the microbiome in human health and disease. Comprehensive understanding of our microbiome will enhance understanding of disease pathogenesis, which in turn may lead to rationally targeted therapy for a number of conditions, including autoimmunity.

2013-01-01

282

Scintigraphic Evaluation of the Sacroiliac Joints in Anklylosing Spondylitis.  

National Technical Information Service (NTIS)

The sedimentation of /sup 99m/Tc-phosphate complexes into the sacroiliac joints was investigated in 94 patients with loin pains and suspected of ankylosing spondylitis (SpA) and a control group of 96 healthy patients. The investigation yields the followin...

W. Schoerner

1980-01-01

283

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 ...

284

Percivall Pott: tuberculous spondylitis.  

PubMed

Tuberculous spondylitis, also known as Pott's disease, is an entity that produces a characteristic kyphotic deformity, and was described by Sir Percivall Pott in 1779 and 1782. The majority of his patients were infants and young children. Although the incidence of tuberculosis in the industrialized world has since declined dramatically, the number of cases of extrapulmonary disease, though small, has remained relatively unchanged. In developing countries, spondylitis is still generally a disease of children, but in Europe and North America, it more commonly involves older adults. Pott's spondylitis represents a reactivation of latent disease, frequently years after the initial infection. Clinical findings include complaints of back pain and symptoms of fever, chills, weight loss, malaise, and fatigue. Characteristically a late finding, paraplegia is occasionally the initial indicator of spinal involvement. There is an average delay of a year between the onset of symptoms and patient presentation. Plain spinal radiographs usually are the initial diagnostic modality utilized. Computed tomography scanning and magnetic resonance imaging can be used to further define the process. The differential diagnosis includes neoplasm, pyogenic or disseminated fungal infection, and sarcoid arthritis. PMID:8655942

Sternbach, G

1996-01-01

285

Arthritis  

MedlinePLUS

... conditions are present in diseases such as lupus, gout, and hepatitis. Diagnosis Arthritis is diagnosed with a ... in the blood, which is the cause of gout. Gout is a disease that causes arthritis-like ...

286

Arthritis  

MedlinePLUS

... arthritis. Arthritis may occur in men or women. Osteoarthritis is the most common type. Other, more common ... CHANGES Lifestyle changes are the preferred treatment for osteoarthritis and other types of joint swelling. Exercise can ...

287

Treating axial and peripheral spondyloarthritis, including psoriatic arthritis, to target: results of a systematic literature search to support an international treat-to-target recommendation in spondyloarthritis  

PubMed Central

Background Current recommendations for the management of axial spondyloarthritis (SpA) and psoriatic arthritis are to monitor disease activity and adjust therapy accordingly. However, treatment targets and timeframes of change have not been defined. An international expert panel has been convened to develop ‘treat-to-target’ recommendations, based on published evidence and expert opinion. Objective To review evidence on targeted treatment for axial and peripheral SpA, as well as for psoriatic skin disease. Methods We performed a systematic literature search covering Medline, Embase and Cochrane, conference abstracts and studies in http://www.clinicaltrials.gov. Results Randomised comparisons of targeted versus routine treatment are lacking. Some studies implemented treatment targets before escalating therapy: in ankylosing spondylitis, most trials used a decrease in Bath Ankylosing Spondylitis Disease Activity Index; in psoriatic arthritis, protocols primarily considered a reduction in swollen and tender joints; in psoriasis, the Modified Psoriasis Severity Score and the Psoriasis Area and Severity Index were used. Complementary evidence correlating these factors with function and radiographic damage at follow-up is sparse and equivocal. Conclusions There is a need for randomised trials that investigate the value of treat-to-target recommendations in SpA and psoriasis. Several trials have used thresholds of disease activity measures to guide treatment decisions. However, evidence on the effect of these data on long-term outcome is scarce. The search data informed the expert committee regarding the formulation of recommendations and a research agenda.

Schoels, M M; Braun, J; Dougados, M; Emery, P; Fitzgerald, O; Kavanaugh, A; Kvien, T K; Landewe, R; Luger, T; Mease, P; Olivieri, I; Reveille, J; Ritchlin, C; Rudwaleit, M; Sieper, J; Smolen, J S; de Wit, M; van der Heijde, D

2014-01-01

288

Cervical spondylitis due to Neisseria meningitidis.  

PubMed

The diverse clinical spectrum of meningococcal infections includes frequent clinical forms, such as meningitis or septicemia, and uncommon manifestations, such as septic arthritis. Neisseria meningitidis is not generally considered to be a causative agent of osteoarticular infections. We report the first case of acute primary cervical spondylitis in a 48-year-old man. PMID:16618455

Mendes, Stéphanie; Bémer, Pascale; Corvec, Stéphane; Faure, Alexis; Redon, Hervé; Drugeon, Henri B

2006-05-01

289

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.

2014-01-01

290

Comparison of Pyogenic Spondylitis and Tuberculous Spondylitis  

PubMed Central

Pyogenic spondylitis and tuberculous spondylitis are common causes of spinal infection. It is difficult to differentiate tuberculous spondylitis and pyogenic spondylitis clinically and radiologically. Recently magnetic resonance imaging has been reported to be beneficial for early diagnosis and differential diagnosis of the spondylitis, and is being used extensively for diagnosis. However, the diagnosis must be considered in combination with corresponding changes in clinical manifestations, radiological findings, blood and tissue cultures and histopathological findings. Conservative treatments, including antimicrobial medications, are started initially. Surgical treatments, which include anterior or posterior approach, single-stage or two-stage surgery, with or without instrumentation, may be performed as indicated.

2014-01-01

291

PHENYLBUTAZONE (BUTAZOLIDIN) AND BUTAPYRIN(R)--A Study of Clinical Effects in Arthritis and Gout  

PubMed Central

A clinical evaluation of phenylbutazone and Butapyrin® (a mixture of phenylbutazone and aminopyrine) was made in 409 patients who had a variety of rheumatic diseases. Preliminary European claims were substantiated. In gout a specific favorable effect was brought about by phenylbutazone alone. Effects equivalent to the previously reported favorable response to Butapyrin (Irgapyrin) were observed when its constituent phenylbutazone was used alone. The drug had a suppressive effect in a high percentage of patients with rheumatoid arthritis, ankylosing spondylitis, arthritis with psoriasis and mixed arthritis (rheumatoid arthritis plus osteoarthritis). Favorable effect in peritendinitis of the shoulders, osteoporosis of the spine and acute lumbosacral strain also was noted. Toxicity resulted in discontinuance of medication in 10 per cent of patients with each drug. Manifestations of toxicity generally included fluid retention, nausea and rash, but there were several instances of transitory leukopenia and anemia. There was one instance of agranulocytosis with Butapyrin but none with phenylbutazone.† Aggravation of peptic ulcer occurred in ten patients with hemorrhage in two. Generally the toxicity was of a low order as compared with that of other drugs having an antirheumatic effect.

Kuzell, William C.; Schaffarzick, Ralph W.

1952-01-01

292

Rheumatoid arthritis, spondyloarthropathies, and relapsing polychondritis.  

PubMed

The neurologic complications of rheumatic disease are highly variable and their manifestations are linked to the pathogenesis and clinical phenotype of the specific rheumatologic syndrome. In active rheumatoid arthritis (RA), the peripheral nervous system is most commonly involved and mononeuritis multiplex, nerve entrapment and vascultitic sensorimotor neuropathy are not uncommon. Central nervous system complications such as pachymeningitis and cerebral vasculitis are rare. TNF blockade therapy of RA is rarely associated with demyelinating syndromes. In the spondyloarthropathies, especially ankylosing spondylitis (AS), neurologic complications are more frequent in long-standing, advanced disease and include atlantoaxial subluxation, cauda equina syndrome, spinal stenosis, and acute vertebral fractures. Peripheral nervous system involvement in any of the spondyloarthropaties is rare. Relapsing polychondritis (RP) is characterized by recurring bouts of inflammation, destruction of cartilaginous structures, and systemic and rarely central nervous system vasculitis. Visual-oculo and auditory complications are common. Definitive treatment of the neurologic complications and prevention of subsequent ones is dependent upon effective treatment of RA, AS or RP. PMID:24365312

Ostrowski, Rochella A; Takagishi, Troy; Robinson, John

2014-01-01

293

Update on the American College of Rheumatology/Spondyloarthritis Research and Treatment Network/Spondylitis Association of America axial spondyloarhtritis treatment guidelines project.  

PubMed

The American College of Rheumatology, the Spondyloarthritis Research and Treatment Network, and the Spondylitis Association of America have begun collaborating on a project to develop treatment guidelines for axial spondyloarthritis. The project will use the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method, which is based on systematic literature reviews and quantitative evidence summaries, to develop treatment recommendations for the use of pharmacological interventions, rehabilitation, surgery, preventive care, and disease monitoring in patients with ankylosing spondylitis and axial spondyloarthritis. PMID:24810702

Ward, Michael M

2014-06-01

294

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

295

HLA-B27 misfolding and ankylosing spondylitis.  

PubMed

Understanding how HLA-B27 contributes to the pathogenesis of spondyloarthritis continues to be an important goal. Current efforts are aimed largely on three areas of investigation; peptide presentation to CD8T cells, abnormal forms of the HLA-B27 heavy chain and their recognition by leukocyte immunoglobulin-like receptors on immune effector cells, and HLA-B27 heavy chain misfolding and intrinsic biological effects on affected cells. In this chapter we review our current understanding of the causes and consequences of HLA-B27 misfolding, which can be defined biochemically as a propensity to oligomerize and form complexes in the endoplasmic reticulum (ER) with the chaperone BiP (HSPA5/GRP78). HLA-B27 misfolding is linked to an unusual combination of polymorphisms that identify this allele, and cause the heavy chain to fold and load peptides inefficiently. Misfolding can result in ER-associated degradation (ERAD) of heavy chains, which is mediated in part by the E3 ubiquitin ligase HRD1 (SYVN1), and the ubiquitin conjugating enzyme UBE2JL. Upregulation of HLA-B27 and accumulation of misfolded heavy chains can activate ER stress signaling pathways that orchestrate the unfolded protein response. In transgenic rats where HLA-B27 is overexpressed, UPR activation is prominent. However, it is specific for heavy chain misfolding, since overexpression of HLA-B7, an allele that does not misfold, fails to generate ER stress. UPR activation has been linked to cytokine dysregulation, promoting lL-23, IFN?, and lL-1? production, and may activate the IL-23/IL-17 axis in these rats. IL-1? and IFN? are pro- and anti-osteoclastogenic cytokines, respectively, that modulate osteoclast development in HLA-B27-expressing transgenic rat monocytes. Translational studies of patient derived cells expressing HLA-B27 at physiologic levels have provided evidence that ER stress and UPR activation can occur in peripheral blood, but this has not been reported to date in isolated macrophages. Inflamed gastrointestinal tissue reveals evidence for HLA-B27 misfolding, ERAD, and autophagy, without acute UPR activation. A more complete picture of conditions that impact HLA-B27 folding and misfolding, the full spectrum and time course of consequences of ER stress, and critical cell types involved is needed to understand the role of HLA-B27 misfolding in spondyloarthritis pathogenesis. PMID:23993278

Colbert, Robert A; Tran, Tri M; Layh-Schmitt, Gerlinde

2014-01-01

296

Scientists Gain New Insights into Genetic Mechanisms of Ankylosing Spondylitis  

MedlinePLUS

... Anglo-American Spondyloarthritis Consortium and the Wellcome Trust Case Control Consortium 2. The mission of the National Institute ... Australo-Anglo-American Spondyloarthritis Consortium (TASC); Wellcome Trust Case Control Consortium 2 (WTCCC2). Interaction between ERAP1 and HLA- ...

297

Fibromyalgia  

MedlinePLUS

... rheumatic conditions such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis (AS). NOTE: for ... Arthritis Fibromyalgia General Gout Osteoarthritis Rheumatoid Arthritis Systemic lupus erythematosus (SLE or lupus) Management Risk Factors Physical ...

298

Naproxen  

MedlinePLUS

... relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining ... of the joints), juvenile arthritis (a form of joint disease in children), and ankylosing spondylitis (arthritis that mainly ...

299

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

300

Global metabolite profiling of synovial fluid for the specific diagnosis of rheumatoid arthritis from other inflammatory arthritis.  

PubMed

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

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

2014-01-01

301

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.

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

2014-01-01

302

G-protein signaling modulator-3, a gene linked to autoimmune diseases, regulates monocyte function and its deficiency protects from inflammatory arthritis  

PubMed Central

Polymorphism at the GPSM3 gene locus is inversely associated with four systemic autoimmune diseases, including rheumatoid arthritis and ankylosing spondylitis. G-protein signaling modulator-3 (GPSM3) expression is most pronounced in myeloid cells, in which it targets heterotrimeric G-protein G?i subunits of chemokine receptors, critical to immune function. To begin to explore the regulatory role of GPSM3 in monocytes, human THP-1 and primary mouse myeloid cells were cultured under stimulus conditions; GPSM3 was found by immunoblotting to be expressed at highest levels in the mature monocyte. To evaluate the effects of GPSM3 deficiency on a myeloid-dependent autoimmune disease, Collagen Antibody-Induced Arthritis (CAIA) was induced in Gpsm3?/? and control mice, which were then analyzed for clinical score, paw swelling, intra-articular proinflammatory markers, and histopathology. Mice lacking GPSM3 were protected from CAIA, and expression of monocyte-representative pro-inflammatory chemokine receptors and cytokines in paws of Gpsm3?/? mice were decreased. Flow cytometry, apoptosis, and transwell chemotaxis experiments were conducted to further characterize the effect of GPSM3 deficiency on survival and chemokine responsiveness of monocytes. GPSM3-deficient myeloid cells had reduced migration ex vivo to CCL2, CX3CL1, and chemerin and enhanced apoptosis in vitro. Our results suggest that GPSM3 is an important regulator of monocyte function involving mechanisms of differentiation, survival, and chemotaxis, and deficiency in GPSM3 expression is protective in acute inflammatory arthritis.

Giguere, Patrick M.; Billard, Matthew J.; Laroche, Genevieve; Buckley, Brian K.; Timoshchenko, Roman G.; McGinnis, Marcus W.; Esserman, Denise; Foreman, Oded; Liu, Peng; Siderovski, David P.; Tarrant, Teresa K.

2012-01-01

303

G-protein signaling modulator-3, a gene linked to autoimmune diseases, regulates monocyte function and its deficiency protects from inflammatory arthritis.  

PubMed

Polymorphism at the GPSM3 gene locus is inversely associated with four systemic autoimmune diseases, including rheumatoid arthritis and ankylosing spondylitis. G-protein signaling modulator-3 (GPSM3) expression is most pronounced in myeloid cells, in which it targets heterotrimeric G-protein G?i subunits of chemokine receptors, critical to immune function. To begin to explore the regulatory role of GPSM3 in monocytes, human THP-1 and primary mouse myeloid cells were cultured under stimulus conditions; GPSM3 was found by immunoblotting to be expressed at highest levels in the mature monocyte. To evaluate the effects of GPSM3 deficiency on a myeloid-dependent autoimmune disease, collagen antibody-induced arthritis (CAIA) was induced in Gpsm3-/- and control mice, which were then analyzed for clinical score, paw swelling, intra-articular proinflammatory markers, and histopathology. Mice lacking GPSM3 were protected from CAIA, and expression of monocyte-representative pro-inflammatory chemokine receptors and cytokines in paws of Gpsm3-/- mice were decreased. Flow cytometry, apoptosis, and transwell chemotaxis experiments were conducted to further characterize the effect of GPSM3 deficiency on survival and chemokine responsiveness of monocytes. GPSM3-deficient myeloid cells had reduced migration ex vivo to CCL2, CX3CL1, and chemerin and enhanced apoptosis in vitro. Our results suggest that GPSM3 is an important regulator of monocyte function involving mechanisms of differentiation, survival, and chemotaxis, and deficiency in GPSM3 expression is protective in acute inflammatory arthritis. PMID:23280397

Giguère, Patrick M; Billard, Matthew J; Laroche, Geneviève; Buckley, Brian K; Timoshchenko, Roman G; McGinnis, Marcus W; Esserman, Denise; Foreman, Oded; Liu, Peng; Siderovski, David P; Tarrant, Teresa K

2013-06-01

304

Percivall Pott: Tuberculous spondylitis  

Microsoft Academic Search

Tuberculous spondylitis, also known as Pott's disease, is an entity that produces a characteristic kyphotic deformity, and was described by Sir Percivall Pott in 1779 and 1782. The majority of his patients were infants and young children. Although the incidence of tuberculosis in the industrialized world has since declined dramatically, the number of cases of extrapulmonary disease, though small, has

George Sternbach

1996-01-01

305

Novel multiplex technology for diagnostic characterization of rheumatoid arthritis  

PubMed Central

Introduction The aim of this study was to develop a clinical-grade, automated, multiplex system for the differential diagnosis and molecular stratification of rheumatoid arthritis (RA). Methods We profiled autoantibodies, cytokines, and bone-turnover products in sera from 120 patients with a diagnosis of RA of < 6 months' duration, as well as in sera from 27 patients with ankylosing spondylitis, 28 patients with psoriatic arthritis, and 25 healthy individuals. We used a commercial bead assay to measure cytokine levels and developed an array assay based on novel multiplex technology (Immunological Multi-Parameter Chip Technology) to evaluate autoantibody reactivities and bone-turnover markers. Data were analyzed by Significance Analysis of Microarrays and hierarchical clustering software. Results We developed a highly reproducible, automated, multiplex biomarker assay that can reliably distinguish between RA patients and healthy individuals or patients with other inflammatory arthritides. Identification of distinct biomarker signatures enabled molecular stratification of early-stage RA into clinically relevant subtypes. In this initial study, multiplex measurement of a subset of the differentiating biomarkers provided high sensitivity and specificity in the diagnostic discrimination of RA: Use of 3 biomarkers yielded a sensitivity of 84.2% and a specificity of 93.8%, and use of 4 biomarkers a sensitivity of 59.2% and a specificity of 96.3%. Conclusions The multiplex biomarker assay described herein has the potential to diagnose RA with greater sensitivity and specificity than do current clinical tests. Its ability to stratify RA patients in an automated and reproducible manner paves the way for the development of assays that can guide RA therapy.

2011-01-01

306

Disease Modifying Antirheumatic Drugs (DMARDs) (Beyond the Basics)  

MedlinePLUS

... such as ankylosing spondylitis, psoriatic arthritis, and systemic lupus erythematosus. (See "Patient information: Rheumatoid arthritis symptoms and ... also very frequently used for treatment of systemic lupus erythematosus. It can be combined with steroid medications ...

307

Blocking the effects of interleukin-6 in rheumatoid arthritis and other inflammatory rheumatic diseases: systematic literature review and meta-analysis informing a consensus statement  

PubMed Central

Background Suppression of the immunoinflammatory cascade by targeting interleukin 6 (IL-6) mediated effects constitutes a therapeutic option for chronic inflammatory diseases. Tocilizumab is the only IL-6 inhibitor (IL-6i) licensed for rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA), but also other agents targeting either IL-6 or its receptor are investigated in various indications. Objective To review published evidence on safety and efficacy of IL-6i in inflammatory diseases. Methods We performed systematic literature searches in Medline and Cochrane, screened EULAR and American College of Rheumatology meeting-abstracts, and accessed http://www.clinicaltrials.gov. Results Comprehensive evidence supports the efficacy of tocilizumab in RA in DMARD-naïve patients, and after DMARD- and TNFi-failure. Randomised comparisons demonstrate superiority of tocilizumab in JIA, but not ankylosing spondylitis (AS). Other indications are currently investigated. Additional IL-6i show similar efficacy; safety generally appears acceptable. Conclusions IL-6i is effective and safe in RA and JIA, but not in AS. Preliminary results in other indications need substantiation.

Schoels, Monika M; van der Heijde, Desiree; Breedveld, Ferdinand C; Burmester, Gerd R; Dougados, Maxime; Emery, Paul; Ferraccioli, Gianfranco; Gabay, Cem; Gibofsky, Allan; Gomez-Reino, Juan Jesus; Jones, Graeme; Kvien, Tore K; Murikama, Miho M; Nishimoto, Norihiro; Smolen, Josef S

2013-01-01

308

HLA and the Spondyloarthritis  

Microsoft Academic Search

KEYWORDS HLA B27; ankylosing spondylitis; review ABSTRACT The Spondyloarthritis are a group of diseases with a strong tendency for family agregation, which includes mainly Ankylosing Spondylitis (AS), Reiter's Syndrome \\/ Reactive Arthritis (ReA), Enteropathic Spondylitis (Crohn's disease and Ulcerative Colitis), Psoriatic Arthropathy (PsA), and Undifferentiated Spondylitis (uSpA). The axial skeleton, mainly the sacroiliac joints, the peripheral joints - more frequently

Jácome Bruges Armas; Margarida Santos; Maria José Peixoto; Ana Rita Couto; Francisco Garrett

309

Brucellar spondylitis: MRI findings.  

PubMed

This study was carried out to identify the distinguishing features of brucellosis on magnetic resonance imaging (MRI). MRI examinations were performed in 14 patients with spinal brucellosis. A 1-T Magnetom (Erlangen, Siemens) was used to obtain T1-weighted (TR/TE 500/30) and T2-weighted (TR/TE 2000/80/20) spin echo sequences, in both sagittal and axial planes. Thirty-three percent of the vertebrae and 18 levels of disc were involved in the 14 brucellar spondylitis cases. Eleven patients (79.8%) with discitis revealed anterior superior vertebral body involvement. Fourteen (77.7%) of the levels with discitis displayed soft tissue swelling without presence of abscess formation. Seven facet joints of five patients with discitis displayed signal increase after contrast enhancement. Vertebral body signal changes without morphologic changes marked signal increase in the intervertebral disc on T2-weighted and contrast-enhanced sequences, and soft tissue involvement without abscess formation can be accepted as specific MRI features of brucellar spondylitis. The facet joint signal changes following contrast enhancement is another MRI sign of spinal brucellosis, which has not been mentioned so far. PMID:11806395

Ozaksoy, D; Yücesoy, K; Yücesoy, M; Kovanlikaya, I; Yüce, A; Naderi, S

2001-12-01

310

PADI2 Is Significantly Associated with Rheumatoid Arthritis  

PubMed Central

Citrullination, a posttranslational modification of peptidyl arginine to citrulline, plays an essential role in rheumatoid arthritis (RA). Citrullination is catalyzed by a group of peptidylarginine deiminases (PADs) including PADI 1, 2, 3, 4 and 6. Many studies have indicated that the gene encoding PADI4 is a factor in susceptibility to RA. Some studies have detected PADI2 expression in RA synovial tissues, suggesting that PADI2 also plays an important role in the disease. This study evaluated the possible association between the PADI2-encoding gene and RA. Seventeen tag SNPs across the PAD locus were genotyped using a custom-designed Illumina 96-SNP VeraCode microarray. Peripheral blood samples were collected from patients with RA (n?=?267), ankylosing spondylitis (AS, n?=?51) and healthy controls (n?=?160). The results of genotyping were verified using Sequenom MassARRAY in an independent cohort of 307 patients with RA, 324 patients with AS and 509 healthy controls. A western blot analysis was performed using synovial tissue from patients with RA (n?=?7), osteoarthritis (OA, n?=?7) and AS (n?=?5) to determine the levels of expression of PADI2. A microarray analysis revealed a significant association between three selected PADI2 SNPs (rs2235926, rs2057094, rs2076616) and the presence of RA. The increased susceptibility to RA associated with rs2235926 (OR?=?1.706733, 95% CI?=?[1.576366–1.866587], p?=?0.000839) and rs2057094 (OR?=?1.360432, 95% CI?=?[1.065483–1.869482], p?=?0.003291) was further confirmed by the Sequenom MassARRAY. No tag SNPs in the PADI2 locus showed a significant association with AS. Increased expression of PADI2 was detected in RA synovial tissues compared with samples from patients with OA and AS. PADI2 is significantly associated with RA and may be involved in the pathogenesis of the disease.

Chang, Xiaotian; Xia, Yifang; Pan, Jihong; Meng, Qingsong; Zhao, Yan; Yan, Xinfeng

2013-01-01

311

VEGF, FGF1, FGF2 and EGF gene polymorphisms and psoriatic arthritis  

PubMed Central

Background Angiogenesis appears to be a first-order event in psoriatic arthritis (PsA). Among angiogenic factors, the cytokines vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), and fibroblast growth factors 1 and 2 (FGF1 and FGF2) play a central role in the initiation of angiogenesis. Most of these cytokines have been shown to be upregulated in or associated with psoriasis, rheumatoid arthritis (RA) or ankylosing spondylitis (AS). As these diseases share common susceptibility associations with PsA, investigation of these angiogenic factors is warranted. Methods Two hundred and fifty-eight patients with PsA and 154 ethnically matched controls were genotyped using a Sequenom chip-based MALDI-TOF mass spectrometry platform. Four SNPs in the VEGF gene, three SNPs in the EGF gene and one SNP each in FGF1 and FGF2 genes were evaluated. Statistical analysis was performed using Fisher's exact test, and the Cochrane-Armitage trend test. Associations with haplotypes were estimated by using weighted logistic models, where the individual haplotype estimates were obtained using Phase v2.1. Results We have observed an increased frequency in the T allele of VEGF +936 (rs3025039) in control subjects when compared to our PsA patients [Fisher's exact p-value = 0.042; OR 0.653 (95% CI: 0.434, 0.982)]. Haplotyping of markers revealed no significant associations. Conclusion The T allele of VEGF in +936 may act as a protective allele in the development of PsA. Further studies regarding the role of pro-angiogenic markers in PsA are warranted.

Butt, Christopher; Lim, Sooyeol; Greenwood, Celia; Rahman, Proton

2007-01-01

312

Arthritis Foundation  

MedlinePLUS

... arthritis. Sign Up See More Events About the Foundation Annual Report Careers Contact Us Financials Mission & Vision ... Use Products Juvenile Arthritis Osteoarthritis Rheumatoid Arthritis More Foundation Websites Arthritis Today Fight Arthritis Pain Kids Get ...

313

Different familial association patterns of autoimmune diseases between juvenile-onset systemic lupus erythematosus and juvenile rheumatoid arthritis.  

PubMed

The aim of this study was to determine if the prevalence of autoimmune disorders in the relatives of patients with systemic lupus erythematosus (SLE) is greater than that of relatives of patients with juvenile rheumatoid arthritis (JRA). Interviews were used to obtain histories of the following autoimmune disorders among living or deceased first-, second-, and third-degree relatives of 91 SLE and 110 JRA families: ankylosing spondylitis, SLE, rheumatoid arthritis (RA), JRA, multiple sclerosis, juvenile dermatomyositis, Sjögren's syndrome, myasthenia gravis, psoriasis, and thyroid diseases. There were statistically significant differences between the SLE and JRA probands in mean age and gender ratio (19.1 +/- 4.8 vs 14.0 +/- 5.5 years; M (male)/F (female): 17/74 vs 62/48, p<0.005). The prevalence rate of autoimmune diseases in relatives of SLE families (20.9%) was greater than in JRA families (11.8%), but not statistically significantly so. The mean age (18.0 +/- 5.3 vs 14.0 +/- 4.3 years), mean age at diagnosis (13.4 +/- 4.3 vs 7.9 +/- 3.9 years) and gender ratio (F/M, 16/3 vs 5/8) of the patients with affected relatives between these 2 groups all had statistically significant differences. A higher prevalence of SLE in relatives was found in SLE families than in JRA cases. Furthermore, this study revealed a higher incidence of autoimmune disorders among second- and third-degree relatives of SLE or JRA probands versus first-degree ones, especially sisters (including 1 pair of twins) and the maternal aunt in SLE families. These data demonstrate that the prevalence of autoimmune disorders in the relatives of patients with SLE is greater than those of relatives of patients with JRA. This suggests that clinically different autoimmune phenotypes may share common susceptibility genes, which may act as risk factors for autoimmunity. PMID:15181489

Huang, Chun-Mei; Yang, Yao-Hsu; Chiang, Bor-Luen

2004-04-01

314

Infectious Arthritis  

MedlinePLUS

... sternum) may be involved. People who already have rheumatoid arthritis or another joint disease are more likely to ... arthritis can be similar to the symptoms of rheumatoid arthritis. However, viral arthritis symptoms usually disappear within days ...

315

Flurbiprofen  

MedlinePLUS

Flurbiprofen is also used to treat ankylosing spondylitis (arthritis that mainly affects the spine).This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

316

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.

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

2014-01-01

317

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

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; Chimenti, Sergio; Grossi, Paolo; Marchesoni, Antonio; Di Nuzzo, Sergio; Griseta, Vito; Gargiulo, Anna; Parodi, Aurora; Simoni, Lucia; Bellia, Gilberto

2014-01-01

318

Tuberculous Spondylitis: a case report  

PubMed Central

A 21 year old oriental male presented with a one month history of neck pain associated with neck stiffness and dysphagia. A five week course of chiropractic treatment relieved most of his symptoms. Due to persistent tenderness in the suboccipital region and substantial weight loss, he was subsequently hospitalized. Further investigations revealed tuberculous osteomyelitis affecting the left lateral mass of C1 and likely the C2 vertebra. Tuberculous spondylitis accounts for more than 50% of all cases of skeletal tuberculosis and is the most common cause of vertebral infection, particularly in young people. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6

Thiel, Haymo; Gotlib, Allan

1986-01-01

319

Investigating a pathogenic role for TXNDC5 in rheumatoid arthritis  

PubMed Central

Introduction Expression of TXNDC5, which is induced by hypoxia, stimulates cell proliferation and angiogenesis. Our previous study detected increased TXNDC5 expression in the synovial tissues of rheumatoid arthritis (RA) patients using proteomic methods. The current study investigated a pathogenic role for TXNDC5 in RA. Method Expression of TXNDC5 in synovial membranes was quantitatively analyzed by immunohistochemistry, Western blotting and real-time polymerase chain reaction (PCR). Serum TXNDC5 levels and serum anti-TXNDC5 antibody levels were determined using sandwich enzyme-linked immunosorbent assay (ELISA). A total of 96 single nucleotide polymorphisms (SNPs) in or near the TXNDC5 gene were genotyped using custom-designed Illumina 96-SNP VeraCode microassay. Allele frequencies and genotype frequencies of SNPs were assessed using a case-control design in a cohort of 267 Chinese patients with RA, 51 patients with ankylosing spondylitis (AS) and 160 healthy controls. Additional genotyping of 951 patients with RA and 898 healthy controls was performed for four SNPs (rs2277105, rs369086, rs443861 and rs11962800) using the TaqMan method. Results Real-time PCR, Western blotting and immunohistochemistry detected significantly higher TXNDC5 expression in the synovial tissues of RA patients compared to samples from patients with osteoarthritis (OA) or AS. ELISA detected significantly higher levels of TXNDC5 in the blood of RA patients compared to OA, AS and systemic lupus erythematosus patients, and healthy controls. ELISA did not detect significantly different levels of anti-TXNDC5 antibody in the blood of RA, OA and AS patients and healthy controls. A total of 9 SNPs (rs9505298, rs41302895, rs1225936, rs1225938, rs372578, rs443861, rs408014, rs9392189 and rs2743992) showed significant association with RA, while 16 SNPs (rs1044104, rs1225937, rs1225938, rs372578, rs89715, rs378963, rs1225944, rs1225947, rs1238994, rs369086, rs408014, rs368074, rs1225954, rs1225955, rs13209404 and rs3812162) showed significant association with AS. Taqman SNP assay demonstrated that rs443861 has an association with RA, which correlates with the microassay results. Conclusions TXNDC5 is up-regulated in synovial tissues of RA patients. TXNDC5 has a genetic effect on the risk of RA and AS.

2011-01-01

320

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

321

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.

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

322

CD38 and E2F transcription factor 2 have uniquely increased expression in rheumatoid arthritis synovial tissues.  

PubMed

The purpose of the current study was to find novel rheumatoid arthritis (RA)-specific gene expression by simultaneously comparing the expression profiles of the synovial tissues from patients with RA, osteoarthritis (OA) and ankylosing spondylitis (AS). The Illumina Human HT-12 v4 Expression BeadChip was used to investigate the global gene expression profiles in synovial tissues from RA (n?=?12), OA (n?=?14) and AS (n?=?7) patients. By comparing the profiles in synovial tissues from RA, OA and AS, we identified the CD38, ankyrin repeat domain 38 (ANKRD38), E2F transcription factor 2 (E2F2), craniofacial development protein 1 (CFDP1), cluster of differentiation (CD)7, interferon-stimulated exonuclease gene 20?kDa (ISG20) and interleukin-2 receptor gamma (IL)-2RG genes as differentially expressed gene expression in RA synovial tissues. The increased expression of CD38, E2F2 and IL-2RG, as revealed using real-time polymerase chain reaction (PCR) with synovial tissues from RA (n?=?30), OA (n?=?26) and AS patients (n?=?20), was in agreement with the microarray data. Immunohistochemistry revealed significant CD38 expression and E2F2 in synovial membranes from RA patients (n?=?5). The CD38(+) cells had high a percentage in the RA patients' blood (n?=?103) and in the CD3(+) and CD56(+) subsets. The CD38(+) cell percentage was correlated significantly with RF level (P?=?0·026) in RA patients. The IL-1? and IL-? levels were depressed significantly in the culture medium of RA synovial fibroblast cells (n?=?5) following treatment with siRNAs targeting the E2F2 or CD38 genes. This study suggests that the uniquely increased expression of CD38 and E2F2 in RA synovial tissues contribute to the immunoactivation of the disease. PMID:24397353

Chang, X; Yue, L; Liu, W; Wang, Y; Wang, L; Xu, B; Wang, Y; Pan, J; Yan, X

2014-05-01

323

Increased prevalence of anti-third generation cyclic citrullinated peptide antibodies in patients with rheumatoid arthritis and CREST syndrome.  

PubMed

To investigate the prevalence of anti-third generation cyclic citrullinated peptide antibodies (anti-CCP3) in patients with systemic connective tissue diseases, we assembled a training set consisting of 115 patients with rheumatoid arthritis (RA), 52 with Calcinosis, Raynaud's phenomenon, oesophageal dysmotility, sclerodactyly, telangiectasia (CREST) syndrome, 21 with scleroderma, 20 with ankylosing spondylitis, 18 with reactive arthritis, 25 with juvenile rheumatoid arthritis (RA), 51 with osteoarthritis, 26 with mixed connective tissue disease, 23 with primary Sjogren's syndrome, 74 with systemic lupus erythematosus, 49 with Polymyalgia rheumatica, and 39 with polymyositis/dermatomyositis. The commercial enzyme-linked immunosorbent assay (ELISA) was used to detect anti-CCP antibodies, including anti-CCP2 (regular, second generation of CCP antigen) and anti-CCP3 (third generation of CCP antigen) in disease-related specimens and normal controls. These serum samples were also evaluated for anti-centomere antibodies by anti-centromere ELISA kit. The higher frequencies of anti-CCP3 and anti-CCP2 were detected in 75.6 and 70.4% patients with RA, respectively. At the same time, anti-CCP3 (not anti-CCP2) was significantly increased in samples isolated from patients with CREST syndrome. The clinical sensitivity of IgG anti-CCP3 for the patients with CREST syndrome was 29% (15 of 52) and the specificity was 96% (384 of 397), with the exception of the RA group. The anti-centromere antibodies were significantly higher in patients with CREST only. The results of our study suggest that compared to anti-CCP2 assay, the new anti-CCP3 assay can enhance the clinical sensitivity for diagnosis of RA and, as an associate marker combined with anticentromere, can distinguish CREST syndrome from other systemic connective tissue diseases, especially RA. The clinical specificity of anti-CCP3 was lower than anti-CCP2 assay in diagnosis of RA because of the crossreaction to the patients with CREST syndrome. PMID:17426360

Wu, R; Shovman, O; Zhang, Y; Gilburd, B; Zandman-Goddard, G; Shoenfeld, Yehuda

2007-02-01

324

Dactylitis with pitting oedema of the hand in longstanding ankylosing spondylitis  

Microsoft Academic Search

Summary The case of a patient with seronegative spondyloarthropathy showing oligoarthritis of the hand together with large pitting oedema is reported. Unlike the patients with late on set peripheral spondyloarthropathy described by Dubost and Sauvezie who show minimal involvement of the axial skeleton, the patient has been suffering from AS for about twenty years.

I. Olivieri; A. Padula; L. Favaro; A. Pierro; G. S. Oranges; S. Ferri

1995-01-01

325

Combined spa–exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial  

Microsoft Academic Search

Results. Analysis of variance showed a statistically significant time- effect (P < 0.001) and time-by-treatment interaction (P 0.004), indicating that the 3 groups differed over time with respect to the course of the PIC. Four weeks after start of spa- exercise therapy, the mean difference in PIC between group 1 and controls was 0.49 (95% confidence interval (CI) 0.16 -

Astrid van Tubergen; Robert Landewé; Désirée van der Heijde; Alita Hidding; Nico Wolter; Max Asscher; Albrecht Falkenbach; Ekkehard Genth; Henk Goei Thè; Sjef van der Linden

2001-01-01

326

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

327

Infection risk in Rheumatoid Arthritis and Spondyloarthropathy patients under treatment with DMARDs, Corticosteroids and TNF-? antagonists  

PubMed Central

Background Infections which complicate rheumatic diseases such as Rheumatoid Arthritis (RA) and Spondyloarthropathy (SpA) (Psoriatic Arthritis [PA] and Ankylosing Spondylitis [AS]), may cause significant morbidity and mortality. However, among the studies on the incidence rate (IR) of infections in such patients, very few have involved controls and the results have been controversial, probably due to methodological difficulties. To estimate infection rates in RA and SpA patients under disease-modifying anti-rheumatic drugs (DMARDs), corticosteroids (CS) and tumor necrosis factor (TNF)? antagonists, alone or combined, a single-centre retrospective observational cohort study has been performed. Patients and methods Incidence rates/100 patient-years of any infections were evaluated in RA and SpA outpatients observed in the period November 1, 2003 through December 31, 2009 and stratified according to therapy. Infection incidence rate ratios (IRR) were calculated using Poisson regression models which adjusted for demographic/clinical characteristics of the patients. Results Three hundred and thirtyone infections [318 (96.1%) non-serious and 13 (3.9%) serious] have been registered among 176 of the 341 patients (52%). The IR/100 patient-years of all infections was 36.3 ranging from 12.4 (DMARDs + CS) to 62.7 (anti-TNF??+?CS). The most frequent infection site was respiratory tract, and bacteria were responsible for three quarters of all infections. In the multivariate analysis, adding anti-TNF? to DMARDs doubled the IRR compared to DMARDs alone, anti-TNF??+?CS significantly tripled it, whereas anti-TNF??+?CS + DMARDs only increased the risk 2.5 times. The degree of disease activity was strongly and significantly associated with the infection risk (severe or moderate versus mild, IRR?=?4). Female sex was significantly associated with increased infection risk, while duration of disease and anti-influenza vaccination were protective, the latter even for cutaneous/soft-tissue (mainly herpetic) infections. Conclusion The combination anti-TNF? with CS was found to be the most pro-infective treatment, whereas DMARDs alone were relatively safe. Physicians, therefore, should be aware that there may be an increased risk of infection when using anti-TNF? and CS therapy together. Anti-influenza vaccination appears to provide broad protection, adding evidence to support its use in these patients, and deserves further study.

2014-01-01

328

Sulindac  

MedlinePLUS

... a breakdown of the lining of the joints), rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), and ankylosing spondylitis (arthritis that mainly affects the spine). Sulindac also is used to treat pain in the shoulder caused by bursitis (inflammation of a fluid-filled ...

329

Indomethacin  

MedlinePLUS

... a breakdown of the lining of the joints), rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), and ankylosing spondylitis (arthritis that mainly affects the spine). Indomethacin is also used to treat pain in the shoulder caused by bursitis (inflammation of a fluid-filled ...

330

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. ...

331

Diagnostic imaging of sacroiliac joints and the spine in the course of spondyloarthropathies  

PubMed Central

Summary Spondyloarthropathies belong to a group of rheumatic diseases, in which inflammatory changes affect mainly the sacroiliac joints, spine, peripheral joints, tendon, ligaments and capsule attachments (entheses). This group includes 6 entities: ankylosing spondylitis, arthritis associated with inflammatory bowel disease, reactive arthritis, undifferentiated spondyloarthropathy, psoriatic arthritis and juvenile spondyloarthropathy. In 2009, ASAS (Assessment in SpondyloArthritis international Society) association, published classification criteria for spondyloarthropathies, which propose standardization of clinical-diagnostic approach in the case of sacroiliitis, spondylitis and arthritis. Radiological diagnosis of inflammatory changes of sacroiliac joints is based on a 4 step radiographic grading method from 1966. According to modified New York criteria, the diagnosis of ankylosing spondylitis is made based on the presence of advanced lesions, sacroiliitis of at least 2 grade bilaterally or 3–4 unilaterally. In case of other types of spondyloarthropathies diagnosis is made based on presence of at least grade 1 changes. In MRI, active inflammation of sacroiliac joints is indicated by the presence of subchondral bone marrow edema, synovitis, bursitis, or enthesitis. ASAS discusses only the classic form of axial spondyloarthropathies, which is ankylosing spondylitis. To quantify radiological inflammatory changes in the course of the disease, Stoke Ankylosing spondylitis classification Spinal Score (SASSS) is recommended. The signs of inflammation and scarrying of the spinal cord in the course of ankylosing spondylitis, present in MRI include: bone marrow edema, sclerosis, fat metaplasia, formation of syndesmophytes, and ankylosis.

Sudol-Szopinska, Iwona; Urbanik, Andrzej

2013-01-01

332

Juvenile Arthritis  

MedlinePLUS

... in children with juvenile arthritis. The impact of chronic and recurrent pain on children. Ways to limit the impact of pain on ... arthritis (JIA). A term for various types of chronic arthritis in children. ... can cause swelling, pain, damage to the joints, and, in some cases, ...

333

A Case of Nail Psoriasis-associated Psoriatic Arthritis Successfully Treated with Adalimumab.  

PubMed

We report on a case of psoriatic arthritis associated with nail psoriasis that was successfully treated with adalimumab. A 51-year-old Japanese woman presented with joint swelling and pain. She had noticed fingernail deformity five years previously. Swelling and pain of the 2nd and 4th distal interphalangeal (DIP) joints of the left hand had occurred about one year earlier, and had worsened three months before she attended our hospital for assessment. On examination, there was swelling and tenderness of the DIP joints of both hands. There were multiple hyperkeratotic punctate depressions on the nail plates of both hands, as well as scales and onycholysis with shortening of the nails (Figure 1), but her trunk and limbs showed no changes specific to psoriasis. Laboratory tests revealed elevation of C-reactive protein (CRP) to 1.13 mg/dl and erythrocyte sedimentation rate to 38 mm/h. However, rheumatic antibodies were negative, including antinuclear antibodies, rheumatoid factor, and anti-cyclic citrullinated peptide antibodies. Her human leukocyte antigen (HLA) status was A2, A26, B39, and B61. A plain X-ray film of the fingers revealed erosion and narrowing of the DIP joints of both hands. A diagnosis of psoriatic arthritis (PsA) associated with nail psoriasis was made from these joint and nail findings. Oral methotrexate (MTX) was started at 4 mg/week (maximum dose: 10 mg/week) for her arthritis. Although her joint symptoms improved temporally, nail symptoms did not. CRP also decreased, but it increased again after 16 months. Recurrent synovitis was diagnosed and treatment with adalimumab (40 mg biweekly) was started. CRP improved rapidly, and her nail lesions resolved completely after five months of adalimumab therapy (Figure 2). Currently, inflammation is suppressed and her nail deformity has not recurred. PsA has been reported to affect from 5% to 42% of patients with psoriasis (1,2). Involvement of the nails is more frequent in patients with PsA than in those without PsA, and nail lesions with or without other skin lesions have been observed in about 80% of patients with PsA (8). However, there has only been one previous report of PsA with psoriatic eruptions localized to the nails, as in our case (3). It has been reported that PsA is related to specific HLA types. While ankylosing spondylitis has a strong relation with HLA-27, it has been reported that HLA-B13, B17 (including the subtypes B38 and B39), Cw6, Cw7, DR4, and DR7 are relevant to PsA (4,5). In addition, relation of PsA with HLA-A2 has been reported in Japanese patients (6,7). Our patient had an increase in both HLA-A2 and B39. Recently, it has become evident that PsA often has a chronic progressive course with early bone destruction, and causes marked impairment of the quality of life (6,7). A randomized double-blind trial of methotrexate (MTX) demonstrated it to be an efficient treatment only for arthritis in patients with psoriasis (8). In our patient, PsA was temporarily improved by MTX, but her punctate nail depressions and onycholysis did not resolve. Therefore, we switched to adalimumab to treat both PsA and nail lesions. Adalimumab was not only shown to improve skin eruptions but also improved joint symptoms and inhibited the progression of joint destruction in a placebo-controlled double-blind trial (9). Tumor necrosis factor inhibitors have only been used to treat PsA for a few years. Treatment with these drugs must be performed effectively and safely. PMID:24813847

Ikumi, Natsumi; Kitamura, Noboru; Shiraiwa, Hidetaka; Inomata, Hirotake; Nozaki, Takamasa; Kuwana, Yoshikazu; Matsukawa, Yoshihiro; Hayama, Takashi; Sawada, Shigemasa; Takei, Masami; Ochiai, Toyoko

2014-04-01

334

The syndrome of multiple ankyloses and facial anomalies  

Microsoft Academic Search

An infant with the clinical syndrome of multiple joint ankyloses and facial anomalies was examined at autopsy. Neuropathologic analysis disclosed reduced numbers of spinal motor neurons and denervation atrophy of skeletal muscle as the basis for joint ankyloses. A comparison of the neuropathologic findings in this case to those of other clinically similar cases reported recently confirms that this phenotype

Roger S. Williams; Lewis B. Holmes

1980-01-01

335

[Sports and recreational activities as a form of functional treatment of patients with ankylosing spondilytis].  

PubMed

Ankylosing spondylitis is a chronic inflammatory rheumatic disease that primarily affects the sacroiliac joints and spine, although it may involve entheses, peripheral joints and extraarticular organs. Disease treatment is directed toward the suppression of the inflammatory process and the improvement of the musculoskeletal system function. There are several treatment modalities: education of the patient and members of the family, pharmacological treatment, physical therapy and, in some cases, surgical treatment. An important segment of various modalities of physical therapy belongs to kinesitherapy, sports and recreation whose duration and intensity largely depends not only on the actual functional impairments, but also on the presence of some other disease or contraindications. Kinesitherapy is directed toward maintenance and improvement of the function of the spine, thoracic cavity and large synovial joints as well as the prevention of deformities or contractures. Kinesitherapy and sports programmes may involve individual or group approach. Patients are encouraged to participate in sports activities that may imitate or substitute specific forms of exercises. PMID:18949929

Grubisi?, Frane; Grazio, Simeon; Znika, Matea

2007-01-01

336

Certolizumab pegol: a review of its use in patients with axial spondyloarthritis or psoriatic arthritis.  

PubMed

Certolizumab pegol (Cimzia(®)) is a polyethylene glycolylated antigen-binding fragment of a recombinant human monoclonal antibody that binds to and selectively neutralizes tumour necrosis factor (TNF) ?. In the EU, subcutaneous certolizumab pegol is indicated for the treatment of adults with severe active axial spondyloarthritis (axSpA), comprising ankylosing spondylitis (AS) and non-radiographic axSpA (nr-axSpA), and for adults with active psoriatic arthritis (PsA). In the USA it is indicated for the treatment of adults with active AS or active PsA. This article reviews the efficacy and tolerability of certolizumab pegol in these patients and briefly summarizes its pharmacology. In two ongoing, well-designed studies, data at 12 and 24 weeks showed that treatment with certolizumab pegol (200 mg every 2 weeks or 400 mg every 4 weeks) was effective in improving the clinical signs and symptoms of disease, health-related quality of life and productivity in patients with axSpA (the RAPID-axSpA study) or PsA (the RAPID-PsA study), with the improvements maintained during longer-term (48 weeks) treatment. Within the axSpA population, clinical benefits with certolizumab pegol were seen both in patients with AS and in those with nr-axSpA. In addition, 12 weeks' treatment with certolizumab pegol reduced inflammation in the sacroiliac joints and spine in patients with axSpA and 24 weeks' treatment with the agent slowed radiographic disease progression in patients with PsA. Certolizumab pegol was generally well tolerated in these studies, with a tolerability profile consistent with that seen in previous clinical trials in other indications. Although additional long-term and comparative data are needed to position certolizumab pegol with respect to other TNF? antagonists, current evidence indicates that certolizumab pegol is an effective option for the treatment of axSpA (including AS and nr-axSpA) and PsA. PMID:24919863

Dhillon, Sohita

2014-06-01

337

HLA-B27 positive juvenile arthritis with cardiac involvement preceding sacroiliac joint changes  

PubMed Central

While cardiovascular disease develops in up to 50% of adult patients with ankylosing spondylitis, it is very uncommon in its juvenile counterpart. Regarding the early stage of the disease, before onset of sacroiliac joint changes, only two cases with aortic incompetence have been published while reports of mitral valve involvement are not available. A 13 year old boy is described with an HLA-B27 positive asymmetric oligoarthritis and enthesitis, without back pain or radiographic evidence of sacroiliitis. Echocardiography showed an echogenic structure measuring 8 × 11 × 20 mm at the fibrous continuity between the aortic and mitral valves extending through a false tendon into an echogenic thickened posterior papillary muscle, causing a grade II aortic and grade I/II mitral regurgitation. Short term corticosteroid and long term non-steroidal anti-inflammatory drug and disease modifying antirheumatic drug treatments efficiently controlled the symptoms. The cardiac findings remained unchanged during a follow up of 20 months. Careful cardiac evaluation appears to be mandatory even in these young patients.???Keywords: juvenile ankylosing spondylitis; HLA-B27; aortic valve insufficiency; mitral valve insufficiency

Lee, S; Im H, Y; Schueller, W

2001-01-01

338

Patellofemoral Arthritis  

MedlinePLUS

... are covered with a slippery substance called articular cartilage. This helps the bones glide smoothly along each ... page Description Patellofemoral arthritis occurs when the articular cartilage along the trochlear groove and on the underside ...

339

Rheumatoid Arthritis  

MedlinePLUS Videos and Cool Tools

... vertebrae to prevent slippage of the vertebrae. Self-Care Rheumatoid arthritis cannot be cured but it can be managed through medications and self-care. The following are important self-care tips: Exercise ...

340

Arthritis Advice  

MedlinePLUS

... people most often have osteoarthritis, rheumatoid arthritis, or gout. Osteoarthritis (OA) is the most common type of ... heart, muscles, blood vessels, nervous system, and eyes. Gout is one of the most painful kinds of ...

341

Psoriatic Arthritis  

MedlinePLUS

... Molluscum contagiosum Nummular dermatitis Pityriasis rosea Poison ivy Psoriasis Psoriatic arthritis Signs, symptoms Who gets, causes Diagnosis, ... it is so important for people who have psoriasis to let their doctor know if they have ...

342

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 ...

343

Rheumatoid Arthritis  

Microsoft Academic Search

\\u000a Rheumatoid arthritis (RA) affects all ethnic groups. Women are nearly three times more likely than men to develop the disease.\\u000a The pattern of arthritis typically favors distal and symmetrical involvement. The most commonly involved joints are the wrists,\\u000a metacarpophalangeal, proximal interphalangeal, and metatarsophalangeal joints. However, many other joints can also be involved.\\u000a Shoulder, elbow, hip, knee, or neck disease (particularly

James R. O'Dell; Josef S. Smolen; Daniel Aletaha; Dwight R. Robinson; E. William St. Clair

344

Quick Stats on Arthritis  

MedlinePLUS

... Clinically Significant Arthritis with Functional Limitation Arthritis Self-Management Education - Dose-Response Development and Evaluation of a Mail Delivered Self-Management Education Program for People with Arthritis Completed Projects A ...

345

Arthritis: Metacarpophalangeal (MP) Joint  

MedlinePLUS

... Z Hand Anatomy Find a Hand Surgeon Arthritis - MP Joint Email to a friend * required fields From * ... drift (See Figure 2). When arthritis affects the MP joints, the condition is called MP joint arthritis. ...

346

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, ...

347

Arthritis of the Knee  

MedlinePLUS

... in the article titled "Viscosupplementation Treatment for Arthritis." Gold Salt Injections Special medical treatments for rheumatoid arthritis include gold salt injections and other disease-modifying drugs. Top ...

348

Septic arthritis in patients with rheumatoid arthritis  

Microsoft Academic Search

There is an increasing number of rheumatoid patients who get septic arthritis. Chronic use of steroids is one of the important predisposing factors. The clinical picture of septic arthritis is different in immunocompromised patients like patients with rheumatoid arthritis. The diagnosis and management are discussed in this review article.

Abdulaziz Al-Ahaideb

2008-01-01

349

Reactive arthritis or chronic infectious arthritis?  

PubMed Central

Microbes reach the synovial cavity either directly during bacteraemia or by transport within lymphoid cells or monocytes. This may stimulate the immune system excessively, triggering arthritis. Some forms of ReA correspond to slow infectious arthritis due to the persistence of microbes and some to an infection triggered arthritis linked to an extra-articular site of infection.

Sibilia, J; Limbach, F

2002-01-01

350

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

351

[Rheumatoid arthritis].  

PubMed

Pathogenesis of rheumatoid arthritis is likely to implicate anti-citrullinated protein/ peptide antibody(ACPA) and an immunodistortion including abnormal T cell subpopulation. Based on above and other recent findings, new biological agents targeted to inflammatory cytokines such as tocilizumab, activated T cells (abatacept) or B cells (ocrelizumab), as well as new small molecule drugs such as JAK3 inhibitor, are sure to further facilitate remission without impaired activity of daily life in patients with RA. The contribution of Japanese physician-scientists to the progress in rheumatology has been significant as described in this review, and it must be increasingly greater in the near future. PMID:19280922

Kameda, Hideto; Takeuchi, Tsutomu

2009-03-01

352

Autoimmune diseases: Solution of the environmental, immunological and genetic components with principles for immunotherapy and transplantation  

Microsoft Academic Search

Autoimmune diseases have environmental and genetic components. These are the microbial trigger, the immunity system component and the genetic component. Here we describe these components and how they interact. Known microbial triggers are Streptococcus pyogenes for rheumatic carditis, Proteus mirabilis for rheumatoid arthritis and Klebsiella pneumoniae for ankylosing spondylitis. The immunity system component has been clarified by realisation that no

Duncan D. Adams; John G. Knight; Alan Ebringer

2010-01-01

353

Rare Association of Chronic Lymphocytic Thyroiditis with Dermatomyositis  

Microsoft Academic Search

Autoimmune thyroid disease (AITD) has been associated with other autoimmune diseases such as chronic urticaria, insulin-dependent diabetes mellitus, Sjøgren's syndrome, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, systemic lupus erythematosus, psoriasis, ankylosing spondylitis, and dermatomyositis (DM) (1,2). AITD is a common disorder affecting primarily women, and both genetic and environmental factors are included in its pathogenesis (3). DM is considered

Konstantinos Charalabopoulos; Evanthia Mittari; Dimitrios Peschos; Christos Golias; Alexander Charalabopoulos; Eleni Tsanou; Anna Batistatou

2006-01-01

354

Investigation of joint disease  

Microsoft Academic Search

The role of nuclear medicine in the diagnosis and management of the major arthropathies is critically reviewed, with particular reference to osteoarthritis, rheumatoid and similar forms of arthritis, ankylosing spondylitis, non-specific back pain, gout, the neuropathic joint, avascular necrosis, infection and the consequences of prosthetic joint insertion. Attention is drawn both to practical applications and deficiencies in current techniques and

M. V. Merrick

1992-01-01

355

Chronic inflammatory rheumatic diseases in black Zimbabweans  

Microsoft Academic Search

The pattern of chronic inflammatory rheumatic diseases seen in 52 black Zimbabweans was determined. These diseases constituted 2% of all treatable chronic endemic medical diseases registered around Gweru City. Rheumatoid arthritis (RA) and gout were the commonest, 38.8% and 28.8% of the total respectively. Systemic lupus erythematosus (SLE), polymyositis, progressive systemic sclerosis, mixed connective tissue disease, ankylosing spondylitis, and Reiter's

S K Lutalo

1985-01-01

356

Diclofenac-associated hepatotoxicity: Analysis of 180 cases reported to the food and drug administration as adverse reactions  

Microsoft Academic Search

Diclofenac is a nonsteroidal anti-inflammatory drug approved in the United States in 1988 for the treatment of patients with osteoarthritis, rheumatoid arthritis, or ankylosing spondylitis. To characterize the clinical, biochemical, and histological features and possible mechanisms of hepatic injury associated with its use, a retrospective analysis was undertaken of 180 patients whose cases were reported to the Food and Drug

Alpha T. Banks; Hyman J. Zimmerman; Kamal G. Ishak; John G. Harter

1995-01-01

357

Diclofenac induced in vivo nephrotoxicity may involve oxidative stress-mediated massive genomic DNA fragmentation and apoptotic cell death  

Microsoft Academic Search

Diclofenac (DCLF) is a nonsteroidal anti-inflammatory drug that is widely used for the treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute muscle pain conditions. Toxic doses of DCLF can cause nephrotoxicity in humans and experimental animals. However, whether this DCLF-induced nephrotoxicity involves apoptotic cell death in addition to necrosis is unknown. The goals of this investigation were to determine

E. J Hickey; R. R Raje; V. E Reid; S. M Gross; S. D Ray

2001-01-01

358

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.

2010-01-01

359

Arthritis and Heart Disease  

MedlinePLUS

... they meet – breaks down, causing pain and stiffness. Rheumatoid arthritis (RA) : a condition affecting 1.5 million Americans ... of adults with heart disease. For people with rheumatoid arthritis, their RA is now known to be a ...

360

Estimates Childhood Arthritis  

MedlinePLUS

... find a rheumatologist, use the American College of Rheumatology Geographic Membership Directory . Data Source: Sacks JJ, Helmick ... visits from selected pediatric conditions Childhood Arthritis and Rheumatology Research Alliance (CARRA) Arthritis Foundation American College of ...

361

Arthritis: Frequently Asked Questions  

MedlinePLUS

... 60% of the people with arthritis are women. Gout is more common in men. Genetic: Specific genes ... What causes arthritis? Elevated uric acid levels cause gout, and specific infections can cause certain forms of ...

362

Immunogenicity and safety of the 2009 non-adjuvanted influenza A\\/H1N1 vaccine in a large cohort of autoimmune rheumatic diseases  

Microsoft Academic Search

BackgroundDespite the WHO recommendation that the 2010–2011 trivalent seasonal flu vaccine must contain A\\/California\\/7\\/2009\\/H1N1-like virus there is no consistent data regarding its immunogenicity and safety in a large autoimmune rheumatic disease (ARD) population.Methods1668 ARD patients (systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), ankylosing spondylitis (AS), systemic sclerosis, psoriatic arthritis (PsA), Behçet's disease (BD), mixed connective tissue disease, primary antiphospholipid syndrome

Carla G S Saad; Eduardo F Borba; Nadia E Aikawa; Clovis A Silva; Rosa M R Pereira; Ana Luisa Calich; Julio C B Moraes; Ana C M Ribeiro; Vilma S T Viana; Sandra G Pasoto; Jozelio F Carvalho; Ivan L A França; Lissiane K N Guedes; Samuel K Shinjo; Percival D Sampaio-Barros; Maria T Caleiro; Celio R Goncalves; Ricardo Fuller; Mauricio Levy-Neto; Maria do Carmo S Timenetsky; Alexander R Precioso; Eloisa Bonfa

2011-01-01

363

MR Imaging Characteristics of Tuberculous Spondylitis vs Vertebral Osteomyelitis  

Microsoft Academic Search

Retrospective evaluation was made of four patients with tuberculous spondylitis wbe had been studied by MR with Ti- and T2-weighted images in the sagittal plane and spin-density-weighted images in the axial plane. Evaluation was made of the distribution of abnormal signals within the body and posterior elements of the vertebrae, the intervertebral disk, and the associated paraspinal and epidural areas.

Alison S. Smith; Meredith A. Weinstein; Akira Mizushima; Bret Coughlin; Stephen P. Hayden; Milton M. Lakin; Charles F. Lanzieri

364

Percutaneous endoscopic discectomy and drainage for infectious spondylitis  

PubMed Central

Fifteen patients with infectious spondylitis were treated by percutaneous endoscopic discectomy and drainage (PEDD) and associated appropriate parenteral antibiotics. Infectious spondylitis was diagnosed clinically, on the basis of elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values, and on roentgenographic and magnetic resonance imaging (MRI) findings. Causative bacteria were identified in 13 (86.7%) of 15 biopsy specimens. Systemic antibiotics were administered according to sensitivity analyses of pathogens. All patients reported immediate back pain relief except for two, who required anterior debridement and fusion one week and two weeks later, respectively. Two other patients with recurrent infection and intractable pain underwent surgical intervention at one month and eight months after PEDD, respectively. The remaining 11 patients recovered uneventfully after full-course, specific, antimicrobial therapy. No surgery related complications or side effects were observed during at least 12 months of follow-up. In conclusion, PEDD can provide retrieval of sufficient specimens and has high diagnostic efficacy, thereby enabling prompt and appropriate antibiotic therapy to the offending pathogens. It can be considered an effective alternative for treating uncomplicated spondylitis.

Yang, Shih-Chieh; Chen, Lih-Huei; Niu, Chi-Chien; Lai, Po-Liang; Chen, Wen-Jer

2006-01-01

365

Alaska Arthritis and Osteoporosis Plan.  

National Technical Information Service (NTIS)

Table of Contents: Tables and figures; Executive summary; Introduction; What is Arthritis; What is Osteoporosis; Arthritis in the United States and Alaska; Osteoporosis in the United States and Alaska; Why Address both Arthritis and Osteoporosis in this P...

T. Knowles, J. Livey, K. Pearson

2002-01-01

366

Rheumatoid Arthritis Educational Video Series  

MedlinePLUS Videos and Cool Tools

... Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid Arthritis Patients Rehabilitation of Older Adult ... Sheets Benefits and Risks of Opioids in Arthritis Management How to Give a Subcutaneous Injection All information ...

367

Rheumatoid Arthritis Educational Video Series  

MedlinePLUS Videos and Cool Tools

... Depression in Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid ... intended for educational purposes only. Physicians and other health care professionals are encouraged to consult other sources ...

368

Juvenile Rheumatoid Arthritis  

Microsoft Academic Search

\\u000a Juvenile rheumatoid arthritis (JRA) is the most common type of childhood and adolescent chronic arthritis and a major cause\\u000a of short- and long-term disability among the pediatric age group with chronic pediatric diseases (Cassidy & Petty, 2005) The\\u000a term juvenile rheumatoid arthritis is used here because the criteria for this diagnosis (Cassidy et al., 1986) were the inclusion\\u000a criteria for

Michael A. Rapoff; Carol B. Lindsley

369

Bacterial and lyme arthritis  

Microsoft Academic Search

Septic arthritis is an infectious disease emergency, requiring aggressive joint drainage and prompt antibiotic therapy. Because\\u000a age and joint damage are major risk factors, septic arthritis may become more common as the baby-boom generation reaches senescence.\\u000a Bacteremic joint infections have a high mortality, and long-term disability from joint damage is common. Lyme arthritis has\\u000a a negligible mortality and low morbidity

John J. Ross; Linden T. Hu

2004-01-01

370

Juvenile Arthritis: Disease Types  

MedlinePLUS

... and Juvenile Chronic Arthritis ) Juvenile Spondyloarthropathies Lupus in Children Scleroderma Non-inflammatory Disorders / Chronic Pain Syndromes Fibromyalgia About the Foundation Annual Report Careers ...

371

Treating Psoriatic Arthritis  

MedlinePLUS

Toggle navigation Large Dropdown Menu Psoriasis About Psoriasis Treatments Related Conditions Women and Psoriasis Life with Psoriasis Access Health Care Resources and Tools Psoriatic Arthritis About Psoriatic ...

372

Surgical treatment of infectious spondylitis in patients undergoing hemodialysis therapy  

PubMed Central

Treatment of infectious spondylitis in hemodialysis patients remains a challenge because of comorbidities. This study aimed to evaluate the impact of end-stage renal disease (ESRD) on the clinical manifestations and surgical outcomes of patients with spinal infection. Sixteen patients who underwent surgical intervention were included. There were 3 thoracic and 13 lumbar lesions. All patients presented with intractable back pain at the start of treatment. Six patients had a fever, nine had inflammation at the hemodialysis access site, and six of them had concomitant bacteremia. Ten patients had an elevated leukocyte count. Serological tests indicated an elevation of the C-reactive protein and erythrocyte sedimentation rate level in all patients. Five patients had a neurological compromise. Postoperative complications included two mortalities, two iliac bone graft and implant dislodgement, and one retroperitoneal wound dehiscence. The preoperative mean visual analog scale score was 7.7 (range, 6–9), which improved to 3.4 (range, 2–5) at the final follow-up for 14 surviving patients. Neurological improvement was obtained by at least one grade in four Frankel C category patients. The radiographs revealed a good bony fusion in 12 cases although with a variable bone graft subsidence. In conclusion, early diagnosis of infectious spondylitis is difficult due to latent symptoms. A spine infection should be suspected in hemodialysis patients with severe back pain, even when they are afebrile. Surgical intervention for infectious spondylitis in ESRD patients undergoing hemodialysis can be performed with acceptable outcomes; however, the complication and mortality rates are relative high.

Fu, Tsai-Sheng; Kao, Yu-Hsein; Tsai, Tsung-Ting; Lai, Po-Liang; Niu, Chi-Chieh; Chen, Wen-Jer

2010-01-01

373

Chlamydia and chronic arthritis.  

PubMed

Certain bacterial infections have been demonstrated to be causative of reactive arthritis. The most common bacterial trigger of reactive arthritis is Chlamydia trachomatis. Chlamydia pneumoniae is another known cause, albeit far less frequently. Although Chlamydia-induced reactive arthritis will often spontaneously remit, approximately 30% of patients will develop a chronic course. Modern medicine has provided rather remarkable advances in our understanding of the chlamydiae, as these organisms relate to chronic arthritis and the delicate balance between host and pathogen. C. trachomatis and C. pneumoniae both have a remarkable ability to disseminate from the initial site of infection and establish persistently viable organisms in distant organ sites, namely the synovial tissue. How these persistent chlamydiae contribute to disease maintenance remains to be fully established, but recent data demonstrating that long-term combination antimicrobial treatment can not only ameliorate the symptoms but eradicate the persistent infection suggest that these chronically infecting chlamydiae are indeed a driving force behind the chronic inflammation. We are beginning to learn that this all appears possible even after an asymptomatic initial chlamydial infection. Both C. trachomatis and C. pneumoniae are a clear cause of chronic arthritis in the setting of reactive arthritis; the possibility remains that these same organisms are culpable in other forms of chronic arthritis as well. PMID:21864020

Carter, John D; Inman, Robert D; Whittum-Hudson, Judith; Hudson, Alan P

2012-12-01

374

Gene therapy for arthritis  

PubMed Central

Arthritis is among the leading causes of disability in the developed world. There remains no cure for this disease and the current treatments are only modestly effective at slowing the disease's progression and providing symptomatic relief. The clinical effectiveness of current treatment regimens has been limited by short half-lives of the drugs and the requirement for repeated systemic administration. Utilizing gene transfer approaches for the treatment of arthritis may overcome some of the obstacles associated with current treatment strategies. The present review examines recent developments in gene therapy for arthritis. Delivery strategies, gene transfer vectors, candidate genes, and safety are also discussed.

Traister, Russell S.

2008-01-01

375

Anterior instrumentation in tuberculous spondylitis: is it effective and safe?  

PubMed

Radical anterior débridement and strut grafting is the gold standard in the surgical treatment of tuberculosis spondylitis. For many years anterior instrumentation was avoided due to concerns about infection until recently. We investigated the effectiveness and safety of anterior instrumentation for different sites of involvement, number of involved levels, and different age groups in 100 consecutive patients (mean age, 44.3 +/- 12.4). We measured preoperative, postoperative, and final kyphotic deformities radiographically and looked for the presence of fusion. Patients had a minimum followup of 3 years (average, 4.5 years; range, 3-6 years). Addition of anterior instrumentation was effective in the correction of kyphotic deformity (19.8 degrees +/- 7.3 degrees) and facilitated solid fusion, with an average loss of 1.6 degrees +/- 1.8 degrees. Of the 44 patients with neurologic symptoms, 40 (90.9%) achieved full and four (9.1%) achieved partial recovery. There were no apparent pseudarthroses and implant failures. All patients demonstrated clinical healing of tuberculosis without recurrence and reactivation. All domains of the SRS-22 questionnaire showed improvements at the last followup. Anterior instrumentation represents a safe and effective method for the treatment of tuberculosis spondylitis, and it may be the ideal stabilization method thanks to less segment fusion, single approach, and obviating the need for external immobilization. PMID:17452918

Benli, I Teoman; Kaya, Alper; Acaro?lu, Emre

2007-07-01

376

Rheumatoid arthritis and fatigue.  

PubMed

Essential facts There are nearly 690,000 people in the UK with rheumatoid arthritis, a chronic autoimmune disease. Many of these people experience pain, inflammation, stiffness, reduced mobility and joint function, and fatigue. PMID:25005390

2014-07-01

377

What Is Psoriatic Arthritis?  

MedlinePLUS

... with a physician experienced in treating this condition. Cyclosporine, methotrexate, and sulfasalazine are some of the DMARDs used to treat psoriatic arthritis. Cyclosporine and methotrexate also can effectively treat psoriasis. One ...

378

Physical Activity and Arthritis  

MedlinePLUS

... activity are right for you. - American College of Sports Medicine - American Council on Exercise - American College of Rheumatology’s ... Let’s Move Together — Arthritis Foundation . American College of Sports Medicine. American Council on Exercise . YMCA . Videos Physical Activity ...

379

Psoriasis/Psoriatic Arthritis  

MedlinePLUS Videos and Cool Tools

... Are you pregnant or breastfeeding? Dr. Eichenfield, a pediatric and adolescent dermatologist with Rady Children's Hospital in ... Risk factors associated with having psoriatic arthritis in patients with cutaneous psoriasis. J Dermatol 37(5):426- ...

380

Living with Arthritis  

MedlinePLUS

... the large weight-bearing joints such as the shoulders, knees, hips, and spine, and the small joints of the hands, most commonly the thumbs. Rheumatoid arthritis is a chronic disorder affecting any part of ...

381

Arthritis of the Hand  

MedlinePLUS

... no longer work, a joint replacement or a fusion (arthrodesis) is performed. Joint fusions provide pain relief but stop joint motion. The ... you. Arthritis of the Hand cont. A joint fusion using a plate and screws at the base ...

382

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. ...

383

What Is Psoriatic Arthritis?  

MedlinePLUS

About psoriasis Treating psoriasis Psoriatic arthritis Pso what? Bullying Info for parents Childhood psoriasis Treatments Diet Support your child Get involved At school Bullying Resources Parent's forum Find a pediatric derm Further ...

384

Arthritis and the Feet  

MedlinePLUS

... for months, or years, then abate, sometimes permanently. Gout (gouty arthritis) : Gout is a condition caused by a buildup of ... sauces, shellfish, and brandy is popularly associated with gout, there are other protein compounds in foods such ...

385

Arthritis of the Wrist  

MedlinePLUS

... by just two types: osteoarthritis and rheumatoid arthritis. Osteoarthritis Osteoarthritis (OA) is a progressive condition that destroys the ... Healthy joints move easily because of articular cartilage. Osteoarthritis causes this cartilage to wear away. When the ...

386

Understanding Arthritis: Eradicating Myths  

MedlinePLUS

... Knee Ankle Foot, Heel, & Toe View All Exercise Videos From yoga to strength training, get step-by- ... of an exclusive group fighting arthritis with extra energy and resolve! Support an Event Honor and Memorials ...

387

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

388

Arthritis: a family affair.  

PubMed

A diagnosis of arthritis affects not only those who have the disease, but also their family and close friends. Arthritis is not confined to old people, but affects people of all ages from the very young upwards. It is the biggest single cause of physical disability in the UK. It can produce a complex burden of physical and psycho-social effects. The misperception that it occurs only in later life is unhelpful for younger people. PMID:19911729

Spence, Jane

2009-01-01

389

[Inflammatory arthritis of the elderly].  

PubMed

Inflammatory arthritis of the elderly have growned new interest because of their frequency and also because new syndromes or subsets of arthritis of the young adults have been recently described. The originality of seropositive rheumatoid arthritis beginning after 70 years old is that management and prognosis are not different from early onset a RA. Various subsets of mild seronegative arthritis of the elderly that pose diagnostic problems with polymyalgia rheumatism (PMR) are also described. New syndromes, at least partly, presents as an original expression of late onset arthritis. Theses syndromes are characterized by rapid onset of arthritis with pitting non inflammatory oedema (RS3PE, described by McCarthy). Same syndromes resistant to steroids will reveal hemopathy or metastastic carcinoma. Late onset of inflammatory spondylarthropathy presenting as undifferentiated arthritis, fever, loss of weight and large oedemia is probably the most original presentation of arthritis specific to old males. PMID:16544922

Le Parc, Jean-Marie

2005-12-15

390

Psoriatic Arthritis of the Hand  

MedlinePLUS

... in to name and customize your collection. DESCRIPTION Psoriasis is a skin disease in which patients have ... the body. Between 5-20% of patients with psoriasis may develop an associated arthritis. Arthritis means inflamed ...

391

Psoriatic Arthritis of the Hand  

MedlinePLUS

... to name and customize your collection. Register DESCRIPTION Psoriasis is a skin disease in which patients have ... the body. Between 5-20% of patients with psoriasis may develop an associated arthritis. Arthritis means inflamed ...

392

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.  

National Technical Information Service (NTIS)

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 incorrec...

J. I. Fabrikant J. T. Lyman

1982-01-01

393

Distribution of HLA-B27 subtypes in patients with ankylosing spondylitis: the disease is associated with a common determinant of the various B27 molecules  

Microsoft Academic Search

HLA-B27 subtypes can be defined by cellular, serological, and biochemical techniques. The seven subtypes so far identified represent structural variants of B27 with limited variations in the amino acid sequence of the B27 molecule. The routinely typed B27 'antigen' remains a common (shared, public) determinant present on various B27 molecules. The distribution of the subtypes varies strongly among different ethnic

B S Breur-Vriesendorp; A J Dekker-Saeys; P Ivanyi

1987-01-01

394

Up regulation of the production of tumour necrosis factor ? and interferon ? by T cells in ankylosing spondylitis during treatment with etanercept  

PubMed Central

Objective: To assess the change in the cytokine secreting ability of CD4+ and CD8+ T cells and macrophages during etanercept treatment. Patients and methods: Peripheral blood mononuclear cells from 10 patients with AS treated with 25 mg etanercept and 10 patients with AS treated with placebo were investigated during treatment given twice weekly subcutaneously. Production of cytokines by T cells was investigated after in vitro stimulation by flow cytometry. Results: Twelve weeks of etanercept treatment induced a significant increase in the number of interferon ? (IFN?) positive (14.2% (9.6–19.5%) before v 24.4% (13.4–36.4%) after) and TNF? positive CD4+ T cells (p=0.008 for both cytokines) and IFN? positive (37.5% (19.0–45.4%) before v 52.9% (33.2–60.0%) after) and TNF? positive CD8+ T cells (p=0.008 for both cytokines) upon phorbol myristate acetate/ionomycin stimulation, but not in the placebo group. Furthermore, etanercept treatment induced a significant increase in the number of IFN? positive CD8+ T cells (p=0.024 at 12 weeks) and a non-significant increase of TNF? positive CD8+ T cells after in vitro stimulation with the aggrecan derived peptides. Conclusions: Neutralisation of peripheral TNF? does not induce a down regulation of the ability of T cells to produce TNF? but rather an up regulation, possibly due to a counterregulatory mechanism.

Zou, J; Rudwaleit, M; Brandt, J; Thiel, A; Braun, J; Sieper, J

2003-01-01

395

HLA-B27 and Ankylosing Spondylitis geographic distribution as the result of a genetic selection induced by malaria endemic? A review supporting the hypothesis  

Microsoft Academic Search

The geographic distribution of HLA-B27 shows a latitude-related gradient inverse to that of malaria endemic. An apparent exception occurs in New Guinea, a region where malaria is present, but where HLA-B27 frequency shows, however, an orographic gradient antithetic to that of malaria incidence. We therefore suggest that Plasmodium falciparum may have exerted a negative selection on this gene. This might

Alessandro Mathieu; Alberto Cauli; Maria Teresa Fiorillo; Rosa Sorrentino

2008-01-01

396

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

397

[Arthritis and clinical history].  

PubMed

In front of a patient with arthritis, clinical good-sense tells that the most probable diagnosis are the most prevalent ones. Nevertheless, we have to exclude a multiplicity of other aetiologies, less frequent, but with highest implications in the therapeutic conduct. Infections by Brucella and by Borrelia are rare causes of chronic arthritis, yet are diagnosis to consider, even when the clinical manifestations aren't the most typical, as there still exist endemic areas in Portugal. Here we report two clinical cases about patients with arthritis for more than one year, subject to ineffective exams ant treatments. Only the clinical history could put on evidence clinical-epidemiological data, suggestive of Brucellosis and Lyme Disease, namely the professional contact with infected animals, and the history of probable erythema migrans, that pointed toward the correct diagnosis. So, with directed therapeutic, there was complete resolution of the inflammatory symptoms. PMID:22521022

Silva, Lígia; Sampaio, Luzia; Pinto, José; Ventura, Francisco S

2011-01-01

398

Juvenile psoriatic arthritis.  

PubMed

Among 664 juvenile chronic arthritis patients cared for in the Outpatient Clinic of the Pediatric Rheumatology Unit of the National Institute of Rheumatology and Physiotherapy 11 were found with juvenile psoriatic arthritis, and their data regarding skin, joint, ophthalmological, laboratory and radiological manifestations were analysed. These patients were categorised according to the four subgroups suggested by Truckenbrodt et al. Considering that the occurrence of the disease is rare, the small number of patients investigated in this study can provide additional data to the study of Truckenbrodt. The higher number of patients with JPA thus studied can give more information for a multicentric evaluation. PMID:1790632

Koó, E; Balogh, Z; Gömör, B

1991-09-01

399

Radiological study of the sacroiliac joints in vertebral ankylosing hyperostosis.  

PubMed Central

A radiological study of the sacroiliac joints was undertaken in 54 patients (32 males, 22 females) with vertebral ankylosing hyperostosis (VAH) and in 46 control patients (24 males, 22 females) matched for age and sex. The ages ranged from 38 to 90 years. The radiographs were taken in anteroposterior, oblique, and craniocaudal projections. The films were read for cranial, ventral, and caudal capsular ossifications, for ventral and caudal osteophytes, and for bone sclerosis. Cranial and/or ventral capsular ossifications were found in 28 (87.5%) males with VAH and in 4 (16.6%) control males (p less than 0.0005), but only in 2 females with VAH and no control female. Sacroiliac capsular ossifications in males with VaH are frequent from the onset, but complete bridging of the joint is not reached before the sixth decade. Women, either VAH or control, have more sacroiliac osteophytes than men. There were 11 out of 22 control women with osteophytes versus 4 out of 24 men (p less than 0.025). The incidence of osteophytes does not seem to increase with age after 50 years. Our findings support the idea of VAH being a distinct entity and not a major form of osteophytosis. Images

Brigode, M; Francois, R J; Dory, M A

1982-01-01

400

New surgical technique and distraction osteogenesis for ankylosed dental movement.  

PubMed

Dental ankylosis often presents a significant vertical alveolar defect that is an esthetic problem for prosthetic rehabilitation. Moreover, surgical-orthodontic treatment by corticotomies and distraction devices provides special attention to avoid the loss of blood supply to the segment; furthermore, gingival recessions may appear because the gingival tissues cannot proliferate as fast as the immediate repositioning of the tooth.This case report presents a surgical technique for buccal, palatal, and vertical movements, and examines the effects of a tooth/arch-borne tooth distractor appliance, for the alignment of ankylosed teeth.The slow movements of tooth and bone block and fine cut simplifies orthodontic treatment in patients and makes it possible to achieve complex movements in a relatively short period. The reported dislocation procedure allows a use of buccal-lingual vertical osteotomy with horizontal osteotomy to correct tooth positions via bony block movement maintaining gingival tissues in position. The used sonic saw have proven to be a valuable alternative to manual or rotating tools, oscillating saws, or piezoelectric units because it is faster and easier for surgical approach. PMID:24777021

Agabiti, Ivo; Capparè, Paolo; Gherlone, Enrico Felice; Mortellaro, Carmen; Bruschi, Giovanni B; Crespi, Roberto

2014-05-01

401

Diclofenac induced toxic manifestations on adjuvant induced arthritic rats pheripheral and reproductive organ of male wistar rats rattus norvegicus  

Microsoft Academic Search

Non-Steroidal Anti-inflammatory Drugs (NSAIDs) are the most frequently prescribed therapeutic agents, used for the treatment of rheumatic diseases, because they have analgesic, antipyretic and anti- inflammatory actions. Diclofenac (Voltaren) is a well-known member of the acetic acid family of NSAIDs, used to reduce inflammation and pain associated with arthritis osteoarthritis, and ankylosing spondylitis. There is considerable interest in the toxicity

Sambandam Subramanian

2009-01-01

402

Selective IgA deficiency and spondyloarthropathy: a distinct disease?  

PubMed Central

A woman with selective IgA deficiency and severe ankylosing spondylitis (AS), complicated by intractable peripheral arthritis, is described. Three previous cases of selective IgA deficiency and AS have been reported, all of whom had severe AS. It is suggested that selective IgA deficiency is a poor prognostic factor in AS and therefore warrants further investigation to determine the clinical course of such patients.

Herrero-Beaumont, G; Armas, J B; Elswood, J; Will, R K; Calin, A

1990-01-01

403

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

404

A case of psoriasis with secondary amyloidosis, associated symbrachydactyly of the hand and a transverse deficiency of the foot.  

PubMed

Secondary amyloidosis is associated with a variety of chronic inflammatory diseases such as rheumatoid arthritis, ankylosing spondylitis, familial Mediterranean fever, osteomyelitis, inflammatory bowel diseases and infective or neoplastic conditions. Few cases of secondary amyloidosis complicating psoriasis have been reported. We describe a 58-year-old patient with secondary amyloidosis, psoriasis, an associated symbrachydactyly of the hand and a transverse deficiency of the foot. To the best of our knowledge, no case of this association has been previously reported. PMID:22953651

Balzani, A; Pagnotta, A; Montesi, G; Gravante, G; Nicoli, F; Cervelli, V

2012-07-01

405

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

406

Organizing Pneumonia Preceding Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis patients are susceptible to interstitial lung disease, and joint manifestations of rheumatoid arthritis usually precede lung involvements by several years. Organizing pneumonia, as the first manifestation of rheumatoid arthritis, is extremely rare, and its clinical features remain currently unknown. We present a case and a literature review of patients who were pathologically diagnosed with organizing pneumonia first and met the diagnostic criteria of rheumatoid arthritis later. In this review, we observed the following: (1) patients with organizing pneumonia preceding rheumatoid arthritis have a high prevalence of rheumatoid factor or anticyclic citrullinated peptide antibodies; (2) almost all patients developed rheumatoid arthritis within one year after the diagnosis of organizing pneumonia. We suggest that patients with organizing pneumonia and positive for either rheumatoid factor or anticyclic citrullinated peptide antibody should be cautiously followed up regarding the development of rheumatoid arthritis, particularly during the first year after the diagnosis of organizing pneumonia.

Kinoshita, Yoshiaki; Sakamoto, Atsuhiko; Hidaka, Kouko

2014-01-01

407

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.

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

2013-01-01

408

What Is Juvenile Arthritis?  

MedlinePLUS

... booklet. To order the Juvenile Arthritis Q&A full-text version, please contact NIAMS using the contact information above. To view the complete text or to order online, visit ... updates and for any questions about any medications you are taking, please ...

409

What Is Reactive Arthritis?  

MedlinePLUS

... NIAMS publication. To order Reactive Arthritis Q&A full-text version, please contact NIAMS using the contact information above. To view the complete text or to order online, visit ... updates and for any questions about any medications you are taking, please ...

410

What Is Rheumatoid Arthritis?  

MedlinePLUS

... publication. To order Rheumatoid Arthritis Handout on Health full-text version, please contact NIAMS using the contact information above. To view the complete text or to order online, visit ... updates and for any questions about any medications you are taking, please ...

411

Rheumatoid arthritis: sequences  

Microsoft Academic Search

Objective: Rheumatoid arthritis (RA) is an autoimmune disorder of unknown etiology characterized by symmetric, erosive synovitis and sometimes multisystem involvement. It affects 1% of the adult population and exhibits a chronic fluctuating course which may result in progressive joint destruction, deformity, disability and premature death. We review the literature data relative to the peculiar pathologic features of the disease shown

Pier Nuccio Scutellari; Carlo Orzincolo

1998-01-01

412

Oxidation in rheumatoid arthritis  

Microsoft Academic Search

Oxygen metabolism has an important role in the pathogenesis of rheumatoid arthritis. Reactive oxygen species (ROS) produced in the course of cellular oxidative phosphorylation, and by activated phagocytic cells during oxidative bursts, exceed the physiological buffering capacity and result in oxidative stress. The excessive production of ROS can damage protein, lipids, nucleic acids, and matrix components. They also serve as

Carol A Hitchon; Hani S El-Gabalawy

2004-01-01

413

Classification of Psoriatic Arthritis  

MedlinePLUS

... provider TalkPsoriasis Online Community Free Health E-Newsletters Psoriasis and Psoriatic Arthritis Info Kit One to One ... Register Find us online: Facebook Twitter YouTube TalkPsoriasis Psoriasis About Psoriasis Treatments Related Conditions Women and Psoriasis ...

414

Diagnosing Psoriatic Arthritis  

MedlinePLUS

... provider TalkPsoriasis Online Community Free Health E-Newsletters Psoriasis and Psoriatic Arthritis Info Kit One to One ... Register Find us online: Facebook Twitter YouTube TalkPsoriasis Psoriasis About Psoriasis Treatments Related Conditions Women and Psoriasis ...

415

B Effector Cells in Rheumatoid Arthritis and Experimental Arthritis  

PubMed Central

Rheumatoid arthritis is a chronic autoimmune immune disease affecting approximately 1% of the population. There has been a renewed interest in the role of B cells in rheumatoid arthritis based on the evidence that B cell depletion therapy is effective in the treatment of disease. This review summarizes the current knowledge of the mechanisms by which B cells contribute to autoimmune arthritis including roles as autoantibody producing cells, antigen-presenting cells, cytokine producing cells, and regulatory cells.

Finnegan, Alison; Ashaye, Susan; Hamel, Keith M.

2013-01-01

416

Questions and Answers about Reactive Arthritis.  

National Technical Information Service (NTIS)

The arthritis associated with reactive arthritis typically involves pain and swelling in the knees, ankles, and feet. wrists, fingers, and other joints are affected less often. People with reactive arthritis commonly develop inflammation of the tendons (t...

2002-01-01

417

Video-Assisted Thoracic Surgery for Tubercular Spondylitis  

PubMed Central

The present study evaluated the outcome of video-assisted thoracic surgery (VATS) in 9 patients (males = 6, females = 3) with clinico-radiological diagnosis of tubercular spondylitis of the dorsal spine. The mean duration of surgery was 140.88 ± 20.09 minutes, mean blood was 417.77 ± 190.90?mL, and mean duration of postoperative hospital stay was 5.77 ± 0.97 days, Seven patients had a preoperative Grade A neurological involvement, while at the time of final followup the only deficit was Grade D power in 2 patients. In patients without bone graft placement (n = 6), average increase in Kyphosis angle was 16°, while in patients with bone graft placement (n = 3) the deformity remained stationary. At the time of final follow up, fusion was achieved in all patients, the VAS score for back pain improved from a pretreatment score of 8.3 to 2, and the function assessment yielded excellent (n = 4) to good (n = 5) results. In two patients minithoracotomy had to be resorted due to extensive pleural adhesions (n = 1) or difficulty in placement of graft (n = 1). Videoassisted thoracoscopic surgery provides a safe and effective approach in the management of spinal tuberculosis. It has the advantages of decreased blood loss and post operative morbidity with minimal complications.

Singh, Roop; Gogna, Paritosh; Parshad, Sanjeev; Karwasra, Rajender Kumar; Karwasra, Parmod Kumar; Kaur, Kiranpreet

2014-01-01