MedWorm: Ankylosing Spondylitis

Inflammation and ankylosis: still an enigmatic relationship in spondyloarthritis

Annals of the Rheumatic Diseases — Mon, 06 Feb 2012 05:00:00 +0100

The introduction of targeted therapies against cytokine tumour necrosis factor (TNF) alpha has dramatically changed the management, prognosis and perspectives of patients with ankylosing spondylitis (AS) and related forms of spondyloarthritis.1 Both the soluble TNF receptor etanercept and the different anti-TNF antibodies are highly successful in reducing the signs and symptoms of disease, thereby improving quality of life, participation in the work force and the overall wellbeing of patients.2 3 Clinical evidence suggests that anti-TNF therapies are more successful and the effect more sustained than in other diseases such as rheumatoid arthritis (RA) and inflammatory bowel disease.4 However, in contrast to what is seen in patients with RA, anti-TNF does not appear to have an impact on the...

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MRI inflammation at the vertebral unit only marginally predicts new syndesmophyte formation: a multilevel analysis in patients with ankylosing spondylitis

Annals of the Rheumatic Diseases — Mon, 06 Feb 2012 05:00:00 +0100

Conclusion MRI inflammation in a vertebral unit slightly increases the propensity to form a new syndesmophyte in the same vertebral unit, but does not predict the growth of already existing syndesmophytes. Despite this association, the large majority of new syndesmophytes developed in vertebral units without inflammation. The subtle association at the vertebral unit level did not translate into an association at the patient level. (Source: Annals of the Rheumatic Diseases)

Reversible male infertility under treatment with an anti-TNF{alpha} agent: a case report

Annals of the Rheumatic Diseases — Mon, 06 Feb 2012 05:00:00 +0100

We describe here a rare case of reversible oligoasthenozoospermia in a young patient. Case report This case concerns a 35-year-old father of a healthy 4-year-old child who was successfully treated for 3 years with adalimumab, a monoclonal human antibody against TNFα, 40 mg subcutaneously every 2 weeks for ankylosing spondylitis (AS). The therapy was well tolerated except for transient mild increases of liver enzymes. Three years after therapy onset, the patient was investigated for infertility. The sperm analysis revealed an oligoasthenozoospermia with a substantially decreased sperm concentration of 0.9 mil/ml (N>15 mil/ml, WHO 20101) and decreased sperm... (Source: Annals of the Rheumatic Diseases)

Pain management for inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and other spondylarthritis)

NeLM - Disease Focused Reviews — Wed, 01 Feb 2012 05:00:00 +0100

Source: Cochrane Area: Evidence > Disease Focused Reviews Background Even with optimal disease-modifying treatment and good control of disease activity, persistent pain due to structural damage is common in people with inflammatory arthritis and therefore additional treatment for pain might be required. Because comorbidity is highly prevalent in people with inflammatory arthritis, it is important to consider comorbidities such as gastrointestinal or liver diseases in deciding upon optimal pharmacologic pain therapy. Objectives To assess the efficacy and safety of pharmacological pain treatment in patients with inflammatory arthritis who have gastrointestinal or liver comorbidities, or both. Search methods We searched MEDLINE, EMBASE...

Inflammatory Spinal Disease in Psoriatic Arthritis: A Report from the GRAPPA 2010 Annual Meeting.

J Rheumatol — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Gladman DD Abstract Diagnosing axial disease in patients with psoriatic arthritis (PsA) has been largely dependent on identifying inflammatory back pain (IBP), which itself has been difficult to define. We review the criteria used to identify IBP in patients with ankylosing spondylitis (AS) and other forms of spondyloarthritis. Recently, the Ankylosing SpondyloArthritis International Society (ASAS) developed a list of clinical and radiographic criteria for identifying IBP in patients with AS. However, it is more difficult to identify IBP in patients with PsA because generally they have less pain than patients with rheumatoid arthritis or AS. Further, PsA patients may have clinical symptoms of pain but negative radiographs. It may be more useful to identify sacroiliitis or ...

The intestinal microbiome in ankylosing spondylitis: Comment on the article by Rosenbaum and Davey

Arthritis and Rheumatism — Mon, 30 Jan 2012 13:25:38 +0100

(Source: Arthritis and Rheumatism)

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Nonsteroidal antiinflammatory drug intake according to the Assessment of SpondyloArthritis International Society Score in clinical trials evaluating tumor necrosis factor blockers: Example of etanercept in advanced ankylosing spondylitis

Arthritis Care and Research — Fri, 27 Jan 2012 10:29:35 +0100

ConclusionThis study confirms the feasibility and simplicity of the ASAS‐NSAID score and suggests that such a score be integrated in all studies in spondylarthritis either to check the quality of the observed data (i.e., intergroup baseline characteristics) or to evaluate the NSAID‐sparing effect of other therapies. (Source: Arthritis Care and Research)

Pain management for inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and other spondylarthritis) and gastrointestinal or liver comorbidity.

Cochrane Database of Systematic Reviews — Thu, 26 Jan 2012 08:18:08 +0100

CONCLUSIONS: On the basis of the current review, there is scant evidence to guide clinicians about how gastrointestinal or liver comorbidities should influence the choice of pain treatment in patients with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis or other spondylarthritis. Based upon additional studies that included a mixed population of participants with a range of rheumatic conditions, NSAIDs should be used cautiously in patients with inflammatory arthritis and a history of gastrointestinaI comorbidity as there is consistent evidence that they may be at increased risk. PMID: 22258995 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

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

Arthritis Research and Therapy — Wed, 25 Jan 2012 05:00:00 +0100

Reduced spinal mobility is associated with restrictive pulmonary function in patients with ankylosing spondylitis, emphasizing the importance of maintaining spinal flexibility in the management of the disease. (Source: Arthritis Research and Therapy)

Serum COMP-C3b complexes in rheumatic diseases and relation to anti-TNF-alpha treatment

Arthritis Research and Therapy — Fri, 20 Jan 2012 05:00:00 +0100

Conclusion: COMP-C3b levels are elevated in several rheumatologic diseases and correlate with inflammatory measures in RA. COMP-C3b levels in RA decrease during TNF-alpha inhibition differently from CRP, suggesting that formation of COMP-C3b relates to disease features not reflected by general inflammation measures. (Source: Arthritis Research and Therapy)

Sick leave in patients with ankylosing spondylitis before and after anti-TNF therapy: a population-based cohort study

Rheumatology — Fri, 20 Jan 2012 05:00:00 +0100

Conclusion. There is a decline in sick leave during the first 12 months after initiation of TNF-antagonist treatment in AS patients not explained by societal factors or secular trends. The proportion of AS patients on disability pension remained unchanged during the observation period. (Source: Rheumatology)

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Assessment of work instability in spondyloarthritis: a cross-sectional study using the ankylosing spondylitis work instability scale

Rheumatology — Fri, 20 Jan 2012 05:00:00 +0100

Conclusion. Work instability was found to be high and its main determinant was patient's global assessment. The predictive validity of the AS-WIS in terms of job retention should be further assessed. (Source: Rheumatology)

The IL23/Th17 pathway as a therapeutic target in chronic inflammatory diseases.

Inflammation and Allergy Drug Targets — Fri, 20 Jan 2012 05:00:00 +0100

Authors: Toussirot E Abstract IL-23 is a pro-inflammatory cytokine belonging to the IL-12 cytokine family. IL-23 is essential for the differentiation of Th17 lymphocytes, a subtype of T lymphocyte implicated in chronic inflammatory/autoimmune mediated diseases. IL-23 and Th17 correspond to a new axis that drives immune activation and chronic inflammation through the differentiation and activation of Th17 cells. Animal models of chronic inflammatory diseases such as chronic joint diseases, inflammatory bowel diseases and demyelinating diseases strongly suggest the involvement of this cytokine pathway. Thus, IL-23/Th17 is considered as a relevant therapeutic target in autoimmune driven diseases, and biological agents blocking IL-23 or IL-17 are currently being developed. Ustekinumab ...

Guidance on the use of adalimumab for juvenile idiopathic arthritis in Japan

Modern Rheumatology — Thu, 19 Jan 2012 06:56:48 +0100

Abstract Adalimumab is a monoclonal antibody produced by DNA recombination technology, and is the first human monoclonal antibody against human tumor necrosis factor (TNF)-α in the world. Adalimumab binds with high affinity and specificity to soluble TNF-α and normalizes its biological action. The clinical development of adalimumab started in Europe. Adalimumab was approved for the treatment of rheumatoid arthritis (RA) in December 2002 in the United States and in September 2003 in the European Union. Since then, adalimumab has been approved for the expanded indications of psoriatic arthritis (PsA), ankylosing spondylitis (AS), Crohn’s disease (CD), psoriasis (Ps), and juvenile idiopathic arthritis (JIA) in the United States and the European Union, and it is now used w...

Assessment of Preclinical Atherosclerosis in Patients with Ankylosing Spondylitis.

J Rheumatol — Sun, 15 Jan 2012 05:00:00 +0100

CONCLUSION: AS is associated with an increased risk of atherosclerosis independent of traditional risk factors. Disease activity, functional and mobility limitations, structural damage, and inflammation are the most incriminated risk factors. PMID: 22247364 [PubMed - as supplied by publisher] (Source: J Rheumatol)

Predictors of Early Minimal Disease Activity in Patients with Psoriatic Arthritis Treated with Tumor Necrosis Factor-α Blockers.

J Rheumatol — Sun, 15 Jan 2012 05:00:00 +0100

CONCLUSION: In patients with PsA, age, CRP, and BASFI at the beginning of treatment were found to be reliable predictors of MDA after 3 months of TNF-α blocker therapy. PMID: 22247361 [PubMed - as supplied by publisher] (Source: J Rheumatol)

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Evaluation of Circulating Endothelial and Platelet Microparticles in Men with Ankylosing Spondylitis.

J Rheumatol — Sun, 15 Jan 2012 05:00:00 +0100

CONCLUSION: Circulating EMP and PMP, known to be indicators and mediators of vascular injury, were not significantly altered in men with AS who did not have classical cardiovascular risk factors. Significantly downregulated MP in patients receiving biological agents suggested that anti-TNF treatment may have a beneficial effect on vascular function in AS. PMID: 22247348 [PubMed - as supplied by publisher] (Source: J Rheumatol)

Interferon-γ Contributes to HLA-B27-associated Unfolded Protein Response in Spondyloarthropathies.

J Rheumatol — Sun, 15 Jan 2012 05:00:00 +0100

CONCLUSION: Expressions of GRP78, CHOP, and XBP-1 were higher in monocytes/macrophages of patients with SpA than those in both OA patients and healthy controls, suggesting that UPR may participate in the pathogenesis of SpA. TNF-α and IFN-α, IFN-ß, and IFN-γ significantly activated HLA-B27 promoter in the U937 cell line, and IFN-γ, the strongest activating factor, may induce the UPR in HLA-B27-expressing cells. PMID: 22247344 [PubMed - as supplied by publisher] (Source: J Rheumatol)

Interferon‐gamma release assay versus tuberculin skin test across RA, PsA, and AS patients prior to treatment with golimumab, a human anti‐TNF antibody

Arthritis and Rheumatism — Wed, 11 Jan 2012 05:00:00 +0100

Conclusion: In the absence of a true gold‐standard test for latent TB infection, results of this large comparison of IGRA and TST in patients with rheumatic disease suggest that the IGRA provides greater specificity and possibly greater sensitivity than the TST. © 2012 American College of Rheumatology. (Source: Arthritis and Rheumatism)

Is there a higher genetic load of susceptibility loci in familial ankylosing spondylitis?

Arthritis Care and Research — Mon, 09 Jan 2012 05:00:00 +0100

Conclusions:HLA‐B27 is more prevalent in familial than sporadic cases of AS, demonstrating higher familial aggregation of AS in patients with HLA‐B27 positivity. The frequency of the recently described non‐MHC susceptibility loci is not markedly different between the sporadic and familial cases of AS. © 2012 by the American College of Rheumatology (Source: Arthritis Care and Research)

The practical value of biologics registries in Africa and Middle East: challenges and opportunities

Clinical Rheumatology — Fri, 06 Jan 2012 16:49:37 +0100

Abstract Biologics, including tumor necrosis factor (TNF) inhibitors, are increasingly used for the treatment of inflammatory conditions such as rheumatoid arthritis (RA), psoriatic arthritis, and ankylosing spondylitis. The efficacy of these drugs has been demonstrated in randomized controlled trials (RCTs). However, these studies are conducted in controlled environments, and the results may not necessarily reflect clinical outcomes in daily clinical practice. In Europe and other western countries, numerous biologics registries that enroll and monitor patients receiving biologics have been established. These registries follow patients irrespective of whether they continue with the initial biologic drug. Thus, real-life efficacy data from these registries can be used to as...

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Home-based exercise therapy in ankylosing spondylitis: short-term prospective study in patients receiving tumor necrosis factor alpha inhibitors

Rheumatology International — Wed, 04 Jan 2012 16:50:16 +0100

Abstract The importance of exercise and regular physiotherapy in patients with ankylosing spondylitis (AS) under treatment with tumor necrosis factor alpha inhibitors (TNFα inhibitors) was reported in some studies, but the literature on this topic is still scarce. The aim of this study was to assess the effects of home-based exercise therapy on functional capacity, disease activity, spinal mobility, quality of life, emotional state and fatigue in patients with AS receiving TNFα inhibitors. Forty-two AS patients were trained on the disease, and home-based exercise program was demonstrated to all the patients. At baseline and at the end of 10 week, we evaluated Bath AS Disease Activity Index, Bath AS Functional Index, Bath AS Metrology Index, Multidimensional Assessme...

Assessment of sexual functions in female patients with ankylosing spondylitis compared with healthy controls

Rheumatology International — Wed, 04 Jan 2012 16:50:12 +0100

Abstract Healthy human sexuality is integral to a well-lived life. Recent studies reported that sexual problems were common in patients with ankylosing spondylitis (AS) in relation to the consequences of the illness such as pain, stiffness of the spine and depression. Twenty-three female patients with AS and 27 healthy female controls were applied the Female Sexual Function Index (FSFI) to determine the influence of the disease on sexual functions. The rate of low sexual function was 60.9% in female patients with AS and 66.7% in healthy controls (P > 0.05). Ten patients were depressed in our study group according to the Beck Depression Inventory (BDI), while 15 healthy controls were depressed (P > 0.05). No statistically significant differences wer...

Value of diffusion-weighted magnetic resonance imaging in early diagnosis of ankylosing spondylitis

Rheumatology International — Mon, 02 Jan 2012 16:55:45 +0100

The objective of this study is to estimate the value of diffusion-weighted MRI (DWI) in the detection of abnormalities in sacroiliac joints in the patients with early ankylosing spondylitis (AS) and investigate the feasibility of whole-body DWI (WB-DWI) in systemic evaluation of AS. Sixteen patients with early AS, 18 patients with simple low back pain (LBP), and 18 healthy volunteers were involved in this study. All subjects underwent conventional MRI and DWI. Apparent diffusion coefficient (ADC) in subchondral bone marrows of sacroiliac joints was measured. Independent-sample t test was used to statistically analyze the difference of ADC values between groups. WB-DWI was performed in additional 12 patients with clinically confirmed AS. The image results were analyzed by multiple post...

Prevalence and factors associated with uveitis in spondyloarthropathies patients in France: Results from the EXTRA observational survey

Arthritis Care and Research — Sun, 01 Jan 2012 05:00:00 +0100

Conclusion:Results indicate that uveitis is the most common extra‐articular feature of SpAs and that it occurs preferentially in HLA‐B27 positive patients and over all the course of the disease. (Source: Arthritis Care and Research)

[MRI examinations for axial and peripheral spondyloarthritis].

Zeitschrift fur Rheumatologie — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Baraliakos X, Braun J Abstract The diagnosis of ankylosing spondylitis (AS) is based on the modified New York criteria and therefore on defined structural changes in the sacroiliac joint as detected by conventional radiographs. However, x-rays are not able to detect early stages of the disease in which inflammation predominates and irreversible structural changes have not yet taken place. This probably contributes to a substantial time delay until a diagnosis is made. Magnetic resonance imaging (MRI) is able to visualize active and chronic changes in axial and peripheral spondyloarthritis (SpA) even before the occurrence of structural changes. The ability to demonstrate both active and, in a limited way, also structural changes makes MRI a diagnostic tool of increasing imp...

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[Early axial spondyloarthritis : Diagnostic approach and screening].

Zeitschrift fur Rheumatologie — Sun, 01 Jan 2012 05:00:00 +0100

[Early axial spondyloarthritis : Diagnostic approach and screening]. Z Rheumatol. 2012 Jan;71(1):19-26 Authors: Poddubnyy D, Rudwaleit M, Sieper J Abstract The diagnosis of axial spondyloarthritis (SpA) or ankylosing spondylitis (AS) is often delayed by 5-10 years after the first symptoms have appeared. In order to improve the early diagnosis of SpA an evidenced-based algorithm including clinical, laboratory and imaging parameters was developed. Moreover, the recently published ASAS criteria for axial and peripheral SpA should give rheumatologists more confidence in making the diagnosis of SpA and provide further support for the SpA concept. Furthermore, an easy strategy for the recognition of patients with a high probability of AS/SpA on the primary care level has been de...

Treatment for mycetoma with oral itraconazole in ankylosing spondylitis

Rheumatology International — Fri, 30 Dec 2011 16:41:57 +0100

Content Type Journal ArticleCategory Letter to the EditorsPages 1-2DOI 10.1007/s00296-011-2350-8Authors Ilknur Basyigit, Department of Pulmonary Disease, School of Medicine, Kocaeli University, Umuttepe, Kocaeli, 41400 TurkeyAyten Yazici, Department of Rheumatology, Sakarya Education and Research Hospital, Sakarya, TurkeyEsra Kuslu Ucar, Department of Pulmonary Disease, School of Medicine, Kocaeli University, Umuttepe, Kocaeli, 41400 TurkeyHasim Boyaci, Department of Pulmonary Disease, School of Medicine, Kocaeli University, Umuttepe, Kocaeli, 41400 TurkeyFusun Yildiz, Department of Pulmonary Disease, School of Medicine, Kocaeli University, Umuttepe, Kocaeli, 41400 Turkey Journal Rheumatology InternationalOnline ISSN 1437-160XPrint ISSN 0172-8172 (Source: Rheumatology Internatio...

Four cases of ankylosing spondylitis in medieval skeletal series from Croatia

Rheumatology International — Fri, 30 Dec 2011 16:41:56 +0100

Abstract Osteological changes consistent with ankylosing spondylitis were observed in three males and one female skeleton recovered from four medieval sites—Velim, Koprivno, Buje, and Rijeka—all situated on Croatia’s eastern Adriatic coast and its immediate hinterland. The skeletons present changes in the spine, ribs, sacrum, and innominates that are typical of ankylosing spondylitis that is a progressive, inflammatory disease of connective tissue calcification. The disease most commonly affects the sacroiliac joints, the joints of the spine, and the costovertebral joints. In the final stages of the disease, the vertebral bodies remodel and together with the associated syndesmophytes form a continuous, smooth bone surface that is sometimes referred to as “bamboo sp...

Chilblain lupus induced by TNF-α antagonists: a case report and literature review

Clinical Rheumatology — Fri, 30 Dec 2011 07:10:35 +0100

We report the case of a 72-year-old man with history of ankylosing spondylitis, who, during the treatment with infliximab, developed painful, erythematous-violaceous plaques with later development of ulcers on his feet associated with cold exposure. Concomitantly with the appearance of these lesions, he presented increased antinuclear antibodies (ANA) titers, positivity for anti-DNA and IgM anticardiolipin antibodies, low complement levels, polyclonal hypergammaglobulinemia, and lymphopenia. He was diagnosed of chilblain lupus induced by infliximab, this agent was withdrawn and initiated treatment for chilblains with improvement of lesions. On reviewing of the literature, we found seven reported cases of tumor necrosis factor α (TNF-α) antagonists-induced chilblain lupus, all in rh...

Psychometric evaluation of the Arabic version of the multidimensional assessment of fatigue scale (MAF) for use in patients with ankylosing spondylitis

Rheumatology International — Wed, 28 Dec 2011 16:46:14 +0100

Abstract Fatigue is a frequent symptom during ankylosing spondylitis (AS) often under estimated which needs to be measured properly with respect to its intensity by appropriate measures, such as the multidimensional assessment of fatigue (MAF). The aims of this study were to translate into the classic Arabic version of the MAF questionnaire and to validate its use for assessing fatigue in Moroccan patients with AS. The MAF contains 16 items with a global fatigue index (IGF). The MAF was translated and back-translated to arabic, pretested and reviewed by a committee following the Guillemin criteria (J Clin Epidemiol 46:1417–1432, 1993). It was then validate on 110 Moroccan patients with AS. Reliability for the 3-day test–retest was assessed using internal consistency by...

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A multicenter, open-label, efficacy, pharmacokinetic, and safety study of adalimumab in Japanese patients with ankylosing spondylitis

Modern Rheumatology — Wed, 28 Dec 2011 16:44:10 +0100

Abstract We evaluated the efficacy, pharmacokinetics, and safety of adalimumab in Japanese patients with active ankylosing spondylitis (AS) who had an inadequate response to, or who were intolerant of, treatment with ≥1 nonsteroidal anti-inflammatory drugs (NSAIDs). This phase 3, multicenter, open-label trial assessed the percentage of patients with a 20% response in the Assessment of SpondyloArthritis international society working group criteria (ASAS20) at week 12 as the primary endpoint. Secondary outcome measures included assessments of disease activity, clinical response, functionality, and spinal mobility at weeks 12 and 60. Serum trough adalimumab concentrations were summarized using descriptive statistics. The adverse event profile was summarized for patients who...

Gender characterization in a large series of Brazilian patients with spondyloarthritis

Clinical Rheumatology — Wed, 28 Dec 2011 06:52:23 +0100

Abstract An increasing number of women have been diagnosed with spondyloarthritis (SpA) in recent decades. While a few studies have analyzed gender as a prognostic factor of the disease, no studies have addressed this matter with a large number of patients in South America, which is a peculiar region due to its genetic heterogeneity. The aim of the present study was to analyze the influence of gender on disease patterns in a large cohort of Brazilian patients with SpA. A prospective study was carried out involving 1,505 patients [1,090 males (72.4%) and 415 females (27.6%)] classified as SpA according to the European Spondyloarthropaties Study Group criteria who attended at 29 reference centers for rheumatology in Brazil. Clinical and demographic variables were recorded an...

Interleukin‐22 and IL‐22‐producing NKp44+NK cells in the subclinical gut inflammation of patients with ankylosing spondylitis

Arthritis and Rheumatism — Tue, 27 Dec 2011 05:00:00 +0100

Conclusions:Our findings indicate that overexpression of IL‐22 together with an increased number of IL‐22‐producing‐NKp44+ NK cells occurs in the gut of AS patients where appear to play a tissue‐protective role. (Source: Arthritis and Rheumatism)

Rheumatoid Joint Disease - Mindfulness Exercises Help Significantly

Health News from Medical News Today — Mon, 26 Dec 2011 08:00:00 +0100

A small study published online in the Annals of Rheumatic Diseases reveals that "Mindfulness" exercises, irrespective of how difficult they are, that focus on experiencing the present moment can help to limit the stress and fatigue linked to painful rheumatoid joint disease. Researchers assessed 73 patients aged between 20 and 70 years with painful joint disease due to rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis for a minimum of 12 months... (Source: Health News from Medical News Today)

Improvement in pain intensity, spine stiffness, and mobility during a controlled individualized physiotherapy program in ankylosing spondylitis

Rheumatology International — Sat, 24 Dec 2011 16:44:44 +0100

In this study we assessed the functional status of AS patients in relation to disease duration and activity. Furthermore, in volunteering patients we analyzed the efficacy of a controlled, individualized physiotherapeutic program. Altogether, clinical data of 75 AS patients were retrospectively analyzed. Anthropometrical data, duration since diagnosis and disease activity, pain intensity, tender points, sacroiliac joint involvement determined by X-ray, functional condition, and physical activity level were recorded. Subjective, functional, and physical tests were performed. Out of the 75 patients, 10 volunteered to undergo a complex physical exercise program twice a week for 3 months. The program included 1.5 h of general posture reeducation, manual mobilization of the spi...

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Arachnoid ossificans of thoracolumbosacral spine in the advanced ankylosing spondylitis: a case report

Rheumatology International — Sat, 24 Dec 2011 06:41:24 +0100

We describe a 76-year-old man of ankylosing spondylitis with arachnoiditis ossificans, who has suffered from low back pain and neuropathic leg pain. Content Type Journal ArticleCategory Short CommunicationPages 1-3DOI 10.1007/s00296-011-2293-0Authors Kyung Bin Joo, Department of Radiology, Hanyang University Hospital, 17 Haengdang-dong, Sungdong-gu, Seoul, 133-792 KoreaSeunghun Lee, Department of Radiology, Hanyang University Hospital, 17 Haengdang-dong, Sungdong-gu, Seoul, 133-792 KoreaChang-Nam Kang, Department of Orthopaedic Surgery, Hanyang University Hospital, Seoul, 133-792 KoreaTae-Hwan Kim, Department of Rheumatology, Hanyang University Hospital, Seoul, 133-792 Korea Journal Rheumatology InternationalOnline ISSN 1437-160XPrint ISSN 0172-8172 (Source: Rheumatology Int...

Micropuncture Needles Combined with Ultrasound Guidance for Unusual Central Venous Cannulation: Desperate Times Call for Desperate Measures. A New Trick for Old Anesthesiologists.

Anesthesia and Analgesia — Tue, 20 Dec 2011 05:00:00 +0100

Authors: Castillo D, McEwen DS, Young L, Kirkpatrick J Abstract Central vascular access can be a very challenging task in patients with skeletal deformities such as ankylosing spondylitis, kyphosis, and chin-on-chest deformity. The use of traditional methods of accessing the central venous circulation in these patients can require multiple attempts and may lead to significant complications such as bleeding, pneumothorax, and vascular injury. Ultrasound-guided central venous access has become a very common procedure in the United States and Europe; its efficacy and safety have been demonstrated, and together with the use of micropuncture needles, the technique can facilitate central venous access in complicated cases. PMID: 22190551 [PubMed - as supplied by publisher] (Source: A...

Integrative Structural Biomechanical Concepts of Ankylosing Spondylitis

Clinical and Developmental Immunology — Sun, 18 Dec 2011 23:53:19 +0100

Ankylosing spondylitis (AS) is not fully explained by inflammatory processes. Clinical, epidemiological, genetic, and course of disease features indicate additional host-related risk processes and predispositions. Collectively, the pattern of predisposition to onset in adolescent and young adult ages, male preponderance, and widely varied severity of AS is unique among rheumatic diseases. However, this pattern could reflect biomechanical and structural differences between the sexes, naturally occurring musculoskeletal changes over life cycles, and a population polymorphism. During juvenile development, the body is more flexible and weaker than during adolescent maturation and young adulthood, when strengthening and stiffening considerably increase. During middle and later ages, the musculo...

Does anti-tnf therapy cause any change in platelet activation in ankylosing spondylitis patients?

Journal of Thrombosis and Thrombolysis — Thu, 15 Dec 2011 16:50:03 +0100

In this study, we evaluated platelet and endothelial activation parameters in AS patients. Fiftynine AS patients and 22 healthy controls were included. The clinical features and acute phase parameters were evaluated. In all patients and healthy controls, platelet-monocyte complexes (PMC), platelet-neutrophil complexes, basal and ADP-stimulated P-selectin (CD62P) expression were determined by flow cytometry; soluble E-selectin (sE-selectin) and soluble CD40L (sCD40L) were determined by ELISA. AS patients were divided into two groups as active and inactive by using BASDAI. In 15 AS patients, the evaluated parameters were assessed before and after 12 weeks of anti-TNF therapy. PMC and sCD40L levels in AS patients were significantly higher than in the control group (P values 0.013 a...

Plasma Phospholipid Fatty Acid Content Is Related to Disease Activity in Ankylosing Spondylitis.

J Rheumatol — Thu, 15 Dec 2011 05:00:00 +0100

CONCLUSION: There was a positive correlation between levels of arachidonic acid in plasma phospholipids and disease activity assessed by BASDAI in patients with AS. A Western diet does not appear to influence this correlation, but seems to affect blood lipids involved in atherogenic processes. PMID: 22174215 [PubMed - as supplied by publisher] (Source: J Rheumatol)

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Scleritis: A Paradoxical Effect of Etanercept? Etanercept-associated Inflammatory Eye Disease.

J Rheumatol — Thu, 15 Dec 2011 05:00:00 +0100

CONCLUSION: Ocular inflammation is paradoxically a potential adverse effect of etanercept, even in previously uninvolved eyes. PMID: 22174213 [PubMed - as supplied by publisher] (Source: J Rheumatol)

Incidence and risk factors for progressive multifocal leukoencephalopathy among patients with selected rheumatic diseases

Arthritis Care and Research — Mon, 12 Dec 2011 05:00:00 +0100

AbstractWe conducted a large, population‐based study to describe the incidence and risk factors for progressive multifocal leukoencephalopathy (PML) among patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), psoriasis (PsO), juvenile idiopathic arthritis (JIA), inflammatory bowel disease (IBD), and ankylosing spondylitis (AS) using national inpatient and outpatient administrative data from the entire Center for Medicare and Medicaid Services (CMS) from 2000‐2009. Suspected PML cases were identified using hospital discharge diagnosis codes. Risk factors for PML were evaluated using outpatient data >= 6 months prior to PML diagnosis.Among 2,030,578 patients with autoimmune diseases of interest, a total of 53 PML cases were identified (2.6/100,000 patients). Most PML cas...

Spinal inflammation by magnetic resonance imaging in patients with ankylosing spondylitis: association with disease activity and outcome parameters

Rheumatology International — Sat, 10 Dec 2011 16:55:15 +0100

Abstract Magnetic resonance imaging (MRI) has major contribution in early diagnosis of ankylosing spondylitis (AS). As it is difficult to determine disease activity owing to the lack of close relation between laboratory tests, clinical findings and imaging, MRI has been used as an objective outcome measure. The aim of this study is to investigate the relation between spinal MRI findings with disease activity and other outcome measures. Fifty patients fulfilling modified New York criteria for AS were enrolled to the study. All the patients were evaluated with Bath AS Disease Activity Index (BASDAI), AS Disease Activity Score (ASDAS), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASMI), Bath AS Radiology Index (BASRI) and As Quality of Life. Erythrocyte sedimen...

Celecoxib: A Review of its Use for Symptomatic Relief in the Treatment of Osteoarthritis, Rheumatoid Arthritis and Ankylosing Spondylitis

Drugs — Sat, 10 Dec 2011 07:06:09 +0100

(Source: Drugs)

Scientists Perform First Asian Genome-Wide Association Study On Spine Disease

Health News from Medical News Today — Tue, 06 Dec 2011 10:00:00 +0100

Singapore and China scientists, headed by Dr Liu Jianjun, Senior Group Leader and Associate Director of Human Genetics at the Genome Institute of Singapore (GIS) and Dr Gu Jieruo, a rheumatologist at the 3rd Affiliated Hospital of the Sun Yat-Sen University, have identified new genes that are associated with the spine disease ankylosing spondylitis (AS). This discovery, reported in the advanced online issue of Nature Genetics, brings scientists closer to understanding the disease and work towards its cure. AS is a progressive autoimmune disease... (Source: Health News from Medical News Today)

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Initiation of Tumor Necrosis Factor-{alpha} Antagonists and the Risk of Hospitalization for Infection in Patients With Autoimmune Diseases [Original Contribution]

JAMA — Tue, 06 Dec 2011 05:00:00 +0100

Conclusion Among patients with autoimmune diseases, compared with treatment with nonbiologic regimens, initiation of TNF-α antagonists was not associated with an increased risk of hospitalizations for serious infections. (Source: JAMA)

Aortitis in a patient with psoriatic arthritis

Modern Rheumatology — Mon, 05 Dec 2011 17:42:28 +0100

Abstract Aortitis, inflammation of the aortic tissue, is most commonly caused by vasculitic rheumatic conditions, and less frequently infectious organisms. Involvement of the aorta is well defined in HLA-B27-associated spondyloarthropathies such as long-standing ankylosing spondylitis and Reiter’s syndrome. However, unlike other spondyloarthropathies, aortic involvement or true aortitis is not a feature of psoriatic arthritis and has been reported in only a few cases. Herein, we report the case of a 22 year-old woman with psoriatic arthritis who developed descending aortitis while using tumor necrosis factor inhibitors. Content Type Journal ArticleCategory Case ReportPages 1-4DOI 10.1007/s10165-011-0566-9Authors Abdurrahman Tufan, Division of Rheumatology, Depa...

Enrichment of circulating IL‐17‐secreting IL‐23 receptor‐positive γδ T cells in patients with active ankylosing spondylitis

Arthritis and Rheumatism — Mon, 05 Dec 2011 05:00:00 +0100

Conclusions:Recently, mouse models have shown IL‐17 secreting γδ T cells to be pathogenic in infection and autoimmunity. Our data is the first description of a potentially pathogenic role for these cells in a human autoimmune disease. Since IL‐23 is a maturation and growth factor for IL‐17 producing cells, increased IL‐23R expression may regulate the function of this putative pathogenic γδ T cell population. (Source: Arthritis and Rheumatism)

Association of Interleukin-10 gene polymorphisms with ankylosing spondylitis.

Clinical and Investigative Medicine — Sun, 04 Dec 2011 21:30:02 +0100

Conclusion: Our results indicate that the gene haplotype of IL-10 can contribute to the susceptibility to AS in a Chinese population. PMID: 22129927 [PubMed - in process] (Source: Clinical and Investigative Medicine)

Singapore and China scientists perform first Asian genome-wide association study on spine disease

EurekAlert! - Social and Behavioral Science — Sun, 04 Dec 2011 05:00:00 +0100

(Agency for Science, Technology and Research (A*STAR), Singapore) Singapore and China scientists, headed by Dr. Liu Jianjun, Senior Group Leader and Associate Director of Human Genetics at the Genome Institute of Singapore and Dr. Gu Jieruo, a rheumatologist at the 3rd Affiliated Hospital of the Sun Yat-Sen University, have identified new genes that are associated with the spine disease ankylosing spondylitis. This discovery, reported in the advanced online issue of Nature Genetics on Dec. 4 2011, brings scientists closer to understanding the disease and work towards its cure. (Source: EurekAlert! - Social and Behavioral Science)

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Different clinical features in patients with ankylosing spondylitis from southern and northern China

APLAR Journal of Rheumatology — Sun, 04 Dec 2011 05:00:00 +0100

Conclusion: Significant diagnostic delay and higher prevalence of HLA‐B27 were found in southern AS patients. The prevalence of buttock pain and peripheral arthritis at disease onset in northern AS was more frequent than in southern AS patients. (Source: APLAR Journal of Rheumatology)

A genome-wide association study in Han Chinese identifies new susceptibility loci for ankylosing spondylitis

Nature Genetics — Sun, 04 Dec 2011 05:00:00 +0100

Authors: Zhiming Lin, Jin-Xin Bei, Meixin Shen, Qiuxia Li, Zetao Liao, Yanli Zhang, Qing Lv, Qiujing Wei, Hui-Qi Low, Yun-Miao Guo, Shuangyan Cao, Mingcan Yang, Zaiying Hu, Manlong Xu, Xinwei Wang, Yanlin Wei, Li Li, Chao Li, Tianwang Li, Jianlin Huang, Yunfeng Pan, Ou Jin, Yuqiong Wu, Jing Wu, Zishi Guo, Peigen He, Shaoxian Hu, Husheng Wu, Hui Song, Feng Zhan, Shengyun Liu, Guanmin Gao, Zhangsuo Liu, Yinong Li, Changhong Xiao, Juan Li, Zhizhong Ye, Weizhen He, Dongzhou Liu, Lingxun Shen, Anbin Huang, Henglian Wu, Yi Tao, Xieping Pan, Buyun Yu, E Shyong Tai, Yi-Xin Zeng, Ee Chee Ren, Yan Shen, Jianjun Liu & Jieruo Gu To identify susceptibility loci for ankylosing spondylitis, we performed a two-stage genome-wide association study in Han Chinese. In the discovery stage, we analyzed 1,35...

Positive immunomodulator data presented by Celgene

Pharmacy Europe — Fri, 02 Dec 2011 15:13:00 +0100

The company announced Phase II data for apremilast, its investigational oral treatment for ankylosing spondylitis (Source: Pharmacy Europe)

The prevalence of HLA‐B27 in the United States: Data from the U.S. National Health and Nutrition Examination Survey, 2009

Arthritis and Rheumatism — Fri, 02 Dec 2011 05:00:00 +0100

Conclusion:Our findings provide the first U.S. national prevalence estimates for HLA‐B27. A decline in the prevalence of HLA‐B27 with age is suggested by these data but must be confirmed by additional studies. (Source: Arthritis and Rheumatism)

Interaction of pregnancy and autoimmune rheumatic disease.

Autoimmunity Reviews — Fri, 02 Dec 2011 05:00:00 +0100

Authors: Ostensen M, Villiger PM, Förger F Abstract During pregnancy, the fetus represents a natural allograft that is not normally rejected. While the maternal immune system retains the ability to respond to foreign antigens, tolerance mechanisms are up-regulated to protect the fetus from immunologic attacks by the mother. The profound immunologic adaptations during and after pregnancy do influence maternal autoimmune rheumatic diseases in several ways. One is triggering the onset of a rheumatic disease in the post partum period, the other influencing disease activity of established rheumatic disease. The review will discuss the mechanisms of increased susceptibility of rheumatoid arthritis (RA) in the first year post partum with a specific emphasis on the role of fetal cells or ...

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Serum cytokine levels and periodontal parameters in ankylosing spondylitis

Journal of Periodontal Research — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion: The results of present study suggest that bleeding on probing was the only different periodontal parameter between the AS and the control group, and the periodontal status of patients with AS may be affected by IL‐6 levels. (Source: Journal of Periodontal Research)

Radiographic progression is associated with resolution of systemic inflammation in patients with axial spondylarthritis treated with tumor necrosis factor α inhibitors: A study of radiographic progression, inflammation on magnetic resonance imaging, and circulating biomarkers of inflammation, angiogenesis, and cartilage and bone turnover

Arthritis and Rheumatism — Thu, 01 Dec 2011 05:00:00 +0100

ConclusionOur findings indicate that inflammation on baseline MRI is associated with higher CTX‐II levels. Radiographic progression is associated with decreased systemic inflammation, as assessed by IL‐6 and CRP levels and MRI, supporting the notion of a link between the resolution of inflammation and new bone formation in SpA patients during anti‐TNFα therapy. (Source: Arthritis and Rheumatism)

Ankylosing spondylitis macrophage production of higher levels of interleukin‐23 in response to lipopolysaccharide without induction of a significant unfolded protein response

Arthritis and Rheumatism — Thu, 01 Dec 2011 05:00:00 +0100

ConclusionThe greater production of IL‐23 by AS patient macrophages in response to LPS provides further support for the development of Th17/IL‐23–directed therapy. Since significant UPR induction was not detected in AS patient macrophages, the relationship between UPR and inflammatory cytokine production remains unclear. (Source: Arthritis and Rheumatism)

Clinical images: Epidural hematoma in ankylosing spondylitis

Arthritis and Rheumatism — Thu, 01 Dec 2011 05:00:00 +0100

(Source: Arthritis and Rheumatism)

Associations of IL‐23R polymorphisms with ankylosing spondylitis in East Asian population: a new case–control study and a meta‐analysis

International Journal of Immunogenetics — Thu, 01 Dec 2011 05:00:00 +0100

In conclusion, we found no evidence for association between IL‐23R and AS in East Asian population. Major attention should be paid to other genes belonged to IL‐23 signalling pathway network in the future. (Source: International Journal of Immunogenetics)

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The L-arginine/asymmetric dimethylarginine (ADMA) ratio is improved during anti-Tumor Necrosis Factor–α therapy in patients with inflammatory arthropathies: Association with aortic stiffness

Artery Research — Thu, 01 Dec 2011 05:00:00 +0100

Background: Anti-Tumor Necrosis Factor (TNF)-α therapy seems to improve cardiovascular risk in patients with inflammatory arthropathies such as rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase (NOS). ADMA competes with L-arginine as a substrate for NOS, and the L-arginine/ADMA ratio is suggested to be important for modulation of NOS activity. Objective: To examine the effect of anti-TNF-α therapy on ADMA and L-arginine/ADMA, and the associations between ADMA, L-arginine/ADMA and aortic stiffness in patients with inflammatory arthropathies. (Source: Artery Research)

HLA alleles and drug hypersensitivity reactions

International Journal of Immunogenetics — Thu, 01 Dec 2011 05:00:00 +0100

SummaryThe human leucocyte antigen (HLA) system is well known for its association with certain diseases such as ankylosing spondylitis, celiac disease and many others. More recently, severe and even fatal drug hypersensitivity reactions linked to particular HLA alleles have been discovered. The significance of these discoveries has led the European Medicines Agency (EMA) and its member state agencies to recommend HLA gene testing before initiation of drug treatment. To date, the following drugs have been identified as causing significant drug hypersensitivity reactions in patients who have the following HLA alleles: abacavir and HLA‐B*57:01, carbamazepine and HLA‐B*15:02/A*31:01 and finally allopurinol and HLA‐B*58:01. This review will outline and discuss these three drugs and their ...

Membranous glomerulonephritis with the use of etanercept in ankylosing spondylitis.

The Annals of Pharmacotherapy — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSIONS: In addition to the well-described serious adverse drug events, including serious infections, the use of etanercept in ankylosing spondylitis can be associated with the development of MGN. Health care providers, especially rheumatologists, should be aware of this potentially serious adverse drug reaction. PMID: 22116994 [PubMed - in process] (Source: The Annals of Pharmacotherapy)

Trachway intubating stylet for tracheal intubation in an ankylosing spondylitis patient undergoing total hip replacement under general anesthesia.

Acta Anaesthesiologica Taiwanica — Thu, 01 Dec 2011 05:00:00 +0100

We present here a 54-year-old man with ankylosing spondylitis, scheduled to undergo total hip replacement. Pre-operative airway assessment revealed a recognized difficult airway. The Trachway was successfully used for oral tracheal intubation at the first attempt. The Trachway can be an alternative choice for intubation in ankylosing spondylitis patients. PMID: 22221690 [PubMed - in process] (Source: Acta Anaesthesiologica Taiwanica)

Spondyloarthritides

Best Practice and Research. Clinical Rheumatology — Thu, 01 Dec 2011 05:00:00 +0100

The most important clinical features of the spondyloarthritides (SpA) are not only inflammatory back pain (IBP) but also peripheral (enthesitis) and extra-articular symptoms. For clinical purposes, two forms related to the predominant clinical manifestation – axial and peripheral SpA – and five subgroups– ankylosing spondylitis (AS), SpA associated with psoriasis and inflammatory bowel disease (IBD), reactive arthritis and undifferentiated SpA – are differentiated. Axial SpA including AS is the most frequent subtype of SpA, followed by psoriatic arthritis and undifferentiated SpA, while reactive arthritis and IBD-related SpA are less frequent. The prevalence of SpA has been shown to be similar to rheumatoid arthritis. The outcome of the disease is influenced by the degree of diseas...

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Replication of association of the interleukin 23 receptor rs1343151 variant with rheumatoid arthritis in Caucasian sample sets

Annals of the Rheumatic Diseases — Wed, 30 Nov 2011 05:00:00 +0100

The IL-23R region is associated with a number of non-infectious inflammatory conditions including inflammatory bowel disease, ankylosing spondylitis and psoriasis,1–3 and albeit with less consistent evidence, rheumatoid arthritis (RA).4–6 Association of rs1343151 (G->A) with RA, but not rs1004819/rs10489629/rs2201841, has been reported in European and New Zealand sample sets;5 none of rs3212227/rs6887695/rs7530511 was associated in European and North American sample sets,6 and rs7517847 was not associated in meta-analysed European and New Zealand sample sets.4 Given the immunological evidence pointing to the importance of the Th17–IL-23 axis in inflammation and autoimmunity,7 and the unresolved question of whether or not IL-23R is associated with RA, we further investi...

Distinct impacts of syndesmophyte formation on male and female patients with ankylosing spondylitis

APLAR Journal of Rheumatology — Wed, 30 Nov 2011 05:00:00 +0100

Conclusion: AS patients with syndesmophytes experienced imbalance of bone metabolism due to inflammatory cytokine release. Male AS patients had high levels of bone resorption markers, cytokines and adhesion molecules, reflecting a disorder of bone metabolism. (Source: APLAR Journal of Rheumatology)

Baseline radiographic damage, elevated acute phase reactants and cigarette smoking status predict radiographic progression in the spine in early axial spondyloarthritis

Arthritis and Rheumatism — Tue, 29 Nov 2011 05:00:00 +0100

Conclusion:The presence of radiographic damage at baseline (syndesmophytes), elevated acute phase reactants, and cigarette smoking were all independently associated with radiographic spinal progression in early axial SpA. (Source: Arthritis and Rheumatism)

I can never have a lie-in as I will pay for it in stiffness

The Irish Times - Health — Tue, 29 Nov 2011 00:32:11 +0100

MY HEALTH EXPERIENCE: Ankylosing spondylitis causes pain, stiffness, poor sleep and anxiety, saysDARAGH KEATING (Source: The Irish Times - Health)

Association of the ANTXR2 gene polymorphism and ankylosing spondylitis in Chinese Han.

Scandinavian Journal of Rheumatology — Mon, 28 Nov 2011 05:00:00 +0100

Conclusions: ANTXR2 might not be a susceptibility gene of AS in Chinese Han. PMID: 22118297 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Rheumatology)

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Bone tissue metabolism in men with ankylosing spondylitis.

Advances in Medical Sciences — Wed, 23 Nov 2011 05:00:00 +0100

Conclusions: Our results indicate that disease duration and higher age are risk factors for osteoporosis in patients with AS. Inflammation might contribute to the accelerated bone loss in AS through stimulation of bone degradation. PMID: 22112431 [PubMed - as supplied by publisher] (Source: Advances in Medical Sciences)

Comparison of recommendations for the use of anti-tumour necrosis factor therapy in ankylosing spondylitis in 23 countries worldwide

Rheumatology — Tue, 22 Nov 2011 05:00:00 +0100

Conclusion. Most national recommendations follow the international ASAS recommendations, suggesting that the latter are widely implemented. This might contribute to comparable access with anti-TNF-α treatment across countries. This article shows that general consensus exists about the use of anti-TNF-α therapy in AS across the world, although some countries require additional objective signs of inflammation and/or more pre-treatment, which limits access. (Source: Rheumatology)

Safety of non-steroidal anti-inflammatory drugs, including aspirin and paracetamol (acetaminophen) in people receiving methotrexate for inflammatory arthritis (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, other spondyloarthritis).

Cochrane Database of Systematic Reviews — Sun, 20 Nov 2011 22:06:03 +0100

CONCLUSIONS: In the management of rheumatoid arthritis, the concurrent use of NSAIDs with methotrexate appears to be safe provided appropriate monitoring is performed. The use of anti-inflammatory doses of aspirin should be avoided. PMID: 22071858 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Evaluation of the Iranian versions of the bath ankylosing spondylitis disease activity index (BASDAI), the bath ankylosing spondylitis functional index (BASFI) and the patient acceptable symptom state (PASS) in patients with ankylosing spondylitis

Rheumatology International — Sat, 19 Nov 2011 16:53:29 +0100

Abstract The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) are widely used instruments in assessment of patients suffering from ankylosing spondylitis (AS). The Patient Acceptable Symptom State (PASS) is regarded as a target for patients’ well-being. The aim of this study was to translate and adapt BASDAI, BASFI and PASS into the Iranian official language, Farsi, and evaluate their reliability and validity. Ninety patients with AS were included in this study. The questionnaires were translated into Farsi and back translated into English, modified until the final versions were approved with minor adaptations and the VAS was changed to numerical rating scales from 0 to 10. Forty-eight-hour test–re...

Morphea associated with the use of adalimumab: a case report and review of the literature

Modern Rheumatology — Fri, 18 Nov 2011 06:59:08 +0100

We describe a 37-year-old man with ankylosing spondylitis treated with adalimumab who developed morphea lesions in the lower limbs after 12 months of treatment. Adalimumab was discontinued, which resulted in progressive improvement in the skin lesions, with only mild hyperpigmentation remaining. We also review reports of morphea and other adverse cutaneous events related to anti-TNF treatment. Content Type Journal ArticleCategory Case ReportPages 1-3DOI 10.1007/s10165-011-0550-4Authors Julio Ramírez, Arthritis Unit, Department of Rheumatology, Hospital Clinic, University of Barcelona, Villarroel 170, Stairway 11, 2nd Floor, 08036 Barcelona, SpainM. Victoria Hernández, Arthritis Unit, Department of Rheumatology, Hospital Clinic, University of Barcelona, Villarroel 170, Stai...

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Physical Fitness in Patients With Ankylosing Spondylitis: A Comparison With Population Controls.

Physical Therapy — Thu, 17 Nov 2011 05:00:00 +0100

CONCLUSION:/b>The lower cardiorespiratory fitness and reduced flexibility in the AS group indicate that physical therapy programs should include cardiorespiratory fitness exercises as a basic component to reduce the risk of cardiovascular disease. PMID: 22095208 [PubMed - as supplied by publisher] (Source: Physical Therapy)

Extra-articular manifestations of ankylosing spondylitis: Prevalence, characteristics and therapeutic implications.

European Journal of Internal Medicine — Wed, 16 Nov 2011 18:01:29 +0100

Authors: El Maghraoui A Abstract Ankylosing spondylitis (AS) is the most frequent and most severe subtype of spondyloarthritis and can be an outcome of any of the other spondyloarthritis subtypes. It primarily affects the axial joints, most notably the sacroiliac joints. Other sites of involvement include the spine, peripheral joints, and entheses (capsules, ligaments, and tendons). Inflammatory enthesopathy progressing to ossification and ankylosis is the pathologic basis for the disease. Extra-articular manifestations vary widely in terms of both frequency and severity. The most common extra-articular manifestations are represented by uveitis, bowel disease, heart, lung, skin, bone and kidney involvement. This review focuses on prevalence and clinical characteristics of the most ...

Associations between interleukin-23R polymorphisms and ankylosing spondylitis susceptibility: a meta-analysis

Inflammation Research — Wed, 16 Nov 2011 16:46:43 +0100

Conclusions This meta-analysis shows that the IL-23R polymorphisms are associated with the development of AS in Europeans. Content Type Journal ArticleCategory Original Research PaperPages 1-7DOI 10.1007/s00011-011-0398-2Authors Young Ho Lee, Division of Rheumatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 126-1, Anam-dong 5 ga, Seongbuk-gu, Seoul 136-705, KoreaSung Jae Choi, Division of Rheumatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 126-1, Anam-dong 5 ga, Seongbuk-gu, Seoul 136-705, KoreaJong Dae Ji, Division of Rheumatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 126-1, A...

Ankylosing spondylitis is characterized by an increased turnover of several different metalloproteinase-derived collagen species: a cross-sectional study

Rheumatology International — Tue, 15 Nov 2011 16:47:46 +0100

Abstract Ankylosing spondylitis (AS) is characterized by gradual cementation of the vertebrae, a process that is described by excessive extracellular matrix remodeling. Specific matrix metalloproteinase (MMP)-derived collagen fragments are released to the circulation, and measurement of those might act as biomarkers of ankylosis. The aim of the study was to investigate the diagnostic value of five novel assays measuring different collagen species. Five newly developed ELISAs measuring MMP-degraded collagen fragments in serum of 40 AS patients and 40 age-matched controls were measured: collagen type I (C1M), type II (C2M), type III (C3M), type IV (C4M) and type VI (C6M) as well as the bone formation marker osteocalcin. The levels of the five collagen neoepitopes were signif...

The ClASsification for Psoriatic ARthritis (CASPAR) Criteria -- A Retrospective Feasibility, Sensitivity, and Specificity Study.

J Rheumatol — Tue, 15 Nov 2011 05:00:00 +0100

CONCLUSION: Our study demonstrates that the feasibility, specificity, and sensitivity of the CASPAR are maintained when adapted for retrospective use to classify an established research cohort. PMID: 22089469 [PubMed - as supplied by publisher] (Source: J Rheumatol)

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ANKH and Susceptibility to and Severity of Ankylosing Spondylitis.

J Rheumatol — Tue, 15 Nov 2011 05:00:00 +0100

CONCLUSION: These results confirm data in white Europeans that ANKH is probably not a major determinant of susceptibility to AS. ANKH polymorphisms do not markedly influence AS disease severity, as measured by BASMI and mSASSS. PMID: 22089454 [PubMed - as supplied by publisher] (Source: J Rheumatol)

ACR: Novel Drug Shows Promise in Rheumatoid Diseases (CME/CE)

MedPage Today Primary Care — Thu, 10 Nov 2011 16:00:00 +0100

CHICAGO (MedPage Today) -- Apremilast, an investigative oral agent, provided benefits in psoriatic arthritis, with or without concomitant methotrexate, and in ankylosing spondylitis, according to two studies reported here. (Source: MedPage Today Primary Care)

Ten years experience on needle biopsy in the early diagnosis of sacroiliitis

Arthritis and Rheumatism — Thu, 10 Nov 2011 05:00:00 +0100

ConclusionMRI, though of low sensitivity, is specific for the diagnosis of early sacroiliitis. Needle biopsy can detect sacroiliitis earlier than MRI. © 2011 American College of Rheumatology. (Source: Arthritis and Rheumatism)

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

Rheumatology International — Wed, 09 Nov 2011 17:47:45 +0100

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 ...

Active Non-Radiographic Axial Spondyloarthritis - Humira Beats Placebo Significantly

Health News from Medical News Today — Wed, 09 Nov 2011 13:00:00 +0100

Abbott announced results from the Phase 3 ABILITY-1 study of HUMIRA® (adalimumab) in patients with active non-radiographic axial spondyloarthritis (axSpA) at the American College of Rheumatology Annual Scientific Meeting (ACR) in Chicago. HUMIRA (adalimumab) is a prescription medicine designed to reduce signs and symptoms of ankylosing spondylitis in adults. It can be used alone or with certain other medicines to reduce signs and symptoms of psoriatic arthritis in adults and could prevent further damage to bones and joints, assisting patients to perform their daily activities... (Source: Health News from Medical News Today)

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Coexisting systemic lupus erythematosus and ankylosing spondylitis : a case report and review of the literature.

Lupus — Wed, 09 Nov 2011 05:00:00 +0100

Authors: Kook MH, Yoo HG, Hong MJ, Yoo WH PMID: 22072022 [PubMed - as supplied by publisher] (Source: Lupus)

Abbott Reports Five-Year Data for HUMIRA® (Adalimumab) in Ankylosing Spondylitis

Abbott.com — Tue, 08 Nov 2011 18:00:00 +0100

(Source: Abbott.com)

Increased Mortality in Ankylosing SpondylitisIncreased Mortality in Ankylosing Spondylitis

Medscape Today Headlines — Tue, 08 Nov 2011 11:20:19 +0100

How do we improve long-term survival in ankylosing spondylitis? Annals of the Rheumatic Diseases (Source: Medscape Today Headlines)

Pedicle subtraction osteotomy through pseudarthrosis to correct thoracolumbar kyphotic deformity in advanced ankylosing spondylitis

European Spine Journal — Tue, 08 Nov 2011 06:50:00 +0100

Conclusion PSO can be safely performed through the site of pseudarthrotic lesion in AS patients with pseudarthrosis and kyphotic deformity. After PSO, supplemental anterior fusion is sometimes necessary to support the anterior and middle column in a second stage if there is a bone defect in the osteotomy site. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00586-011-2054-5Authors Bang-ping Qian, Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321, Zhongshan Road, 210008 Nanjing, ChinaYong Qiu, Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321, Zhongshan Road, 210008 Nanjing, ChinaBin Wang, Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing Universi...

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SMC does not recommend naproxen + esomeprazole combination product (Vimovo®)

NeLM - Drug Specific Reviews — Tue, 08 Nov 2011 05:00:00 +0100

Source: Scottish Medicines Consortium (SMC) Area: Evidence > Drug Specific Reviews The Scottish Medicines Consortium (SMC) does not recommend the use of naproxen 500mg/esomeprazole 20mg (Vimovo®) within NHS Scotland for the symptomatic treatment of osteoarthritis (OA), rheumatoid arthritis (RA) and ankylosing spondylitis (AS), in patients who are at risk for developing NSAID-associated gastric and/or duodenal ulcers and where treatment with lower doses of naproxen or of other NSAIDs is not considered sufficient. The Drug Advice notes that combined naproxen/esomeprazole has been shown in studies to be associated with a lower incidence of endoscopic gastric ulcers than NSAID alone, and with similar improvements in pain and functioning compared to a cyclo-oxygenase-2 (COX-2) ...

A case of leukoencephalopathy associated with adalimumab-treated rheumatoid arthritis and a review of literature

Rheumatology International — Mon, 07 Nov 2011 17:11:40 +0100

We present here the case of leukoencephalopathy secondary to adalimumab, which is a tumor necrosis factor α (TNF-α) inhibitor. We also reviewed the other 14 published leukoencephalopathy cases associated with the use of TNF inhibitors. Eleven patients had underlying rheumatoid arthritis, and the others had psoriatic arthritis, ankylosing spondylitis and Still’s disease. The median duration of treatment with anti-TNF-α before the presentation of neurological symptoms was 9.2 months (range: 1.5–24). The duration of using anti-TNF-α was not related with the outcome. Although cases of neurological adverse events associated with anti-TNF-α treatment are rare, it is very important to monitor the neurological signs and symptoms suggestive of a demyelinating disorder in RA pat...

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?

Rheumatology International — Mon, 07 Nov 2011 17:11:36 +0100

Abstract 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 c...

Initiation of Tumor Necrosis Factor-{alpha} Antagonists and the Risk of Hospitalization for Infection in Patients With Autoimmune Diseases [Original Contribution]

JAMA — Sun, 06 Nov 2011 04:00:00 +0100

Performance of ultrasounds compared with radiographs to detect chronic enthesitis signs in patients with ankylosing spondylitis

Rheumatology International — Sat, 05 Nov 2011 17:07:52 +0100

Abstract To assess the performance of ultrasound in detecting erosion, swelling, and new bone comparing to radiographs in five lower limb entheses in patients with ankylosing spondylitis (AS). Prospective study of 60 patients meeting modified New York criteria for AS. Lateral radiographs of both knees and ankles followed by a high-resolution Doppler ultrasound examination with a high-frequency (15 MHz) linear probe were performed. Ultrasound had an excellent sensitivity, but specificity was very weak compared to radiographs for erosion, swelling, and new bone formation. Negative and positive predictive values were good only for erosion. Ultrasound seems to be a performant instrument in detecting signs of chronic enthesitis particularly when radiograph is normal. C...

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Serum melatonin level in ankylosing spondylitis: is it increased in active disease?

Rheumatology International — Sat, 05 Nov 2011 17:07:51 +0100

Abstract In the recent years, the role of melatonin (MLT) in the pathogenesis of inflammatory arthritis has been investigated, and the serum levels of MLT have been evaluated, but clinical study concerning MLT and ankylosing spondylitis (AS) is little reported in literature. We aimed to investigate the serum levels of MLT and their relation with the disease activity parameters of patients with AS. Forty AS patients and 40 healthy controls (matched for age and sex with the patients) participated in this study. Demographic and clinical data were collected and assessed. Disease activity of AS patients was assessed clinically according to the Bath AS Disease Activity Index (BASDAI), while AS functional impairment was assessed using the Bath AS Functional Index (BASFI). Serum s...

Potential of genome-wide association study data to contribute to better treatments: examples from ankylosing spondylitis

Future Medicine: Personalized Medicine — Thu, 03 Nov 2011 16:48:21 +0100

Personalized Medicine , November 2011, Vol. 8, No. 6, Pages 599-601. (Source: Future Medicine: Personalized Medicine)

A discrete event modelling framework for simulation of long-term outcomes of sequential treatment strategies for ankylosing spondylitis

Annals of the Rheumatic Diseases — Wed, 02 Nov 2011 04:00:00 +0100

Conclusions The modelling framework provides great flexibility to implement complex algorithms representing treatment selection, disease progression and changes in costs and utilities over time of patients with AS. Results obtained from the simulation are plausible. (Source: Annals of the Rheumatic Diseases)

Patient-reported Outcome in Psoriatic Arthritis: A Comparison of Web-based Versus Paper-completed Questionnaires.

J Rheumatol — Tue, 01 Nov 2011 04:00:00 +0100

CONCLUSION: The PB and WB versions of 10 standardized self-administered questionnaires in patients with PsA were comparable. The WB format was well accepted by PsA outpatients. Patients may thus be offered a choice of format as well as the choice to complete the questionnaires either in the clinic or remotely by Internet. PMID: 22045844 [PubMed - as supplied by publisher] (Source: J Rheumatol)

Association of IL-12B Genetic Polymorphism with the Susceptibility and Disease Severity of Ankylosing Spondylitis.

J Rheumatol — Tue, 01 Nov 2011 04:00:00 +0100

CONCLUSION: The IL-12B A1188C genotype was associated with the development and disease severity of AS. PMID: 22045842 [PubMed - as supplied by publisher] (Source: J Rheumatol)

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Ethnic Influence in Clinical and Functional Measures of Brazilian Patients with Spondyloarthritis.

J Rheumatol — Tue, 01 Nov 2011 04:00:00 +0100

CONCLUSION: Ethnic background is associated with distinct clinical aspects of SpA in Brazilian patients. African Brazilian patients with SpA have a poorer quality of life and report worse disease compared to whites. PMID: 22045839 [PubMed - as supplied by publisher] (Source: J Rheumatol)

Time for a gut check: Evidence for the hypothesis that HLA–B27 predisposes to ankylosing spondylitis by altering the microbiome

Arthritis and Rheumatism — Tue, 01 Nov 2011 04:00:00 +0100

(Source: Arthritis and Rheumatism)

Increased risk of cardiovascular and cerebrovascular diseases in individuals with ankylosing spondylitis: A population‐based study

Arthritis and Rheumatism — Tue, 01 Nov 2011 04:00:00 +0100

ConclusionCompared with the general population, patients with AS are at increased risk for many types of cardiovascular and cerebrovascular diseases, and are more likely to be hospitalized for these diseases. The excess risk is greatest in younger patients with AS. (Source: Arthritis and Rheumatism)

Fine mapping of a major histocompatibility complex in ankylosing spondylitis: Association of the HLA–DPA1 and HLA–DPB1 regions

Arthritis and Rheumatism — Tue, 01 Nov 2011 04:00:00 +0100

ConclusionHLA markers and linkage disequilibrium blocks near HLA–DPA1 and HLA–DPB1 are statistically associated with AS. We identified a region located around the HLA–DPA1 and HLA–DPB1 loci associated with AS, another region within the MHC that is different from HLA–B27. (Source: Arthritis and Rheumatism)

Induction of inflammatory bowel disease flares by golimumab: Report of three patients with enteropathic spondylarthritis or ankylosing spondylitis and comorbid colitis

Arthritis and Rheumatism — Tue, 01 Nov 2011 04:00:00 +0100

(Source: Arthritis and Rheumatism)

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Computerized tomography scan facilitates the diagnosis of sacroiliitis in patients with suspected spondyloarthritis: Results of the ECHOSPA cohort

Arthritis and Rheumatism — Tue, 01 Nov 2011 04:00:00 +0100

Conclusions:Definite sacroiliitis was underestimated by radiograph, as compared to CT‐scan. CT‐scan should facilitate the diagnosis of ankylosing spondylitis in patients with suspected SpA. (Source: Arthritis and Rheumatism)

[Adefovir dipivoxil-induced Fanconi syndrome and hypophosphatemic osteomalacia associated with muscular weakness in a patient with chronic hepatitis B].

Journal of Southern Medical University — Tue, 01 Nov 2011 04:00:00 +0100

We report a case of chronic hepatitis B with a history of taking adefovir dipivoxil at 10 mg/day for 4 years. The patient complained of lumbosacral and joint pain and had the diagnosis of ankylosing spondylitis (AS) or spondyloarthropathy in several hospitals before admission in our hospital. A diagnosis of acquired Fanconi syndrome and hypophosphatemia osteomalacia associated with progressive muscular weakness was made eventually. We reviewed the literature and found reports of only fewer than 10 similar cases. Clinical attention should be given to kidney damage induced by adefovir dipivoxil. PMID: 22126791 [PubMed - in process] (Source: Journal of Southern Medical University)

Comparing new bone formation in ankylosing spondylitis and diffuse diffuse idiopathic skeletal hyperostosis patients – a retrospective cohort study over 6 years

Arthritis and Rheumatism — Mon, 31 Oct 2011 04:00:00 +0100

Conclusions:The rates of new bone formation in AS and DISH were largely similar. Both groups showed osteophyte development but, expectedly, syndesmophytes were more frequent in AS, while DISH patients had more degenerative bone spurs, this was similar at follow up. The nature of the different mechanisms of bone formation needs further study. (Source: Arthritis and Rheumatism)

Radiographic severity in ankylosing spondylitis is associated with polymorphism in large multifunctional peptidase 2 (LMP2) in the SPARCC cohort

Arthritis and Rheumatism — Thu, 27 Oct 2011 04:00:00 +0100

Conclusion:This is the first study to demonstrate that LMP2 variants can affect radiographic severity in AS. Baseline mSASSS remains the strongest predictor of radiographic progression but explains only a fraction of the variability seen. © 2011 American College of Rheumatology. (Source: Arthritis and Rheumatism)

The use, safety and effectiveness of herpes zoster vaccination in individuals with inflammatory and autoimmune diseases: a longitudinal observational study

Arthritis Research and Therapy — Mon, 24 Oct 2011 04:00:00 +0100

Conclusions: Use of the zoster vaccine was uncommon among older patients with autoimmune diseases, including those not exposed to immunosuppressive medications. The short-term risk of HZ did not appear to be increased in vaccinated patients, even among those using immunosuppressive therapies (e.g. biologics) at the time of vaccination. However, our study was limited by the small number of vaccinated patients, and further evidence is needed to confirm the vaccine's safety and efficacy in this population. (Source: Arthritis Research and Therapy)

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Improving the treatment of ankylosing spondylitis in the UK

Rheumatology — Sat, 22 Oct 2011 04:00:00 +0100

(Source: Rheumatology)

ERAP1 polymorphisms and haplotypes are associated with ankylosing spondylitis susceptibility and functional severity in a Spanish population

Rheumatology — Sat, 22 Oct 2011 04:00:00 +0100

Conclusions. These results suggest that the ERAP1 gene is associated with genetic predisposition to AS and influences the functional severity of the disease in a Spanish population. (Source: Rheumatology)

Services for people with ankylosing spondylitis in the UK--a survey of rheumatologists and patients

Rheumatology — Sat, 22 Oct 2011 04:00:00 +0100

Conclusion. This is the first study to explore the services available to people with AS in the UK. Almost one-third of patients are not seen in rheumatology departments and therefore may be under-treated. For those who are seen, access to anti-TNF drugs and other therapies remains an issue. (Source: Rheumatology)

Clinical and ultrasonography assessment of peripheral enthesitis in ankylosing spondylitis

Rheumatology — Sat, 22 Oct 2011 04:00:00 +0100

Conclusions. PDUS permits detection of structural and inflammatory abnormalities of the enthesis in AS and may complement the physical examination in order to better evaluate enthesitis. (Source: Rheumatology)

The contribution of disease activity on functional limitations over time through psychological mediators: a 12-month longitudinal study in patients with ankylosing spondylitis

Rheumatology — Sat, 22 Oct 2011 04:00:00 +0100

Conclusion. Higher baseline disease activity predicted greater functional limitations at 12 months through helplessness and depression. Our findings suggest that helplessness and depression may constitute future treatment targets in reducing functional limitations in patients with AS. (Source: Rheumatology)

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Characterization of a novel isoform of the human ORMDL3 gene

Cell and Tissue Research — Thu, 20 Oct 2011 15:53:02 +0100

This study reveals the presence of a novel ORMDL3 splicing isoform, ORMDL3 V1 in human. Content Type Journal ArticleCategory Regular ArticlePages 1-6DOI 10.1007/s00441-011-1261-zAuthors Rui Jin, Department of Pediatrics, the First Affiliated Hospital, Nanjing Medical University, 300 Guang Zhou Road, Nanjing, Jiangsu Province 210029, ChinaWen-Xiao Yuan, Department of Pediatrics, the First Affiliated Hospital, Nanjing Medical University, 300 Guang Zhou Road, Nanjing, Jiangsu Province 210029, ChinaHua-Guo Xu, Department of Pediatrics, the First Affiliated Hospital, Nanjing Medical University, 300 Guang Zhou Road, Nanjing, Jiangsu Province 210029, ChinaWei Ren, Department of Pediatrics, the First Affiliated Hospital, Nanjing Medical University, 300 Guang Zhou Road, Nanjing, Jiangsu Pro...

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

Clinical Rheumatology — Tue, 18 Oct 2011 15:59:12 +0100

Abstract 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 ind...

Does HLA‐B*2706 protect against ankylosing spondylitis? A meta‐analysis

APLAR Journal of Rheumatology — Tue, 18 Oct 2011 04:00:00 +0100

AbstractThe human leukocyte antigen (HLA)‐B*2706 is a relatively rare subtype of HLA‐B27. In contrast to most HLA‐B27 subtypes, some studies have reported HLA‐B*2706 to be protective against ankylosing spondylitis (AS). A systematic review and a meta‐analysis of available studies was performed to investigate the association of HLA‐B*2706 with AS. After literature review a random effect meta‐analysis was performed. No studies were found comparing the frequency of HLA‐B*2706 in AS patients and controls. Meta‐analysis of seven studies using HLA‐B27‐positive AS patients and controls showed a protective effect of HLA‐B*2706 on development of AS in HLA‐B27 individuals (odds ratio = 0.128, 95% CI = 0.043–0.378, P < 0.001). The results of the meta‐analy...

When to suspect seronegative spondyloarthropathy on MRI?

Radiologia — Tue, 18 Oct 2011 04:00:00 +0100

We describe the magnetic resonance imaging (MRI) findings for the spine in patients with seronegative spondyloarthropathy (SNS) and discuss the indications for MRI in the diagnosis and follow-up of this type of patients. We describe the pathological aspects of four patients diagnosed with SNS (Crohn's disease, ankylosing spondylitis, and psoriasis) with spinal involvement. The MRI findings in SNS vary in function of the type and stage of disease. Osteitis of the anterior vertebral bodies is a very early sign of spinal involvement in this group of diseases. Inflammatory involvement of the discovertebral complex that involves the adjacent vertebral bodies to a greater or lesser extent occurs later. MRI of the spine makes it possible to evaluate incipient signs of disease that are characteris...

NSAID‐intake according to the ASAS score in clinical trials evaluating TNF blockers: The example of etanercept in advanced ankylosing spondylitis

Arthritis Care and Research — Mon, 17 Oct 2011 04:00:00 +0100

ConclusionsThis study confirms the feasibility and the simplicity of ASAS‐NSAID score and suggests that such score be integrated in all studies in spondyloarthritis either to check the quality of the observed data (e.g. inter‐group baseline characteristics) or to evaluate the NSAID sparing effect of other therapies. © 2011 by the American College of Rheumatology. (Source: Arthritis Care and Research)

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Population‐Based Estimates of Medical Comorbidities in Erectile Dysfunction in a Taiwanese Population

The Journal of Sexual Medicine — Thu, 13 Oct 2011 04:00:00 +0100

Conclusion. The results show that patients with ED have a higher prevalence of multiple noncardiovascular comorbidities than the general population in Taiwan. Chung S‐D, Chen Y‐K, Kang, J‐H, Keller JJ, Huang C‐C, and Lin H‐C. Population‐based estimates of medical comorbidities in erectile dysfunction in a Taiwanese population. J Sex Med **;**:**–**. (Source: The Journal of Sexual Medicine)

Discovery of candidate serum proteomic and metabolomic biomarkers in Ankylosing Spondylitis.

Molecular and Cellular Proteomics : MCP — Thu, 13 Oct 2011 04:00:00 +0100

In this study we employed nLC-MS analysis to detect and quantify proteins and small compounds including endogenous peptides and metabolites in serum from 18 AS patients and 9 healthy individuals. We identified a total of 621 proteins in serum, of which 22 showed significant up- or down-regulation (p<0.05) in AS patients. ROC analysis of combined levels of serum amyloid P component and inter-alpha-trypsin inhibitor heavy chain 1 revealed high diagnostic value for Ankylosing Spondylitis (AUC = 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 ac...

Interferon--2a: Exacerbation of ankylosing spondylitis: case report

Reactions — Wed, 12 Oct 2011 06:03:59 +0100

(Source: Reactions)

Aberrant axial mineralization precedes spinal ankylosis: a molecular imaging study in ank/ank mice

Arthritis Research and Therapy — Wed, 12 Oct 2011 04:00:00 +0100

Conclusions: Changes in joint pathology of ank/ank mice as evaluated by histological and radiographic means are qualitative, but only semi-quantitative in nature. In contrast, molecular imaging provides a quantitative assessment. Ankylosis in ank/ank mice developed simultaneously in distal and axial joints, contrary to the previous notion that it is a centripetal process. NIR imaging might be feasible for early disease diagnosis and for monitoring disease progression in ankylosing spondylitis. (Source: Arthritis Research and Therapy)

[Parathyroid dysfunction and rheumatic manifestations.]

Zeitschrift fur Rheumatologie — Wed, 12 Oct 2011 04:00:00 +0100

Authors: Frey DP Abstract Parathyroid dysfunction, leading to severe clinical symptoms and radiographic changes, has decreased over the last years due to routine laboratory checks including serum calcium levels. Thus, abnormal calcium levels are detected early in the course of the disease and the underlying cause treated accordingly. Hyperparathyroidism often leads to osteoporosis and low-trauma fractures. When evaluating secondary osteoporosis analysis of calcium, phosphate and intact parathyroid hormone levels are mandatory. Osteitis fibrosa cystica and brown tumors are less frequent findings of hyperparathyroidism. However, in patients with arthritis or bone symptoms, hyperparathyroidism has to be evaluated as a possible reason. Other manifestations of hyperparathyroidism includ...

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Comparison of the BASDAI and the miniBASDAI in assessing disease activity in patients with ankylosing spondylitis

Clinical Rheumatology — Tue, 11 Oct 2011 15:53:07 +0100

Abstract The BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) is the most widely used instrument for the assessment of disease activity in ankylosing spondylitis (AS). Objective. The aims to investigate whether the alternative BASDAI, here termed as the miniBASDAI [(Question (Q) 1 fatigue + Q2 spinal pain) + mean of (Q5 strength morning stiffness + Q6 duration morning stiffness)] / 3], measures disease activity more accurately in the subgroup of AS patients without peripheral manifestations. One hundred and ten patients were included in this cross-sectional study according to the modified New York criteria for AS. Clinical and biological parameters were evaluated. The disease activity was evaluated by the BASDAI. We calculated the miniBASDAI by omitting both ...

Combination therapy for pain management in inflammatory arthritis (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, other spondyloarthritis).

Cochrane Database of Systematic Reviews — Tue, 11 Oct 2011 01:20:04 +0100

CONCLUSIONS: Based on 23 trials, all at high risk of bias, there is insufficient evidence to establish the value of combination therapy over monotherapy for people with IA. Importantly, there are no studies addressing the value of combination therapy for patients with IA who have persistent pain despite optimal disease suppression. Well designed trials are needed to address this question. PMID: 21975788 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Letter: New-onset psoriasis associated with adalimumab: A report of two cases.

Dermatol Online J — Mon, 10 Oct 2011 11:40:02 +0100

We report two patients that developed cutaneous and histologic changes consistent with psoriasis while receiving treatment with adalimumab for inflammatory arthridities: one patient with Crohn disease and ankylosing spondylitis who tolerated adalimumab for 15 months before developing psoriasis and another patient with rheumatoid arthritis who developed psoriasis 3 years after starting adalimumab. Both patients experienced rapid resolution of their psoriasis after discontinuation of adalimumab. PMID: 21971280 [PubMed - in process] (Source: Dermatol Online J)

IFNγ regulates discordant mechanisms of uveitis versus joint and axial disease in a murine model resembling spondyloarthritis

Arthritis and Rheumatism — Mon, 10 Oct 2011 04:00:00 +0100

CONCLUSIONS:This is the first detailed description of a murine disease model wherein uveitis coincides with arthritis and spondylitis. Our observations provide great opportunity to understand the pathogenesis of a relatively common but poorly understood disease. © 2011 American College of Rheumatology. (Source: Arthritis and Rheumatism)

The microbiome and ankylosing spondylitis

Arthritis and Rheumatism — Mon, 10 Oct 2011 04:00:00 +0100

(Source: Arthritis and Rheumatism)

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The intestinal microbiome in ankylosing spondylitis. Comment on the hypothesis article by Rosenbaum and Davey

Arthritis and Rheumatism — Mon, 10 Oct 2011 04:00:00 +0100

(Source: Arthritis and Rheumatism)

Portuguese version of the bath indexes for ankylosing spondylitis patients: a cross-cultural adaptation and validation

Clinical Rheumatology — Wed, 05 Oct 2011 05:45:00 +0100

Abstract The Bath Ankylosing Spondylitis Activity Index (BASDAI), Functional Index (BASFI), Metrology Index (BASMI), and Global Score (BASG) are commonly used to assess patients with ankylosing spondylitis (AS). The aim of this study was to cross-culturally adapt and validate these indexes into the Portuguese language. Seventy-eight patients were included in the study. After forward and backward translations, the questionnaires were administered and tested for internal consistency, test–retest reliability, face validity, content validity, and construct validity. The outcome measures HAQ, EQ-5D, and SF-36 were also implemented. Metrological parameters (BASMI components) and chest expansion were evaluated. Correlation coefficients for test–retest were 0.875, 0.937, 0.831...

Serum levels of IL-33 is increased in patients with ankylosing spondylitis

Clinical Rheumatology — Tue, 04 Oct 2011 05:48:46 +0100

Abstract Interleukin-33 (IL-33) is implicated in rheumatoid arthritis with effects of promoting tumor necrosis factor-alpha (TNF-α) and interleukin-17 (IL-17) productions, which have been demonstrated to play a pivotal role in ankylosing spondylitis (AS). However, changes of IL-33 levels and its effects in AS have not been investigated. Eighty-nine and 178 healthy controls were included in the current study. Erythrocyte sedimentation rate, serum levels of C-reactive protein, IL-17, and IL-33 were determined. Effects of IL-33 on TNF-α and IL-6 productions were investigated. Effects of IL-33 on neutrophil migration were also evaluated. Serum levels of IL-33 were elevated in AS patients. Moreover, IL-33 was significantly higher in active AS patients according to Bath Ankylo...

Rehabilitation treatment strategies in ankylosing spondylitis.

J Rheumatol — Sat, 01 Oct 2011 04:00:00 +0100

Authors: Colina M, Ciancio G, Govoni M PMID: 21965695 [PubMed - in process] (Source: J Rheumatol)

Relationship Between Smoking and Patient-reported Measures of Disease Outcome in Ankylosing Spondylitis.

J Rheumatol — Sat, 01 Oct 2011 04:00:00 +0100

CONCLUSION: Smoking has a dose-dependent relationship with measures of disease severity in AS. The association with increased disease activity, decreased function, and poor quality of life in smokers was independent of age, sex, deprivation level, and disease duration. PMID: 21965641 [PubMed - as supplied by publisher] (Source: J Rheumatol)

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Alloplastic, patient-fitted TMJ reconstruction in patients with autoimmune/connective tissue disease

International Journal of Oral and Maxillofacial Surgery — Sat, 01 Oct 2011 04:00:00 +0100

Rheumatoid arthritis is the most common autoimmune/connective tissue disease involving the temporomandibular joints (TMJ), but other systemic inflammatory diseases that can affect the TMJ include psoriatic arthritis, systemic lupus erythematosus, ankylosing spondylitis, and gout. Classic symptoms include pain, headaches, morning stiffness, clicking, crepitus, decreased bite force, mastication difficulty, and jaw immobility. Although initially a predominantly resorptive process, advanced disease may ultimately lead to ankylosis of the joint due to prolonged hypomobility. Progressive retrusion of the mandible and malocclusion can develop due to the loss of vertical condylar and ramus height, with subsequent downward and backward rotation of the mandible. (Source: International Journal of Ora...

Serial Interferon-gamma Release Assays for the Diagnosis of Latent Tuberculosis Infection in Patients Treated with Immunosuppressive Agents.

The Korean Journal of Laboratory Medicine — Sat, 01 Oct 2011 04:00:00 +0100

CONCLUSIONS: In patients receiving immunosuppressive agents, both IGRA conversions and reversions were observed. Serial IGRA testing may not be needed in patients with a positive initial IGRA result showing high IFN-γ levels, because of high consistency in the test results. PMID: 22016681 [PubMed - in process] (Source: The Korean Journal of Laboratory Medicine)

Expert opinion and key recommendations for the physical therapy and rehabilitation of patients with ankylosing spondylitis

APLAR Journal of Rheumatology — Sat, 01 Oct 2011 04:00:00 +0100

Conclusion: These recommendations were developed using evidence‐based data and expert opinion. The implementation of these recommendations should encourage a more comprehensive and methodical approach in the rehabilitation of patients with AS. Regular lifelong exercise is the mainstay of rehabilitation and there is a considerable need for well‐designed studies which will enlighten the role of physical therapy in the management of AS. (Source: APLAR Journal of Rheumatology)

Increased mortality in ankylosing spondylitis is related to disease activity

Annals of the Rheumatic Diseases — Fri, 30 Sep 2011 04:00:00 +0100

Conclusions Mortality is increased in patients with AS and circulatory disease is the most frequent cause of death. Parameters reflecting the duration and intensity of inflammation are associated with reduced survival. These results indicate that, to improve long-term survival in AS, there is a need for early detection and anti-inflammatory treatment as well as a vigilant approach for cardiovascular risk factors. (Source: Annals of the Rheumatic Diseases)

Enthesis erosion in spondyloarthritis is not a persistent structural lesion

Annals of the Rheumatic Diseases — Fri, 30 Sep 2011 04:00:00 +0100

Conclusions US examination of Achilles erosions is reliable and sensitive to change. An association was found between Achilles erosions and objective activity-based measurements of SpA outcomes. (Source: Annals of the Rheumatic Diseases)

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Osteoimmunology and osteoporosis

Arthritis Research and Therapy — Fri, 30 Sep 2011 04:00:00 +0100

The concept of osteoimmunology is based on growing insights on the links between the immune system and bone at the anatomical, vascular, cellular and molecular level. In both rheumatoid arthritis (RA) and ankylosing spondylitis (AS), bone is a target of inflammation.Activated immune cells at sites of inflammation produce a wide spectrum of cytokines in favor of increased bone resorption in RA and AS, resulting in bone erosions, osteitis, peri-inflammatory and systemic bone loss.Peri-inflammatory bone formation is impaired in RA, resulting in non-healing of erosions which allows a local vicious circle of inflammation between synovitis, osteitis and local bone loss. In contrast , peri-inflammatory bone formation is increased in AS, resulting in healing of erosions, ossifying enthesitis and p...

The link of HLA-B27 with interleukin-23/Interleukin-17 axis in coexisting systemic lupus erythematosus and ankylosing spondylitis.

Lupus — Fri, 30 Sep 2011 04:00:00 +0100

Authors: Park SJ, Kim JH, Pai KS, Shin JI PMID: 21965278 [PubMed - as supplied by publisher] (Source: Lupus)

The effects of combined spa therapy and rehabilitation on patients with ankylosing spondylitis being treated with TNF inhibitors

Rheumatology International — Tue, 27 Sep 2011 05:52:53 +0100

The objective of the present study was to evaluate the effects and tolerability of combined spa therapy and rehabilitation in a group of AS patients being treated with TNF inhibitors. Thirty AS patients attending the Rheumatology Unit of the University of Padova being treated with TNF inhibitors for at least 3 months were randomized and assessed by an investigator independent from the spa staff: 15 were prescribed 10 sessions of spa therapy (mud packs and thermal baths) and rehabilitation (exercises in a thermal pool) and the other 15 were considered controls. The patients in both groups had been receiving anti-TNF agents for at least three months. The outcome measures utilized were BASFI, BASDAI, BASMI, VAS for back pain and HAQ. The evaluations were performed in all patients a...

Cost of medication errors in rheumatic patients in Mexico

Clinical Rheumatology — Fri, 23 Sep 2011 15:49:12 +0100

This study aims to measure the frequency of medication error (ME) in rheumatology outpatients of the Social Security System (SS) in Mexico and to measure the costs by comparing the days lost at work as direct consequence of the medication error against the theoretical cost of no error in the process. A prospective 6-month survey was conducted in a reference hospital in Guadalajara, Mexico. ME was defined as any discrepancy between the prescription and medicine taken by patients. The origin of the discrepancy was identified and registered. We present 381 patients: 292 with rheumatoid arthritis, 57 with ankylosing spondylitis, and 32 with systemic lupus erythematosus. One hundred twenty seven (33%) had medication errors. Ninety eight (77%) got worse in their condition due to ME. Forty ...

Does it need to perform anterior column support after Smith-Petersen osteotomy for ankylosing spondylitis?

European Spine Journal — Tue, 20 Sep 2011 05:46:48 +0100

Conclusions In our study of subjects presenting with anterior opening angles from 10° to 32°, we obtained successful fusion without the need for additional anterior interbody fusion. Improved gap healing and increased correction angles were obtained when the opening was present in the upper or lower body endplates compared to those at the disc space level. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00586-011-2015-zAuthors Ki-Tack Kim, Department of Orthopedic Surgery, Spine Center, Kyung Hee University East West Neomedical Center, Seoul, KoreaDae-Jean Jo, Department of Neurosurgery, Spine Center, Kyung Hee University East West Neomedical Center, #149, Sangil-dong, Kangdong-gu, Seoul, 134-090 KoreaSang-Hun Lee, Department of Orthoped...

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Effects of genetic polymorphisms of programmed cell death 1 and its ligands on the development of ankylosing spondylitis

Rheumatology — Tue, 20 Sep 2011 04:00:00 +0100

Conclusions. Our results suggest that PD-1 G-536A, PD-L1 A8923C and PD-L2 C47103T polymorphisms are associated with the presence of AS. (Source: Rheumatology)

High-dose etanercept in ankylosing spondylitis: results of a 12-week randomized, double blind, controlled multicentre study (LOADET study)

Rheumatology — Tue, 20 Sep 2011 04:00:00 +0100

Conclusions. High-dose (100 mg/week) etanercept in the treatment of AS for 12 weeks is as safe as the standard dose (50 mg/week). However, it does not significantly increase its efficacy. Trial Registration. Clinicaltrials.gov, http://clinicaltrials.gov/, NCT00873730. (Source: Rheumatology)

Coexistence of rheumatoid arthritis and ankylosing spondylitis

Clinical Rheumatology — Mon, 19 Sep 2011 15:40:13 +0100

Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s10067-011-1851-xAuthors Pınar Borman, Clinic of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Cebeci, Ulucanlar Street, 06340 Ankara, TurkeyFigen Ayhan, Clinic of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Cebeci, Ulucanlar Street, 06340 Ankara, TurkeyMüyesser Okumuş, Clinic of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Cebeci, Ulucanlar Street, 06340 Ankara, Turkey Journal Clinical RheumatologyOnline ISSN 1434-9949Print ISSN 0770-3198 (Source: Clinical Rheumatology)

Correlation of HLA B27 subtypes with clinical features of ankylosing spondylitis

APLAR Journal of Rheumatology — Mon, 19 Sep 2011 04:00:00 +0100

Conclusion: B*2705 was the main subtype observed in both patient and control groups. Frequency of B*2704 was more in AS patients compared to controls. Occurrence of AS‐associated uveitis was more often in B*2704‐positive AS patients compared to B*2705‐positive ones. (Source: APLAR Journal of Rheumatology)