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Sample records for ankylosing spondylitis systematic

  1. Ankylosing Spondylitis

    Science.gov (United States)

    ... to block a protein involved in the body’s inflammatory response. Four biologics are approved by the FDA for treating ankylosing spondylitis. They work by blocking a protein called tumor necrosis factor-alpha (TNF-α) that helps drive inflammation. Calcification. A process ...

  2. Ankylosing spondylitis

    OpenAIRE

    Mukesh Edavalath

    2010-01-01

    Ankylosing spondylitis belongs to a group of rheumatic diseases known as the spondyloarthropathies (SpA), which show a strong association with the genetic marker HLA-B27. Inflammatory back pain and stiffness are prominent early in the disease, whereas chronic, aggressive disease may produce pain and marked axial immobility or deformity. Modern medicine has no established treatment for it. From the Ayurvedic perspective, the disease can fall under amavata, which may be effectively managed when...

  3. What Is Ankylosing Spondylitis?

    Science.gov (United States)

    ... Spondylitis PDF Version Size: 135 KB November 2014 What Is Ankylosing Spondylitis? Fast Facts: An Easy-to- ... affects about twice as many men as women. What Causes Ankylosing Spondylitis? The cause of AS is ...

  4. Ankylosing spondylitis.

    Science.gov (United States)

    Edavalath, Mukesh

    2010-07-01

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

  5. Ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Mukesh Edavalath

    2010-01-01

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

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

    Science.gov (United States)

    Malinowski, Krzysztof Piotr; Kawalec, Paweł

    2015-04-01

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

  7. Pharmacological treatment of ankylosing spondylitis: a systematic review.

    Science.gov (United States)

    Boulos, Pauline; Dougados, Maxime; Macleod, Stuart M; Hunsche, Elke

    2005-01-01

    The purpose of this study was to review the evidence regarding the efficacy and safety of pharmacological therapies currently available for the treatment of ankylosing spondylitis (AS).A literature search using MEDLINE from 1966 through to April 2005 and a hand search of abstracts from the American College of Rheumatology (ACR) meetings for 2001 through to 2004 were performed. References of articles retrieved were also searched. The MEDLINE search yielded 570 citations and 157 abstracts from ACR were identified. Eighty-four studies were randomised controlled trials (RCTs); 53 fulfilled the inclusion criteria (pharmacological treatment of AS and RCT) and were included in this review. Statistical pooling of data was not performed because of the disparate outcome measures used. Eight RCTs found nonselective NSAIDs and two RCTs found cyclo-oxygenase (COX)-2-selective NSAIDs to be superior to placebo for relief of pain and improvement in physical function. Twenty-nine RCTs showed comparable efficacy and safety between nonselective NSAIDs. One RCT showed no difference between methylprednisolone 1g and 375 mg. Seven RCTs assessing the efficacy of sulfasalazine (sulphasalazine) and two RCTs of methotrexate provided contradictory evidence as to their benefit for treatment of AS. One RCT showed intravenous pamidronate 60 mg to be more effective than 10mg intravenously for the treatment of axial pain. All six RCTs of anti-tumour necrosis factor (TNF)-alpha agents demonstrated superiority to placebo for the treatment of axial and peripheral symptoms. Nonselective as well as COX-2-selective NSAIDs can be used for pain control in patients with AS. Other proven treatment options include sulfasalazine for the treatment of peripheral joint symptoms, while limited evidence supports the use of pamidronate or methotrexate, which require further studies. Anti-TNFalpha agents have been found very effective for the treatment of both peripheral and axial symptoms in patients with AS, but

  8. Mortality in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Exarchou, Sofia; Lie, Elisabeth; Lindström, Ulf;

    2016-01-01

    OBJECTIVES: Information on mortality in ankylosing spondylitis (AS) is scarce. Our study therefore aimed to assess: (1) mortality in AS versus the general population, and (2) predictors of death in the AS population. METHODS: Nationwide cohorts of patients with AS diagnosed at rheumatology...

  9. Imaging in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Lambert, Robert G W

    2012-01-01

    Imaging is an integral part of the management of patients with ankylosing spondylitis and axial spondyloarthritis. Characteristic radiographic and/or magnetic resonance imaging (MRI) findings are key in the diagnosis. Radiography and MRI are also useful in monitoring the disease. Radiography...... and sensitivity to change, become a new standard method for assessment of structural damage. Ultrasonography allows visualization of peripheral arthritis and enthesitis, but has no role in the assessment of axial manifestations. Computed tomography is a sensitive method for assessment of structural changes...

  10. Disseminated Tuberculosis Mimicking Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Valérie Huyge

    2011-01-01

    Full Text Available Ankylosing spondylitis is a chronic inflammatory disorder affecting mainly the axial skeleton. Here we report a case of a man with a clinical suspicion of ankylosing spondylitis but with a persistence of increased inflammatory markers. In this case, 18F-FDG-PET/CT revealed multiple hypermetabolic lesions in axial skeleton, lymph nodes, and the lung, suggestive of either disseminated tuberculosis or lymphoma. Histological analysis of the pulmonary lesion revealed mycobacterium tuberculosis. This case highlights, firstly, the importance of excluding other diagnoses in the presence of clinical picture of ankylosing spondylitis and high inflammatory markers and, secondly, the determining role of PET/CT.

  11. Andersson Lesion in Ankylosing Spondylitis

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    Manimegalai N, KrishnanKutty K, Panchapakesa Rajendran C, Rukmangatharajan S, Rajeswari S

    2004-04-01

    Full Text Available Andersson lesions are destructive foci that appear at the discovertebral junction in ankylosingspondylitis. We report three cases of ankylosing spondylitis with such lesions. These lesions simulatean infection and in our country, mimic spinal tuberculosis.

  12. The effectiveness of specific exercise types on cardiopulmonary functions in patients with ankylosing spondylitis: a systematic review.

    Science.gov (United States)

    Saracoglu, Ismail; Kurt, Gamze; Okur, Eda Ozge; Afsar, Emrah; Seyyar, Gulce Kallem; Calik, Bilge Basakci; Taspinar, Ferruh

    2017-03-01

    The aim of this review was to assess the effectiveness of specific exercise types on pulmonary functions, aerobic and functional capacity in patients with ankylosing spondylitis (AS). A systematic search of Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, AMED, EMBASE (OVID) was conducted in January 2016. The outcome measures were spirometric measurements, chest expansion, 6 minute walk distance (6MWD), pVO2, Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The search strategy was applied with limitation of date and language and this initial electronic search resulted in 143 relevant studies. After duplicates were removed, the titles and abstracts of 52 articles were screened. Of these, 14 full-text articles met initial criteria and were retrieved for review, with eight studies meeting final inclusion criteria. Both specific and conventional exercise groups showed significant improvements in BASDAI and BASFI scores (p  0.05). Specific exercises are an effective adjuvant therapy to enhance cardiopulmonary functions in patients with AS; therefore, it is assumed that in addition to the medical treatments, specific exercise therapy might reduce the cardiopulmonary complications related with AS.

  13. Construct validity of clinical spinal mobility tests in ankylosing spondylitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Castro, Marcelo P; Stebbings, Simon M; Milosavljevic, Stephan; Bussey, Melanie D

    2016-07-01

    The study aimed to determine, using systematic review and meta-analysis, the level of evidence supporting the construct validity of spinal mobility tests for assessing patients with ankylosing spondylitis. Following the guidelines proposed in the Preferred Reporting Items for Systematic reviews and Meta-Analyses, three sets of keywords were used for data searching: (i) ankylosing spondylitis, spondyloarthritis, spondyloarthropathy, spondylarthritis; (ii) accuracy, association, construct, correlation, Outcome Measures in Rheumatoid Arthritis Clinical Trials, OMERACT, truth, validity; (iii) mobility, Bath Ankylosing Spondylitis Metrology Index-BASMI, radiography, spinal measures, cervical rotation, Schober (a further 19 keywords were used). Initially, 2558 records were identified, and from these, 21 studies were retained. Fourteen of these studies were considered high level of evidence. Compound indexes of spinal mobility showed mostly substantial to excellent levels of agreement with global structural damage. Individual mobility tests for the cervico-thoracic spine showed only moderate agreements with cervical structural damage, and considering structural damage at the lumbar spine, the original Schober was the only test that presented consistently substantial levels of agreement. Three studies assessed the construct validity of mobility measures for inflammation and low to fair levels of agreement were observed. Two meta-analyses were conducted, with assessment of agreement between BASMI and two radiological indexes of global structural damage. The spinal mobility indexes and the original Schober test show acceptable construct validity for inferring the extent of structural damage when assessing patients with ankylosing spondylitis. Spinal mobility measures do not reflect levels of inflammation at either the sacroiliac joints and/or the spine.

  14. Risk of malignancy in ankylosing spondylitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Deng, Chuiwen; Li, Wenli; Fei, Yunyun; Li, Yongzhe; Zhang, Fengchun

    2016-08-18

    Current knowledge about the overall and site-specific risk of malignancy associated with ankylosing spondylitis (AS) is inconsistent. We conducted a systematic review and meta-analysis to address this knowledge gap. Five databases (PubMed, EMBASE, Web of Science, the Cochrane library and the virtual health library) were systematically searched. A manual search of publications within the last 2 years in key journals in the field (Annals of the Rheumatic Diseases, Rheumatology and Arthritis &rheumatology) was also performed. STATA 11.2 software was used to conduct the meta-analysis. After screening, twenty-three studies, of different designs, were eligible for meta-analysis. AS is associated with a 14% (pooled RR 1.14; 95% CI 1.03-1.25) increase in the overall risk for malignancy. Compared to controls, patients with AS are at a specific increased risk for malignancy of the digestive system (pooled RR 1.20; 95% CI 1.01 to 1.42), multiple myelomas (pooled RR 1.92; 95% CI 1.37 to 3.69) and lymphomas (pooled RR 1.32; 95% CI 1.11 to 1.57). On subgroup analysis, evidence from high quality cohort studies indicated that AS patients from Asia are at highest risk for malignancy overall. Confirmation of findings from large-scale longitudinal studies is needed to identify specific risk factors and to evaluate treatment effects.

  15. Ankylosing spondylitis and risk of venous thromboembolism: A systematic review and meta-analysis

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    Patompong Ungprasert

    2016-01-01

    Full Text Available Background: Several immune-mediated inflammatory disorders, such as rheumatoid arthritis, psoriatic arthritis, and systemic lupus erythematosus have been linked to an increased risk of venous thromboembolism (VTE. However, the data on ankylosing spondylitis (AS are limited. Methods: We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio comparing the risk of VTE and possible pulmonary embolism (PE in patients with AS versus non-AS participants. Pooled risk ratio and 95% confidence intervals were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird. Results: Of 423 potentially relevant articles, three studies met our inclusion criteria and thus, were included in the data analysis. The pooled risk ratio of VTE in patients with AS was 1.60 (95% confidence interval: 1.05–2.44. The statistical heterogeneity of this study was high with an I2 of 93%. Conclusion: Our study demonstrated a statistically significant increased VTE risk among patients with AS.

  16. Juvenile versus adult-onset ankylosing spondylitis -- clinical, radiographic, and social outcomes. a systematic review.

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    Jadon, Deepak R; Ramanan, Athimalaipet V; Sengupta, Raj

    2013-11-01

    Ankylosing spondylitis (AS) has 2 main modes of onset: juvenile-onset AS (JoAS) and adult-onset AS (AoAS). It is not known whether JoAS is a subtype of AS, or AS modulated by early age of onset and longer disease duration. We performed a systematic review of the literature, identifying 12 articles and 1 abstract directly comparing JoAS and AoAS cohorts, with observational study design. Patients with JoAS appear to have more peripheral joint involvement both clinically and radiographically (especially knees and ankles) and more root joint involvement (hips and shoulders); they are more likely to proceed to hip arthroplasty and often initially present with peripheral rather than axial symptoms. Patients with AoAS appear to have more axial symptoms and radiographic disease, particularly in the lumbar spine, and worse axial metrology. In terms of other characteristics, more evidence is needed to confidently state whether JoAS and AoAS are different.

  17. Home based and group based exercise programs in patients with ankylosing spondylitis: systematic review

    Directory of Open Access Journals (Sweden)

    Sofia Lopes

    2016-04-01

    Full Text Available Introduction: Ankylosing Spondylitis (AS is a chronic inflammatory rheumatic disease characterized by inflammation of the joints of the spine and sacroiliac and to a lesser percentage of the peripheral joints. It is a debilitating condition which reduces quality of life in patients with AS. The practice of physical therapy is recommended as non-pharmacological treatment as well as the treatment and prevention of associated deformities. Objective: To collect and summarize the available evidence in scientific databases to realize the effectiveness of home based and group based programs in patients with AS. Methods: Systematic review, where articles for the study were collected from scientific database PubMed. We have found 65 articles with publication date between January 1, 2004 and January 31, 2014. Inclusion and exclusion criteria were established to make the selection of articles to include in the study. All investigators provided their agreement in presencial meeting for a final selection, and at a later stage, the articles were read in full by the three investigators. Results: The present systematic review includes eight randomized controlled trials. All articles show functional benefits in patients with AS subject to exercise programs in group based and / or home based. From the eight articles, 4 addressed programs conducted in home based context and 4 addressed in group based context programs. Conclusion: There appears to be evidence that the programs carried out based on group are more effective than those home based conducted in patients with AS. It was concluded also be advantageous to carry out home based exercise programs than the absence of any exercise program.

  18. [Axial spondyloarthritis and ankylosing spondylitis].

    Science.gov (United States)

    Nordström, Dan; Kauppi, Markku

    2010-01-01

    Current classification criteria for ankylosing spondylitis do not allow diagnosis before radiographic changes are visible in sacroiliacal joints. The the new axial spondyloarthropathy (SpA) criteria include axial SpA without radiographic changes as well as established ankylosing spondylitis, recognizing them as a continuum of the same disease. This is of major importance as the burden of early SpA is comparable to that of later stage disease. Diagnosis relies on inflammatory MRI findings which is the most significant change compared to earlier criteria. Emerging data on the efficacy of tumor necrosis factor (TNF) alpha blocking therapies already in early but also in established disease have given new promising alternatives for treatment of this often very cumbersome disease, that rarely responds to classic DMARDs.

  19. [Renal abnormalities in ankylosing spondylitis].

    Science.gov (United States)

    Samia, Barbouch; Hazgui, Faiçal; Abdelghani, Khaoula Ben; Hamida, Fethi Ben; Goucha, Rym; Hedri, Hafedh; Taarit, Chokri Ben; Maiz, Hedi Ben; Kheder, Adel

    2012-07-01

    We will study the epidemiologic, clinical, biological, therapeutic, prognostic characteristics and predictive factors of development of nephropathy in ankylosing spondylitis patients. We retrospectively reviewed the medical record of 32 cases with renal involvement among 212 cases of ankylosing spondylitis followed in our service during the period spread out between 1978 and 2006. The renal involvement occurred in all patients a mean of 12 years after the clinical onset of the rheumatic disease. Thirty-two patients presented one or more signs of renal involvement: microscopic hematuria in 22 patients, proteinuria in 23 patients, nephrotic syndrome in 11 patients and decreased renal function in 24 patients (75%). Secondary renal amyloidosis (13 patients), which corresponds to a prevalence of 6,1% and tubulointerstitial nephropathy (7 patients) were the most common cause of renal involvement in ankylosing spondylitis followed by IgA nephropathy (4 patients). Seventeen patients evolved to the end stage renal disease after an average time of 29.8 ± 46 months. The average follow-up of the patients was 4,4 years. By comparing the 32 patients presenting a SPA and renal disease to 88 with SPA and without nephropathy, we detected the predictive factors of occurred of nephropathy: tobacco, intense inflammatory syndrome, sacroileite stage 3 or 4 and presence of column bamboo. The finding of 75% of the patients presented a renal failure at the time of the diagnosis of renal involvement suggests that evidence of renal abnormality involvement should be actively sought in this disease.

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

    Science.gov (United States)

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

    2014-01-01

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

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

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

    2013-04-01

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

  2. Decreased central corneal thickness in ankylosing spondylitis.

    Science.gov (United States)

    Ortak, Huseyin; Inanır, Ahmet; Demir, Selim; Uysal, Alper; Şahin, Şafak; Sağcan, Mustafa; Önder, Yalçın; Alim, Sait; Demir, Ayşe Kevser

    2014-04-01

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

  3. Cardiac Involvement in Ankylosing Spondylitis

    Science.gov (United States)

    Ozkan, Yasemin

    2016-01-01

    Ankylosing spondylitis is one of the subgroup of diseases called “seronegative spondyloarthropathy”. Frequently, it affects the vertebral colon and sacroiliac joint primarily and affects the peripheral joints less often. This chronic, inflammatory and rheumatic disease can also affect the extraarticular regions of the body. The extraarticular affections can be ophthalmologic, cardiac, pulmonary or neurologic. The cardiac affection can be 2-10% in all patients. Cardiac complications such as left ventricular dysfunction, aortitis, aortic regurgitation, pericarditis and cardiomegaly are reviewed. PMID:27222669

  4. Scintigraphic findings in ankylosing spondylitis.

    Science.gov (United States)

    Lentle, B C; Russell, A S; Percy, J S; Jackson, F I

    1977-06-01

    A prospective study of bone scintigraphic findings has been carried out in 63 patients, firmly diagnosed as having ankylosing spondylitis. In addition to abnormal uptake of the radiotracer at the sacroiliac joints, a peripheral arthropathy has been a common finding, particularly in the proximal joints, occurring in up to 50% of patients. Increased uptake of radiotracer in the spine has also been found both diffusely and focally. Focal increases have been noted at the apophyseal joints in 40% of patients and in three patients with a sterile intervertebral diskitis, an unusual complication of this disease only diagnosed in two patients after bone scintigraphy.

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

    Science.gov (United States)

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

    2012-01-01

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

  6. Physiotherapy for ankylosing spondylitis: Systematic review and a proposed rehabilitation protocol.

    Science.gov (United States)

    Sharan, Deepak; Rajkumar, Joshua Samuel

    2016-10-25

    Ankylosing Spondylitis (AS) is a chronic inflammatory disease of insidious onset, mostly affecting the axial skeleton. It leads to varying degrees of restricted spinal mobility, pain and loss of functional capacity. Rehabilitation, especially Physiotherapy and exercises, are considered integral components of its management. Various rehabilitation modalities are available for the benefit of individuals with AS, but a sequenced protocol has not been reported. A scientific review was performed using the following search engines: MEDLINE (Pubmed), COCHRANE Library and Physiotherapy Evidence Database (PEDro). Studies which had at least one of the group receiving rehabilitation and the major outcomes studied were pain, stiffness, mobility (spine and chest wall) and physical function (disease activity, ADL, QOL and global function) were selected. A total of 19 studies were shortlisted for the review which included a total of 1142 subjects with AS. The review of literature showed that individuals with AS had beneficial effects from exercise programmes compared to no exercise. Patient education, active involvement and motivation of individuals with AS played an important role in the overall treatment outcomes. Based on the review, a four phase sequenced rehabilitation protocol has been laid down for the benefit of individuals with AS.

  7. Ankylosing Spondylitis: a Reflection and a Question

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    Annia Deysi Hernández Martín

    2014-07-01

    Full Text Available Ankylosing spondylitis is a chronic inflammatory disease that affects the synovial membrane, joint entheses and para-articular structures of the spine, including the sacroiliac joints and limbs. We present a case of ankylosing spondylitis that had evolved for 12 years despite the relatively early diagnosis and treatment, showing flexion deformity and limitation of spinal movements. On radiological examination an early evolution to ankylosis was observed, which motivated us to make a reflection and a question.

  8. Spinal instability in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Badve Siddharth

    2010-01-01

    Full Text Available Background: Unstable spinal lesions in patients with ankylosing spondylitis are common and have a high incidence of associated neurological deficit. The evolution and presentation of these lesions is unclear and the management strategies can be confusing. We present retrospective analysis of the cases of ankylosing spondylitis developing spinal instability either due to spondylodiscitis or fractures for mechanisms of injury, presentations, management strategies and outcome. Materials and Methods: In a retrospective analysis of 16 cases of ankylosing spondylitis, treated surgically for unstable spinal lesions over a period of 12 years (1995-2007; 87.5% (n=14 patients had low energy (no obvious/trivial trauma while 12.5% (n=2 patients sustained high energy trauma. The most common presentation was pain associated with neurological deficit. The surgical indications included neurological deficit, chronic pain due to instability and progressive deformity. All patients were treated surgically with anterior surgery in 18.8% (n=3 patients, posterior in 56.2% (n=9 patients and combined approach in 25% (n=4 patients. Instrumented fusion was carried out in 87.5% (n=14 patients. Average surgical duration was 3.84 (Range 2-7.5 hours, blood loss 765.6 (± 472.5 ml and follow-up 54.5 (Range 18-54 months. The patients were evaluated for pain score, Frankel neurological grading, deformity progression and radiological fusion. One patient died of medical complications a week following surgery. Results: Intra-operative adverse events like dural tears and inadequate deformity correction occurred in 18.7% (n=3 patients (Cases 6, 7 and 8 which could be managed conservatively. There was a significant improvement in the Visual analogue score for pain from a pre-surgical median of 8 to post-surgical median of 2 (P=0.001, while the neurological status improved in 90% (n=9 patients among those with preoperative neurological deficit who could be followed-up (n =10. Frankel

  9. Bone scintigraphy in ankylosing spondylitis

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    Otsuka, Nobuaki; Fukunaga, Masao; Tomomitsu, Tatsushi (Kawasaki Medical School, Kurashiki, Okayama (Japan)); Morita, Rikushi

    1991-10-01

    Twelve patients with ankylosing spondylitis (11 males and one female) were examined by both bone scintigraphy and dual energy X-ray absorptiometry (DEXA). Bone scintigraphy revealed increased accumulation in the sacroiliac joint in 6 patients, the spines in 10, and the other joints, including the sternoclavicular joint, in 8 patients. Each one patient had an intense tracer uptake in the finger and toe joints. In 4 patients in whom DEXA was concurrently performed at the level of 2nd to 4th lumbar vertebrae, there was no consistent tendency for mean bone mineral density. In 2 of 3 patients receiving DEXA for the radius, bone marrow density was within the normal range. (N.K.).

  10. Are Systematic Screening for Vitamin D Deficiency and Vitamin D Supplementation Currently Feasible for Ankylosing Spondylitis Patients?

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    Mickael Essouma

    2017-01-01

    Full Text Available Beyond its role in calcium and phosphorus metabolism for healthy bone mineralization, there is increasing awareness for vitamin D contribution in modulation of immune reactions. Given that ankylosing spondylitis (AS is a chronic inflammatory disease involving excess immune/inflammatory activity and posing great therapeutic challenges, it is conceivable to claim that vitamin D treatment may be a safe and effective treatment to influence or modify the primary disease and its related comorbidities. Nevertheless, consistent body of research supporting this hypothesis is still lacking. In this paper, we examine whether systematic screening and treatment for vitamin D deficiency are feasible at present. We will review the immunomodulatory role of vitamin D and its contribution in initiation and progression of AS, as well as how they would determine the occurrence of comorbid conditions. Our conclusion is that despite the overwhelmed interest about vitamin D treatment in AS patients, systematic screening and treatment for vitamin D deficiency of all AS patients are not feasible as yet. This stresses the need for further extensive well-designed research to prove vitamin D efficacy in AS beyond bone protection. And if utility is proven, personalized treatment regimes, duration of treatment, and threshold values for vitamin D should be provided.

  11. Tumor necrosis factor-alpha inhibitor combined with methotrexate for ankylosing spondylitis: a systematic review and meta-analysis

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    Shaopeng Lin

    2014-06-01

    Full Text Available To evaluate the benefits and harms of combination of tumor necrosis factor-alpha (TNF-α inhibitor and methotrexate (MTX compared with TNF-α inhibitor monotherapy in the treatment of ankylosing spondylitis (AS. Randomized controlled trials were identified from Medline, Embase, Cinahl, Central and Clinical Trials Registry Platform, as well as from the reference sections of retrieved articles. The risk of bias was evaluated in all included trials. Data were extracted by two reviewers independently using a specially designed extraction form. The Cochrane Collaboration’s Review Manager 5.2 software was used for data analysis. The search retrieved 852 titles, of which 3 original trials were included, involving 187 participants. The overall risk of bias is low in all three trials. Only one study was placebo controlled, and all of them examined small samples. The analysis showed no significant advantage of the MTX combination versus monotherapy. Two trials assessed Assessment of Ankylosing Spondylitis (ASAS 40 and the pooled risk ratio (RR was 1.37 and 95% confidence interval 0.84 to 2.23. The RR for ASAS20 was 1.16 (0.88 to 1.52. Likewise, there were no significant difference between two groups in partial remission, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Magnetic resonance imaging activity score and other secondary outcomes. Withdrawals for side effects and for any reason were similar in two groups, RR were 1.89 (0.71 to 5.02 and 1.11 (0.67 to 1.84, respectively. The evidence available did not support any benefit of adding MTX to TNF-α inhibitor for the treatment of AS.

  12. [Unusual muscular involvement in ankylosing spondylitis].

    Science.gov (United States)

    Wattiaux, M J; Rondier, J; Bletry, O; Godeau, P; Cayla, J

    1985-03-01

    Muscle involvement in ankylosing spondylitis has been little studied. The authors report two cases with marked muscular atrophy and functional impotence, which had directed the diagnosis towards a myopathy over a period of several years in the first case, and a suspected primary muscular disease associated with ankylosing spondylitis in the second. Muscle biopsies eliminated the diagnosis of myopathy in both cases, with rapid functional recovery with proper treatment. Following a review of the literature, two hypotheses can be considered to explain the muscular involvement in ankylosing spondylitis: one mechanism which appears well-established is a radiculitis with involvement of the paravertebral muscles: other authors suggest that there is nonspecific, generalized muscular involvement in this disorder.

  13. Management of Pregnancy with Ankylosing Spondylitis

    Institute of Scientific and Technical Information of China (English)

    Qian Zhou; Xu-ming Bian; Jun-tao Liu

    2012-01-01

    To discuss the interaction between pregnancy and ankylosing spondylitis,and the management of pregnancy with ankylosing spondylitis.Methods Twelve cases of pregnancy with ankylosing spondylitis in Peking Union Medical College Hospital from September 2004 to July 2011 were analyzed retrospectively,focusing on the arteritis condition,pregnancy complications,and outcomes.Results All the 12 patients had full-term pregnancy.Five cases gave birth naturally,and 7 cases received cesarean section for maternity factors.No adverse pregnancy outcomes were encountered.Waist pain appeared in 2 cases in the second trimester,for both of which medication failed.One of the 2 cases had natural childbirth,while the other maintained pregnancy smoothly to cesarean section.Conclusions Pregnancy monitoring can help obtain favorable pregnancy outcomes.Attention should be paid to postpartum change of the illness.

  14. Coexistence of Ankylosing Spondylitis and Klinefelter's Syndrome

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    Şenol Kobak

    2013-01-01

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

  15. Alternative Treatments for Ankylosing Spondylitis

    Science.gov (United States)

    ... Have Spondylitis? Treatment Information Medications Exercise & Posture Diet & Nutrition Medication & Diet Dietary Supplements Changing Your Diet The London AS / Low Starch Diet Complementary Treatments Possible Complications Iritis or Anterior Uveitis Fatigue in Spondylitis Pain in ...

  16. Men's Experiences of Living with Ankylosing Spondylitis

    DEFF Research Database (Denmark)

    Madsen, Mette; Jensen, Kim Vilbek; Esbensen, Bente Appel

    2015-01-01

    BACKGROUND: The majority of patients with ankylosing spondylitis (AS) are male, although potential gender differences have not been investigated in relation to disease management. Moreover, men's perceptions of experiencing AS have not been reported in the literature. AIMS: This study sought......, and not being able to exercise challenged the men's masculine identity. Copyright © 2014 John Wiley & Sons, Ltd....

  17. Ankylosing Spondylitis versus Nonradiographic Axial Spondyloarthritis

    DEFF Research Database (Denmark)

    Glintborg, Bente; Sørensen, Inge J; Østergaard, Mikkel

    2017-01-01

    OBJECTIVE: To compare baseline disease activity and treatment effectiveness in biologic-naive patients with nonradiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) who initiate tumor necrosis factor inhibitor (TNFi) treatment and to study the role of potential confounders...

  18. The Association of Myotonia Congenita and Ankylosing Spondylitis: Case Report

    OpenAIRE

    Bağçacı, Sinan; Albayrak, Ilknur; Karakaşlı, Sema; Küçükşen, Sami; Sallı, Ali

    2015-01-01

    This is the first report about the association of ankylosing spondylitis and myotonia congenita. Ankylosing spondylitis is a systemic rheumatologic disease that is characterized by axial skeletal inflammation and accompanied by systemic involvement. The most significant findings of myotonia are the stiffness and the delayed relaxation following the muscle contraction. Both of these pathologies can cause stiffness and also delaying of diagnosis of each other. Key words: Ankylosing spondyliti...

  19. [Some aspects of pathogenesis of ankylosing spondylitis].

    Science.gov (United States)

    Erdes, Sh

    2011-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease of the spine (spondylitis) and sacroiliac joints (sacroileitis) associated in many cases with inflammatory affection of the peripheral joints (arthritis), entesises (entesitis), eyes (uveitis), intestine (enteritis) and aortic root (aortitis). AS is considered now as a prototype of diseases from the group of seronegative spondyloarthritis. AS is a hereditary disease. Predisposition to AS (90%) is associated with genetic factors the key gene of which is HLA-B27. As pathogenesis of AS is not still verified, three hypotheses are considered basing on HLA-B27 biology. The role of environmental factors involved in AS development (tension in enteses and infection) are discussed.

  20. How well are the ASAS/OMERACT Core Outcome Sets for Ankylosing Spondylitis implemented in randomized clinical trials? A systematic literature review.

    Science.gov (United States)

    Bautista-Molano, Wilson; Navarro-Compán, Victoria; Landewé, Robert B M; Boers, Maarten; Kirkham, Jamie J; van der Heijde, Désirée

    2014-09-01

    This study aims to investigate how well the Assessment of SpondyloArthritis international Society (ASAS)/Outcome Measures in Rheumatology Clinical Trials (OMERACT) core set and response criteria for ankylosing spondylitis (AS) have been implemented in randomized controlled trials (RCTs) testing pharmacological and non-pharmacological interventions. A systematic literature search was performed up to June 2013 looking for RCTs in patients with axial spondyloarthritis (SpA) (AS and non-radiographic axial SpA). The assessed domains and instruments belonging to the core sets for disease-controlling anti-rheumatic therapy (DC-ART) and symptom-modifying anti-rheumatic drugs (SMARDs) were extracted. Results were reported separately for those trials published until 2 years after the publication of the core set (1 April 2001; 'control trials') and those trials published at least 2 years after the publication date ('implementation trials'). One hundred twenty-three articles from 99 RCTs were included in the analysis, comparing 48 'control trials' and 51 'implementation trials'. Regarding DC-ART core set, the following domains were significantly more frequently assessed in the 'implementation group' in comparison to the 'control group': 'physical function' (100 vs 41.7 %; p ≤ 0.001), 'peripheral joints/entheses' (100 vs 33.3 %; p ≤ 0.001) and 'fatigue' (100 vs 0 %; p ≤ 0.001). Three instruments were significantly more used in the 'implementation group': Bath Ankylosing Spondylitis Functional Index (BASFI) (100 vs 8.3 %; p = ≤ 0.001), CRP (92.3 vs 58.3 %; p = 0.01) and Bath Ankylosing Spondylitis Metrology Index (BASMI) (53.8 vs 0 %; p = 0.001). Regarding SMARD core set domains, physical function (92 vs 23 %; p ≤ 0.001) and fatigue (84 vs 17 %; p ≤ 0.001), as well as the instruments BASFI (88 vs 14 %; p ≤ 0.001) and BASMI (52 vs 0 %; p ≤ 0.001), increased significantly in the 'implementation group'. Twenty per cent of

  1. [Physiotherapy in rheumatoid arthritis and ankylosing spondylitis].

    Science.gov (United States)

    Mariacher-Gehler, S; Wyss-Näther, A; Aeschlimann, A G

    2001-08-01

    Both Rheumatoid Arthritis (RA) and Ankylosing Spondylitis (AS) are chronic, inflammatory systemic diseases. RA predominantly manifests itself in the peripheral joints, whereas AS most prominently in the spine. As time progresses the roles of active and physical therapy become increasingly important. The aims of intensive and dynamic exercise for patients with RA and AS are formulated following the ICIDH-2. Thus, the aims are a direct equation of body function, activities and participation. The benefits of exercise therapy are increased joint mobility, increased muscle strength, improved functional ability and better cardiorespiratory function without incurring a flare of the disease.

  2. Factors affecting the pathogenesis of ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    周昌德

    2001-01-01

    @@Ankylosing spondylitis (AS) occurs more frequently in young males than in females. The prevalence of AS in Taiwan, according to our previous study, is about 0.3%.1 AS mainly affects the spine, however, it can also result in peripheral arthritis that occurs in the toes, ankles, knees, hip joints and the tendon and ligaments around those joints.2 In addition, the spine of some AS patients may develop kyphoscoliosis due to late diagnosis or failure to cooperate in following the routine medication and exercises prescribed by their doctors.

  3. High prevalence of low bone mineral density in patients within 10 years of onset of ankylosing spondylitis: a systematic review.

    Science.gov (United States)

    van der Weijden, M A C; Claushuis, T A M; Nazari, T; Lems, W F; Dijkmans, B A C; van der Horst-Bruinsma, I E

    2012-11-01

    Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease. Decreased bone mineral density (BMD) is a common complication of AS, with a prevalence range of 19 to 62 %. Many studies have shown decreased BMD in AS with long disease duration, but only a few studies investigated BMD in early AS. The prevalence of decreased BMD in early disease stages of AS has not yet been clearly described, and for that reason, we reviewed the literature which describes the prevalence of decreased BMD in AS patients with a short disease duration (articles which used the modified New York criteria for the diagnosis of AS, included patients with a disease duration of less than 10 years, and used the WHO criteria for osteopenia and osteoporosis. Decreased BMD was defined as a T score articles that acquired BMD data of lumbar spine and femoral neck by DXA were used. The literature search provided us 35 articles of which 7 matched all our criteria, and they will be further outlined in this review. The overall prevalence of decreased BMD of the articles reviewed is 54 % (n = 229/424) for lumbar spine and 51 % (n = 224/443) for femoral neck. The prevalence of osteopenia vs. osteoporosis for lumbar spine is 39 vs. 16 % and for femoral neck, 38 vs. 13 %. This review showed a high total prevalence of 51-54 % decreased BMD and 13-16 % osteoporosis in AS with a short disease duration. This high prevalence was not to be expected in a relatively young and predominantly male population. Further research is needed to determine the clinical relevance of this low BMD by investigating the relation between low BMD and vertebral and nonvertebral fractures at this early stage in AS.

  4. Spinal fractures in patients with ankylosing spondylitis.

    Science.gov (United States)

    Leone, Antonio; Marino, Marzia; Dell'Atti, Claudia; Zecchi, Viola; Magarelli, Nicola; Colosimo, Cesare

    2016-10-01

    The ankylosed spine is prone to fracture even after minor trauma due to its changed biomechanical properties. The two central features of ankylosing spondylitis (AS) that promote the pathological remodeling of the spine are inflammation and new bone formation. AS is also associated with osteoporosis that is attributed to an uncoupling of the bone formation and bone resorption processes. Therefore, bone resorption occurs and promotes weakening of the spine as well as increased risk of vertebral fractures which can be hugely different in terms of clinical relevance. Even in the presence of symptomatic clinical vertebral fractures, the diagnosis can be overruled by attributing the pain to disease activity. Furthermore, given the highly abnormal structure of the spine, vertebral fracture diagnosis can be difficult on the basis of radiography alone. CT can show the fractures in detail. Magnetic resonance imaging is considered the method of choice for the imaging of spinal cord injuries, and a reasonable option for exclusion of occult fractures undetected by CT. Since it is equally important for radiologists and clinicians to have a common knowledge base rather than a compartmentalized view, the aim of this review article was to provide the required clinical knowledge that radiologists need to know and the relevant radiological semiotics that clinicians require in diagnosing clinically significant injury to the ankylosed spine.

  5. Surgical management of temporomandibular joint ankylosis in ankylosing spondylitis.

    Science.gov (United States)

    Felstead, Andrew M; Revington, Peter J

    2011-01-01

    Relatively few patients develop such severe degenerative temporomandibular joint (TMJ) disease that they require total joint replacement. Current indications include those conditions involving condylar bone loss such as degenerative (osteoarthritis) or inflammatory joint disease (ankylosing spondylitis, rheumatoid, and psoriatic). Ankylosis of the temporomandibular joint (TMJ) secondary to ankylosing spondylitis remains an under investigated entity. We aim to provide an overview of treatment objectives, surgical procedures, and our experience with total TMJ replacement for this condition.

  6. Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis

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    Andrew M. Felstead

    2011-01-01

    Full Text Available Relatively few patients develop such severe degenerative temporomandibular joint (TMJ disease that they require total joint replacement. Current indications include those conditions involving condylar bone loss such as degenerative (osteoarthritis or inflammatory joint disease (ankylosing spondylitis, rheumatoid, and psoriatic. Ankylosis of the temporomandibular joint (TMJ secondary to ankylosing spondylitis remains an under investigated entity. We aim to provide an overview of treatment objectives, surgical procedures, and our experience with total TMJ replacement for this condition.

  7. T lymphocyte subset imbalances in patients contribute to ankylosing spondylitis.

    Science.gov (United States)

    Wang, Chenggong; Liao, Qiande; Hu, Yihe; Zhong, DA

    2015-01-01

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

  8. The effectiveness of exercise therapy for ankylosing spondylitis: a review.

    Science.gov (United States)

    Wang, Ching-Yi; Chiang, Pin-Yen; Lee, Hong-Shen; Wei, James Cheng-Chung

    2009-09-01

    Exercise therapy is an important component of current standard therapy for patients with ankylosing spondylitis. The purpose of this review is to provide important guidelines when prescribing exercises by reviewing articles evaluating the effectives and usefulness of exercise therapy in patients with ankylosing spondylosis.

  9. Danish recommendations on treatment of ankylosing spondylitis and spondyloarthritis based on multinational project initiative

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Madsen, Ole Rintek; Erlendsson, J.

    2008-01-01

    INTRODUCTION: The multinational initiative "3e Initiative in Rheumatology - Multi-national Recommendations for the Management of Ankylosing Spondylitis 2006-7" served the primary purpose of providing specific recommendations for the management of ankylosing spondylitis and spondyloarthritis...

  10. Coexistence of rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

    Barczyńska, Tacjana Anna; Węgierska, Małgorzata; Żuchowski, Paweł; Dura, Marta; Zalewska, Joanna; Waszczak, Marzena; Jeka, Sławomir

    2015-01-01

    Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are chronic progressive inflammatory diseases, leading to joint damage and reducing the physical fitness of patients. They are among the most common rheumatic diseases. However, their etiology and symptomatology are different. Formerly, AS was often wrongly diagnosed as RA. Today there are no major diagnostic difficulties in differentiation between these diseases, thanks to modern laboratory tests and imaging. However, a problem may arise when the patient has symptoms typical for both diseases simultaneously. Cases of coexistence of RA with AS - according to our best knowledge - are rare. This study aims to compare our experience in diagnosis and treatment of concomitant RA and AS with the experience of other researchers. Implementation of the proper diagnostic algorithm, allowing for correct diagnosis of both diseases in one patient, may be useful for differential diagnosis of similar cases in the future.

  11. SIGNIFICANCE OF PERIPHERAL ARTHRITIS IN ANKYLOSING SPONDYLITIS

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    Sh. F. Erdes

    2014-01-01

    Full Text Available Objective: to elucidate the role of peripheral arthritis in ankylosing spondylitis (AS and its impact on therapy choice in daily practice of rheumatologists. Subjects and methods. The investigation enrolled 330 consecutive patients with AS referred to rheumatologists during 4 months in 24 cities and towns of the Russian Federation. A specially designed clinical schedule was filled out for all the patients. Results. Peripheral arthritis was present in 47% of patients, including in 17 and 46% who had upper and lower limb joint involvement, respectively. Patients with peripheral arthritis had higher ESR, BASDAI and ASDAS-ESR levels. They were also found to have more marked functional disorders than the patients with its isolated axial variant. The clinical signs of hip joint involvement were detected in 56% of the patients and they were bilateral in 43%. In the rheumatologists' opinion, 24 (8% needed total hip joint replacement. Conclusion. Peripheral arthritis aggravates AS.

  12. Inhibition of Complement Retards Ankylosing Spondylitis Progression

    Science.gov (United States)

    Yang, Chaoqun; Ding, Peipei; Wang, Qingkai; Zhang, Long; Zhang, Xin; Zhao, Jianquan; Xu, Enjie; Wang, Na; Chen, Jianfeng; Yang, Guang; Hu, Weiguo; Zhou, Xuhui

    2016-01-01

    Ankylosing spondylitis (AS) is a chronic axial spondyloarthritis (SpA) resulting in back pain and progressive spinal ankyloses. Currently, there are no effective therapeutics targeting AS largely due to elusive pathogenesis mechanisms, even as potential candidates such as HLA-B27 autoantigen have been identified. Herein, we employed a proteoglycan (PG)-induced AS mouse model together with clinical specimens, and found that the complement system was substantially activated in the spinal bone marrow, accompanied by a remarkable proportion alteration of neutrophils and macrophage in bone marrow and spleen, and by the significant increase of TGF-β1 in serum. The combined treatment with a bacteria-derived complement inhibitor Efb-C (C-terminal of extracellular fibrinogen-binding protein of Staphylococcus aureus) remarkably retarded the progression of mouse AS by reducing osteoblast differentiation. Furthermore, we demonstrated that two important modulators involved in AS disease, TGF-β1 and RANKL, were elevated upon in vitro complement attack in osteoblast and/or osteoclast cells. These findings further unravel that complement activation is closely related with the pathogenesis of AS, and suggest that complement inhibition may hold great potential for AS therapy. PMID:27698377

  13. Bone Mineral Density in Ankylosing Spondylitis

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    Bahar Çakmak

    2003-12-01

    Full Text Available Ankylosing Spondylitis (AS, a chronic inflammatory rheumatic disease. One of the most frequent and important complications in these patients is osteoporosis. There are controversial studies on the correlation of osteoporosis and disease duration, activity and functional status. Twenty-one male and five female patients diagnosed as AS according to Modified New York, ESSG( European Spondyloartropaties Study Group and Amor criteria were included in this study. Disease duration and age-sex of the patients was assessed. Patients with ankylosed lumbar spine in late stages of the disease were excluded. Bone mineral density (BMD was measured by DEXA( Hologic at lumbar and femoral neck regions. BASDAI was used for evaluation of disease activity and BASFI index for functional status evaluation.Correlation of BMD with disease duration, BASDAI and BASFI indexes was assessed. BMD at lumbar spine and femoral neck regions was found to be osteoporotic in 11,5 % of the patients. In the lumbar region there was no correlation between BMD and disease duration, BASFI and BASDAI indexes. BMD values of femoral neck showed a weak inverse correlation with disease duration, while no correlation was found between BMD and BASFI and BASDAI. As a conclusion in AS patients osteoporosis besides the disease itself many secondarily influence disease prognosis and complications. Therefore osteoporosis should be evaluated in the management and follow-up of AS patients.

  14. From rehabilitation to remission in ankylosing spondylitis

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    A. Spadaro

    2011-06-01

    Full Text Available During the past years, exercise and non-steroidal anti-inflammatory drugs (NSAIDs have been the mainstay of symptom control for Ankylosing Spondylitis (AS, a chronic, inflammatory rheumatic disease characterized by inflammatory back pain due to sacroiliitis and spondylitis. The ASsessment in AS (ASAS international working group has constructed evidence based recommendations to guide the physician in the management of AS (1. Among the major recommendations for the management of AS, the ASAS group stated that there is a level Ib evidence that NSAIDs improve spinal pain, peripheral joint pain, and function, but comparative studies (1 or population-based survey (2 of different NSAIDs/coxib have not demonstrated one preparation to be clearly better than the others. Wanders et al (3 showed that the clinical efficacy of continuous NSAIDs/coxib treatment for AS was similar to intermittent ‘‘on demand’’ use and they suggested that the continuous treatment with NSAIDs/coxib could slow the radiographic disease progression over 2 years...

  15. ANKYLOSING SPONDYLITIS IN THE VOLGA BULGARIA

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    D. I. Abdulganieva

    2015-01-01

    Full Text Available There is much evidence that ankylosing spondylitis (AS is a disease that is also much older than early human civilizations and man as a whole. Until now, the Russia's earliest (14th c ntury archaeological finding of such a patient remains a Volga Bulgaria inhabitant suffering with AS during his life. In the Republic of Tatarstan, at the site of an ancient Bulgar settlement appearing in the early ninth century, archaeologists have discovered an unusual grave: the deceased sitting with his back against the western wall of a tomb pitand having a bronze crosslet under his fingers. According to a historical source, it was the way of burying Christian hierarchs as pastors sitting on the altar and anticipating the great assize during which the destinies of human souls should be ruled. Anthropological analysis showed that the bones belonged to a 35–45-year-old man who was 158–163 cm tall. During the examination of the remains,attention was called to the following features of the spinal structure: ankylosis of the inferior cervical and superior thoracic vertebrae (СV–ThI and inferior thoracic and lumbar spine (ThIV–LII predominantly due to ossification of the anterior longitudinal ligament. Facet vertebral joints and costotransverse joints were also ankylosed at the same levels. The man's neck was fixed in a bent-over position with the head down, the chin touching the breast bone – the socalled soliciting posture. By and large, the vertebral changes are characteristic of late (X-ray stage III spondylitis. Spinal and pelvic photos and X-films are given for demonstration. The studies conducted by historical scientists and forensic medical experts suggest that the found remains are most likely to belong to Christian Theodore nicknamed Jerusaleman, also further known as Holy Theodore philosopher Kamsky (Bulgarian, who was mentioned in the Nikon chronicle in 1323.

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

    Directory of Open Access Journals (Sweden)

    Hodler Juerg

    2007-02-01

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

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

    OpenAIRE

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

    2007-01-01

    Abstract Background Ankylosing spondylitis is a chronic inflammatory rheumatic disorder which usually begins in early adulthood. The diagnosis is often delayed by many years. MR imaging has become the preferred imaging method for detection of early inflammation of the axial skeleton in ankylosing spondylitis. The goal of this study was to assess the frequency and distribution of abnormalities on whole body MR imaging in patients with suspected early ankylosing spondylitis and with active conf...

  18. Hydrosyringomyelia in an Ankylosing Spondylitis Patient After Stabilization Surgery

    Directory of Open Access Journals (Sweden)

    Deniz Oke Topcu

    2013-08-01

    Full Text Available Ankylosing Spondylitis (AS is a chronic, systemic, and autoimmune inflammatory disease which mainly affects axial skeleton. Despite current approaches in ankylosing spondylitis treatment, the disease frequently causes to thoracolumbar kyphotic deformity due to its progressive course. Many surgical procedures including decompression, stabilization and final fusion could be performed for the treatment of kyphotic deformity. Hydromyelia and syrinx are the terms used to define dilatation in central spinal cord. Some authors reported syringomyelia progression related to spinal operation. In our case; 48-year-old woman, who has been followed for ankylosing spondylitis; spinal cord injury secondary to syringomyelia was detected 7 years after stabilization surgery. Consequently, it should be kept in mind that syringomyelia, which is a rare complication, may develop in patients who underwent stabilization surgery.

  19. Integrative Structural Biomechanical Concepts of Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Alfonse T. Masi

    2011-01-01

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

  20. [Purine metabolism in ankylosing spondylitis: clinical study].

    Science.gov (United States)

    Jiménez Balderas, F J; Robles, E J; Juan, L; Badui, E; Arellano, H; Espinosa Said, L; Mintz Spiro, G

    1989-01-01

    We undertook a prospective study of 23 male patients with Ankylosing Spondylitis (AS) (New York Criteria), 18 HLA-B27 positive and 5 HLA-B27 negative, five of them had hyperuricemia. The following data of evolution were taken into consideration: age at onset of disease, time course of the disease, presence of urolithiasis, heart disease, flares of uveitis. Clinical activity and degree of disability were evaluated every one to 3 months; on each visit, every patient had determinations of serum and urinary uric acid levels, serum and phosphorus, erythrocyte sedimentation rate (ESR), serum protein electrophoresis, as well as X-ray films of the vertebral spine and pelvis. Three groups of patients were detected, all of them with equal age at onset, duration of disease, frequency of B27, peripheral arthritis, and leukocytosis. One group had hyperuricemia (5 of 23 patients, 80% of them HLA-B27 positive) and a lesser degree of clinical activity of the disease (p less than .001, a higher frequency of uveitis (40%, lower levels of serum gammaglobulins (p less than 0.05) and ESR (p less than 0.05), a lesser degree of ankylosis of the spine, and a better functional prognosis than the other groups. Another group (8 of 23 patients, 75% of them were HLA-B27 positive) had normouricemia and hyperuricosuria, and showed a higher frequency of fever (50%), an abnormal urinalysis, and urolithiasis (25%).

  1. Ankylosing Spondylitis Associated With Bilateral TMJ Ankylosis

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ju Seop; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Chonbuk National University, Iksan (Korea, Republic of)

    2000-09-15

    A 31-year-old male with severe limitation of mouth opening was referred to our department of Chonbuk National University Hospital. The physical status of the patient was hyposthenic. Extraoral examination showed no condylar movement of the both temporomandibular joints, no pain, no faical swelling or paresthesia. Intraoral examination showed several cervical caries on the upper anterior teeth, and gingival swelling on the whole dentition. Transcranial view showed no condylar movement, and narrowing of joint spaces. Chest P-A view showed straightening of thoracic, lumbar spine, and squaring of vertebrae of the same spines. Conventional lateral radiograph of cervical spine showed calcification of the intervertebral ligament. Computed tomograph showed extensive bone formation between temporal bone and the both condylar heads. Labortory findings showed positive reaction on HLA-B27 histocompatibility antigen and increased level of IgA, IgG, ESR. Based on the clinical, radiographic, and the labortary findings, final diagnosis was made as bony ankylosis of the both temporomandibular joints secondary to ankylosing spondylitis.

  2. Secukinumab for ankylosing spondylitis and psoriatic arthritis

    Science.gov (United States)

    Lubrano, Ennio; Perrotta, Fabio Massimo

    2016-01-01

    The treatment of ankylosing spondylitis (AS) and psoriatic arthritis (PsA) positively changed since the introduction of anti-TNFα drugs. These treatments were shown to reduce the symptoms and signs of the diseases and improve the quality of life. However, a variable percentage of patients do not respond to anti-TNFα or can exhibit a loss of response and, furthermore, despite anti-TNFα drugs’ proven efficacy in reducing peripheral radiographic progression in PsA, the impact in reducing radiographic damage in AS is still debated. Recently, the discovery of new pathogenic mechanisms paved the way to the development of new drugs that target other pro-inflammatory cytokines. In particular, the inhibition of interleukin (IL)-17, which is the principal cytokine produced by Th17 lymphocytes, a pro-inflammatory subset involved in both inflammation and new bone formation in AS and PsA, demonstrated promising results. The new molecule secukinumab, an IL-17A inhibitor, showed its efficacy and safety in phase III randomized clinical trials in AS and PsA and is the first non-anti-TNFα biologic approved for the treatment of AS, providing a useful alternative treatment strategy in both diseases. The aim of this article was to review the pathophysiological basis, the efficacy and the safety of secukinumab treatment in AS and PsA patients.

  3. Genetics and genomics of ankylosing spondylitis.

    Science.gov (United States)

    Thomas, Gethin P; Brown, Matthew A

    2010-01-01

    Ankylosing spondylitis (AS) is a common, highly heritable arthropathy, the pathogenesis of which is poorly understood. The mechanism by which the main gene for the disease, HLA-B27, leads to AS is unknown. Genetic and genomic studies have demonstrated involvement of the interleukin-23 (IL-23) signaling pathway in AS, a finding which has stimulated much new research into the disease and has led to therapeutic trials. Several other genes and genetic regions, including further major histocompatibility complex (MHC) and non-MHC loci, have been shown to be involved in the disease, but it is not clear yet how they actually induce the condition. These findings have shown that there is a strong genetic overlap between AS and Crohn's disease in particular, although there are also major differences in the genes involved in the two conditions, presumably explaining their different presentations. Genomic and proteomic studies are in an early phase but have potential both as diagnostic/prognostic tools and as a further hypothesis-free tool to investigate AS pathogenesis. Given the slow progress in studying the mechanism of association of HLA-B27 with AS, these may prove to be more fruitful approaches to investigating the pathogenesis of the disease.

  4. The ongoing quest for biomarkers in Ankylosing Spondylitis.

    Science.gov (United States)

    Danve, Abhijeet; O'Dell, James

    2015-11-01

    Ankylosing Spondylitis poses significant challenges in terms of early diagnosis, assessment of disease activity, predicting response to the treatment and monitoring radiographic progression. With better understanding of underlying immunopathogenesis, effective targeted therapies are available which improve symptoms, quality of life and possibly slow the radiographic progression. There has been a growing interest in the discovery of biomarkers for defining various aspects of disease assessment and management in Ankylosing Spondylitis. The C-reactive protein and HLA-B27 are most commonly used biomarkers. This review describes many other newer biomarkers which have potential clinical applications in this chronic inflammatory disease.

  5. The epidemiology of extra-articular manifestations in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Stolwijk, Carmen; Essers, Ivette; van Tubergen, Astrid

    2015-01-01

    OBJECTIVE: To assess the incidence and risks of common extra-articular manifestations (EAMs), that is, acute anterior uveitis (AAU), psoriasis and inflammatory bowel disease (IBD), in patients with ankylosing spondylitis (AS) compared with population-based controls. METHODS: All incident patients...

  6. Infrared sauna in patients with rheumatoid arthritis and ankylosing spondylitis

    NARCIS (Netherlands)

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

    2009-01-01

    To study the effects of infrared (IR) Sauna, a form of total-body hyperthermia in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients were treated for a 4-week period with a series of eight IR treatments. Seventeen RA patients and 17 AS patients were studied. IR was well

  7. CLINICAL PROFILE AND TREATMENT OUTCOMES IN PATIENTS WITH ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    Ramesh Naidu

    2015-09-01

    Full Text Available Ankylosing spondylitis belongs to a group of diseases known as Spondyloarthritides characterized by inflammatory low backache. It is a chronic inflammatory disease of unknown etiology, mostly associated with HLA B27 positivity affecting skeletal (both axial and extra - axial and extra skeletal system. In general population Ankylosing spondylitis is likely to develop in about 1% to 2% of HLA - B27+ who have a disease - associated B27 subtype and is much more common among HLA - B27+ first degree relatives of HLA - B27+ AS Patients. Positive family history is a strong risk factor for the development of the disease. Ankylosing Spondylitis is a disease which mostly affects young males and working population. It is a chronic illness with exacerbations and remissions and leads to debility and significant morbidity and hence affects the quality of life significantly. This study has been carried out in Medicine department of Ra ngaraya medical college GGH Kakinada, Sraddha Hospital, Visakhapatnam, Andhra medical college, KGH, Visakhapatnam, GEMS College and Hospital, Srikakulam with an aim to study the articular and extra articular manifestations of Ankylosing Spondylitis, factor s affecting exacerbations and remissions. Correlation between disease activity and acute phase reactants, familial association, and to study the short term treatment outcomes.

  8. Dr. Feng Xinghua's Experience in Treating Ankylosing Spondylitis

    Institute of Scientific and Technical Information of China (English)

    Liu Hongxiao

    2006-01-01

    @@ Ankylosing spondylitis (AS) is a rheumatic disease mainly involving the axial joints, characterized by sacro-iliilis and rigid spine. Dr. Feng Xinghua from Guang'anmen Hospital affiliated to China Academy of Chinese Medical Sciences has been engaged in the clinical research and treatment of arthralgia syndrome for more than 30 years. His experience is summarized as follows.

  9. Ankylosing spondylitis and risk of ischaemic heart disease

    DEFF Research Database (Denmark)

    Essers, Ivette; Stolwijk, Carmen; Boonen, Annelies;

    2016-01-01

    OBJECTIVE: To investigate the incidence and risk of ischaemic heart disease (IHD) and acute myocardial infarction (AMI), including the role of non-steroidal anti-inflammatory drugs (NSAID), in patients with ankylosing spondylitis (AS) compared with population controls. METHODS: All patients...

  10. A stratified model for health outcomes in ankylosing spondylitis

    NARCIS (Netherlands)

    P. Machado; R. Landewé; J. Braun; K.G.A. Hermann; X. Baraliakos; D. Baker; B. Hsu; D. van der Heijde

    2011-01-01

    To investigate the relationships between several health outcomes in ankylosing spondylitis (AS). Baseline pretreatment data from 214 patients with AS participating in the AS Study for the Evaluation of Recombinant Infliximab Therapy were analysed. Measures of health-related quality of life (HRQoL) a

  11. Reproducibility of the Bath Ankylosing Spondylitis Indices of disease activity (BASDAI), functional status (BASFI) and overall well-being (BAS-G) in anti-tumour necrosis factor-treated spondyloarthropathy patients

    DEFF Research Database (Denmark)

    Madsen, Ole R; Rytter, Anne; Suetta, Charlotte;

    2010-01-01

    The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Function Index (BASFI) and the Bath Ankylosing Spondylitis Global Score (BAS-G) (ranges 0-10) have gained widespread in use as self-reported measures of disease activity, functional impairment...... and overall well-being in patients with ankylosing spondylitis and other spondyloarthropathies (SpA). In Denmark, BASDAI, BASFI and BAS-G are systematically used to monitor treatment response in patients treated with tumour necrosis factor (TNF) inhibitors. The purpose of the present study was to examine...

  12. Progressive Pulmonary Fibrocystic Changes of Both Upper Lungs in a Patient with Ankylosing Spondylitis

    OpenAIRE

    Kim, Do Youn; Lee, Seok Jeong; Ryu, Yon Ju; Lee, Jin Hwa; Chang,Jung Hyun; Kim, Yookyung

    2015-01-01

    Ankylosing spondylitis is a chronic inflammatory multisystem disease that primarily affects the axial joints. Pleuropulmonary involvement is an uncommon extra-articular manifestation of ankylosing spondylitis. There is a wide spectrum of pulmonary parenchymal changes in ankylosing spondylitis, beginning in the early stages of the disease and increasing over time. The lesions are usually asymptomatic, and not visible on chest radiographs in early stages. We reported a case of advanced ankylosi...

  13. Common MIR146A Polymorphisms in Chinese Ankylosing Spondylitis Subjects and Controls.

    Directory of Open Access Journals (Sweden)

    Zhenmin Niu

    Full Text Available Common polymorphisms of microRNA gene MIR146A were reported as associated with different autoimmune diseases, include systemic lupus erythematosus, psoriatic arthritis, asthma and ankylosing spondylitis. In this study we investigated MIR146A SNPs in Chinese people with ankylosing spondylitis. Three common SNPs: rs2910164, rs2431697 and rs57095329 were selected and genotyped in 611 patients and 617 controls. We found no association between these SNPs and ankylosing spondylitis in our samples.

  14. Symptom modifiers in therapy for ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Vladimir Vasilyevich Badokin

    2010-01-01

    Full Text Available Based on the data available in the literature, the author gives information on the prevalence of ankylosing spondyloarthritis. The clinical picture and pathogenesis of this disease and the principles of its diagnosis and treatment are described. Particular emphasis is placed on the use of etoricoxib, a nonsteroidal anti-inflammatory drug, in ankylosing spondyloarthritis. The available data strongly prove that etoricoxib is an alternative in the treatment of inflammatory diseases of the joints and vertebral column, ankylosing spondyloarthritis in particular.

  15. Imaging of axial spondyloarthritis including ankylosing spondylitis.

    Science.gov (United States)

    Braun, J; Baraliakos, X

    2011-03-01

    New bone formation of the vertebral column is pathognomonic for ankylosing spondylitis (AS), while acute and/or chronic changes in the sacroiliac joints are relevant for diagnosis. The 'gold standard' for assessment of structural changes in AS are conventional radiographs, while MRI is useful to assess inflammation. Recent MRI studies have shown that the lower half of the thoracic spine is most commonly affected in AS. Scoring tools for spinal inflammation such as the ASspiMRI-a have been proposed, successfully used in large clinical trials and compared in a multireader experiment; none was finally preferred by OMERACT. Quantification of structural spinal AS changes is performed by the modified Stokes AS Spine Score (mSASSS), which evaluates lateral cervical and lumbar radiographs. Two years was identified as the shortest possible follow-up time based on the reliability and sensitivity to change of the mSASSS. A potential disadvantage of the mSASSS is that the thoracic spine is not included. Recent data based on the mSASSS have suggested that tumour necrosis factor blockers do not inhibit radiographic progression in AS. Since the mean radiographic change is reported to be less than 1 syndesmophyte over 2 years, the sensitivity to change of the mSASSS has been questioned. However, in one study where continuous non-steroidal anti-inflammatory drugs use was compared with on-demand use, a difference between these two methods of drug intake was reported. The face and construct validity of the mSASSS has been criticised because a score of ´1´ contains a mixture of osteodestructive (erosions) and osteoproliferative changes (squaring and sclerosis). A new scoring system, the RASSS, which concentrates only on bone formation and which includes the lower part of the thoracic spine is currently being evaluated. The relationship between inflammation and new bone formation in AS has recently been investigated. Low sclerostin and DKK-1 serum levels, both inhibitors of bone

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

    Science.gov (United States)

    Uygunoğlu, Uğur; Uluduz, Derya; Taşçılar, Koray; Saip, Sabahattin

    2014-01-01

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

  17. Treatment persistence in patients with rheumatoid arthritis and ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Marina Amaral de Ávila Machado

    2016-01-01

    Full Text Available ABSTRACT OBJECTIVE To evaluate treatment persistence in patients with rheumatoid arthritis and ankylosing spondylitis who started therapies with disease-modifying antirheumatic drugs (DMARD and tumor necrosis factor blockers (anti-TNF drugs. METHODS This retrospective cohort study from July 2008 to September 2013 evaluated therapy persistence, which is defined as the period between the start of treatment until it is discontinued, allowing for an interval of up to 30 days between the prescription end and the start of the next prescription. Odds ratio (OR with 95% confidence intervals (95%CI were calculated by logistic regression models to estimate the patients’ chances of persisting in their therapies after the first and after the two first years of follow-up. RESULTS The study included 11,642 patients with rheumatoid arthritis – 2,241 of these started on anti-TNF drugs (+/-DMARD and 9,401 patients started on DMARD – and 1,251 patients with ankylosing spondylitis – 976 of them were started on anti-TNF drugs (+/-DMARD and 275 were started on DMARD. In the first year of follow-up, 63.5% of the patients persisted in their therapies with anti-TNF drugs (+/-DMARD and 54.1% remained using DMARD in the group with rheumatoid arthritis. In regards to ankylosing spondylitis, 79.0% of the subjects in anti-TNF (+/-DMARD group and 41.1% of the subjects in the DMARD group persisted with their treatments. The OR (95%CI for therapy persistence was 1.50 (1.34-1.67 for the anti-TNF (+/-DMARD group as compared with the DMARD group in the first year for the patients with rheumatoid arthritis, and 2.33 (1.74-3.11 for the patients with ankylosing spondylitis. A similar trend was observed at the end of the second year. CONCLUSIONS A general trend of higher rates of therapy persistence with anti-TNF drugs (+/-DMARD was observed as compared to DMARD in the study period. We observed higher persistence rates for anti-TNF drugs (+/-DMARD in patients with ankylosing

  18. Comparison of the faecal microflora of patients with ankylosing spondylitis and controls using molecular methods of analysis

    NARCIS (Netherlands)

    Stebbings, S; Munro, K; Simon, MA; Tannock, G; Highton, J; Harmsen, H; Welling, G; Seksik, P; Dore, J; Grame, G; Tilsala-Timisjarvi, A

    2002-01-01

    Objectives. To determine whether differences within the complex intestinal microflora can be demonstrated between patients with ankylosing spondylitis (AS) and healthy individuals. Methods. The composition of the faecal microflora of 15 ankylosing spondylitis patients and 15 matched controls was det

  19. Differences in pathophysiology between rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

    Lories, R J; Baeten, D L P

    2009-01-01

    Rheumatoid arthritis and ankylosing spondylitis are common and severe chronic inflammatory skeletal diseases. Recognizing the differences rather than emphasizing similarities is important for a better understanding of the disease processes, the identification of specific therapeutic targets and in the long-term better treatment options for the individual patients. We discuss a number of pathophysiological differences between rheumatoid arthritis and ankylosing spondylitis by looking at the anatomical characteristics, differences and similarities in the autoimmune and autoinflammatory reactions, association with other immune mediated inflammatory diseases, structural outcome, and their potential significance for further therapeutic developments. Further research into the differences between these diseases should focus on the specific nature of the immune/inflammatory components, the role of resident cells in the joint and joint-associated tissues, the types and mechanisms of tissue remodeling and the characteristics of the articular cartilage. Better insights into their individual characteristics may lead to better therapeutic strategies, specific targets and useful biomarkers.

  20. Current treatment approaches in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Bilal Elbey

    2015-03-01

    Full Text Available Ankylosing spondylitis (AS is a chronic, inflammatory, rheumatic disease that mainly affects sacroiliac joints and spine. AS predominantly occurs more often in males and typically begins in the second or third decade. The mainstay of therapy in AS are nonsteroidal anti-inflammatory drugs, which reduce inflammation and pain. Disease modifying antirheumatic drugs (DMARD did not have enough evidence to prove their effect in AS treatment. The use of DMARD may not sufficient to improve the treatment and symptoms. Currently, TNF-blockers such as, Golimumab Etanersept Adalimumab İnfliksimab have promising results in the treatment of AS. TNF-blockers improve the clinical signs and symptoms, and improve the patients’ physical function and quality of life. This manuscript is focused that Current pharmacological treatments in patients with ankylosing spondylitis.

  1. Radiological changes of the symphysis in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Jajic, Z.; Jajic, I.; Grazio, S. [Univ. Hospital Sestre Milosrdnice, Zagreb (Croatia). Dept. for Rheumatology, Physical Medicine and Rehabilitation

    2000-07-01

    Purpose: To evaluate the symphyseal changes in patients with ankylosing spondylitis. Material and Methods: Radiological-morphological changes of the symphysis were studied in 68 patients (66 men, 2 women) with ankylosing spondylitis whose age ranged from 21 to 75 years. The duration of the disease was from 2 to 50 years. Results and Conclusion: Changes in the symphysis were found in 16 patients (23.5%) and were less prominent than findings in the sacroiliac joints. We classified these changes into four stages: minimal changes, apparent destruction, reparation and ankylosis. The third and the fourth stages of the changes in the symphysis were found more frequently in patients who suffered from the disease for more than 15 years. Radiological evaluation of symphyseal changes can be helpful in the evaluation of disease progression as well as in establishing a differential diagnosis.

  2. Coexistence of Ankylosing Spondylitis and Löfgren’s Syndrome

    Directory of Open Access Journals (Sweden)

    Senol Kobak

    2014-01-01

    Full Text Available A 46-year-old male patient diagnosed with ankylosing spondylitis presented to our polyclinic with complaints of pain, swelling, and limitation in joint mobility in both ankles and erythema nodosum skin lesions in both pretibial sites. The sacroiliac joint graphy and the MRI taken revealed active and chronic sacroiliitis. On the thorax CT, multiple mediastinal and hilar lymphadenopathies were reported. Mediastinoscopic excisional lymph node biopsy was taken and noncalcified granulomatous structures, lymphocytes, and histiocytes were determined on histopathological examination. The patients were diagnosed with ankylosing spondylitis, sarcoidosis, and Löfgren’s syndrome. NSAIDs, sulfasalazine, and low dose corticosteroid were started. Significant regression was seen in the patient’s subjective and laboratory assessments.

  3. Longitudinal Analyses of Presenteeism and Its Role as a Predictor of Sick Leave in Patients With Ankylosing Spondylitis

    NARCIS (Netherlands)

    An Tran-Duy, A.; Nguyen, Thien T. V.; Thijs, Herbert; Baraliakos, Xenofon; Heldmann, Frank; Braun, Juergen; Boonen, Annelies

    2015-01-01

    ObjectiveTo investigate, in a cohort of patients with ankylosing spondylitis (AS) adequately treated with infliximab, changes over time in presenteeism and the role of presenteeism relative to that of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis

  4. Sexual function in male patients with ankylosing spondylitis.

    Science.gov (United States)

    Ozkorumak, E; Karkucak, M; Civil, F; Tiryaki, A; Ozden, G

    2011-01-01

    Sexuality is an important part of healthy life. Patients with ankylosing spondylitis (AS) may be vulnerable to sexual problems because of disease activity and comorbid emotional problems. However, sexuality is a scarcely studied subject in AS. The aim of this study is to compare patients with AS with healthy control. A total of 43 male patients, who referred to the Department of Physical Medicine and Rehabilitation Clinics of the Karadeniz Technical University Farabi Hospital between May 2010 and July 2010, and were diagnosed as AS according to modified New York criteria, were included in the study. Control group consisted of healthy 43 age- and sex-matched male individuals with normal inflammatory levels. The AS patients were compared in means of sociodemographic variables and sexual function with Glombok-Rust Sexual Satisfaction Scale (GRSSS) and clinical interview. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were used to determine anxiety and depression levels, respectively. The disease activity and functional conditions were evaluated with the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Metrology Index (BASMI) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDI). A total of 43 patients with AS and 43 healthy heterosexual male were included in the study. The total GRSSS score was significantly higher in patients with AS, whereas they also had significantly higher sexual complaint than healthy control. The diagnosis of sexual dysfunction according to DSM-IV was significantly higher in the patients with AS as well as depression and anxiety. In study group, GRSSS total score was modestly correlated with disease activity. The psychological status had close relation with sexual functions in AS. Overall assessment is required for complete evaluation in patients with AS.

  5. Polyarthritis flare in patient with ankylosing spondylitis treated with infliximab

    Directory of Open Access Journals (Sweden)

    E. Filippucci

    2011-06-01

    Full Text Available Over the last ten years, the treatment of seronegative spondyloarthropathies has changed dramatically with the introduction of the anti-tumor necrosis factor alpha (TNFα agents. Nevertheless, there is a growing number of studies describing several adverse reactions in patients treated with biological agents. In the present report we describe the case of a 22-year-old male patient with ankylosing spondylitis who developed a “paradoxic” adverse reaction, while receiving infliximab.

  6. Investigation of Spatial Clusters of Patients with Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Özge PASİN

    2014-10-01

    Full Text Available Objective: The Geographic Information System (GIS, in health area studies especially topics such as the distribution, clustering and mapping of disease, the geographic location of health services and the determination of healthcare distribution, are frequently used. Limited regional studies on these subjects are available in our country. The aim of this work is to investigate the distribution and clustering status of ankylosing spondylitis disease in Duzce by the GIS based global spatial clustering methods. Materials and Methods: 52 patients with ankylosing spondylitis who admitted to Physical Therapy and Rehabilitation polyclinic in Duzce University Researching and Training Hospital on various dates for diagnosis or treatment were included in study. With the help of the patient data collected from reports in 2013 year, spatial clusters of the disease were examined by Nearest neighbor, Moran I, Getis ORD, and Ripley's K function methods. The study was conducted in ArcGIS program. Results: With the examined global spatial clustering methods, in the center of Duzce the distribution of ankylosing spondylitis patients was obtained and it was determined a significant spatial cluster for this disease. However, thence a few collected data set and the used only the data of a health center, due to the rarity of ankylosing spondylitis disease, clustering may not reflect the truth. Because the health center where data is collected is the largest and most comprehensive in Duzce, it should not be ignored that results are important like a preliminary study. Conclusion: To raise the level of public health and to improve remedial policies it is recommended to examine the clustering structures in the issues such as the distribution and location of disease, staff, health center which have important role in the planning, protection, and the diagnosis-treatment process.

  7. Coexistence of Ankylosing Spondylitis and Neurofibromatosis Type 1

    OpenAIRE

    Baris Gundogdu; Servet Yolbas; Ahmet Yildirim; Murat Gonen; Suleyman Serdar Koca

    2016-01-01

    Ankylosing spondylitis (AS) is a systemic disease primarily characterized by the inflammation of sacroiliac joints and axial skeleton. Neurofibromatosis type 1 (NF1) is a multisystem genetic disease which is characterized by cutaneous findings, most importantly café-au-lait spots and axillary freckling, by skeletal dysplasia, and by the growth of both benign and malignant nervous system neoplasms, most notably benign neurofibromas. In this case report, we present a 43-year-old male with AS an...

  8. MRI of the axial skeletal manifestations of ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Levine, D.S.; Forbat, S.M.; Saifuddin, A. E-mail: asaifuddin@aol.com

    2004-05-01

    Magnetic resonance imaging (MRI) is a valuable tool in the imaging and assessment of patients with ankylosing spondylitis. MRI can demonstrate the acute and chronic changes of sacroiliitis, osteitis, discovertebral lesions, disc calcifications and ossification and arthopathic lesions, which characterize the disease, as well as the complications, which include fracture and the rare cauda equina syndrome. This article reviews the range of MRI findings commonly seen within the axial skeleton in patients with this condition.

  9. Prevalence of fibromyalgia in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Aref Hosseinian Amiri

    2014-01-01

    Full Text Available Introduction: Ankylosing spondylitis (AS is a chronic inflammatory disease that affects the peripheral and axial skeletal system, causing pain, arthritis, low back pain and functional incapacity. Questionnaires are used to assess disease activity bath ankylosing spondylitis disease activity index (BASDAI to measure the effect of AS on patient′s life quality, functional incapacity bath ankylosing spondylitis functional index (BASFI; and Ankylosing Spondylitis quality of life (ASQoL. Fibromyalgia (FM is one of the most common causes of generalized pain and fatigability and can coexist with other diseases; it can be assessed by the FM impact questionnaire (FIQ. There are few studies that demonstrated correlations between FM and AS. The present study obtained data regarding the epidemiologic profile of patients with AS and FM and evaluated the prevalence of FM in patients with AS. The FM influence on BASDAI, BASFI and ASQoL test scores was assessed. Materials and Methods: A total of 36 patients with AS, diagnosed according to the modified New York criteria, were studied. Clinical and functional assessment was performed and BASDAI, BASFI and ASQoL tests were applied. Patients with a diagnosis of FM were evaluated through the FIQ. Results: Seven patients met the criteria for FM; thus a FM prevalence of 19.4% was observed among patients with AS. FM was more prevalent among women (2.5:1. Age at disease onset (AS was 24.3 years. The human leukocyte antigen-B27 antigen was positive in most of them (83.2%. When comparing BASDAI, BASFI and ASQoL test means, it was observed that values are significantly higher (P < 0.01 among patients with FM. We concluded that the coexistence of FM with AS is associated with disease activity aspects including pain, as well as functional disability and quality of life.

  10. Ankylosing spondylitis in an athlete with chronic sacroiliac joint pain.

    Science.gov (United States)

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

    2014-02-01

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

  11. Nursing and safety of silver needle diathermy treating ankylosing spondylitis.

    Science.gov (United States)

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

    2015-03-01

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

  12. Update on ankylosing spondylitis: current concepts in pathogenesis.

    Science.gov (United States)

    Smith, Judith A

    2015-01-01

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

  13. Vestibular evoked myogenic potentials in patients with ankylosing spondylitis.

    Science.gov (United States)

    Özgür, Abdulkadir; Serdaroğlu Beyazal, Münevver; Terzi, Suat; Coşkun, Zerrin Özergin; Dursun, Engin

    2016-10-01

    Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease with unknown etiology. Although sacroiliac joint involvement is the classic sign along with the formed immune mediators, it may result in immune-mediated inner ear disease and may cause damage to the audiovestibular system. Vestibular evoked myogenic potentials (VEMP) is a clinical reflex test used in the diagnosis of vestibular diseases and is performed by recording and evaluating the muscle potentials resulting from the stimulation of the vestibular system with different stimuli. The aim of this study is to evaluate the cervical VEMP test results in AS patients without vestibular symptoms. Thirty-three patients with AS and a control group of 30 healthy volunteers with similar demographic characteristics were evaluated in the study. VEMP wave latency, P13-N23 wave amplitude, and VEMP asymmetry ratio (VAR) values were compared between the groups. The relationship between clinical and laboratory findings of the AS patients and VEMP data were also investigated. Compared with healthy people, this study shows the response rate of patients with ankylosing spondylitis was reduced in the VEMP test, and P13-N23 wave amplitude showed a decrease in AS patients who had VEMP response (p ankylosing spondylitis. The data obtained from this study suggest that AS may lead to decreased sensitivity of the vestibular system.

  14. Prevalence and Characteristics of Lung Involvement on High Resolution Computed Tomography in Patients with Ankylosing Spondylitis: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Abdellah El Maghraoui

    2012-01-01

    Full Text Available To determine the prevalence of lung involvement and the spectrum of abnormalities revealed on HRCT in patients with AS, a systematic literature review was conducted in the Medline database up to May 2009 and in the abstracts of rheumatology scientific meetings (2006–2008. A hand search of references was also performed. Among the 264 selected articles, 10 articles (303 patients allowed a calculation of the prevalence of lung abnormalities on thoracic HRCT in AS. A total of 185 patients (61% had an abnormal thoracic HRCT: upper lobe fibrosis in 21 (6.9%, emphysema in 55 (18.1%, bronchiectasis in 33 (10.8%, and ground glass attenuation in 34 (11.2%. Non specific interstitial abnormalities were observed in 101 (33% patients. The most common observed abnormalities were pleural thickening (52%, parenchymal bands (45% and interlobular septal thickening (30%. Only the prevalence of upper lobe fibrosis increased significantly with disease duration (3 studies. Mild and non-specific interstitial abnormalities on thoracic HRCT are common in patients with AS, even in patients with early disease and without respiratory symptoms.

  15. Prevalence and characteristics of lung involvement on high resolution computed tomography in patients with ankylosing spondylitis: a systematic review.

    Science.gov (United States)

    El Maghraoui, Abdellah; Dehhaoui, Mohamed

    2012-01-01

    To determine the prevalence of lung involvement and the spectrum of abnormalities revealed on HRCT in patients with AS, a systematic literature review was conducted in the Medline database up to May 2009 and in the abstracts of rheumatology scientific meetings (2006-2008). A hand search of references was also performed. Among the 264 selected articles, 10 articles (303 patients) allowed a calculation of the prevalence of lung abnormalities on thoracic HRCT in AS. A total of 185 patients (61%) had an abnormal thoracic HRCT: upper lobe fibrosis in 21 (6.9%), emphysema in 55 (18.1%), bronchiectasis in 33 (10.8%), and ground glass attenuation in 34 (11.2%). Non specific interstitial abnormalities were observed in 101 (33%) patients. The most common observed abnormalities were pleural thickening (52%), parenchymal bands (45%) and interlobular septal thickening (30%). Only the prevalence of upper lobe fibrosis increased significantly with disease duration (3 studies). Mild and non-specific interstitial abnormalities on thoracic HRCT are common in patients with AS, even in patients with early disease and without respiratory symptoms.

  16. Taylor Approach of Spinal Anaesthesia in a case of Ankylosing Spondylitis for Hip Fracture Surgery

    OpenAIRE

    Urmila Palaria; Mohd Asim Rasheed; D C Punera; Umesh K Bhadani

    2011-01-01

    Ankylosing Spondylitis (AS) is a chronic inflammatory rheumatic disease primarily affecting the axial joints manifesting as stiffnesss of the spine. Patient with ankylosing spondylitis is a challenge to anaesthesiologists in terms of airway management and neuraxial blocks. Modified paramedian approach (Taylor approach) of spinal anaesthesia can be used as an alternative to technically difficult cases in patients undergoing lower limb surgeries.

  17. Taylor Approach of Spinal Anaesthesia in a case of Ankylosing Spondylitis for Hip Fracture Surgery

    Directory of Open Access Journals (Sweden)

    Urmila Palaria

    2011-11-01

    Full Text Available Ankylosing Spondylitis (AS is a chronic inflammatory rheumatic disease primarily affecting the axial joints manifesting as stiffnesss of the spine. Patient with ankylosing spondylitis is a challenge to anaesthesiologists in terms of airway management and neuraxial blocks. Modified paramedian approach (Taylor approach of spinal anaesthesia can be used as an alternative to technically difficult cases in patients undergoing lower limb surgeries.

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

    Science.gov (United States)

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

    2013-09-01

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

  19. Prevalence and factors associated with disturbed sleep in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a systematic review.

    Science.gov (United States)

    Leverment, Shaaron; Clarke, Emily; Wadeley, Alison; Sengupta, Raj

    2017-02-01

    This review explores the prevalence and factors associated with disturbed sleep for patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis in order to clarify consistent findings in this otherwise disparate research field. The association of physical, demographic and psychological factors correlating with poor sleep was explored, and the effectiveness of interventions assessed. Ten electronic databases were searched: AMED, CINAHL, Embase, Medline, PsycINFO, PubMed, Scopus, Web of Science, OpenGrey and BASE. Following application of inclusion and exclusion criteria, 29 articles were critically assessed on the basis of methodology, experimental design, ethics and quality of sleep data, leading to the selection of 15 studies for final review. Poor sleep was reported in 35-90% of patients with axial spondyloarthritis and is more prevalent within this clinical population compared to healthy control subjects. Disturbed sleep is an important aspect of disease for patients and reflects the severity of disease activity, pain, fatigue and functional disability. However, the direction of this relationship is undetermined. Associations with age, gender, years spent in education, quality of life and depression have also been demonstrated. Anti-TNF medication is effective in reducing poor sleep, and exercise has also produced beneficial results. Future research into poor sleep should take account of its multifactorial nature. There is also a current lack of research investigating non-pharmacological interventions or combination therapies. A standardised, validated measurement of poor sleep, appropriate for regular patient screening, would be a useful first step for future research.

  20. Surgical outcome after spinal fractures in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Brilakis Emmanuel

    2009-08-01

    Full Text Available Abstract Background Ankylosing spondylitis is a rheumatic disease in which spinal and sacroiliac joints are mainly affected. There is a gradual bone formation in the spinal ligaments and ankylosis of the spinal diarthroses which lead to stiffness of the spine. The diffuse paraspinal ossification and inflammatory osteitis of advanced Ankylosing spondylitis creates a fused, brittle spine that is susceptible to fracture. The aim of this study is to present the surgical experience of spinal fractures occurring in patients suffering from ankylosing spondylitis and to highlight the difficulties that exist as far as both diagnosis and surgical management are concerned. Methods Twenty patients suffering from ankylosing spondylitis were operated due to a spinal fracture. The fracture was located at the cervical spine in 7 cases, at the thoracic spine in 9, at the thoracolumbar junction in 3 and at the lumbar spine in one case. Neurological defects were revealed in 10 patients. In four of them, neurological signs were progressively developed after a time period of 4 to 15 days. The initial radiological study was negative for a spinal fracture in twelve patients. Every patient was assessed at the time of admission and daily until the day of surgery, then postoperatively upon discharge. Results Combined anterior and posterior approaches were performed in three patients with only posterior approaches performed on the rest. Spinal fusion was seen in 100% of the cases. No intra-operative complications occurred. There was one case in which superficial wound inflammation occurred. Loosening of posterior screws without loss of stability appeared in two patients with cervical injuries. Frankel neurological classification was used in order to evaluate the neurological status of the patients. There was statistically significant improvement of Frankel neurological classification between the preoperative and postoperative evaluation. 35% of patients showed improvement

  1. Coexistence of Ankylosing Spondylitis and Neurofibromatosis Type 1

    Directory of Open Access Journals (Sweden)

    Baris Gundogdu

    2016-01-01

    Full Text Available Ankylosing spondylitis (AS is a systemic disease primarily characterized by the inflammation of sacroiliac joints and axial skeleton. Neurofibromatosis type 1 (NF1 is a multisystem genetic disease which is characterized by cutaneous findings, most importantly café-au-lait spots and axillary freckling, by skeletal dysplasia, and by the growth of both benign and malignant nervous system neoplasms, most notably benign neurofibromas. In this case report, we present a 43-year-old male with AS and NF1.

  2. Perinatal characteristics, older siblings, and risk of ankylosing spondylitis

    DEFF Research Database (Denmark)

    Lindström, Ulf; Forsblad-d'Elia, Helena; Askling, Johan;

    2016-01-01

    BACKGROUND: The effect of circumstances and exposures early in life on the risk of developing ankylosing spondylitis (AS) is largely unknown. The purpose of this study was to determine whether perinatal characteristics predict development of AS. METHODS: AS cases (n = 1960; 59 % men) were defined...... as listed with a diagnosis of AS at least once in the Swedish National Patient Register and registered in the Swedish Medical Birth Register (born ≥1973). Population controls were retrieved from the Swedish Population Register (n = 8378; mean 4.3 controls/case), matched on birth year, sex and county. Odds...

  3. HLA-B27 and ankylosing spondylitis: tales from China.

    Science.gov (United States)

    de Castro, J A López

    2010-01-01

    The two most frequent HLA-B27 subtypes worldwide are B*2704 and B*2705. In the Han population of China B*2704 and, to a lower extent, B*2705 are found with significant frequency, and both are associated to ankylosing spondylitis (AS). Two articles in this issue report that the association to AS in this ethnic group is stronger for B*2704 than for B*2705. Thus, at least among the Han, B*2704 would be the strongest known susceptibility factor for AS.

  4. Affective temperament profile in ankylosing spondylitis patients using TEMPS-A

    Science.gov (United States)

    Yildirim, Tulay; Solmaz, Dilek; Emul, Murat; Akgol, Gurkan; Yalvac, Dilek; Ersoy, Yuksel

    2017-01-01

    [Purpose] This study aimed to compare the most common dominant affective temperaments in Ankylosing Spondylitis patients and investigate the relationship between the dominant affective temperaments and pain levels, disease activity, quality of life, current depression, and anxiety level in Ankylosing Spondylitis patients. [Subjects and Methods] Fifty-one patients diagnosed with axial spondiloartropathy and forty-two age- and gender-matched control subjects were included in this study. Disease duration, erythrocyte sedimentation rate, serum C-reactive protein, pain by the Visual Analog Scale, disease activity by the Bath Ankylosing Spondylitis Disease Activity Index, functional status by the Bath Ankylosing Spondylitis Functional Index; psychological status by the Beck Depression Inventory, Beck Anxiety Inventory and overall health assessment by the Ankylosing Spondylitis Quality of Life Scale were assessed in patients. The Turkish version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto Questionnaire was used to determine the dominant affective temperament. [Results] There was no statistical difference in the distribution of temperament subtypes between patients with Ankylosing Spondylitis and the controls. Depressive, anxious, and cyclothymic temperament scores were higher in patients with high values on the Bath Ankylosing Spondylitis Functional Index and Visual Analog Scale. There was a correlation between anxious subtypes of affective temperament scores and the value of Ankylosing Spondylitis Quality of Life Scale. Correlation analysis also found depressive, cyclothymic, irritable, and anxious temperament and psychiatric symptoms to be significantly related. [Conclusion] Affective temperament may contribute to symptoms of depression and anxiety in patients with Ankylosing Spondylitis and may increase disease activity and may reduce their quality of life. PMID:28356618

  5. Evaluation of the MR imaging findings of ankylosing spondylitis involving the thoracolumbar spine

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    Park, Jun Kyoon; Choi, Jeong Yeol [Chosun Univ., Kwangju (Korea, Republic of). Coll. of Medicine; Park, Jin Gyoon [Chonnam Univ., Kwangju (Korea, Republic of). Coll. of Medicine

    1998-02-01

    To evaluate the MR imaging findings of ankylosing spondylitis involving the thoracolumbar spine. We retrospectively analyzed MR imaging findings in ten patients with ankylosing spondylitis involving the thoracolumbar spine. All were male and ranged in age from 24 to 47 (mean, 33) years. MR images were obtained using a 1.5T imager, and signal intensity changes of vertebral bodies were evaluated on sagittal T1- and T2-weighted images. Plain radiographic findings were also evaluated. Characteristics MR imaging findings of ankylosing spondylitis involving the thoracolumbar vertebral bodies were focal signal intensity changes at the corners and along the anterior borders of the vertebral bodies. (author). 19 refs., 4 figs.

  6. The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations

    DEFF Research Database (Denmark)

    Exarchou, Sofia; Lindström, Ulf; Askling, Johan;

    2015-01-01

    arthritis (21.7% versus 15.3%, P study demonstrated a prevalence of clinically diagnosed ankylosing spondylitis of 0.18%. It revealed......INTRODUCTION: Prevalence estimates of ankylosing spondylitis vary considerably, and there are few nationwide estimates. The present study aimed to describe the national prevalence of clinically diagnosed ankylosing spondylitis in Sweden, stratified according to age, sex, geographical, and socio......, were identified from the National Patient Register. Data regarding disease manifestations, patient demographics, level of education, pharmacological treatment, and geographical region were retrieved from the National Patient Register and other national registers. RESULTS: A total of 11,030 cases...

  7. Ankylosing Spondylitis and Posture Control: The Role of Visual Input

    Directory of Open Access Journals (Sweden)

    Alessandro Marco De Nunzio

    2015-01-01

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

  8. The Role of MicroRNAS in Ankylosing Spondylitis.

    Science.gov (United States)

    Li, Zheng; Wong, Sunny H; Shen, Jianxiong; Chan, Matthew T V; Wu, William Ka Kei

    2016-04-01

    Ankylosing spondylitis (AS) is a common and genetically heterozygous inflammatory rheumatic disease characterized by new bone formation, ankylosis and inflammation of hip, sacroiliac joints and spine. Until now, there is no method for early diagnosis of AS and the effective treatment available for AS patients remain largely undefined.We searched articles indexed in PubMed (MEDLINE) database using Medical Subject Heading (MeSH) or Title/Abstract words ("microRNA" and "ankylosing spondylitis") from inception up to November 2015.Genetic polymorphisms of miRNAs and their targets might alter the risk of AS development whereas certain miRNAs exhibit correlation with inflammatory index.Let-7i and miR-124 were upregulated whereas miR-130a was downregulated in circulating immune cells of AS patients. These deregulated miRNAs could modulate key immune cell functions, such as cytokine response and T-cell survival.miRNA deregulation is key to AS pathogenesis. However, clinical utilization of miRNAs for management of AS patients requires further support from future translational studies.

  9. Alexithymia and Self-Esteem in Patients with Ankylosing Spondylitis

    Science.gov (United States)

    SOLMAZ, Mustafa; BİNBAY, Zerrin; CİDEM, Muharrem; SAĞIR, Selim; KARACAN, İlhan

    2014-01-01

    Introduction Ankylosing spondylitis (AS), which has an unknown etiology, inflammatory disorder, characterized by inflammation of the spinal joints and adjacent structures. It has a negatif effect on all aspects of a patients’s life: Physcally, psychologically and socially. The purpose of this study was to determine the effect of AS on self-esteem and alexithymia. Method In this study, 50 patients from the department of physical therapy and rehabilitation with the diaognosis of AS who were under traetment and follow-up and 50 healty volunteers who matched for age and gender were taken. Toronto Alexithymia Scale (TAS), Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale (RSES), Beck Anxiety Inventory (BAI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were performed to both patients and control group. Results Compared to the control group, the anxiety and depression scores were higher in the patient group and the alexithymic characteristics were significantly higher, self-esteem scores were significantly lower in the patient group (pself-esteem of these patients should be considered carefully. More studies are needed on this regard.

  10. Efficacy and safety of adalimumab in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Mounach A

    2014-08-01

    Full Text Available Aziza Mounach, Abdellah El MaghraouiRheumatology Department, Military Hospital Mohammed V, Rabat, MoroccoAbstract: Ankylosing spondylitis (AS is the most common and most severe subtype of spondyloarthritis. It also may be an outcome of any of the other spondyloarthritis subtypes. AS preferentially affects the sacroiliac joints and the tip of the column, with a tendency to later ankylosis. Peripheral joints, enthesis, and other extra-articular involvement may be observed. Tumor necrosis factor (TNF inhibitors are now well-established, effective drugs in the treatment of AS symptoms. Adalimumab, which is a fully human monoclonal antibody that binds to and neutralizes TNF, has demonstrated efficacy in treating AS symptoms, including axial involvement, peripheral arthritis, enthesitis, uveitis, gut involvement, and psoriasis. Furthermore, adalimumab has showed an overall acceptable safety profile. In this paper, we review the efficacy and safety profile of adalimumab in the treatment of AS, and discuss its differences from the other anti-TNF drugs reported in the literature.Keywords: ankylosing spondylitis, spondyloarthritis, adalimumab, tumor necrosis factor-α

  11. The classification and diagnostic criteria of ankylosing spondylitis.

    Science.gov (United States)

    Raychaudhuri, Siba P; Deodhar, Atul

    2014-01-01

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

  12. Ankylosing spondylitis and cardiovascular risk – case report

    Directory of Open Access Journals (Sweden)

    Daniela Anghel

    2016-12-01

    Full Text Available Introduction: Ankylosing spondylitis (AS is a chronic progressive inflammatory disease of the axial skeleton and peripheral joints associated with HLA B27 antigen and with the predominance of the male gender (with an average between 20 and 30 years old. Case presentation A 48 years old male patient was admitted to our clinic, having a long history regarding this disease since he was 16. This patient has switched 3 therapies with anti TNF alpha agents until now, and we hope to obtain a good response for a long time. During the treatment with Etanercept he presented an acute anterior uveitis which had a good response to therapy. Conclusion: The ankylosing spondylitis management is complicated when we have the possibility to choose only three anti TNF alpha agents. If a patient does not respond to the first or second agent we are constrained to follow the last one. Therefore the principal problem regarding this special case is that the patient is non responder at the last agent. So the question that arises is witch will be the next therapy for this patient?

  13. PRIMARY CEMENTLESS TOTAL HIP ARTHROPLASTY IN ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    Nageshwara Rao

    2015-12-01

    Full Text Available INTRODUCTION Ankylosing Spondylitis (AS, family of Spondyloarthritides (SpAs, is a chronic inflammatory disease affecting the axial skeleton, the entheses and occasionally the peripheral joints. The shoulders and hips are considered axial joints and involvement occurs in up to 50% of patients and is more common than involvement of the more distal joints. Aim of our study is to evaluate outcome of Cementless Total Hip Arthroplasty (THA in ankylosing spondylitis. MATERIALS AND METHODS We prospectively and retrospectively reviewed 27 hips in 20 patients who underwent cementless THA between 2007-2013. Mean age of patient was 31.5 years. We analysed demographic data, preoperative deformity, Harris Hip Score, ambulatory status, need for walking aids. RESULTS All patients experienced significant improvement in function, range of motion, posture and ambulation. Postoperative Harris Hip Score improved from 18.95 to 89.35; 90% are completely pain free, 5% have occasional discomfort and 5% have mild-to-moderate pain. CONCLUSION Cementless THA for deformed hips in young patients with AS is worthwhile surgical intervention, as it increases the mobility of the patient, improves the ability to sit comfortably, decrases the morbidity of the disease. However, the technically demanding nature of the procedure should not be underestimated.

  14. Respiratory muscle performance as a possible determinant of exercise capacity in patients with ankylosing spondylitis.

    NARCIS (Netherlands)

    Esch, M. van der; Hul, A.J. van 't; Heijmans, M.; Dekker, J.

    2004-01-01

    Reduction of exercise capacity in patients with ankylosing spondylitis is associated with skeletal muscle performance. The contribution of respiratory muscle performance is questionable. This pilot study was designed to investigate the relationship between respiratory muscle performance and exercise

  15. Sacroiliitis in Ankylosing Spondylitis: Comparison with Multidetector Row CT and Plain Radiography

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    Yu, Ji Youn; Joo, Kyung Bin; Choi, Byeong Kyoo; Ryu, Jeong Ah; Kim, Tae Hwan; Choi, Woo Jung [Hanyang University Hospital, Seoul (Korea, Republic of)

    2009-03-15

    The objective of our study was to compare multidetector row CT and the plain radiographs for making the diagnosis and grading the sacroiliitis that accompanies ankylosing spondylitis. We wanted to determine the role of multidetector row CT for the evaluation of the sacroilitis in patients with ankylosing spondylitis. One hundred ninety two patients with clinically suspected ankylosing spondylitis were evaluated by conventional radiography and multidetector row CT. Two musculoskeletal radiologists retrospectively analyzed the images, and they graded the sacroiliitis using the modified New York Criteria. Multidetector row CT demonstrated a significantly higher sensitivity (74.5%, 83.3%) than did plain radiography (59.9%, 66.7%) for detecting early sacroiliitis (p<0.05). Multidetector row CT showed a higher grade of sacroiliitis in 114 and 127 of 384 sacroiliac joints. Performing multidetector row CT rather than plain radiography for making the diagnoses of accompanying ankylosing spondylitis allows an early start of treatment with a subsequently improved prognosis

  16. Coexisting ankylosing spondylitis and rheumatoid arthritis: A case report with literature review

    Institute of Scientific and Technical Information of China (English)

    GUO Ying-ying; YANG Li-li; CUI Hua-dong; ZHAO Shuai; ZHANG Ning

    2011-01-01

    A 30-year-old female patient with coexisting ankylosing spondylitis and rheumatoid arthritis was diagnosed and treated.The human leukocyte antigen (HLA)-B27 is a predisposing factor of ankylosing spondylitis and HLA-DR4 is a predisposing factor of rheumatoid arthritis.This patient was HLA-B27 and HLA-DR4 positive,and ankylosing spondylitis manifested before rheumatoid arthritis.After disease modifying anti-rheumatic drugs successfully arrested ankylosing spondylitis activity the patient conceived and delivered a healthy baby.One year later,she developed peripheral polyarthritis and was diagnosed with rheumatoid arthritis.We hypothesized that pregnancy may be one of the environmental factors that can activate rheumatoid arthritis,and that disease modifying anti-rheumatic drugs play an important role in keeping the disease under control.

  17. Assessment of Serum ADMA Levels and Aortic Elastic Properties in Patients with Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Hasan Kaya

    2013-08-01

    Full Text Available Introduction: Ankylosing spondylitis is a chronic inflammatory disease which may be associated with cardiovascular complications. The aim of the study was to investigate aortic elastic properties and serum asymetric dimethylarginine (ADMA levels in patients with ankylosing spondylitis without any cardiac involvement.Patients and Methods: Fifty-five ankylosing spondylitis patients and 30 age/gender matched healthy subjects were enrolled into this study. Fasting glucose, serum lipids, C-reactive protein (CRP, erythrocyte sedimentation rate (ESR and ADMA were studied. Aortic strain, distensibility and stiffness index were calculated from aortic diameters measured by transthoracic echocardiography and simultaneous blood pressure measurements.Results: ESR and CRP were higher in patients group. Serum ADMA levels were also higher in ankylosing spondylitis than in controls (0.76 ± 0.19 vs. 0.55 ± 0.12, p< 0.001. In subgroup analysis, ADMA was significantly lower in anti-TNF-alfa treatment group than conventional treatment group (0.68 ± 0.15 vs. 0.87 ± 0.18, p< 0.001. Mean aortic strain and distensibility were lower and stiffness index was higher in ankylosing spondylitis group than controls. No correlation between ADMA and aortic elastic properties was observed. In ankylosing spondylitis group, a negative significant correlation was found between duration of ankylosing spondylitis and aortic strain and distensibility.Conclusion: Our study suggest that patients with ankylosing spondylitis without cardiac involvement, aortic elasticity was impaired and ADMA levels were increased, while there was no significant correlation between aortic elastic properties and ADMA levels.

  18. Ankylosing spondylitis complicated by trauma: MR findings correlated with plain radiographs and CT

    Energy Technology Data Exchange (ETDEWEB)

    Goldberg, A.L. (Dept. of Diagnostic Radiology, Allegheny General Hospital, Pittsburgh, PA (United States) Medical Coll. of Pennsylvania, Pittsburgh, PA (United States)); Keaton, N.L. (Dept. of Diagnostic Radiology, Allegheny General Hospital, Pittsburgh, PA (United States) Medical Coll. of Pennsylvania, Pittsburgh, PA (United States)); Rothfus, W.E. (Dept. of Diagnostic Radiology, Allegheny General Hospital, Pittsburgh, PA (United States) Medical Coll. of Pennsylvania, Pittsburgh, PA (United States)); Daffner, R.H. (Dept. of Diagnostic Radiology, Allegheny General Hospital, Pittsburgh, PA (United States) Medical Coll. of Pennsylvania, Pittsburgh, PA (United States))

    1993-01-01

    Four patients with ankylosing spondylitis sustained a traumatic spinal injury. In three cases, pseudoarthrosis developed at the discovertebral junction, while involvement of the neural arch occurred in the fourth. Although the diagnosis of ankylosing spondylitis was readily established on plain radiographs, magnetic resonance more effectively indentified the complicating injury and in two cases demonstrated the presence of cord compression. Computed tomography was also contributory in delineating bony and ligamentous abnormalities of the neural arch. (orig.)

  19. Safety of Etoricoxib, Celecoxib, and Nonselective Nonsteroidal Antiinflammatory Drugs in Ankylosing Spondylitis and Other Spondyloarthritis Patients

    DEFF Research Database (Denmark)

    Kristensen, L E; Jakobsen, A K; Askling, J

    2015-01-01

    OBJECTIVE: Safety data regarding the use of etoricoxib and other nonsteroidal antiinflammatory drugs (NSAIDs) in ankylosing spondylitis (AS) and other spondyloarthritis (SpA) patients are rather limited. Our objective was to estimate and compare rates of gastrointestinal, renovascular, and cardio......OBJECTIVE: Safety data regarding the use of etoricoxib and other nonsteroidal antiinflammatory drugs (NSAIDs) in ankylosing spondylitis (AS) and other spondyloarthritis (SpA) patients are rather limited. Our objective was to estimate and compare rates of gastrointestinal, renovascular...

  20. Atlantoaxial Ankylosis Detected on Neck CT Scans in a Patient with Ankylosing Spondylitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Ah; Lee, Seung Hun; Joo, Kyung Bin [Dept. of Radiology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of); Ryu, Jeong Ah [Dept. of Radiology, Guri Hospital, Hanyang University College of Medicine, Guri (Korea, Republic of); Kim, Tae Hwan [Dept. of Rheynmatology, Seoul Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2011-07-15

    Ankylosing spondylitis is a chronic inflammatory disorder of unknown cause that principally affects the axial skeleton. The cervical spine is also vulnerable to this disease process and the characteristic feature of cervical involvement is atlantoaxial subluxation. However, only a few cases of atlantoaxial ankylosis have been reported to date. We report a case of atlantoaxial ankylosis in a patient with ankylosing spondylitis with radiologic findings incidentally detected on neck CT scans.

  1. Double level Chance-type fractures of spine in ankylosing spondylitis

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    Vargaonkar Shantaram

    2014-12-01

    Full Text Available Chance fractures are usually associated with seat belt injuries. Mechanism is always related to flexion-distraction at vertebral level. Double level Chance-type fractures have rarely been reported in published literature. We presented such a fracture at D10 and L3 level in a 38-year-old patient with ankylosing spondylitis. Management was done with posterior decompression and short segment fi xation separately. Key words: Chance fractures; Ankylosing spondylitis; Spine

  2. Human leukocyte antigen-B27 alleles in Xinjiang Uygur patients with ankylosing spondylitis.

    Science.gov (United States)

    Zou, H-Y; Yu, W-Z; Wang, Z; He, J; Jiao, M

    2015-05-25

    We investigated the distribution of human leukocyte antigen (HLA)-B27 subtypes in Uygur ankylosing spondylitis patients in Xinjiang. B27-positive patients with ankylosing spondylitis were subtyped by using polymerase chain reaction-sequence-based typing. The HLA-B27 subtype frequencies of Uygur patients were compared with those in Han patients in Xinjiang and the other areas of China. B*2705 was the predominant subtype in Uygur patients with a frequency of 58.95%, which was much higher than that in Han patients in Xinjiang (31.58%, P ankylosing spondylitis patients; B*2704 was the main (61.18%) subtype in Han patients in Xinjiang, followed by B*2705 (31.58%) and was similar to the characteristics of Han patients in the other areas of China. B*2724 in Han ankylosing spondylitis patients has not been previously reported. Additionally, the B*2702/B*2705 homozygote was identified in Uygur patients. B*2702/B*2704, B*2704/B*2705, and B*2705/B*2705 homozygotes were identified in 3 Han patients. The distribution of HLAB27 subtypes in Uygur ankylosing spondylitis patients in Xinjiang significantly differed from that in Han patients. Understanding the distribution of HLAB27 subtypes in ethnic minority populations of Xinjiang is important for anthropological genetic studies and for analyzing the impact of genetic background on ankylosing spondylitis susceptibility.

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

    Science.gov (United States)

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

    2013-05-01

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

  4. Ankylosing spondylitis: A state of the art factual backbone

    Institute of Scientific and Technical Information of China (English)

    Mohammad; Ghasemi-rad; Hosam; Attaya; Emal; Lesha; Andrea; Vegh; Tooraj; Maleki-Miandoab; Emad; Nosair; Nariman; Sepehrvand; Ali; Davarian; Hamid; Rajebi; Abdolghader; Pakniat; Seyed; Amirhossein; Fazeli; Afshin; Mohammadi

    2015-01-01

    Ankylosing spondylitis(AS) is a chronic inflammatory disease that affects 1% of the general population. As one of the most severe types of spondyloarthropathy, AS affects the spinal vertebrae and sacroiliac joints, causing debilitating pain and loss of mobility. The goal of this review is to provide an overview of AS, from the pathophysiological changes that occur as the disease progresses, to genetic factors that are involved with its onset. Considering the high prevalence in the population, and the debilitating life changes that occur as a result of the disease, a strong emphasis is placed on the diagnostic imaging methods that are used to detect this condition, as well as several treatment methods that could improve the health of individuals diagnosed with AS.

  5. Do sex hormones play a role in ankylosing spondylitis?

    Science.gov (United States)

    Masi, A T

    1992-02-01

    Ankylosing spondylitis (AS) has a striking disease marker, i.e., HLA-B27, indicating the major genetic predisposition; however, expression of disease is also strongly influenced by age- and sex-related factors. Sex steroids studies suggest greater androgenicity in AS than normal control persons. Therapeutic interventions that normalize such sex steroid status have shown clinical improvements in males and females. Muscle histopathology in AS shows frequent changes early in disease consistent with neuropathic and myopathic mechanisms of a noninflammatory nature. Accepting the available, aggregate data, one may infer that sex steroid imbalance in persons susceptible to AS may target axial and proximal muscle tissues, resulting in relative functional hypertonicity. Such phenomenon, developing in preteen and younger adult ages, may contribute to peripheral and axial manifestations of enthesopathy in this disease by complex and currently unknown mechanisms.

  6. The epidemiology of osteoporosis and fractures in ankylosing spondylitis.

    Science.gov (United States)

    Sambrook, Philip N; Geusens, Piet

    2012-08-01

    Bone is a target in many inflammatory rheumatic diseases. Inflammation leads to a wide range of changes in bone, and especially bone remodeling. In ankylosing spondylitis (AS) bone loss has been documented, but measuring bone density in the spine is hampered by new bone formation in syndesmophytes, periost and within the vertebrae. The risk of vertebral fractures is increased in AS. The diagnosis of vertebral fractures requires imaging and adequate evaluation of vertebral heights. In addition, in the ankysosed spine segments, additional imaging is often needed to diagnose spinal fractures at unusual locations (cervical spine) or in the posterior arch structures. Risk factors for vertebral fractures are helpful for case finding. Fracture prevention is indicated in high risk patients with AS, especially when they have already a vertebral fracture or in the presence of osteoporosis.

  7. Ankylosing spondylitis and secretor status: a re-evaluation.

    Science.gov (United States)

    Smith, G W; James, V; Mackenzie, D A; Stewart, J; Blackwell, C C; Elton, R A; Nuki, G

    1997-07-01

    Non-secretion of ABO blood group substances in body fluids is associated with susceptibility to some bacterial infections. Non-secretors were previously found to be over-represented in patients with ankylosing spondylitis (AS) (49%) compared to controls (27%). Re-evaluation of secretor status in a population of 92 AS patients and 103 controls revealed identical proportions of non-secretors (28%). Of 43 patients studied in both surveys, 6/22 typed initially as non-secretors proved to be secretors using both haemagglutination inhibition assay (HAI) and enzyme-linked immunosorbent assay (ELISA) techniques. Loss of secreted blood group antigens in the saliva is the cause of this mis-typing. Careful attention to the method of collection, handling and preservation of saliva specimens is essential for accurate assessment of secretor status. Therefore, there is no link between secretor status and AS.

  8. The genetics of ankylosing spondylitis and axial spondyloarthritis.

    Science.gov (United States)

    Robinson, Philip C; Brown, Matthew A

    2012-08-01

    Ankylosing spondylitis (AS) and spondyloarthritis are strongly genetically determined. The long-standing association with HLA-B27 is well described, although the mechanism by which that association induces AS remains uncertain. Recent developments include the description of HLA-B27 tag single nucleotide polymorphisms in European and Asian populations. An increasing number of non-MHC genetic associations have been reported, which provided amongst other things the first evidence of the involvement of the IL-23 pathway in AS. The association with ERAP1 is now known to be restricted to HLA-B27 positive disease. Preliminary studies on the genetics of axial spondyloarthritis demonstrate a lower HLA-B27 carriage rate compared with AS. Studies with larger samples and including non-European ethnic groups are likely to further advance the understanding of the genetics of AS and spondyloarthritis.

  9. Ankylosing spondylitis and central core disease: case report.

    Science.gov (United States)

    Scola, Rosana Herminia; Lin, Kátia; Iwamoto, Fãbio Massaiti; Arruda, Walter Oleschko; Werneck, Lineu Cesar

    2003-09-01

    Ankylosing spondylitis (AS) is an inflammatory disorder of unknown cause that primarily affects the axial skeleton. Neurological manifestations of AS are usually related to spinal deformities. Previous studies of the paraspinal muscles of AS patients showed muscle fiber atrophy, and core fibers. On the other hand, central core disease (CCD) is a genetic condition that primarily involves the skeletal muscles, but can present articular deformities secondary to muscular weakness. We report the case of a 45-year-old man with clinical and radiological diagnosis of AS and proximal muscular weakness in the lower limbs. Needle electromyography showed myopathic features and nerve conduction study was normal. Muscle biopsy disclosed almost complete predominance of type-1 fibers, and fibers with central cores. This is the first report of AS and CCD. Whether central core myopathy is coincidental or a new association with AS is discussed.

  10. Bilateral sacroiliitis and uveitis comorbidity: brucellosis? Ankylosing spondylitis?

    Science.gov (United States)

    Akyol, Lütfi; Aslan, Kerim; Özgen, Metin; Sayarlioglu, Mehmet

    2015-09-22

    We present a rare case of a comorbidity of sacroiliitis and brucellosis infection. A 28-year-old woman received irregular medication due to ongoing backache and hip pain for 5 years. The patient presented to our hospital for evaluation of visual loss and was diagnosed with uveitis. Sacroiliac MRI was performed to investigate the inflammatory backache and hip pain, and the aetiology of the uveitis, revealing the presence of sacroiliitis. The patient's blood test results were as follows: positive brucellosis Rose Bengal test and positive tube agglutination test with a titre of 1/640. The patient was treated with doxycycline and rifampicin for 8 weeks for the brucellosis infection, and with acemetacin for the ankylosing spondylitis. The patient's back and hip pain decreased significantly 8 weeks later; however, the uveitis was not controlled by the treatment. Therefore, anti-tumour necrosis factor (infliximab) treatment was started.

  11. MRI of cervical spine injuries complicating ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Koivikko, Mika P.; Koskinen, Seppo K. [Helsinki Medical Imaging Center, Helsinki University Central Hospital, Toeoeloe Hospital, Department of Radiology, Helsinki (Finland)

    2008-09-15

    The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed. A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI. On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson's, 1 atlas posterior arch (Jefferson's on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection. Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis. (orig.)

  12. Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Sawacha Zimi

    2012-08-01

    Full Text Available Abstract Background Ankylosing spondylitis is a major chronic rheumatic disease that predominantly affects axial joints, determining a rigid spine from the occiput to the sacrum. The dorsal hyperkyphosis may induce the patients to stand in a stooped position with consequent restriction in patients’ daily living activities. The aim of this study was to develop a method for quantitatively and objectively assessing both balance and posture and their mutual relationship in ankylosing spondylitis subjects. Methods The data of 12 healthy and 12 ankylosing spondylitis subjects (treated with anti-TNF-α stabilized, with a mean age of 51.42 and 49.42 years; mean BMI of 23.08 and 25.44 kg/m2 were collected. Subjects underwent a morphological examination of the spinal mobility by means of a pocket compass needle goniometer, together with an evaluation of both spinal and hip mobility (Bath Ankylosing Spondylitis Metrology Index, and disease activity (Bath Ankylosing Spondylitis Disease Activity Index. Quantitative evaluation of kinematics and balance were performed through a six cameras stereophotogrammetric system and a force plate. Kinematic models together with a test for evaluating balance in different eye level conditions were developed. Head protrusion, trunk flexion-extension, pelvic tilt, hip-knee-ankle flexion-extension were evaluated during Romberg Test, together with centre of pressure parameters. Results Each subject was able to accomplish the required task. Subjects’ were comparable for demographic parameters. A significant increment was observed in ankylosing spondylitis subjects for knee joint angle with the target placed at each eye level on both sides (p  Conclusions Our findings confirm the need to investigate both balance and posture in ankylosing spondylitis subjects. This methodology could help clinicians to plan rehabilitation treatments.

  13. Favorable effect of rehabilitation on balance in ankylosing spondylitis: a quasi-randomized controlled clinical trial.

    Science.gov (United States)

    Demontis, Alessandra; Trainito, Sabina; Del Felice, Alessandra; Masiero, Stefano

    2016-03-01

    Balance impairment is a frequent and undertreated manifestation in ankylosing spondylitis, leading to increased risk of falls and lower quality of life. Our aim was to assess supervised training and home-based rehabilitation efficacy on balance improvement in ankylosing spondylitis subjects on biologic agents. This was a single-blinded, quasi-randomized parallel study in a single outpatient Rehabilitation Clinic of a tertiary referral center. Subjects with ankylosing spondylitis on biologic agents were assigned either to supervised training and home-based rehabilitation program (rehabilitation group) plus educational-behavioral therapy, or to educational-behavioral therapy alone (educational groups). The same therapist provided therapy. Outcome measures were assessed at baseline (T0), end of treatment (T1) and at 7-month follow-up (T2). Rheumatologic outcomes were Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index and Bath Ankylosing Spondylitis Disease Activity Index. Balance parameters (anterior-posterior oscillation, latero-lateral oscillation, sway area, sway density and sway path) were evaluated by stabilometry in a condition of open and closed eyes. Forty-six subjects (36 M, 10 F) were enrolled. Demographic data and clinical status at baseline were comparable between the two groups (22 rehabilitation group, 20 educational group). Primary outcome was sway density that improved both at T1 (SDy: open eyes p = 0.003, closed eyes p = 0.004) and at T2 (SDx: open eyes p = 0.0015, closed eyes p = 0.032). A trend toward improvement in the rehabilitation group rather than in the educational group emerged for balance parameters, especially those measured with closed eyes (0.004 ankylosing spondylitis. Eyes-closed trials show a more marked trend toward improvement, and this may suggest a positive effect of rehabilitation on proprioception.

  14. High-dose thalidomide increases the risk of peripheral neuropathy in the treatment of ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Hong-xia Xue

    2015-01-01

    Full Text Available Thalidomide is an effective drug for the treatment of ankylosing spondylitis but might induce peripheral neuropathy. This major adverse reaction has attracted much concern. The current study aimed to observe the incidence of thalidomide-induced peripheral neuropathy among ankylosing spondylitis patients for 1 year after treatment. In this study, 207 ankylosing spondylitis cases received thalidomide treatment, while 116 ankylosing spondylitis cases received other treatments. Results showed that the incidence of thalidomide-induced peripheral neuropathy in the thalidomide group was higher than that in the non-thalidomide group. There was no significant difference in the incidence of neuropathy between the < 6 months medication and ≥ 6 months medication groups. There were no differences in the mean age, gender, or daily dose between the two groups. The incidence of peripheral neuropathy among patients receiving 25, 50, 75, or 100 mg thalidomide per day was 4.6%, 8.5%, 17.1%, 21.7%, respectively. The incidence was significantly different between the groups receiving 25 mg and 100 mg thalidomide. In conclusion, thalidomide can induce peripheral neuropathy within 1 year after treatment of ankylosing spondylitis; however, age and gender have no obvious impact on the incidence of peripheral neuropathy. The incidence of peripheral neuropathy is associated with increasing daily doses of thalidomide.

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

    Science.gov (United States)

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

    2013-07-01

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

  16. Progression rate of ankylosing spondylitis in patients with undifferentiated spondyloarthritis

    Science.gov (United States)

    Xia, Qing; Fan, Dazhi; Yang, Xiao; Li, Xiaona; Zhang, Xu; Wang, Mengmeng; Xu, Shengqian; Pan, Faming

    2017-01-01

    Abstract Background: The idea that undifferentiated spondyloarthritis (uSpA) represents the early undifferentiated stage of ankylosing spondylitis (AS) and other well-defined SpA subtypes is well known. The gist of this study is to assess the rate estimate of patients with uSpA evolved to AS during long-term follow-up. Methods: A systematic search was implemented to identify pertinent articles. The primary outcome was the rate estimate that patients with uSpA fulfilling the diagnosis of AS according to the modified New York criteria during follow-up. The rate estimate and corresponding 95% confidence interval (95%CI) were pooled by the random-effects model in STATA 11.0 software. Meta-regression analyses were adopted to explore the sources of heterogeneity. The quality assessment was conducted by the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Begg test and the Egger test were applied to assess publication bias. Results: Sixteen papers were finally included in this study after screening 1299 citations. The pooled rate of patients with uSpA progression to AS synthesized from the 16 papers was 0.323 (95%CI 0.257–0.389). Subgroup analysis based on the length of follow-up showed that the rate at the time-point of 5, 8, and 10 years follow-up was 0.220 (95%CI 0.110–0.330), 0.291 (95%CI 0.257–0.325), and 0.399 (95%CI 0.190–0.608), respectively; while the rate in Asia, Europe, and Latin America was 0.367 (95%CI 0.282–0.452), 0.228 (95%CI 0.066–0.390), and 0.269 (95%CI 0.209–0.329), respectively. Meta-regression analysis indicated that the length of follow-up alone accounts for 45.23% of the total heterogeneity. Nearly half of the papers scored fair quality and none publication bias was identified based on the Begg test and the Egger test. Further, line chart describes an obviously increased trend for the patients with uSpA fulfilling the diagnosis of AS over time. Conclusion: The

  17. Sexual activity in Moroccan men with ankylosing spondylitis.

    Science.gov (United States)

    Rostom, Samira; Mengat, Meryam; Mawani, Nada; Jinane, Hakkou; Bahiri, Rachid; Hajjaj-Hassouni, Najia

    2013-06-01

    The aim of this study was to assess the perceived impact of ankylosing spondylitis (AS) on sexual activity within Moroccan men and to identify the associations with demographic, psychological status, quality of sleep, and disease-related variables. A total of 110 patients with a confirmed diagnosis of AS according to the modified New York classification criteria were invited to participate in the study. Patients completed a questionnaire, which also included questions relating to the impact of AS on their sexual function, socio-demographic and clinical characteristics. The patient sample comprised 110 men. The mean age of patients was 38.5 ± 12.6 years. Among the 110 patients, only 73 (67 %) have already had sexual activity. In this group of patients, 32 (44 %) were unsatisfied, 30 (41 %) reported erectile dysfunction, and 28 (38.4 %) had orgasmic trouble. Multivariate analysis showed that fatigue and sleep disturbance were independently associated with erectile dysfunction. This study suggests that AS in men seems to impact on sexual lives. Fatigue and sleep disturbance were independently associated with perceived problems with sexual activity.

  18. THE BASIC PRINCIPLES OF TREATMENT OF ANKYLOSING SPONDYLITIS (BECHTEREW'S DISEASE

    Directory of Open Access Journals (Sweden)

    Shandor Fedorovich Erdes

    2013-01-01

    Full Text Available The history of treatment of ankylosing spondylitis (AS and the reasons behind the development of modern approaches to its therapy are briefly described. The main tasks and principles of non-pharmacological and drug therapies for ASare briefly reported. The need for therapeutic physical training is emphasized, since its role in maintaining the functional status in this group of patients has been proved. The lecture casts doubt on effectiveness of physiotherapy andother physical techniques because of the poor evidence base. The lecture emphasizes the disease-modifying role of nonsteroidal anti-inflammatory drugs and requirement to receive them constantly for patients with Bechterew's disease. Meanwhile, the basic anti-inflammatory drugs in patients with this disease are reported to play an auxiliary role and to have no effect on disease progression. The pronounced clinical effectiveness of all tumor necrosis factor α inhibitors is emphasized; certain differences in their therapeutical effect are described. The problems of surgical treatment, which deal with correction of disease complications or undesirable effects, are discussed.

  19. Detection of novel diagnostic antibodies in ankylosing spondylitis: An overview.

    Science.gov (United States)

    Quaden, Dana H F; De Winter, Liesbeth M; Somers, Veerle

    2016-08-01

    Ankylosing spondylitis (AS) is a debilitating, chronic, rheumatic disease characterized by inflammation and new bone formation resulting in fusion of the spine and sacroiliac joints. Since early treatment is impeded by a delayed diagnosis, it is highly important to find new biomarkers that improve early diagnosis and may also contribute to a better assessment of disease activity, prognosis and therapy response in AS. Because of the absence of rheumatoid factor, AS was long assumed to have a seronegative character and antibodies are thus not considered a hallmark of the disease. However, emerging evidence suggests plasma cells and autoantibodies to be involved in the disease course. In this review, the role of B cells and antibodies in AS is discussed. Furthermore, an overview is provided of antibodies identified in AS up till now, and their diagnostic potential. Many of these antibody responses were based on small study populations and further validation is lacking. Moreover, most were identified by a hypothesis-driven approach and thus limited to antibodies against targets that are already known to be involved in AS pathogenesis. Hence, we propose an unbiased approach to identify novel diagnostic antibodies. The already successfully applied techniques cDNA phage display and serological antigen selection will be used to identify antibodies against both known and new antigen targets in AS plasma. These newly identified antibodies will enhance early diagnosis of AS and provide more insight into the underlying disease pathology, resulting in a more effective treatment strategy and eventually an improved disease outcome.

  20. MRI appearances of inflammatory vertebral osteitis in early ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Kurugoglu, Sebuh; Kanberoglu, Kaya; Mihmanli, Ismail; Cokyuksel, Oktay [Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University (Turkey); Kanberoglu, Ayfer [Department of Physical Medicine, SSK Istanbul Hospital, Istanbul (Turkey)

    2002-03-01

    Background: Undiagnosed and early ankylosing spondylitis (AS), especially in adolescent patients suffering from back pain, may present with the finding of vertebral osteitis on MRI. Aims: To identify the early MRI changes of vertebral osteitis in AS. Patients and methods: Five patients (three boys, two girls) aged 11-20 years (mean 15.4 years) suffering from back pain underwent MRI of the thoracolumbar spine. There was no initial diagnosis of AS. After clinical and radiological suspicion of AS, MRI of the sacroiliac (SI) joints was performed. Results: During the course of AS, destructive and reactive changes affect the discovertebral junctions that are initially seen in the thoracolumbar area. At this stage plain radiography of the spinal column may be normal. On MR images, inflammatory osteitis of the vertebrae is seen as hypointense areas on T1-weighted images and hyperintense areas on T2-W images. The lesions enhance homogenously with contrast material. Conclusions: Awareness of the MRI appearances of vertebral osteitis is helpful in suspecting AS. Radiological examination of the SI facilitates the diagnosis and unnecessary further imaging can be avoided. (orig.)

  1. The abilities of golimumab in the therapy of ankylosing spondylitis

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    Sh. F. Erdes

    2014-09-01

    Full Text Available The paper summarizes the data of the GO-RAISE trial evaluating the efficacy and tolerability of golimumab (GLM in patients with ankylosing spondylitis (AS. The trial was launched in 57 clinical centers of North America, Europe, and Asia in 2005. It enrolled 356 patients with high AS activity (BASDAI≥4 in whom previous and current therapies with nonsteroidal anti-inflammatory drugs (NSAIDs or disease-modifying anti-rheumatic drugs were ineffective. Group 1 patients received subcutaneous placebo; Group 2 had subcutaneous GLM 50 mg; Group 3 took GLM 100 mg every 4 weeks. Concomitant therapy with methotrexate, sulfasalazine, hydroxychloroquine, glucocorticoids, and NSAIDs was continued in previous doses. The investigators have concluded that GLM therapy in patients with AS gives rise to a rapid clinical and radiographic response that persists for a long time. Although no comparative trials of GLM versus other tumor necrosis factor-α (TNF-α inhibitors used to treat AS have conducted, the available data show that its efficacy and tolerability in these patients are similar to those of the TNF-α inhibitors already used in Russia. The GLM dose of 100 mg is noted to be worse tolerated than that of 50 mg with their practically equal clinical efficacy. The standard dose of GLM is 50 mg subcutaneously administered once monthly for all indications, including also for AS.

  2. The abilities of golimumab in the therapy of ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Sh. F. Erdes

    2014-01-01

    Full Text Available The paper summarizes the data of the GO-RAISE trial evaluating the efficacy and tolerability of golimumab (GLM in patients with ankylosing spondylitis (AS. The trial was launched in 57 clinical centers of North America, Europe, and Asia in 2005. It enrolled 356 patients with high AS activity (BASDAI≥4 in whom previous and current therapies with nonsteroidal anti-inflammatory drugs (NSAIDs or disease-modifying anti-rheumatic drugs were ineffective. Group 1 patients received subcutaneous placebo; Group 2 had subcutaneous GLM 50 mg; Group 3 took GLM 100 mg every 4 weeks. Concomitant therapy with methotrexate, sulfasalazine, hydroxychloroquine, glucocorticoids, and NSAIDs was continued in previous doses. The investigators have concluded that GLM therapy in patients with AS gives rise to a rapid clinical and radiographic response that persists for a long time. Although no comparative trials of GLM versus other tumor necrosis factor-α (TNF-α inhibitors used to treat AS have conducted, the available data show that its efficacy and tolerability in these patients are similar to those of the TNF-α inhibitors already used in Russia. The GLM dose of 100 mg is noted to be worse tolerated than that of 50 mg with their practically equal clinical efficacy. The standard dose of GLM is 50 mg subcutaneously administered once monthly for all indications, including also for AS.

  3. Multidetector Computed Tomography of Cervical Spine Fractures in Ankylosing Spondylitis

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    Koivikko, M.P.; Kiuru, M.J.; Koskinen, S.K. [Helsinki Univ. Central Hospital, Toeoeloe Trauma Center (Finland). Dept. of Radiology

    2004-11-01

    Purpose: To analyze multidetector computed tomography (MDCT) cervical spine findings in trauma patients with advanced ankylosing spondylitis (AS). Material and Methods: Using PACS, 2282 cervical spine MDCT examinations requested by emergency room physicians were found during a period of 3 years. Of these patients, 18 (16 M, aged 41-87, mean 57 years) had advanced AS. Primary imaging included radiography in 12 and MRI in 11 patients. Results: MDCT detected one facet joint subluxation and 31 fractures in 17 patients: 14 transverse fractures, 8 spinous process fractures, 2 Jefferson's fractures, 1 type I and 2 type II odontoid process fractures, and 1 each: atlanto-occipital joint fracture and C2 laminar fracture plus isolated transverse process and facet joint fractures. Radiographs detected 48% and MRI 60% of the fractures. MRI detected all transverse and odontoid fractures, demonstrating spinal cord abnormalities in 72%. Conclusion: MDCT is superior to plain radiographs or MRI, showing significantly more injuries and yielding more information on fracture morphology. MRI is valuable, however, in evaluating the spinal cord and soft-tissue injuries. Fractures in advanced AS often show an abnormal orientation and are frequently associated with spinal cord injuries. In these patients, for any suspected cervical spine injuries, MDCT is therefore the imaging modality of choice.

  4. Coxitis in patients with ankylosing spondylitis: clinicoradio logic comparisons

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    A. G. Bochkova

    2005-01-01

    Full Text Available Objective. To analyze and compare clinical, radiological and ultrasonic signs of coxitis in pts with ankylosing spondylitis (AS. Material and methods. 35 pts with AS and clinical signs of coxitis were included. Median age was 26 years, AS duration 9 years, coxitis duration 5 years. 17 pts with AS without clinical signs of coxitis constituted control group. Pain on visual analog scale, hip joint mobility, radiological changes and ultrasonic signs of exudation were assessed. Results. Among the pts with AS prevailed those with the beginning of the disease before 20 years of age (77%. 71% of pts had bilateral coxitis. In 40% of pts coxitis signs during the first years were inconstant. Most frequent radiological signs of coxitis were narrowing of joint space (91,9%, femoral head or/and acetabulum cysts (77,4%, femoral head osteophytes (67,7%. Femoral head deformity (8,1%, partial bone anchylosis (6,5%, marginal bone erosions (3% acetabulum protrusion (1,6% were rare signs. Exudation was present in 84% of damaged hip joints. Bone destruction was significantly more frequent in pts with longer duration of AS and coxitis and was associated with more prominent functional disability and higher frequency of exudation. Hip joint exudation frequency and its volume did not influence pain intensity. Radiological changes were revealed in 12 hip joints of 7 pts of control group.

  5. BONE METABOLISM AND ITS REGULATION IN PATIENTS WITH ANKYLOSING SPONDYLITIS

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    O. V. Bugrova

    2016-01-01

    Full Text Available Osteoporosis in ankylosing spondylitis (AS may exacerbate pain and functional disorders and increases the risk of fractures. The mechanisms  of its development in AS have not been adequately studied.Objective: to study bone mineral density (BMD  and its regulation in patients with AS.Subjects and methods. 70 patients (mean age, 43.2±9.2 years with a documented diagnosis of AS (mean disease duration, 17.1±7.8 years and a control group of 30 healthy individuals were examined. All the patients underwent estimation of BMD and the serum concentrations of osteocalcin,  CrossLaps, and key regulators of osteoclastogenesis, such as osteoprotegerin (OPG  and a receptor activator of nuclear factor kappa-B ligand (RANKL by an enzyme immunoassay. Results and discussion. In patients with AS, bone metabolism was characterized  by a decrease in bone formation and by some increase in bone tissue degradation especially in high AS activity. These patients showed the elevated levels of the major blocker of osteoclastogenesis OPG and the OPG/RANKL ratio, which can cause the process of ossification characteristic  of AS.

  6. Lung findings on high resolution CT in early ankylosing spondylitis

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    Kiris, Adem E-mail: ademkiris@hotmail.com; Ozgocmen, Salih; Kocakoc, Ercan; Ardicoglu, Ozge; Ogur, Erkin

    2003-07-01

    Objective: Ankylosing spondylitis (AS) is a chronic inflammatory disease mainly affecting the axial skeleton and pulmonary involvement is a well known feature of the disease. The aim of this study was to investigate the pulmonary high resolution computed tomography (HRCT) findings of patients with early AS. The relationship between pulmonary function tests (PFT) and HRCT findings was also determined. Subjects and methods: Twenty-eight patients with AS (mean age 30.8{+-}7.4 and disease duration 7.0{+-}2.6) were included in the study. Patients with a disease duration of >10 years or had other pulmonary diseases were excluded. All patients underwent plain chest radiography (posteroanterior and lateral views), thoracic HRCT and PFT. Results: All chest radiographs were normal and HRCT revealed abnormalities in 18 patients. The most common abnormalities seen on HRCT were mosaic pattern (ten of 28), subpleural nodule (seven of 28) and parenchymal bands (five of 28). Seven of ten patients with mosaic pattern revealed air trapping areas on end expiratory scans. Twelve patients had abnormal PFT and all had restrictive type of involvement. Ten of these 12 patients had abnormal HRCT and the remaining two patients had normal HRCT. On the other hand, eight patients with normal PFT had abnormalities on HRCT. Conclusion: Patients with early AS frequently have abnormalities on HRCT, even though they have normal PFT and chest X-ray. Small airway involvement was found as frequent as interstitial lung disease in early AS.

  7. Involvement of Notch1/Hes signaling pathway in ankylosing spondylitis.

    Science.gov (United States)

    Xu, Wei; Liang, Chao-Ge; Li, Yi-Fan; Ji, Yun-Han; Qiu, Wen-Jun; Tang, Xian-Zhong

    2015-01-01

    We aimed to investigate the role of Notch1/Hes signaling pathway in the pathogenesis of abnormal ossification of hip ligament in patients with ankylosing spondylitis (AS). 22 AS patients scheduled for artificial hip arthroplasty were randomly chosen as AS group. As controls, we used 4 patients diagnosed with transcervical fracture who underwent hip replacement surgery. Notch1 and Hes mRNA expressions were detected by real-time fluorescent quantitative polymerase chain reaction (RFQ-PCR). Immunohistochemistry (IHC) was used to detect Notch1 and Hes protein expression. Correlation analyses of Notch-l and Hes with AS-related clinical factors were conducted with spearman's correlation analysis and partial correlation analysis. RFQ-PCR results showed significant differences in Notch1 and Hes mRNA expressions between AS group and the control group (all Phip joint ligaments of AS patients, Hes protein expression was associated with the clinical course of AS. Taken together, we suggest that signaling pathways mediated by Notch1-Hes may contribute to ligament ossification of hip joints in AS patients.

  8. Ankylosing spondylitis: a dual perspective of current issues and challenges.

    Science.gov (United States)

    Khan, Muhammad Asim

    2006-09-01

    This series of articles on ankylosing spondylitis (AS) provides insight into the burden of disease and focuses on early diagnosis and effective management. AS leads to progressive functional impairment over time and has tremendous impact on society at large in terms of economic costs and indirect costs associated with physical impairment and loss of employment. Early diagnosis is crucial now that we have more effective therapy with tumor necrosis factor (TNF) antagonists, which suppress disease activity and improve the functional ability of patients whose disease is refractory to conventional drug therapy. Early identification of variables that help predict severe disease with bad functional prognosis is needed. If biological therapy with TNF inhibitors is proven to retard disease progression and prevent or delay functional limitations, insight into such prognosticators will help us offer the correct treatment to the correct patient at the correct time. There is also a need to demonstrate longterm benefits of such a therapy as well as a favorable cost/benefit ratio to help convince healthcare authorities, insurance companies, and others of the utility of these drugs for treating patients with AS refractory to conventional drug therapy.

  9. Leukocytoclastic Vasculitis in a Patient with Ankylosing Spondylitis

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    Senol Kobak

    2014-01-01

    Full Text Available A 26-year-old male patient presented to our rheumatology clinic with pain, swelling and limitation of movement in his right ankle, and also purpuric skin lesions in the lower extremity pretibial region. He was asked questions, and he said that he had been having chronic low back pain and morning stiffness for the last few years. His physical examination revealed that he had arthritis in his right ankle, purpuric skin lesions in pretibial regions of both legs, and bilateral FABERE/FADIR positivity. The sacroiliac joint imaging and MRI revealed bilateral sacroiliitis findings, and the lateral heel imaging revealed enthesitis. HLA-B27 was positive. Skin biopsy from lower skin lesions was reported to be consistent with leukocytoclastic vasculitis. Based on clinical, laboratory, radiological, and pathological examinations, the patient was diagnosed with ankylosing spondylitis and leukocytoclastic vasculitis. Administration of corticosteroid, salazopyrin, and nonsteroid anti-inflammatory medications was started. Notable clinical and laboratory regression was observed during his checks 3 months later.

  10. 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.

    Science.gov (United States)

    Bidad, Katayoon; Fallahi, Sasan; Mahmoudi, Mahdi; Jamshidi, Ahmadreza; Farhadi, Elham; Meysamie, Alipasha; Nicknam, Mohammad Hossein

    2012-11-01

    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-retest agreement showed good reliability: interclass correlation coefficient (ICC) for BASDAI was 0.93 (CI at 95%, 0.90-0.95), for BASFI was 0.96 (CI at 95%, 0.94-0.97) and for PASS was 0.87 (CI at 95%, 0.79-0.92). Chronbach's alpha was 0.95, 0.96 and 0.87 for BASDAI, BASFI and PASS, respectively. BASDAI showed a significant correlation with patient global disease activity index, nocturnal back pain, total back pain, number of swollen joints, number of enthesites, morning stiffness, Bath Ankylosing Spondylitis Global Score (BAS-G), BASFI and BASMI. A significant correlation was also found between BASFI and occiput-to-wall distance, mentum-to-sternum distance, chest expansion, finger-to-floor distance, number of swollen joints, number of enthesites, nocturnal back pain, total back pain, BAS-G, BASDAI and BASMI. Patients who answered "no" to PASS (found their condition unsatisfactory) reported significantly increased pain scores, patient global disease activity scores, BAS-G, BASDAI and BASFI scores. The results showed that the Iranian versions of BASDAI, BASFI and PASS are adequately reliable and valid in patients with AS.

  11. A case of severe ankylosing spondylitis posted for hip replacement surgery

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    Nalini Kotekar

    2007-01-01

    Full Text Available A 50-year-old male patient with history of ankylosing spondylitis (AS for 30 years presented for hip replacement surgery. Airway management in ankylosing spondylitis patients presents the most serious array of intubation and airway hazards imagin-able, which is secondary to decrease in cervical spine mobility and possible temporo-mandibular joint disease. Literatures support definitive airway management and many authors consider regional anaesthesia to be contraindicated. The reasons cited include inability to gain neuraxial access and the need for urgent airway control in case of complication of regional anaesthesia.

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

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    Tschoeke Sven K

    2008-06-01

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

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

    Science.gov (United States)

    Masi, Alfonse T

    2014-01-01

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

  14. Bone Mineral Density Assessment in Ankylosing Spondylitis and Characteristics of Bone Turnover Parameters

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    Füsun Şahin

    2005-09-01

    Full Text Available Ankylosing spondylitis, characterised with excessive new bone formation and calcification in spine and peripheral joints, causes osteoporosis which is a general component of inflammatory arthritis. Since is excessive bone formation affects bone mineral density, there are problems in diagnosis and follow-up of osteoporosis efforts made for finding the right diagnostic tool. Besides bone metabolism and turn-over in inflammatory diseases should be known in detail, because it has a place in diagnosis and follow-up. In this review, bone mineral density in ankylosing spondylitis, the importance and usage of bone turn-over parameters are discussed in the light of literature data.

  15. MMP mediated type V collagen degradation (C5M) is elevated in ankylosing spondylitis

    DEFF Research Database (Denmark)

    Veidal, S S; Larsen, D V; Chen, Xijuan;

    2012-01-01

    Type V collagen has been demonstrated to control fibril formation. The aim of this study was to develop an ELISA capable of detecting a fragment of type V collagen generated by MMP-2/9 and to evaluate the assay as biomarker for ankylosing spondylitis (AS).......Type V collagen has been demonstrated to control fibril formation. The aim of this study was to develop an ELISA capable of detecting a fragment of type V collagen generated by MMP-2/9 and to evaluate the assay as biomarker for ankylosing spondylitis (AS)....

  16. Ankylosing spondylitis morbidity trends in Russia and Saturday spondyloarthritis schools

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    Shandor Fedorovich Erdes

    2013-01-01

    Full Text Available The countrywide detection and notification of ankylosing spondylitis (AS are not only late, but are frequently not even done not least due to the undertraining of physicians in this area. Objective: to define a role of special educational programs for physicians in improving the diagnosis and registration of AS on the basis of its morbidity analysis. Subjects and methods. Two levels of spondyloarthritis (SpA schools oriented to rheumatologists and other specialists were developed. Since late 2009, more than 40 schools have been arranged in different cities and towns of the country. The primary and overall morbidities of AS were studied using the data of the Ministry of Health of the Russian Federation from 2006 to 2011 inclusive: 2006-2008 were basic years (prior to SpA educational programs and 2009-2011 are educational years. Results. In the basic years, the overall and primary AS morbidities varied within ±10%. However, there was their growing tendency just in the first year of SpA schools (2009, which persisted in the following year (2010. By 2011, the total number of AS patients increased by 2.4 times as compared to 2008; the number of first diagnosed patients did by more than 4 times. Conclusion. In the past years, the primary and overall morbidity of AS rose drastically, which is likely to be associated with the improved diagnosis of the disease due to the optimization of a diagnostic process and to the introduction of new diagnostic and therapeutic techniques. Special SpA education programs implemented in different regions of the country, by attracting more physicians of various specialties, play a significant part in the introduction of early diagnosis of AS.

  17. Accelerometer Quantification of Physical Activity and Activity Patterns in Patients with Ankylosing Spondylitis and Population Controls

    NARCIS (Netherlands)

    van Genderen, Simon; Boonen, Annelies; van der Heijde, Desiree; Heuft, Liesbeth; Luime, Jolanda; Spoorenberg, Anneke; Arends, Suzanne; Landewe, Robert; Plasqui, Guy

    2015-01-01

    Objective. To compare the total amount of physical activity (TPA) and time spent in various activity intensities of patients with ankylosing spondylitis (AS) and population controls, and to explore factors related to physical activity (PA). Methods. Subjects were asked to wear a triaxial acceleromet

  18. Why golimumab in the treatment of psoriatic arthritis, ankylosing spondylitis and rheumatoid arthritis?

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    M. Rossini

    2015-03-01

    Full Text Available Golimumab is an anti-TNF monoclonal antibody administred subcutaneously once a month and produced with an innovative technology that minimizes immunogenicity. This paper reviews and updates the main studies on the efficacy, safety and pharmacoeconomic aspects of treatment with golimumab of psoriatic arthritis, ankylosing spondylitis and rheumatoid arthritis.

  19. Baseline predictors of response to TNF-α blocking therapy in ankylosing spondylitis

    NARCIS (Netherlands)

    Arends, Suzanne; van der Veer, Eveline; Kallenberg, Cees G. M.; Brouwer, Elisabeth; Spoorenberg, Anneke

    2012-01-01

    PURPOSE OF REVIEW: Identifying the characteristics of patients with ankylosing spondylitis (AS) before start of treatment which are able to predict a beneficial response to tumor necrosis factor-alpha (TNF-α) blocking therapy is relevant, especially in view of the high costs and potential side-effec

  20. Instrumentos de avaliação em espondilite anquilosante Outcome measures in ankylosing spondylitis

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    Themis Mizerkowski Torres

    2006-06-01

    Full Text Available A espondilite anquilosante (EA é uma doença inflamatória crônica caracterizada por acometimento predominante do esqueleto axial. Ocorre de forma insidiosa e é potencialmente debilitante, levando à redução na qualidade de vida dos indivíduos acometidos. A sua etiopatogenia ainda não está totalmente esclarecida, dificultando estratégias no seu diagnóstico e manejo. O avanço da terapia com agentes biológicos veio reforçar discussões sobre a melhor forma de avaliação destes pacientes. Nesta revisão, discutimos os principais instrumentos utilizados para avaliar pacientes com EA e o consenso do grupo internacional (ASAS working group - Assessments in Ankylosing Spondylitis Working Group determinado no OMERACT IV (Outcome Measures in Rheumatology.Ankylosing spondylitis is a chronic and progressive disease involving predominantly the axial skeleton. It is insidious and potentially debilitating, compromising the quality of life of patients suffering from the disease. The etiopathogenesis is still uncertain, which difficult strategies in its diagnosis and treatment. Advances in biological therapies are reforcing discussions in the best way of managing the disease. In this paper, we revise the outcome instruments available for ankylosing spondylitis and the consensus from the ASAS working group (Assessments in Ankylosing Spondylitis Working Group established at the OMERACT IV (Outcome Measures in Rheumatology.

  1. Resolution of inflammation following treatment of ankylosing spondylitis is associated with new bone formation

    DEFF Research Database (Denmark)

    Pedersen, Susanne J; Chiowchanwisawakit, Praveena; Lambert, Robert G W;

    2011-01-01

    To test the hypothesis that in patients with ankylosing spondylitis (AS) a vertebral corner inflammatory lesion (CIL) visible on magnetic resonance imaging (MRI) that completely resolves following treatment with anti-tumor necrosis factor-α (TNF-α) agents is more likely to develop into a de novo...

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

    Science.gov (United States)

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

    2007-01-01

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

  3. Diagnostic delay in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis

    DEFF Research Database (Denmark)

    Sørensen, Jan; Hetland, Merete Lund

    2014-01-01

    ) and ankylosing spondylitis (AS) changed from year 2000 to 2011. METHODS: Month and year of initial symptoms and diagnosis, gender, hospital, year of birth and date of first data entry were obtained for 13 721 patients with RA, PSA or AS who had been registered in the DANBIO registry. Time between symptom onset...

  4. Diagnostic delay in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis

    DEFF Research Database (Denmark)

    Sørensen, Jan; Hetland, Merete Lund

    2015-01-01

    ) and ankylosing spondylitis (AS) changed from year 2000 to 2011. METHODS: Month and year of initial symptoms and diagnosis, gender, hospital, year of birth and date of first data entry were obtained for 13,721 patients with RA, PSA or AS who had been registered in the DANBIO registry. Time between symptom onset...

  5. Is nephrolithiasis an unrecognized extra-articular manifestation in ankylosing spondylitis?

    DEFF Research Database (Denmark)

    Jakobsen, Ane Krag; Jacobsson, Lennart T H; Patschan, Oliver;

    2014-01-01

    BACKGROUND: Ankylosing spondylitis (AS) is associated with several extra-articular manifestations. Nephrolithiasis (NL) has not been recognized as one of those, however, several factors known to increase the risk of NL are at play in AS patients. The objective was to estimate rates and predictors...

  6. Resolution of inflammation following treatment of ankylosing spondylitis is associated with new bone formation

    DEFF Research Database (Denmark)

    Pedersen, Susanne J; Chiowchanwisawakit, Praveena; Lambert, Robert G W;

    2011-01-01

    To test the hypothesis that in patients with ankylosing spondylitis (AS) a vertebral corner inflammatory lesion (CIL) visible on magnetic resonance imaging (MRI) that completely resolves following treatment with anti-tumor necrosis factor-a (TNF-a) agents is more likely to develop into a de novo...

  7. Major histocompatibility complex associations of ankylosing spondylitis are complex and involve further epistasis with ERAP1

    NARCIS (Netherlands)

    Cortes, Adrian; Pulit, Sara L; Leo, Paul J; Pointon, Jenny J; Robinson, Philip C; Weisman, Michael H; Ward, Michael; Gensler, Lianne S; Zhou, Xiaodong; Garchon, Henri-Jean; Chiocchia, Gilles; Nossent, Johannes; Lie, Benedicte A; Førre, Øystein; Tuomilehto, Jaakko; Laiho, Kari; Bradbury, Linda A; Elewaut, Dirk; Burgos-Vargas, Ruben; Stebbings, Simon; Appleton, Louise; Farrah, Claire; Lau, Jonathan; Haroon, Nigil; Mulero, Juan; Blanco, Francisco J; Gonzalez-Gay, Miguel A; Lopez-Larrea, C; Bowness, Paul; Gaffney, Karl; Gaston, Hill; Gladman, Dafna D; Rahman, Proton; Maksymowych, Walter P; Crusius, J Bart A; van der Horst-Bruinsma, Irene E; Valle-Oñate, Raphael; Romero-Sánchez, Consuelo; Hansen, Inger Myrnes; Pimentel-Santos, Fernando M; Inman, Robert D; Martin, Javier; Breban, Maxime; Wordsworth, Bryan Paul; Reveille, John D; Evans, David M; de Bakker, Paul I W; Brown, Matthew A

    2015-01-01

    Ankylosing spondylitis (AS) is a common, highly heritable, inflammatory arthritis for which HLA-B*27 is the major genetic risk factor, although its role in the aetiology of AS remains elusive. To better understand the genetic basis of the MHC susceptibility loci, we genotyped 7,264 MHC SNPs in 22,64

  8. Optimizing physical therapy for ankylosing spondylitis: a case study in a young football player.

    Science.gov (United States)

    Tricás-Moreno, José Miguel; Lucha-López, María Orosia; Lucha-López, Ana Carmen; Salavera-Bordás, Carlos; Vidal-Peracho, Concepción

    2016-04-01

    [Purpose] Ankylosing spondylitis is prevalent in men. Modern and expert consensus documents include physical therapy among the strategies for the treatment of ankylosing spondylitis. This study aimed to describe the physical therapy approach in an athlete with ankylosing spondylitis. [Subject and Methods] The patient, refractory to treatment with anti-inflammatory medication, showed pelvic and lumbar pain and joint, muscle, and functional disorders, which were treated with orthopedic joint mobilization, dry needling, exercise, and whole-body hyperthermia. [Results] After the treatment, pain relief, normal joint mobility, improved muscle function, and return to activities of daily living and competitive sporting activities were recorded. [Conclusion] The literature provides evidence for the use of joint mobilization techniques; however, no previous studies have used the same techniques and methods. There is no previous evidence for the use of dry needling in this pathology. Exercise therapy has a higher level of evidence, and guidelines with scientific support were followed. This research confirms the effectiveness of hyperthermia for arthritis. The early stage of ankylosing spondylitis, and the young age, good overall condition, and cooperative attitude of the patient led to positive outcomes. In conclusion, a favorable response that promoted the remission of the disease was observed.

  9. Ankylosing spondylitis confers substantially increased risk of clinical spine fractures : a nationwide case-control study

    NARCIS (Netherlands)

    Prieto-Alhambra, D; Muñoz-Ortego, J; De Vries, F; Vosse, D; Arden, N K; Bowness, P; Cooper, C; Diez-Perez, A; Vestergaard, P

    2015-01-01

    UNLABELLED: Ankylosing spondylitis (AS) leads to osteopenia/osteoporosis and spine rigidity. We conducted a case-control study and found that AS-affected patients have a 5-fold and 50 % increased risk of clinical spine and all clinical fractures, respectively. Excess risk of both is highest in the f

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

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    Senabre-Gallego JM

    2013-09-01

    Full Text Available José Miguel Senabre-Gallego,1 Carlos Santos-Ramirez,2 Gregorio Santos-Soler,1 Esteban Salas-Heredia,1 Mabel Sánchez-Barrioluengo,3 Xavier Barber,4 José Rosas1 On behalf of the AIRE-MB group 1Rheumatology, Hospital Marina Baixa, Villajoyosa, 2Rheumatology, Hospital Marina Salud, Denia, 3INGENIO (Instituto de Gestión de la Inovación y del Conocimiento (CSIC [Consejo Superior de Investigaciones Científicas]-UPV [Universidad Politécnica de Valencia], Universitat Politècnica de València, Valencia, 4CIO (Centro de Investigación Operativa-UMH (Universidad Miguel Hernández, Universidad Miguel Henández, Elche, Spain Abstract: To date, anti-tumor necrosis factor alfa (anti-TNF-α therapy is the only alternative to nonsteroidal anti-inflammatory drugs for the treatment of ankylosing spondylitis. Etanercept is a soluble TNF receptor, with a mode of action and pharmacokinetics different to those of antibodies and distinctive efficacy and safety. Etanercept has demonstrated efficacy in the treatment of ankylosing spondylitis, with or without radiographic sacroiliitis, and other manifestations of the disease, including peripheral arthritis, enthesitis, and psoriasis. Etanercept is not efficacious in inflammatory bowel disease, and its efficacy in the treatment of uveitis appears to be lower than that of other anti-TNF drugs. Studies of etanercept confirmed regression of bone edema on magnetic resonance imaging of the spine and sacroiliac joint, but failed to reduce radiographic progression, as do the other anti-TNF drugs. It seems that a proportion of patients remain in disease remission when the etanercept dose is reduced or administration intervals are extended. Etanercept is generally well tolerated with an acceptable safety profile in the treatment of ankylosing spondylitis. The most common adverse effect of etanercept treatment is injection site reactions, which are generally self-limiting. Reactivation of tuberculosis, reactivation of

  11. Risk Factors of Heterotopic Ossification Following Total Hip Arthroplasty in Patients With Ankylosing Spondylitis.

    Science.gov (United States)

    Thilak, Jai; Panakkal, Jiss Joseph; Kim, Tae-Young; Goodman, Susan M; Lee, Sang-Soo; Salvati, Eduardo A

    2015-12-01

    This study was to identify the risk factors of heterotopic ossification (HO) after total hip arthroplasty (THA) in ankylosing spondylitis. We analyzed 47 hips (24 patients) with ankylosing spondylitis that underwent primary THA. The incidence of HO was 14.9%. The risk factors were divided into modifiable and nonmodifiable factors. Female gender (P=0.008), preoperative ankylosed hip (P<0.001), occurrence of HO in previous surgery (P=0.036) were nonmodifiable risk factors which increased the prevalence of HO. Of the various modifiable risk factors, elevated preoperative ESR (P=0.007), elevated preoperative CRP (P=0.004) and prolonged duration of surgery (P=0.014) were associated with increased occurrence of HO. Perioperative medical intervention to reduce inflammation (ESR and CRP) may help to decrease HO.

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

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    Taylan Ali

    2012-10-01

    Full Text Available Abstract Background Ankylosing spondylitis (AS is a chronic inflammatory disease of spine and sacroiliac joints; it is characterized by new bone formation, and the disease processes can be accompanied by osteoporosis. In the present study, we investigated changes in bone mineral density (BMD and in the levels of various bone turnover-related biomarkers and cytokines in a cohort of AS patients, with regard to clinical parameters, disease activity, and treatment regimen. Methods 55 AS patients and 33 healthy controls included in the study. Spinal mobility was assessed by the Bath Ankylosing Spondylitis Metrology Index (BASMI, and radiologic changes were scored by the Bath Ankylosing Spondylitis Radiologic Index (BASRI. Patients were also evaluated with the Bath Ankylosing Spondylitis Functional Index (BASFI and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI. Bone mineral density (BMD assessed by dual energy X-ray absorptiometry. Various biomarkers and cytokines of bone turnover including osteoprotegerin (OPG, serum band 5 tartrate-resistant acid phosphatase (TRAP-5, soluble receptor activator of nuclear factor kappa-B ligand (sRANKL, secreted frizzled-related protein 1 (sFRP-1, Dickkopf-related protein 1 (DKK-1, and sclerostin were studied. Results The levels of TRAP-5, NTX, sRANKL, sclerostin, sFRP-1, DKK-1, and IFNγ, were similar between the patients and controls (p > 0.05, while BMD of femoral neck, and OPG levels were significantly lower in AS patients (p  Conclusions In this cross-sectional study we showed that OPG levels were significantly lower in AS patients compared to healthy subjects. On the other hand, the levels of wingless (Wnt signal pathway inhibitors seem not altered. Ectopic bone formation in AS may be related to dysfunction of these molecules at the cellular level.

  13. Association of ORAI1 haplotypes with the risk of HLA-B27 positive ankylosing spondylitis.

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    James Cheng-Chung Wei

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammation of the sacroiliac joints, spine and peripheral joints. The aetiology of ankylosing spondylitis is still unclear. Previous studies have indicated that genetics factors such as human leukocyte antigen HLA-B27 associates to AS susceptibility. We carried out a case-control study to determine whether the genetic polymorphisms of ORAI1 gene, a major component of store-operated calcium channels that involved the regulation of immune system, is a susceptibility factor to AS in a Taiwanese population. We enrolled 361 AS patients fulfilled the modified New York criteria and 379 controls from community. Five tagging single nucleotides polymorphisms (tSNPs at ORAI1 were selected from the data of Han Chinese population in HapMap project. Clinical statuses of AS were assessed by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI, and Bath Ankylosing Spondylitis Global Index (BAS-G. Our results indicated that subjects carrying the minor allele homozygote (CC of the promoter SNP rs12313273 or TT homozygote of the SNP rs7135617 had an increased risk of HLA-B27 positive AS. The minor allele C of 3'UTR SNP rs712853 exerted a protective effect to HLA-B27 positive AS. Furthermore, the rs12313273/rs7135617 pairwise allele analysis found that C-G (OR 1.69, 95% CI 1.27, 2.25; p = 0.0003 and T-T (OR 1.75, 95% CI 1.36, 2.27; p<0.0001 haplotypes had a significantly association with the risk of HLA-B27-positive AS in comparison with the T-G carriers. This is the first study that indicate haplotypes of ORAI1 (rs12313273 and rs7135617 are associated with the risk of HLA-B27 positive AS.

  14. Assessment of subclinical atherosclerosis in ankylosing spondylitis: correlations with disease activity indices

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    F.M. Perrotta

    2013-07-01

    Full Text Available The aim of the study was to evaluate atherosclerosis in ankylosing spondylitis (AS through the assessment of morphological and functional measures of subclinical atherosclerosis. Twenty patients [M/F=12/8, age (median/range 43.5/28-69 years; disease duration (median/range 9.7/1-36 years] with AS classified according to modified New York criteria and twenty age and sex related healthy controls with negative past medical history for cardiovascular events were enrolled in the study. In all patients and controls, the intima-media thickness (IMT of common carotid artery, carotid bulb and internal carotid artery, and the flow-mediated dilatation (FMD of non-dominant arm brachial artery were determined, using a sonographic probe Esaote GPX (Genoa, Italy. Furthermore, we assess the main disease activity and disability indices [bath ankylosing spondylitis disease activity index, ankylosing spondylitis disease activity score-eritrosedimentation rate (ASDAS-ESR, ASDAS-C-reactive protein (CRP, bath ankylosing spondylitis metrology index, bath ankylosing spondylitis functional index and acute phase reactants. Plasmatic values of total cholesterol, low-density lipoprotein, high-density lipoprotein, triglyceride and homocysteine were carried out in all twenty patients. IMT at carotid bulb was significant higher in patients than in controls (0.67 mm vs 0.54 mm; P=0.03. FMD did not statistically differ between patients and controls (12.5% vs 15%; P>0.05. We found a correlation between IMT at carotid bulb and ESR (rho 0.43; P=0.04. No correlation was found between FMD and disease activity and disability indices. This study showed that in AS patients, without risk factors for cardiovascular disease, carotid bulb IMT, morphological index of subclinical atherosclerosis, is higher than in controls.

  15. Elevated serum interleukin-23 levels in ankylosing spondylitis patients and the relationship with disease activity.

    Science.gov (United States)

    Ugur, Mahir; Baygutalp, Nurcan Kilic; Melikoglu, Meltem Alkan; Baygutalp, Fatih; Altas, Elif Umay; Seferoglu, Buminhan

    2015-11-01

    This study was aimed to evaluate the relationship between serum interleukin-23 (IL-23) levels and ankylosing spondylitis (AS).Twenty male patients diagnosed with ankylosing spondylitis according to the 1984 modified New York criteria for AS and twenty male healthy controls were included in this study.The demographic characteristics, clinical and laboratory findings of the patients were recorded. Serum IL-23 levels, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured in both the AS and control groups. The Bath ankylosing spondylitis disease activity ındex (BASDAI), the Bath ankylosing spondylitis functional index (BASFI), and the Bath ankylosing spondylitis metrology index (BASMI) were evaluated as disease activity parameters. The AS patients were divided into two subgroups as active and inactive in respect of CRP, ESR levels and BASDAI scores. The mean serum IL-23 levels of the AS and control groups were 334.45±176.54 pg/ml and 166.49±177.50 pg/ml respectively, and there was a significant difference between the groups. Correlation analysis of serum IL-23 levels with clinical and laboratory parameters showed that there were positive correlations between serum IL-23 levels and the BASDAI, BASFI scores in total, active and inactive patients and the BASMI scores in total and inactive patients and negative correlations between serum IL-23 levels and ESR in inactive patients. It was shown that altered serum IL-23 levels were related to AS disease activity. Further studies in large patient series are necessary to investigate the role of IL-23 protein in etiopathogenesis of AS.

  16. Successful lumbar puncture with Taylor′s approach for the diagnostic workup of meningitis in a patient with Ankylosing spondylitis

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    Gentle Sunder Shrestha

    2015-01-01

    Full Text Available Meningitis and encephalitis are the neurological emergencies. As the clinical findings lack specificity, once suspected, cerebrospinal fluid (CSF analysis should be performed and parenteral antimicrobials should be administered without delay. Lumbar puncture can be technically challenging in patients with ankylosing spondylitis due to ossification of ligaments and obliteration of interspinous spaces. Here, we present a case of ankylosing spondylitis where attempts for lumbar puncture by conventional approach failed. CSF sample was successfully obtained by Taylor′s approach.

  17. THERAPEUTIC EXERCISE FOR PATIENTS WITH ANKYLOSING SPONDYLITIS: RECOMMENDATIONS AND REALITY

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    T. V. Dubinina

    2014-01-01

    Full Text Available Objective. To study how the patients with ankylosing spondylitis (AS follow recommendations for performing physi- cal exercises. Material and methods. To clarify the compliance of patients with AC to physical exercise, a special questionnaire was designed. The Exercise Benefits/Barriers Scale (EBBS was used to assess the perception of physical exercises. The study included 79 patients (the mean age of 34.5 ± 9.4 years with AS (diagnosed according to the New York criteria who have been treated at the clinic of V.A. Nasonova Research Institute of Rheumatology of the Russian Academy of Medical Sciences. Results. Of the 79 patients included in the study, 77.2% were doing therapeutic exercises; 41.0% of patients were doing them every day. 41.0% of the patients have received sets of exercises from the attending doctor, 41.0 % from the Internet, and 18.0% from other sources (brochures for patients or courses for patients with AS. The average total EEBS score was 114.2 ± 17.8 points; the benefits score was 87.1 ± 12.8; and the barriers score was 27.1 ± 5.0. The most frequent responses to question about the benefits of physical exercises were as follows: «They reduce the feeling of stress and tension» (90.6% and «They increase the muscle strength» (93.7%. «I am tired physically from doing exercises» (96.6% was the most common barrier to execution of physical exercises. Conclusion. Despite the positive perception of physical exercises, only 41.0% of the patients with AS have done them every day. The lack of information about exercises recommended for AS patients, the frequency of their use, the effect on the disease activity and functionality significantly limits the use of exercises by patients with AS. It remains unclear exactly, which sets of exercises are most effective and what regularity of exercises should be used to prevent impair- ment of the functions of the spine and joints. 

  18. MR imaging features of foot involvement in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Erdem, C. Zuhal E-mail: sunarerdem@yahoo.com; Sarikaya, Selda; Erdem, L. Oktay; Ozdolap, Senay; Gundogdu, Sadi

    2005-01-01

    Objective: To determine alterations of the soft tissue, tendon, cartilage, joint space, and bone of the foot using magnetic resonance (MR) imaging in ankylosing spondylitis (AS) patients. Materials and Method: Clinical and MR examination of the foot was performed in 23 AS patients (46 feet). Ten asymptomatic volunteers (20 feet) were studied on MR imaging, as a control group. MR imaging protocol included; T1-weighted spin-echo, T2-weighted fast-field echo (FFE) and fat-suppressed short tau inversion recovery (STIR) sequences in sagittal, sagittal oblique, and coronal planes using a head coil. Specifically, we examined: bone erosions, tendinitis (acute and chronic), para-articular enthesophyte, joint effusion, plantar fasciitis, joint space narrowing, soft tissue edema, bone marrow edema, enthesopathy in the Achilles tendon and plantar fascia attachment, subchondral signal intensity abnormalities (edema and sclerosis), tenosynovitis, retrocalcaneal bursitis, subchondral cysts, subchondral fissures, and bony ankylosis. Midfoot, hindfoot, and ankle were included in examined anatomic regions. Results: Clinical signs and symptoms (pain and swelling) due to foot involvement were present in 3 (13%) of the patients while frequency of involvement was 21 (91%) with MR imaging assessment. The MR imaging findings were bone erosions (65%), Achilles tendinitis (acute and chronic) (61%), para-articular enthesophyte (48%), joint effusion (43%), plantar fasciitis (40%), joint space narrowing (40%), subchondral sclerosis (35%), soft tissue edema (30%), bone marrow edema (30%), enthesopathy of the Achilles attachment (30%), subchondral edema (26%), enthesopathy in the plantar fascia attachment (22%), retrocalcaneal bursitis (22%), subchondral cysts (17%), subchondral fissures (17%), tendinitis and enthesopathy of the plantar ligament (13%), and bony ankylosis (9%). The most common involved anatomical region was the hindfoot (83%) following by midfoot (69% ) and ankle (22

  19. Mortality in patients with ankylosing spondylitis in Argentina.

    Science.gov (United States)

    Buschiazzo, Emilio Andres; Schneeberger, Emilce Edith; Sommerfleck, Fernando Andres; Ledesma, Cesar; Citera, Gustavo

    2016-09-01

    Some reports describe an increased mortality in patients with ankylosing spondylitis (AS) compared to the general population. The aims of this study were to evaluate the cumulative survival in patients with AS and to establish possible factors associated with mortality. In cross-sectional retrospective study, AS patients were included according to 1984 modified NY criteria, in the 2000-2010 period, the prevalence of mortality was determined by review of medical records, telephone contact, family reports, and death certificates, and it was compared with mortality in Argentina's general population. One hundred twenty-seven patients were studied, 96 (75.6 %) were male, median age 49 years (interquartile range (IQR) 34-60) and median disease duration 8 years (IQR 4-17). During the follow-up period, 9 patients died (7.1 %). The median estimated survival from diagnosis of AS was 39 years (IQR 34-50) and median cumulative survival was 76 years (IQR 74-85). Cardiovascular disease was the most frequent cause of death (5/9 patients). Deceased patients had a mean age and a mean AS disease duration significantly higher than living patients (68.1 ± 12.4 years vs 46.4 ± 15.09 years, p = 0.0001 and 33 ± 13.7 years vs 12 ± 10.7 years, p = 0.001, respectively), higher frequency of total surgeries [3/5 (60 %) vs 5/105 (4.76 %), p = 0.002] and cauda equina syndrome [3/6 (50 %) vs 2/116 (1.72 %), p = 0.001], respectively. Frequency of mortality in AS patients was higher than the crude mortality rate of Argentina's general population in the same period, with cardiovascular cause being the most frequent one.

  20. Magnetic resonance imaging for ankylosing spondylitis; Magnetresonanztomographie bei ankylosierender Spondylitis (Morbus Struempell-Marie-Bechterew)

    Energy Technology Data Exchange (ETDEWEB)

    Bollow, M. [Augusta-Kranken-Anstalt, Inst. fuer Radiologie, Bochum (Germany)

    2002-12-01

    Ankylosing spondylitis (AS) is the prototypical form of the spondyloarthropathies, which at a prevalence of 2% is among the most frequent rheumatic diseases. Spondyloarthropathy comprises the following five disorders: AS, reactive arthritis, psoriatic arthritis, enteropathic arthritis in Crohn's disease, and ulcerosing colitis as well as undifferentiated spondyloarthropathy. In 99% of the patients with AS initial abnormal findings affect the sacroiliac joints. The radiographic changes required for diagnosing AS occur as late as 5-9 years after the onset of clinical symptoms. MRI of the sacroiliac joints reliably demonstrates both chronic inflammatory changes (erosions, sclerotic changes, bone bridges) and acute inflammatory changes (synovitis, capsulitis, osteitis) and allows for grading the chronicity and acuity of such changes. Enthesitis of the interosseous ligaments of the retroarticular space is a manifestation of AS. Spondylodiscitis (Andersson 1937) may occur as an inflammatory or non-inflammatory process (transdiscal fatigue fracture). Inflammations of the facet and costospinal joints developing into ankylosis are typical of AS. Changes of the vertebral bodies occur as anterior (Romanus 1952), posterior, and marginal spondylitis. All forms of spondyloarthropathies are furthermore characterized by asymmetrical synovitis of the large joints, particularly of the legs (gonarthritis, coxitis, tarsitis, peripheral oligoarthritis), rheumatic fibroosteitis (pelvic enthesitis, rheumatic calcaneopathy), and peri- and synchrondritis of the public symphisis and sternal synchondrosis. Since early inflammatory changes of the spinal column and of the extravertebral localizations in AS are demonstrated by MRI before they become apparent on radiographs, and thereby the diagnostic gap could be closed, the early use of MRI for diagnostic and follow-up is commendable, when new therapeutical options like the so-called 'biologicals' are employed. (orig.) [German

  1. CARDIOVASCULAR RISK IN PATIENTS WITH ANKYLOSING SPONDYLITIS: THE ROLE OF SYSTEMIC INFLAMMATION AND ENDOTHELIAL DYSFUNCTION

    Directory of Open Access Journals (Sweden)

    D. A. Poddubnyy

    2008-01-01

    Full Text Available Aim. To investigate the role of systemic inflammation and endothelial dysfunction as factors of cardiovascular risk in patients with ankylosing spondylitis.Material andMethods. 100 patients with ankylosing spondylitis were included into the study. Screening for arterial hypertension (HT and conventional cardiovascular risk factors (smoking, hyper- and dislipoproteinemia, body overweight, heredity and diabetes mellitus was performed in all patients. 10-year coronary disease risk (Framingham scale and 10-year risk of fatal cardiovascular event (SCORE scale was calculated. Additionally the follows cardiovascular risk factors were assessed: C-reactive protein level (CRP, fibrinogen level, platelet count, antithrombin III activity, plasma fibrinolytic activity, vonWillebrand factor (vWF activity, circulating endothelial cells (CEC count. Besides, endothelial functionwas evaluated by Doppler-ultrasonography of brachial artery in testswith reactive (endothelium-dependent or flow-mediated dilation and nitroglycerine (endotheliumindependent dilation hyperemia. 30 healthy patients were included into control group and were comparable with patients of studied group on sex and age.Results. 10-year coronary disease risk in patients with ankylosing spondylitis was significantly lower than this in patients of control group 4.0%(3,0; 7,5 vs 5.0%(3,0; 11,0, respectively (p<0,05. 10-year risk of fatal cardiovascular event in studied group was relatively low 1.0% (1.0; 2.0. However, analysis of the additional risk factors shown increased thrombogenic potential of blood, which was related to systemic inflammation activity: high platelets count, high fibrinogen activity, increased vWF activity, and decreased fibrinolytic activity. Moreover, signs of endothelial injury (increased level of CEC and vWF activity and endothelial dysfunction were found in patients with ankylosing spondylitis.Conclusion. Cardiovascular risk in patientswith ankylosing spondylitis estimated

  2. Bamboo spine – X-ray findings of ankylosing spondylitis revisited

    Directory of Open Access Journals (Sweden)

    Antoinette Reinders

    2012-09-01

    Full Text Available Ankylosing spondylitis is a debilitating disease that is one of the seronegative spondylarthropathies, affecting more males than females in the proportion of about 6:1 in the age group 15 - 35 years of age. Early radiographic findings include bilateral sacro-iliitis and early axial (lower lumbar spine ankylosis. Typical X-ray findings are florid spondylitis (Romanus lesions, florid diskitis (Andersson lesions, early axial ankylosis, enthesitis, syndesmophytes and insufficiency fractures. Typical radiological abnormalities are pointed out on conventional X-rays and reviewed for early diagnosis and prompt treatment of patients at risk.

  3. Discriminant validity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) in patients with non-radiographic axial spondyloarthritis and ankylosing spondylitis: a cohort study.

    Science.gov (United States)

    Kilic, Erkan; Kilic, Gamze; Akgul, Ozgur; Ozgocmen, Salih

    2015-06-01

    The aim of this study was to assess discriminant validity of Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-reactive protein (-CRP) and ASDAS-erythrocyte sedimentation rate (-ESR) and to compare with The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) as clinical tools for the measurement of disease activity in patients with non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS). Also, the cut-off values for ASDAS-CRP in nr-axSpA and AS is revisited. Patients with axSpA were recruited from Erciyes Spondyloarthritis Cohort (ESPAC) and were assessed for disease activity, quality of life and functional measures. The discriminatory ability of ASDAS-CRP and ASDAS-ESR was assessed using standardized mean differences and receiver operating characteristic (ROC) curves analysis. Optimal cut-off values for disease activity scores were calculated. Two hundred and eighty-seven patients with axSpA (nr-axSpA:132, AS:155) were included in this study. Two ASDAS versions and BASDAI had good correlations with patient's and physician's global assessment in both groups. Discriminatory ability of ASDAS-CRP, ASDAS-ESR and BASDAI were similar in patients with nr-axSpA and AS when the patients were assigned into low and high disease activity according to the ASAS partial remission, patient's and physician's global assessment scores (based on the comparison of ROC curves). ASDAS cut-off values are quite similar between groups indicating that ASDAS-CRP works similarly well in nr-axSpA and AS. The performance of ASDAS to discriminate low and high disease activity and cut-off values are quite similar in patients with AS and non-radiographic axial SpA.

  4. Predictive factors for partial remission according to the Ankylosing Spondylitis Assessment Study working group in patients with ankylosing spondylitis treated with anti-TNFα drugs

    Directory of Open Access Journals (Sweden)

    F.M. Perrotta

    2014-11-01

    Full Text Available The objective of this study was to evaluate the predictive factors for achieving partial remission (PR in patients with ankylosing spondylitis (AS treated with anti-TNFα. We longitudinally enrolled in a multi-center study 214 AS patients, classified according to New York criteria, treated with anti-TNFα drugs adalimumab (ADA, etanercept (ETA and infliximab (INF with at least 12 months of follow up. PR was reached when the score was <20 mm (on a visual analogue scale of 0-100 mm in each of the following 4 domains: 1 patient global assessment (in the last week; 2 pain (spinal pain; 3 function [measured by the bath ankylosing spondylitis functional index (BASFI]; 4 inflammation [mean of intensity and duration of morning stiffness, from the bath ankylosing spondylitis disease activity index (BASDAI]. Two hundred fourteen AS patients (M/F=160/54; median age/range=43.2/19-78 years; median disease duration/ range=96/36-189 months were treated with ADA (15.8%, ETA (28.9% and INF (55.1%. At 12 and 24 months, high serum level of C reactive protein (CRP (≥2 vs ≤0.8 mg/dL were associated with higher rate of PR in AS patients treated with anti-TNFα drugs. At 24 months, PR was associated with shorter disease duration (≤36 vs ≥189 months and higher erythrosedimentation rate (ESR values (≥45 vs ≤17 mm/h. In male patients lower bath ankylosing spondylitis metrology index (BASMI (≤2 vs ≥6 and absence of psoriasis were associated with higher PR rate only at 12 months. Other parameters assessed before treatment, such as BASDAI, BASFI, peripheral arthritis, inflammatory bowel disease and uveitis were not associated with PR. Our long-term longitudinal study in a setting of clinical practice showed that inflammatory parameters (i.e. CRP, ESR and disease duration represent the most important predictive variables to achieve PR with an anti-TNFα treatment.

  5. Scoring inflammatory activity of the spine by magnetic resonance imaging in ankylosing spondylitis: a multireader experiment

    DEFF Research Database (Denmark)

    Lukas, Cédric; Braun, Jürgen; van der Heijde, Désirée

    2007-01-01

    OBJECTIVE: Magnetic resonance imaging (MRI) of the spine is increasingly important in the assessment of inflammatory activity in clinical trials with patients with ankylosing spondylitis (AS). We investigated feasibility, inter-reader reliability, sensitivity to change, and discriminatory ability...... the Ankylosing Spondylitis spine Magnetic Resonance Imaging-activity [ASspiMRI-a, grading activity (0-6) per vertebral unit in 23 units]; the Berlin modification of the ASspiMRI-a; and the Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system, which scores the 6 vertebral units considered......) assessed by Z-scores was good and comparable among methods. CONCLUSION: This experiment demonstrates the feasibility of multiple-reader MRI scoring exercises for method comparison, provides evidence for the feasibility, reliability, sensitivity to change, and discriminatory capacity of all 3 tested scoring...

  6. The role of biomechanical factors in ankylosing spondylitis: the patient’s perspective

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    R.C. Ansell

    2016-02-01

    Full Text Available Biomechanical factors including occupational joint physical stressing and joint injury have been linked to spondyloarthritis. We explored such factors in ankylosing spondylitis (AS. A retrospective, online survey was developed alongside the UK National Ankylosing Spondylitis Society (NASS. Questions on early entheseal symptoms, potential precipitating trauma, sporting activity, and physiotherapy were asked. A total of 1026 patients responded with 44% recalling an instance of injury or trauma as a potential trigger for their AS. After symptom onset, 55% modified sporting activities and 28% reported that the initial AS recommended exercises exacerbated symptoms. Patients report physical trauma, exercise and physiotherapy as potential triggers for AS symptoms. These findings further support the experimental evidence for the role of biomechanical factors in disease.

  7. [Extreme atrophy of the shoulder muscles in juvenile ankylosing spondylitis as a (misleading) main symptom].

    Science.gov (United States)

    Berliner, M; Schmidt, K L

    1989-01-01

    An extreme unilateral muscular atrophy of the shoulder and upper arm region was a symptom of juvenile ankylosing spondylitis in a 20-year-old female patient. No pathological patterns were found in electromyographic, bioptic, and tomographic (CT, NMR) investigations. The muscular atrophy was caused by a shoulder arthritis with severe erosive damage. The false assumption of a neurological disorder and the disregard of anamnesis and low back pain delayed for several years an accurate diagnosis. After the onset of an arthritis of hip joints a collagen disease with myositis was supposed falsely in spite of normal electromyographic results. The unusual muscular atrophy around the shoulder joint probably must be interpreted as a consequence of reflex inhibition and partly due to inactivity. A real myositis seems to not be probable, because newer investigations in contrast to earlier findings show no evidence for inflammatory muscle disease in ankylosing spondylitis.

  8. MUSCLE RELAXANTS: ARE THEY NEEDED IN ANKYLOSING SPONDYLITIS?

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    T. V. Dubinina

    2016-01-01

    Full Text Available Guidelines for the treatment of ankylosing spondylitis (AS lack muscle relaxants. At the same time, the latter are used for combined therapy using nonsteroidal  anti-inflammatory drugs (NSAIDs  in 53.1% of patients in an outpatient  setting. No clear recommendations make the administration of these agents uncontrolled, on the one hand, and substantially restrict therapeutic  possibilities, on the other.Objective: to investigate the short-term effect and safety of using tolperisone hydrochloride  (THC,  Mydocalm®  in patients with AS during group therapeutic  exercise (TE.Subjects and methods. The investigation included 40 patients aged over 18 years with a valid diagnosis of AS who had been treated at the Clinic of the V.A. Nasonova Research Institute of Rheumatology and agreed to participate  in the study. All the patients were randomized  in a 1:1 ratio into two groups: 1 20 patients used NSAIDs in combination with TE; 2 20 patients received NSAIDs,  TE, and THC 450 mg/day. The groups were matched for age, gender, disease duration,  and functional impairments. Before and after completion  of the investigation, the investigators estimated BASDAI, BASFI, patient-rated numerical pain rating scale (NPRS, patient-rated TE performance  scores (NPRS, where 0 (very effective, 10 (ineffective, THC tolerance monitoring  (consideration of adverse events. Spinal motility was evaluated using BASMI and chest excursion measurement.Results and discussion. During TE, both groups showed a significant increase in the volume of movements (p < 0.03, when measuring chest excursion and carrying out modified Schober's test, a decrease in BASDAI (p < 0.01 and BASFI (p < 0.009, as well as a reduction  in patient-rated overall disease activity assessment (p < 0.02 as compared to the baseline values. At the same time the modified Schober test revealed that the increase in motility was significantly higher in Group 2 than in Group 1 (p < 0.05. During the

  9. Role of diffusion-weighted imaging in early ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    PAN Chu; HU Dao-yu; ZHANG Wei; LI Xiao-ming

    2013-01-01

    Background With the advanced MRI techniques,pathologic features can be detected at an early stage and quantitatively evaluated,resulting in the advantages of early diagnosis and prompt treatment.This study aimed to determine the value of diffusion-weighted MR imaging (DWl) in detection of early ankylosing spondylitis (AS) and investigate the characteristic manifestations of AS on whole body DWl (WB-DWl).Methods Twenty patients with the diagnosis of early AS,twenty patients with low back pain (LBP),and twenty-five healthy volunteers were included in this study.The subchondral bone apparent diffusion coefficients (ADC) among these groups in the bilateral ilia and sacrum along the sacroiliac joints were compared.An independent sample t-test was utilized to analyze ADC value differences among groups.P-values less than 0.05 denoted statistical significance.The mean ADC values of focal DWI lesions in AS patients were also measured.Whole body diffusion-weighted imaging was performed in fifteen additional AS patients,and analyzed with MIP and MPR techniques in comparison to conventional MR images in order to evaluate the ability to detect AS lesions with whole body DWI.Results Mean ADC values in AS patients were (0.518±0.122)x10-3 mm2/s in the ilium and (0.503±0.168)x10-3 mm2/s in the sacrum.These were significantly greater than the values measured in the ilium and sacrum of LBP patients,(0.328±0.053)x10-3 mm2/s in the ilium and (0.311±0.081)x10-3 m2/s in the sacrum,and control group,(0.325±0.015)x10-3 mm2/s in the ilium and (0.318±0.011)x10-3 mm2/s in the sacrum respectively.No statistically significant differences were found between LBP group and control group.The mean ADC value of focal DWI lesions in early AS patients was (0.899±0.265)x10-3 mm2/s,which was significantly higher than that of adjacent normal-appearance areas ((0.454±0.079)x103 mm2/s).WB-DWI detected abnormalities in the 15 additional AS patients both within the sacroiliac joints and at other sites

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

    OpenAIRE

    Fernanda Genre; Raquel López-Mejías; Miranda-Filloy, José A.; Begoña Ubilla; Beatriz Carnero-López; Ricardo Blanco; Trinitario Pina; Carlos González-Juanatey; Javier Llorca; González-Gay, Miguel A.

    2014-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease associated with accelerated atherosclerosis and increased risk of cardiovascular (CV) disease. AS patients also display a high prevalence of features clustered under the name of metabolic syndrome (MeS). Anti-TNF- α therapy was found to be effective to treat AS patients by suppressing inflammation and also improving endothelial function. Previously, it was demonstrated that a short infusion of anti-TNF- α monoclonal antib...

  11. Cardiac Autonomic Function in Patients With Ankylosing Spondylitis: A Case-Control Study.

    Science.gov (United States)

    Wei, Cheng-Yu; Kung, Woon-Man; Chou, Yi-Sheng; Wang, Yao-Chin; Tai, Hsu-Chih; Wei, James Cheng-Chung

    2016-05-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease involing spine and enthesis. The primary aim of this study is to investigate the autonomic nervous system (ANS) function and the association between ANS and the functional status or disease activity in AS.The study included 42 AS patients, all fulfilling the modified New York criteria. All the patients are totally symptom free for ANS involvement and had normal neurological findings. These AS patients and 230 healthy volunteers receive analysis of 5 minutes heart rate variability (HRV) in lying posture. In addition, disease activity and functional status of these AS patients are assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Global Score (BAS-G).Both groups were age and sex-matched. Although the HRV analysis indicates that the peaks of total power (TP, 0-0.5 Hz) and high-frequency power (HF, 0.15-0.40 Hz) are similar in both groups, the activities of low-frequency power (LF, 0.04-0.15 Hz), LF in normalized units (LF%), and the ratio of LF to HF (LF/HF) in AS patients are obviously lower than healthy controls. The erythrocyte sedimentation rate and C-reactive protein revealed negative relationship with HF. The AS patients without peripheral joint disease have higher LF, TP, variance, LF%, and HF than the patients with peripheral joint disease. The AS patients without uvetis have higher HF than the patients with uvetis. The total scores of BASDI, BASFI, and BAS-G do not show any association to HRV parameters.AS patients have significantly abnormal cardiac autonomic regulation. This is closely related with some inflammatory activities. Reduced autonomic function may be one of the factors of high cardiovascular risk in AS patients.

  12. Successful management of a cervical fracture in a patient with ankylosing spondylitis by a posterior approach

    Directory of Open Access Journals (Sweden)

    Neeraj Patni

    2015-01-01

    Full Text Available Patients with ankylosing spondylitis (AS are at an increased risk of spinal fractures due to the altered spinal biomechanics. Moreover, it is difficult to treat these fractures due to the combination of ankylosis and osteoporosis. We report successful management of a C6-C7 vertebral fracture in a patient with AS. The patient improved in his neurological status and a good fusion was seen at a follow-up of 24 months.

  13. Cerebral magnetic resonance imaging in a patient with ankylosing spondylitis and multiple sclerosis-like syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Cellerini, M.; Gabbrielli, S. [Neuroradiology Unit, Trauma Center (CTO), Careggi Hospital, Florence (Italy); Bongi, S.M. [Section of Rheumatology, Univ. of Florence (Italy)

    2001-12-01

    Clinical and cerebral magnetic resonance imaging (MRI) findings in a patient with ankylosing spondylitis (AS) and multiple sclerosis-like (MS-like) syndrome are reported. Cerebral MRI demonstrated multiple, MS-like, scattered foci of signal abnormality, one of which showed contrast enhancement. Lesion dissemination in ''space and time'' is a hallmark for diagnosis of MS, and its demonstration by enhanced cerebral MRI prompted suspicion of coexistence of MS and AS in our patient. (orig.)

  14. Expression of IL-2 and IL-11 and its significance in patients with ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    Feng Liu; Fan Wang; Cong-Cong Wang; Nuo Li; Shu-Feng Li

    2013-01-01

    Objective: To explore the expression of IL-2 and IL-11 and its significance in patients with ankylosing spondylitis (AS). Methods: A total of 48 active AS patients in our hospital and 40 normal control subjects were selected in our study. Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), Bath ankylosing spondylitis metrology index (BASMI), ESR and CRP expression levels were compared before treatment, 12 h after treatment and 24 h after treatment. IL-2 and IL-11 expression were also compared between these two groups. Results: The BASDAI score, BASFI score and BASMI score of the AS patients before treatment significantly decreased compared with those 12 weeks and 24 weeks after treatment (P0.05). Pearson's linear-correlation analysis showed that serum IL-2 level had a positive correlation with BASDAI, BASFI, BASMI, ESR and CRP (r=0.661,0.547,0.474,0.362,0.416, P<0.05) and serum IL-11 level had a negative correlation with BASDAI, BASFI, BASMI, ESR and CRP (r=-0.629,-0.412, -0.422, -0.387, -0.408, -0.315, P<0.05). Conclusions: Serum levels of IL-2 in active AS patients significantly increase and will decrease after treatment. However, serum levels of IL-11 significantly decrease and will increase after treatment, which indicates that serum IL-2 has a positive correlation with the degree of AS and serum IL-11 has a negative correlation with the degree of AS, both of which are correlated closely with the onset of AS.

  15. Prospects for the use of celecoxib in patients with ankylosing spondylitis: impact on retarding disease progression

    Directory of Open Access Journals (Sweden)

    Yulia Leonidovna Korsakova

    2012-01-01

    Full Text Available Ankylosing spondylitis (AS is one of the major inflammatory diseases that affect the vertebral column and joints. The first-line drugs for the treatment of this disease are now nonsteroidal anti-inflammatory drugs (NSAIDs that not only reduce painful sensations and rigidity, but also retard the radiological progression of AS. Celecoxib is one of the effective and safe NDAIDs that are promising for the treatment of AS.

  16. Double level Chance-type fractures of spine in ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    Gauresh Shantaram Vargaonkar; Varun Kumar Singh; Abhishek Kashyap; Ramesh Kumar

    2014-01-01

    Chance fractures are usually associated with seat belt injuries. Mechanism is always related to flexion-distraction at vertebral level. Double level Chance-type fractures have rarely been reported in published literature. We presented such a fracture at D10 and L3 level in a 38-year-old patient with ankylosing spondylitis. Management was done with posterior decompression and short segment fixation separately.

  17. TUMOR NECROSIS FACTOR-α INHIBITORS IN THE TREATMENT OF AXIAL SPONDYLOARTHRITIS, INCLUDING ANKYLOSING SPONDYLITIS

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    S. A. Lapshina

    2016-01-01

    Full Text Available The paper provides guidelines for the use of tumor necrosis factor-α  (TNF-α inhibitors in the treatment of patients with axial spondyloarthritis  (axSpA, including ankylosing spondylitis. It gives data on the efficacy of TNF-α inhibitors in patients with non-radiographic axSpA. By using international and Russian guidelines, the authors lay down indications for this therapy and criteria for evaluation of its efficiency and safety.

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

    OpenAIRE

    Masi, Alfonse T.

    2014-01-01

    Ankylosing spondylitis and axial spondyloarthropathy have characteristic age- and sex-specific onset patterns, typical entheseal lesions, and marked heritability, but the integrative mechanisms causing the pathophysiological and structural alterations remain largely undefined. Myofascial tissues are integrated in the body into webs and networks which permit transmission of passive and active tensional forces that provide stabilizing support and help to control movements. Axial myofascial hype...

  19. Odontoid pannus formation in a patient with ankylosing spondylitis causing atlanto-axial instability.

    Science.gov (United States)

    Rajak, Rizwan; Wardle, Phil; Rhys-Dillon, Ceril; Martin, James C

    2012-02-25

    Ankylosing spondylitis is one of the commonest inflammatory diseases of the axial skeleton and can be complicated by atlanto-axial instability. This serious and likely underestimated complication can be easily overlooked. However, there are clear features which can help alert suspicion to initiate the appropriate investigations with imaging that is very effective at diagnosing and assessing this complication. The authors report an unusual case where odontoid pannus formation, akin to that seen in rheumatoid arthritis, was the underlying cause.

  20. Odontoid pannus formation in a patient with ankylosing spondylitis causing atlanto-axial instability

    OpenAIRE

    Rajak, Rizwan; Wardle, Phil; Rhys-Dillon, Ceril; Martin, James C.

    2012-01-01

    Ankylosing spondylitis is one of the commonest inflammatory diseases of the axial skeleton and can be complicated by atlanto-axial instability. This serious and likely underestimated complication can be easily overlooked. However, there are clear features which can help alert suspicion to initiate the appropriate investigations with imaging that is very effective at diagnosing and assessing this complication. The authors report an unusual case where odontoid pannus formation, akin to that see...

  1. Clinical effect analysis of ankylosing spondylitis treated by Chinese medical syndrome differentiation

    Institute of Scientific and Technical Information of China (English)

    冯兴华

    2013-01-01

    Objective To evaluate the curative effect and safety of Bushen Qiangji Decoction (BQD) and Qingre Qiangji Decoction (QQD) in treating ankylosing spondylitis (AS) patients,and to verify the clinical utility of AS syndrome differentiation and treatment scheme[Shen-deficiency induced stasis obstruction syndrome (SDISOS) and dampness-heat obstruction syndrome (DHOS) being two basic syndrome types,Shen invigorating blood activating method (SIBAM) and heat clearing dampness resolving meth-

  2. Splenic tuberculosis in a patient with ankylosing spondylitis treated with adalimumab

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    M. Fernandes

    2011-11-01

    Full Text Available We present a rare case of splenic tuberculosis in a 42-year old man with long-standing ankylosing spondylitis treated with adalimumab. We review the association between antitumor necrosis factor therapy and splenic tuberculosis. Our case, like many other reported cases, illustrates that the index of suspicion of tuberculosis in patients treated with anti TNF therapies must be high and emphasizes that this rare infection may occur even with negative tuberculosis screening before the initiation of therapy.

  3. The role of MRI in early ankylosing spondylitis: emphasis on the sacroiliac and hip joints

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chul Min; Kang, Moo Song; Kim, Chang Soo; Chung, Chun Phil [Maryknoll Hospital, Busan (Korea, Republic of)

    1995-05-15

    In clinically suspected ankylosing spondylitis of sacroiliac (SIJ) and hip joints with normal or minimal secondary bone change in simple X-ray films, we evaluated the role of MRI in sacroiliac and hip joints. Authors evaluated 11 cases (36 joints; SIJ 14 hip 22) confirmed as ankylosing spondylitis by clinical, laboratory, and radiologic findings, and compared the detectability of involvement of joints by simple X-ray film and MRI. Authors analysed MR findings for the presence of pannus and its signal intensities (SI), change of articular cartilage, bony erosion and sclerosis, subchondral bone cysts, osteophytosis, bone marrow edema, joint effusion, adjacent soft tissue change, and contrast enhancement of pannus. MRI detected not only 20 joints (SIJ 11, hip 9) detected in simple X-ray, but also additional 7 joints (SIJ 3, hip 4). MRI depicted simultaneous involvement of SIJ and hip joints in 5 of 11 cases (SIJ 10 joints, hip 9 joints), and bilateral involvement of SIJ and hip joints in 4 among the 5 cases. MRI also demonstrated pannus, which were not detected in conventional films, as intermediate SI on T1WI and high SI on T2WI, in all 27 joints (SIJ 14, hip 13). Gd-DTPA enhanced T1WI revealed enhancement of pannus in 7 cases (17 joints). MRI was a valuable modality in evaluation of clinically suspected ankylosing spondylitis of SIJ or hip joints with normal or minimal secondary bone change in simple X-ray. Simultaneous evaluation of SIJ and hip joints is suggested in clinically suspected ankylosing spondylitis or other joint diseases.

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

    Science.gov (United States)

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

    2013-03-01

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

  5. Anxiety and depression correlate with disease and quality-of-life parameters in Chinese patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Xu X

    2016-05-01

    Full Text Available Xujuan Xu,1,* Biyu Shen,2,3,* Aixian Zhang,4 Jingwei Liu,3 Zhanyun Da,4 Hong Liu,4 Zhifeng Gu4 1Department of Nursing, Affiliated Hospital of Nantong University, 2School of Nursing, Nantong University, 3Department of Nursing, The Second Affiliated Hospital of Nantong University, 4Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong, People’s Republic of China *These authors contributed equally to this work Aim: To evaluate the relationship between mental and physical health in Chinese patients with ankylosing spondylitis (AS and to identify the predictors of psychological status.Methods: Patients with AS (n=103 and healthy controls (n=121 were surveyed between 2010 and 2011 (cross-sectional study. The Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, pain visual analog scale, Health Assessment Questionnaire, revised Self-Rating Anxiety Scale, revised Self-Rating Depression Scale, and Short-Form 36 questionnaire were administered.Results: The frequency of anxiety and depression in patients with AS was higher than that in healthy controls (P<0.001. Severe disease status and reduced quality of life (QoL were associated with anxiety and depression. Disease activity and somatic pain were more severe in the anxious and depressed subgroups. Impaired physical functioning (assessed by Bath Ankylosing Spondylitis Functional Index was higher in the anxious and depressed subgroups, while measures of spinal mobility (assessed by Bath Ankylosing Spondylitis Metrology Index were not associated with depression. Lower QoL was observed in the depressed subgroup.Conclusion: Low socioeconomic status, lack of health insurance, and fatigue contributed to depression in Chinese patients with AS. These patients may require a psychological care approach that is different from those of other countries. Keywords: ankylosing spondylitis, disease activity

  6. Long-term clinical investigation of patients with ankylosing spondylitis treated with /sup 224/Ra

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, E. (Universitatsklinik Friedrichsheim, Frankfurt, West Germany); Ruckbeil, C.; Wick, R.R.

    1983-01-01

    Between 1952 and 1980 about 250 patients with ankylosing spondylitis were treated with /sup 224/Ra at the Orthopaedic University Hospital of Frankfurt/M. In 1970, 119 of them were examined and X-rayed as was another group of 40 patients in 1980. The results of those examined could be compared with a group of 40 patients treated without /sup 224/Ra. Patients with /sup 224/Ra demonstrated a long-lasting period of subjective improvement after the treatment, with reduced consumption of antirheumatoid and analgesic drugs, on the average. Blood examinations show inflammatory activities. Nevertheless, the ankylosing spondylitis proceeded. In the final stages of the disease, neither the clinical aspects nor the X-rays showed any specific changes. We observed no case of malignant bone tumor. Of the 169 examined patients, 22 had a total of 32 children after the treatment with /sup 224/Ra. Among these was a set of twins with cerebral palsy and diabetes insipidus renalis. In conclusion, /sup 224/Ra in ankylosing spondylitis is a recommended treatment without higher risk compared to the common therapy with drugs.

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

    Science.gov (United States)

    Shiue, Ivy

    2015-01-01

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

  8. Traditional Chinese medicine in the treatment of ankylosing spondylitis%强直性脊柱炎的中医药治疗现状

    Institute of Scientific and Technical Information of China (English)

    佟泰鹏; 傅立新

    2014-01-01

    The etiology and pathogenesis of ankylosing spondylitis are not clearly understood. There are still many problems in clinical practice. The acupuncture treatment of ankylosing spondylitis is quite distinctive. This study retrieved relevant literatures of treatment for ankylosing spondylitis using acupuncture and moxibustion,and acupuncture combined with Western medicine,fire needle,massage, Chinese medicine fumigation techniques. The relevant data were analyzed,and the relevant information was systematic reviewed. The effectiveness of acupuncture treatment for ankylosing spondylitis was comprehensively analyzed,exploring the mechanism of therapeutic efficacy. Results suggest that there was smaller number of randomized,controlled trials. This study provides an objective reference for conducting high-quality of acupuncture treatment for this disease.%强直性脊柱炎病因及发病机制尚未完全了解,临床治疗仍有很多难题。中医针灸治疗该症特点较突出,检索针灸及针灸结合西药、火针、推拿、中药熏蒸等手法综合治疗强直性脊柱炎的文献,分析数据并对相关信息进行系统评价,综合分析针灸治疗该症的有效性和科学性,探究其治疗有效性的机制。发现这类文献随机对照试验病例数少,质量不高,为开展高质量针刺治疗该症临床研究提供客观参考依据。

  9. Prevalence of osteoporosis and vertebral fractures and related factors in patients with ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    Mehmet Ali Ulu; (I)brahim Batmaz; Banu Dilek; Remzi (C)evik

    2014-01-01

    Background Osteoporosis and vertebral factures are well recognized features in patients with ankylosing spondylitis (AS).The aim of this study was to investigate the prevalence and risk factors of osteoporosis and vertebral fractures in patients with AS.Methods Fifty-nine AS patients and 40 healthy controls were enrolled.Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry (DEXA) at posterior-anterior (PA) lumbar,lateral lumbar and hip regions.Thoracic and lumbar X-rays were obtained for morphometric measurements.Clinical,biological and radiological statuses were evaluated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI),Bath Ankylosing Spondylitis Metrology Index (BASMI),Bath Ankylosing Spondylitis Functional Index (BASFI),Bath Ankylosing Spondylitis Radiology Index-total (BASRI-t),erythrocyte sedimentation rate (ESR) and the C-reactive protein levels.Results Osteoporosis was present in 32% of patients and 5% of controls according to lateral vertebral BMD measurements.Fracture was present in 31% of patients.The effect of some clinical and laboratory parameters on BMD status and vertebral fractures was analyzed in the patient group.Osteoporosis in lateral lumbar DEXA was associated with higher BASMI,BASFI,BASRI-t scores and ESR level.Low hip BMD was associated with low BMI and high BASFI and BASRI-t scores.Vertebral fractures were associated with advanced age,longer disease duration,longer duration since diagnosis,higher BASMI and BASRI-t scores,higher ESR level,reduced femoral and lateral lumbar BMD.Logistic regression analysis revealed that only BASRI-t score was significantly associated with low lateral spinal BMD and BMI and BASFI score were independently associated with low hip BMD.The presence of compression fractures was independently associated with BASRI-t score and low lateral lumbar BMD.Conclusions Osteoporosis and vertebral fractures in AS seem to be related to the extent of radiological involvement.A low

  10. Validation of the Italian versions of the Bath Ankylosing Spondylitis Functional Index (BASFI and the Dougados Functional Index (DFI in patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    W. Grassi

    2011-09-01

    Full Text Available Objectives: The Bath Ankylosing Spondylitis Functional Index (BASFI and the Dougados Functional Index (DFI are the most commonly used instruments to measure functioning in ankylosing spondylitis (AS. The aim of this study was to translate, adapt and validate these instruments into the Italian language. Methods: The BASFI and DFI questionnaires were translated into Italian by two independent bilingual physicians who were familiar with the medical aspects of AS and by one professional translator. Two rheumatologists familiar with instrument validation, and who were aware of the purpose of the study, examined semantic, idiomatic and conceptual issues and produced by consensus unified versions of each instrument. English back-translations from the Italian were done by a professional translator unaware of the original version. Both English versions were compared, and where needed, modifications to the Italian versions were made. Results: A total of 95 patients were included: 77 males, age (mean±SD 47.9±9.3years, and disease duration 12.4±6.6 years, and 18 females, age 45.9±8.7 years, and disease duration 11.3±8.2 years. Reliability, measured in 23 patients participating a physiotherapy program, showed an acceptable one-week test-retest intraclass correlation coefficient (ICC - BASFI ICC: 0.91, 95% CI: 0,87-0.94 and DFI ICC: 0.86, 95% CI: 0.83-0.90. The internal consistency was 0.90 (Cronbach’s alpha for the BASFI and 0.87 for the DFI. For validity the functional indices were correlated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, Bath Ankylosing Spondylitis Metrology Index (BASMI, Bath Ankylosing Spondylitis Patient Global Score (BAS-G, modified Health Assesment Questionnaire (HAQ-S, SF-36 physical component summary (SF-36 PCS, stiffness, pain, physician’s assessment of disease activity, Bath AS Radiology Index-total (BASRI-t, erythrocyte sedimentation rate (ESR, and C-reactive protein (CRP. The functional indices

  11. Identification of potential transcriptomic markers in developing ankylosing spondylitis: a meta-analysis of gene expression profiles.

    Science.gov (United States)

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

    2015-01-01

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

  12. Treatment efficacy of etanercept and MTX combination therapy for ankylosing spondylitis hip joint lesion in Chinese population.

    Science.gov (United States)

    Lian, Fan; Yang, Xiuyan; Liang, Liuqin; Xu, Hanshi; Zhan, Zhongping; Qiu, Qian; Ye, Yujin

    2012-06-01

    To investigate the efficacy of etanercept and MTX (methotrexate) combination therapy in Chinese patients with ankylosing spondylitis hip joint lesion, the possible courses and maintenance protocol, altogether 97 ankylosing spondylitis patients fulfilling the modified New York criteria with hip joint lesion were enrolled in a 12-month trial treated with combined etanercept and MTX. All these patients were required to be poor responders to SSZ (Sulfasalazine) or MTX therapy for 6 consecutive months or the longer. Etanercept was administered subcutaneously twice a week at a fixed dosage of 25 mg for the first six months, followed by 25 mg once a week in patients with good control of both symptoms and radiological progression, or twice a week for another six months in patients with BASDAI > or = 4. Combined MTX was administered intravenously once a week at the dosage of 15 mg. Demographics, clinical and laboratory features, physical function and quality of life using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), Harris hip score, and radiological assessment using the BASRI-hip index were recorded. Most patients achieved pain release at the end point of assessment. Significant improvement in Bath AS Disease Activity Index (BASDAI) (P therapy was beneficial to ankylosing spondylitis patients with hip joint lesion, and staged dosage deduction in the long term proved to be effective as well as adverse event preventing.

  13. Assessment of functional disability and quality of life in patients with ankylosing spondylitis

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    Mustur Dušan

    2009-01-01

    Full Text Available Introduction Ankylosing spondylitis is a chronic progressive autoimmune inflammatory disorder involving mainly the axial skeleton and larger peripheral joints that progressively limits spinal mobility and may lead to irreversible structural changes and consequently to impaired physical function and reduced quality of life. Objective The aim of this study was to assess functional disability and quality of life of patients with ankylosing spondylitis and determine the correlation between functional disability and quality of life. Methods The study enrolled 74 patients with ankylosing spondylitis (16 females and 58 males. The demographic data of the patients were collected. Functional disability was assessed with the Bath Ankylosing Functional Index (BASFI. Quality of life was assessed by the Short-Form 36 (SF-36 and the European Quality of Life Questionnaire (EuroQoL/EQ-5D. Results In our study, the mean age was 48.5±10.3 years. BASFI was negatively correlated with the SF-36 physical function subscale (p<0.001, physical role (p=0.002, bodily pain (p=0.003, general health (p<0.001, vitality (p=0.012 and mental health (p=0.010 subscale. There was a significantly inverse correlation between the BASFI score and the rating scale of EQ-5D (p=0.001. In the regression model, the BASFI score (p=0.000 showed an independent association with the physical function domain of SF-36. Conclusion In conclusion, the BASFI index was associated with physical function, physical role, bodily pain, general health, vitality and mental health domains of SF-36 and also with the rating scale of EQ-5D.

  14. Assessment of Cardiac Functional Alterations of Ankylosing Spondylitis Patients without Cardiovascular Risk Factors

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    Alper Kepez

    2013-08-01

    Full Text Available Introduction: The aim of this study is to evaluate cardiac functional alterations of ankylosing spondylitis patients without any cardiovascular risk factors.Patients and Methods: Thirty seven consecutive akylosing spondylitis patients without any cardiovascular risk factors constituted our study patient population (age: 41.4 ± 11.1 years, 28 male. Electrocardiographs (ECG of all patients were obtained and all patients underwent comprehensive transthoracic echocardiographic examination. QRS durations, p wave dispersion and corrected QT dispersion (QTcd values were calculated from 12-lead ECG’s. Data reflecting left ventricular systolic and diastolic functions were obtained from echocardiographic examinations. Data of patients were compared with the data of 28 age-and gender matched healthy control subjects (age: 40.1 ± 10.5 years, 19 male.Results: There were no significant differences between patients and controls regarding QRS durations, p wave dispersion and QTcd values. There were also no significant differences between patients and controls regarding parameters reflecting left ventricular systolic and diastolic functions. Annular velocities at mitral and tricuspid annulus levels evaluated with pulsed-wave tissue Doppler imaging were also similar as well. Two (7.2% subjects in the control group and 2 (5.4% patients in the akylosing spondylitis group had minimal aortic regurgitation (p= 0.51. Conclusion: We could not demonstrate any electrocardiographic or echocardiographic evidence of structural myocardial alterations in a small sample of akylosing spondylitis patients free of cardiovascular risk factors. Effects of frequently encountered co-existent cardiovascular risk factors of ankylosing spondylitis patients might have contributed to the conflicting literature data related with this topic.

  15. Review of the costs of illness of ankylosing spondylitis and methodologic notes.

    Science.gov (United States)

    Boonen, Annelies; van der Heijde, Désirée

    2005-04-01

    This article reviews the cost of illness of ankylosing spondylitis in the literature and identifies limitations of comparability of cost of illness studies. The literature was searched semisystematically for studies that aimed to assess the cost of illness of ankylosing spondylitis from the societal perspective. Studies were appraised for methods and results following a self-composed checklist. To compare the aggregated costs between the studies, adjustments for differential timing and purchasing power parities between the countries were applied. In total, 53 titles were retrieved by a MEDLINE search. Five articles reported on the costs of illness in four patient populations, one from the USA and three from Europe. All studies were prevalence studies with a bottom-up approach and reported direct and productivity costs. Patient characteristics differed with respect to sampling source, age, disease duration, presence of spondylitis-related comorbidity and employment status. Categories of resource use and costs were especially difficult to compare with regard to visits to types of healthcare providers and use of formal and informal help in relation to inability to perform unpaid work. In addition, not all studies reported the productivity costs based on human capital as well as the friction cost method. The cost per unit of resource use was only provided explicitly in one publication. Sensitivity analyses were usually not performed. Total 2002 costs based on the human capital approach varied between USD 7243 and 11,840, and productivity costs accounted for 53-73% of the total costs. Total 2002 costs based on the friction costs varied between USD 3353 and 3903, and productivity costs accounted for 15-26% of the total costs. Cost drivers of the direct costs varied among the studies. Physical functioning and/or disease activity were consistent determinants of total costs. In conclusion, between four bottom-up prevalence studies in ankylosing spondylitis from different

  16. Association between arterial stiffness, disease activity and functional impairment in ankylosing spondylitis patients: a cross-sectional study.

    Science.gov (United States)

    Avram, Claudiu; Drăgoi, Răzvan Gabriel; Popoviciu, Horațiu; Drăgoi, Mihai; Avram, Adina; Amaricăi, Elena

    2016-08-01

    Cardiovascular risk is an important factor for increased morbidity and mortality in patients with ankylosing spondylitis. The aim of this study is to assess arterial stiffness in relation to the disease activity and functional limitation in patients with ankylosing spondylitis. Twenty-four patients (mean age 45.8 ± 11.7 years) suffering of ankylosing spondylitis (disease duration 11.1 ± 5.1 years) and 24 gender and age-matched healthy controls were included in the study. Clinical, biological, and functional status of ankylosing spondylitis patients was recorded. Arterial stiffness was assessed by measuring pulse wave velocity (PWV) and pulse wave analysis (PWA) was performed using applanation tonometry. We found significant differences between ankylosing spondylitis patients and healthy controls in regard to PWV (p = 0.047), aortic augmentation pressure-AP (p = 0.028), augmentation index-AIx (p = 0.038) and aortic augmentation index adjusted for heart rate-AIx75 (p = 0.011). PWV and AIx75 were significantly associated with the disease functioning score-BASFI (p = 0.012, r = 0.504; p = 0.041, r = 0.421). Aortic AP and augmentation indexes (AIx and AIx75) were all associated to ASDAS score (p = 0.028, r = 0.448; p = 0.005, r = 0.549; p = 0.025, r = 0.455). Our study showed that ankylosing spondylitis patients have a higher arterial stiffness than the age-matched controls, leading to an increased cardiovascular risk. We found that arterial stiffness is positively associated with disease activity and functional impairment. Chronic spondiloarthropaties should be screened for arterial stiffness, even in the absence of traditional cardiovascular risk factors, in order to benefit from primary prevention measures.

  17. Airway management in a patient of ankylosing spondylitis with traumatic cervical spine injury

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    Nilesh Kumar

    2015-01-01

    Full Text Available Traumatic cervical lesions compressing the spinal cord pose a significant risk of exacerbating the existing neurological condition during tracheal intubation and subsequent positioning. Preexisting ankylosing spondylitis with spinal column involvement renders the spinal column more rigid and introduces difficulty in airway management of the patient with traumatic cervical spinal cord. To improve ease and success, and reduce cervical spine movement, awake fibreoptic intubation (FOI is considered the gold standard technique for airway management in such cases. Attaining appropriate position for intubation was challenge in this case due to rigid curvature of the ankylosed spinal column. To prevent neurological injury to the spinal cord and preserve spinal cord function, minimizing movement during intubation and attaining appropriate position was of prime concern. Optimal sedation with self-positioning by the patient in a comfortable posture is quite imperative and assures both airway as well as neurological protection in such expected difficult situations. We report the use of dexmedetomidine for self-positioning and awake FOI in a patient with ankylosing spondylitis having traumatic cervical spine who was otherwise neither able to co-operative nor able to give appropriate position for FOI.

  18. Evaluation of the effects of Global Postural Reeducation in patients with ankylosing spondylitis.

    Science.gov (United States)

    Silva, Eliane Maria; Andrade, Sandra C; Vilar, Maria J

    2012-07-01

    The objective of this study is to assess the effects of Global Postural Reeducation (GPR) in patients with ankylosing spondylitis and compare GPR with group conventional segmental self-stretching and breathing exercises. This is a controlled interventional study of 38 patients divided into 2 groups: a GPR group (n = 22) and a control group (n = 16). Both groups were treated for more than 4 months. With the GPR group patients, positions that stretched the shortened muscle chains were used. With the control group patients, conventional segmental self-stretching and breathing exercises were performed. The variables analyzed were pain intensity, morning stiffness, spine mobility, chest expansion, functional capacity (Health Assessment Questionnaire-Spondyloarthropathies-HAQ-S), quality of life (Medical Outcome Study Short Form 36 Healthy Survey-SF-36), and disease activity (Bath Ankylosing Spondylitis Disease Activity Index-BASDAI). Statistical analysis was used with a significance level of P < 0.05. There was a statistically significant improvement for all the parameters analyzed between pre-and post-treatment in both groups. In the intergroup comparison, the GPR group showed a significantly greater improvement in morning stiffness (P = 0.013), spine mobility parameters, except finger-floor distance (P = 0.118), in chest expansion (P = 0.028), and in the physical aspect component of the SF-36 (P = 0.001). The results of this study showed that individual treatment with GPR (overall stretching) seems to have better clinical outcomes than group treatment with conventional segmental self-stretching and breathing exercises for patients with ankylosing spondylitis.

  19. Effects of balneotherapy on the reactants of acute inflammation phase in Ankylosing spondylitis

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    Stamenković Bojana

    2009-01-01

    Full Text Available Introduction. Ankylosing spondylitis (AS is a chronic inflammatory disease that affects sacroiliac joints, spinal column and peripheral joints. Beside medication therapy, physical and balneotherapy play an important role in its complex treatment. Objective. The aim of the research was to establish serum concentrations of C-reactive protein (CRP, α 1-acid glycoprotein (α 1-AGP, ceruloplasmine (CP and erythrocyte sedimentation rate (SE before and after the balneotherapy in ankylosing spondylitis. Methods. The research included 50 AS patients according to the revised New York criteria, of mean age 43 years, who were treated for 14 days on the average at the Clinic for Rheumatology of the Institute 'Niška Banja'. All the patients received medications and balneotherapy (radioactive oligomineral baths, peloid, massage, kinesitherapy; the serum concentrations of CRP, α1-AGP, CP and SE were measured before and after balneotherapy. Serum proteins were determined using original Nor Partigen plates Boehringer. Erythrocyte sedimentation rate was measured by Westergreen method. Balneotherapy was applied individually, intensively or mildly, depending on the AS stage and activity phase. Results. After dosed balneotherapy, a significant decrease in the concentrations of CP (p<0.05, α1-AGP (p<0.01 and CRP (p<0.05 was registered in the serums of AS patients. ESR was not significantly reduced. Conclusion. The research proved that α 1-acid glycoprotein, ceruloplasmine and C-reactive protein represent more sensitive inflammation markers as compared to erythrocyte sedimentation rate. The identification of acute phase reactants is important in the evaluation of dosed balneotherapy efficiency in the treatment of ankylosing spondylitis.

  20. Indirect and direct costs of treating patients with ankylosing spondylitis in the Brazilian public health system

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    Valderilio Feijó Azevedo

    2016-04-01

    Full Text Available ABSTRACT Introduction: Patients with Ankylosing Spondylitis (AS require a team approach from multiple professionals, various treatment modalities for continuous periods of time, and can lead to the loss of labour capacity in a young population. So, it is necessary to measure its socio-economic impact. Objectives: To describe the use of public resources to treat AS in a tertiary hospital after the use of biological medications was approved for treating spondyloarthritis in the Health Public System, establishing approximate values for the direct and indirect costs of treating this illness in Brazil. Material and methods: 93 patients selected from the ambulatory spondyloarthritis clinic at the Hospital de Clínicas of the Federal University of Paraná between September 2011 and September 2012 had their direct costs indirect treatment costs estimation. Results: 70 patients (75.28% were male and 23 (24.72% female. The mean age was 43.95 years. The disease duration was calculated based on the age of diagnosis and the mean was 8.92 years (standard deviation: 7.32; 63.44% were using anti-TNF drugs. Comparing male and female patients the mean BASDAI was 4.64 and 5.49 while the mean BASFI was 5.03 and 6.35 respectively. Conclusions: The Brazilian public health system's spending related to ankylosing spondylitis has increased in recent years. An important part of these costs is due to the introduction of new, more expensive health technologies, as in the case of nuclear magnetic resonance and, mainly, the incorporation of anti-TNF therapy into the therapeutic arsenal. The mean annual direct and indirect cost to the Brazilian public health system to treat a patient with ankylosing spondylitis, according to our findings, is US$ 23,183.56.

  1. TREATMENT OF ANKYLOSING SPONDYLITIS BASED ON ALLOPATHIC AND AYURVEDIC SYSTEM OF MEDICINE

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    A.KRISHNA SAILAJA

    2015-01-01

    Full Text Available Ankylosing spondylitis previously known as Bechterew's disease and Marie-Strümpell disease. It is a chronic inflammatory disease of the axial skeleton with variable involvement of peripheral joints and nonarticular structures. AS is a form of spondyloarthritis, a chronic, inflammatory arthritis where immune mechanisms are thought to play a key role. It mainly affects joints in the spine and the sacroiliac joint in the pelvis and can cause eventual fusion of the spine. The treatment of ankylosing spondylitis typically involves the use of medications to reduce inflammation, suppress immunity to stop progression of the disease, physical therapy, and exercise. Medications decrease inflammation in the spine and other joints. Physical therapy and exercise help to improve posture, spine mobility, and lung capacity. Ayurveda offers excellent therapies for treating Ankylosing spondylitis. The treatment comprises of a series of purification procedures for Detoxification through world renowned Ayurveda Panchakarma therapies along with the administration of researched medicines internally In these article treatment strategies for western system of medicine and Indian system of medicine was explained in detail. The main mechanisms involved in treating the conditions such as fever, back pain, swelling at various joints, stiffness in neck and back bone was explained. Different medicines used for the treatment of symptoms and their mechanism of action was explained properly. Strict diet restrictions along with life style modification are essential parts of the therapy. Following the diet as advised not only helps in recovering fast but also in prevents further worsening of the condition. The importance of diet in treating the condition was also explained.

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

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    Stephanie Hennigan

    2008-07-01

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

  3. Effectiveness of ultrasound treatment applied with exercise therapy on patients with ankylosing spondylitis: a double-blind, randomized, placebo-controlled trial.

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    Şilte Karamanlioğlu, Duygu; Aktas, Ilknur; Ozkan, Feyza Unlu; Kaysin, Meryem; Girgin, Nuray

    2016-05-01

    The aim of our study was to evaluate effectiveness of ultrasound treatment applied with exercise therapy in patients with ankylosing spondylitis. Fifty-two patients, who were diagnosed according to modified New York criteria, were aged 25-60, and have spine pain, were randomly assigned to two groups. Ultrasound (US) and exercise therapy were applied to treatment group (27); placebo US treatment and exercise therapy were applied to control group (25). Patients were evaluated before treatment, at the end of treatment, and 4 weeks after the treatment. Daily and night pain, morning stiffness, patient global assessment (PGA), doctor global assessment (DGA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, Ankylosing Spondylitis Disease Activity Score (ASDAS) erythrocyte sedimentation rate (ESR), and ASDAS C-reactive protein (CRP) were used as clinical parameters. In US group, all parameters showed significant improvements at 2 and 6 weeks, in comparison with the baseline. In placebo US group, significant improvement was obtained for all parameters (except tragus-to-wall distance and modified Schober test at 2 weeks and lumbar side flexion and modified Schober test at 6 weeks). Comparison of the groups showed significantly superior results of US group for parameters of BASMI (p ankylosing spondylitis.

  4. Chronic Liver Failure after Treatment with Infliximab for Ankylosing Spondylitis in a Patient with Hepatitis B

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    A 50-year-old man with ankylosing spondylitis was treated successfully with inlfiximab, who was also a HBV carrier for about twenty-ifve years. After injection with inlfiximab for four times, he developed jaundice and HBV DNA was detectable in serum. Serum aminotransferase and total bilirubin levels were higher than normal. Then he was hospitalized and treated with entacavir and Chinese herb medicine. But his liver damage aggravated and was diagnosed as acute on chronic liver failure. Finally, liver transplantation was carried out and he was cured successfully.

  5. Fatigue assessment and its impact in the quality of life of patients with ankylosing spondylitis.

    Science.gov (United States)

    Schneeberger, Emilce Edith; Marengo, María Florencia; Dal Pra, Fernando; Maldonado Cocco, José Antonio; Citera, Gustavo

    2015-03-01

    The most frequently reported symptoms by patients with ankylosing spondylitis (AS) are pain, stiffness, and fatigue. Previous studies have estimated a 63% prevalence of fatigue in AS, with a low correlation of fatigue with pain and functional capacity. The objective of this study is to assess fatigue prevalence in AS patients and establish the main associated factors. A case-control study including AS patients according to New York modified criteria was carried out. The control group included individuals of the general population without rheumatic conditions, matched by gender, age, and socioeconomic level. Disease-related variables were recorded. Functional capacity, disease activity, and quality of life were assessed using Bath Ankylosing Spondylitis Funcional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and ankylosing spondylitis quality of life (ASQoL). CES-D questionnaire was used to evaluate depression and fatigue severity scale (FSS) to evaluate fatigue. Sixty-four consecutive AS patients and 95 controls were included. Patients' median age was 44 years (interquartile range (IQR), 33.25-53), 89.1% were male, and had a median disease duration of 17 years (IQR, 10.3-25). Fatigue prevalence in AS was 73.4% compared to 30.5% in the control group (p < 0.001; OR, 2.08 (95% CI, 1.53-2.83)). Furthermore, fatigue in AS correlated with ASQoL (r = 0.65), BASFI (r = 0.52), BASDAI (r = 0.52), and depression (r = 0.51), whereas no correlation with age or disease duration was found. In the linear regression analysis using fatigue as the dependent variable, depression was the only associated variable (p = 0.01). No association with age, gender, disease duration, BASDAI, BASFI, or presence of comorbidities was found. Finally, BASDAI fatigue question correlated with the FSS (r = 0.55). Fatigue was significantly more prevalent in AS than in healthy controls. The main determinant factor of fatigue was the presence of

  6. Validity of ankylosing spondylitis and undifferentiated spondyloarthritis diagnoses in the Swedish National Patient Register

    DEFF Research Database (Denmark)

    Lindström, U; Exarchou, S; Sigurdardottir, V

    2015-01-01

    OBJECTIVES: Epidemiological studies of spondyloarthritis (SpA), using ICD codes from the Swedish National Patient Register (NPR), offer unique possibilities but hinge upon an understanding of the validity of the codes. The aim of this study was to validate the ICD codes for ankylosing spondylitis...... (AS) and undifferentiated SpA (uSpA) in the NPR against the established classification criteria [modified New York (mNY), Assessment of SpondyloArthritis international Society (ASAS), Amor, and European Spondyloarthropathy Study Group (ESSG) criteria]. METHOD: All patients with an ICD-8/9/10 code...

  7. The impact of ankylosing spondylitis/axial spondyloarthritis on work productivity.

    Science.gov (United States)

    Martindale, Jane; Shukla, Rudresh; Goodacre, John

    2015-06-01

    Ankylosing spondylitis (AS) is a chronic inflammatory condition that has a significant impact on the quality of life and work productivity. New classification criteria have enabled earlier diagnosis of this condition. However, work productivity is an important issue that is still often overlooked during clinical assessments and consultations. This article focusses on the relationship between axial spondyloarthritis (axial SpA) and work productivity. It summarises the impact of this condition on work productivity, and it highlights the tools available to assess this. It also highlights the increasing role and potential of employers, health professionals and new treatments for enhancing work productivity for people with this condition.

  8. Observation on Efficacy in Treating Active Ankylosing Spondylitis with Integrative Chinese and Western Medicine

    Institute of Scientific and Technical Information of China (English)

    刘建中; 刘艳芳; 高志强

    2002-01-01

    @@ Ankylosing spondylitis (AS) mainly affects axial joints, and is also a chronic inflammatory joint disorder with peripheral joint and systemic involvement. Its etiology is unclear, but the efficacy of salicylazosulfapyridine (SASP) in treating AS is generally acknowledged. There is also report on the pure Chinese medical preparation Zhengqing Fengtongning (ZQFTN, 正清风痛宁) in treating AS(1), but there are no reports on whether the ZQFTN and SASP combination therapy can increase the efficacy, or on their side-effects when combined. Since 1996 our hospital has used combination therapy in treating active AS, and compared this with those using SASP alone as control. The results are reported as follows.

  9. [Mandibular osteomyelitis in a patient with ankylosing spondylitis with severe axial and peripheral involvement].

    Science.gov (United States)

    Tomotani, Daniere Yurie Vieira; Miranda, Aryádine Allinne Machado de; Almeida, Lorena Penha; Mubarac, Rebecca Souza; Neves, Anne Christine Garcia; Ribeiro, Sandra Lúcia Euzébio

    2012-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease that affects mainly the axial skeletal system, causing pain and functional incapacity. The peripheral joint involvement occurs in 30 to 40% of cases. Osteomyelitis of the mandible was relatively common before the advent of preventive antibiotic therapy and restorative dentistry. Currently, the infection of the facial bones is a rare condition, being the odontogenic infection the most responsible for cases with mandibular involvement. The authors report the case of a EA patient, with severe peripheral involvement, which progressed to osteomyelitis of the jaw, secondary to the odontogenic infection due to delay in diagnosis and treatment.

  10. Axial spondyloarthritis: a new disease entity, not necessarily early ankylosing spondylitis.

    Science.gov (United States)

    Robinson, Philip Cameron; Wordsworth, Bryan Paul; Reveille, John D; Brown, Matthew A

    2013-02-01

    New classification criteria for axial spondyloarthritis have been developed with the goal of increasing sensitivity of criteria for early inflammatory spondyloarthritis. However these criteria substantially increase heterogeneity of the resulting disease group, reducing their value in both research and clinical settings. Further research to establish criteria based on better knowledge of the natural history of non-radiographic axial spondyloarthritis, its aetiopathogenesis and response to treatment is required. In the meantime the modified New York criteria for ankylosing spondylitis remain a very useful classification criteria set, defining a relatively homogenous group of cases for clinical use and research studies.

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

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    Bin Lin

    2014-01-01

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

  12. Pregabalin for Opioid-Refractory Pain in a Patient with Ankylosing Spondylitis

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    Konstantinos A. Kontoangelos

    2013-01-01

    Full Text Available Background. Ankylosing spondylitis (AS is a systemic inflammatory disease with chronic back pain as the most common presenting symptom. We present a case of a male patient with AS reporting symptoms of severe low back pain, buttock pain, and limited spinal mobility. After chronic treatment with opioids, we administered pregabalin at a dose of 300 mg as an analgesic agent while opioids were discontinued. Findings. Pain symptoms improved progressively, and opioids were gradually discontinued without any withdrawal symptoms reported. Conclusions. Pregabalin is potentially useful in the management of pain in patients with AS while effectively managing the discontinuation of opioid treatment.

  13. Behaviour change intervention increases physical activity, spinal mobility and quality of life in adults with ankylosing spondylitis: a randomised trial

    Directory of Open Access Journals (Sweden)

    Tom O’Dwyer

    2017-01-01

    Full Text Available Questions: Does a 3-month behaviour change intervention targeting physical activity (PA increase habitual physical activity in adults with ankylosing spondylitis (AS? Does the intervention improve health-related physical fitness, AS-related features, and attitude to exercise? Are any gains maintained over a 3-month follow-up

  14. Behaviour change intervention increases physical activity, spinal mobility and quality of life in adults with ankylosing spondylitis: a randomised trial

    OpenAIRE

    Tom O’Dwyer; Ann Monaghan; Jonathan Moran; Finbar O'Shea; Fiona Wilson

    2017-01-01

    Questions: Does a 3-month behaviour change intervention targeting physical activity (PA) increase habitual physical activity in adults with ankylosing spondylitis (AS)? Does the intervention improve health-related physical fitness, AS-related features, and attitude to exercise? Are any gains maintained over a 3-month follow-up

  15. Long-term drug survival and clinical effectiveness of etanercept treatment in patients with ankylosing spondylitis in daily clinical practice

    NARCIS (Netherlands)

    Arends, Suzanne; Brouwer, Elisabeth; Efde, Monique; van der Veer, Eveline; Bootsma, Hendrika; Wink, Freke; Spoorenberg, Johanna

    2017-01-01

    OBJECTIVES: Randomised controlled trials and open-label extension studies have demonstrated the clinical efficacy and safety of tumour necrosis factor-alpha (TNF-α) blocking therapy in pre-selected study patients with ankylosing spondylitis (AS). Our aim was to investigate the 7-year drug survival a

  16. Fractura and dislocation of the thoracic spine without spinal cord injury in a patient with ankylosing spondylitis: A case report.

    Science.gov (United States)

    Glinkowski, W

    2000-12-30

    This article presents a rare case of a fracture of the thoracic spine accompanied by significant dislocation but without spinal cord injury in a 74-year-old male patient with ankylosing spondylitis. A literature search failed to reveal a similar case. Conservative treatment produced a good outcome.

  17. Validation of a new objective index to measure spinal mobility: the University of Cordoba Ankylosing Spondylitis Metrology Index (UCOASMI).

    Science.gov (United States)

    Garrido-Castro, Juan L; Escudero, Alejandro; Medina-Carnicer, Rafael; Galisteo, Alfonso M; Gonzalez-Navas, Cristina; Carmona, Loreto; Collantes-Estevez, Eduardo

    2014-03-01

    Spinal mobility measures are subject to high variability and subjectivity. Automated motion capture allows an objective and quantitative measure of mobility with high levels of precision. To validate the University of Cordoba Ankylosing Spondylitis Metrology Index (UCOASMI), an index measure of spinal mobility, based on automated motion capture, validation studies included the following: (1) validity, tested by correlation--Pearson's r--between the UCOASMI and the mobility index Bath Ankylosing Spondylitis Metrology Index (BASMI), and a measure of structural damage, the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS); (2) reliability, with internal consistency tested by Cronbach's alpha, test-retest by intraclass correlation coefficient (ICC) after 2 weeks, and error measurement, by variation coefficient (VC) and smallest detectable difference (SDD); and (3) responsiveness, by effect size (ES) in a clinical trial of anti-TNF. Patients for the different studies all had ankylosing spondylitis. Validity studies show correlation between the BASMI (r = 0.881) and the mSASSS (r = 0.780). Reliability studies show an internal consistency of Cronbach's α = 0.894, intra-observer ICC = 0.996, test-retest ICC = 0.996, and a measurement error of VC = 2.80% and SDD = 0.25 points. Responsiveness showed an ES after 24 weeks of treatment of 0.48. In all studies, the UCOASMI's performance was better than that of the BASMI. The UCOASMI is a validated index to measure spinal mobility with better metric properties than previous indices.

  18. Pain is a major component of quality of life in patients with ankylosing spondylitis and the possibilities of its relief

    Directory of Open Access Journals (Sweden)

    Oksana Anatolyevna Pirogova

    2013-01-01

    Full Text Available The paper gives the results of an investigation of quality of life (QL in patients with ankylosing spondylitis. It shows the implication of chronic pain syndrome in lowering QL and considers the issues of combination therapy with nimesulide (nise and tizanidine (sirdalud for pain syndrome.

  19. Elevated Serum Levels of Soluble CD30 in Ankylosing Spondylitis Patients and Its Association with Disease Severity-Related Parameters

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    Rongfen Gao

    2015-01-01

    Full Text Available Soluble CD30 (sCD30, a transmembrane glycoprotein that belongs to the tumor necrosis factor receptor (TNFR superfamily, has been shown to be associated with various pathological conditions. This study was designed to measure the levels of serum sCD30 in patients with ankylosing spondylitis (AS and to evaluate the relationships between serum sCD30 levels and other disease severity-related indexes, including bath ankylosing spondylitis disease activity index (BASDAI, ankylosing spondylitis disease activity score (ASDAS, and bath ankylosing spondylitis functional index (BASFI. Our results demonstrated significantly elevated sCD30 levels in AS patients compared to healthy controls (HCs with mean values of 32.0±12.2 and 24.9±8.0 ng/mL, respectively (P**=0.007, suggesting a potential role of sCD30 in the pathogenesis of AS. However, no significant correlations of sCD30 with BASDAI, ASDAS, or BASFI were detected in our study (P>0.05. Therefore, sCD30 cannot be used as a reliable marker for reflecting disease activity and functional ability of AS patients.

  20. Is there a preferred method for scoring activity of the spine by magnetic resonance imaging in ankylosing spondylitis?

    DEFF Research Database (Denmark)

    van der Heijde, Désirée; Landewé, Robert; Hermann, Kay-Geert

    2007-01-01

    This report summarizes the discussion during a module update at OMERACT 8 on scoring methods for activity in the spine on magnetic resonance imaging. The conclusion was that the 3 available scoring methods are all very good with respect to discrimination and feasibility: the Ankylosing Spondyliti...

  1. STEM CELL TRANSPLANTATION AS A POSSIBLE STRATEGY FOR TREATING STANDARD THERAPY-RESISTANT ANKYLOSING SPONDYLITIS

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    I. Z. Gaidukova

    2016-01-01

    Full Text Available The authors have analyzed the literature dealing with studies of the efficiency and safety of stem cell transplantation (SCT in patients with ankylosing spondylitis (AS through the electronic resources Pubmed and Medline by using the keywords «bone marrow transplantation», «hematopoietic stem cell transplantation», «ankylosing spondylitis», «autoimmune diseases», and «sacroiliac joint biopsy». The paper describes four cases of SCT in AS patients, including transplantation that was carried out in one patient with lymphoma concurrent with AS, in two AS patients without blood cancers, and in one patient with AS concurrent with myeloid leukemia. Drug-free remission was achieved in 3 cases: lymphoma concurrent with AS (n=1, AS concurrent with myeloid leukemia (n=1, and AS without comorbidities (n=1. In addition to an improvement in the course of AS, there were also two cases with clinical presentations of AS after SCT. The given cases show that SCT can be basically used to induce drug-free remission in patients with severe forms of standard therapy-resistant AS. However, the introduction of SCT in clinical practice needs to adjust the technique to the specific features of AS patients. 

  2. [Fracture of the cervical spine in ankylosing spondylitis. A case report].

    Science.gov (United States)

    Kaneko, Takahisa; Koyanagi, Izumi; Murakami, Tomohiro; Houkin, Kiyohiro

    2010-09-01

    We report a case of a 61-year-old man with ankylosing spondylitis who showed cervical spine fracture. The patient had fallen down on the floor and presented with severe neck pain. He was treated conservatively with a hard neck collar in an emergency hospital because of C7 body fracture without dislocation. However, the follow-up radiographs demonstrated a progressive C6-7 anterior dislocation. He was referred to our hospital 6 weeks after the trauma. The 3D-CT reconstruction imaging revealed that the fracture extended from the C7 vertebral body to the C6 lamina via the bilateral C6/7 facet joints. The patient underwent C2-Th3 posterior fixation using pedicle and lateral mass screw techniques. The postoperative course was uneventful. He was discharged without any complication at 1 month postoperatively. The radiograph 3 months after surgery showed good bone fusion. Spine fracture with ankylosing spondylitis usually shows significant instability because of the long lever-arm of the fused vertebrae at the fracture level. Solid spinal fusions such as long posterior fusion or anterior-posterior simultaneous fusion are needed in such cases.

  3. Whole Genome Expression Profiling and Signal Pathway Screening of MSCs in Ankylosing Spondylitis

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    Yuxi Li

    2014-01-01

    Full Text Available The pathogenesis of dysfunctional immunoregulation of mesenchymal stem cells (MSCs in ankylosing spondylitis (AS is thought to be a complex process that involves multiple genetic alterations. In this study, MSCs derived from both healthy donors and AS patients were cultured in normal media or media mimicking an inflammatory environment. Whole genome expression profiling analysis of 33,351 genes was performed and differentially expressed genes related to AS were analyzed by GO term analysis and KEGG pathway analysis. Our results showed that in normal media 676 genes were differentially expressed in AS, 354 upregulated and 322 downregulated, while in an inflammatory environment 1767 genes were differentially expressed in AS, 1230 upregulated and 537 downregulated. GO analysis showed that these genes were mainly related to cellular processes, physiological processes, biological regulation, regulation of biological processes, and binding. In addition, by KEGG pathway analysis, 14 key genes from the MAPK signaling and 8 key genes from the TLR signaling pathway were identified as differentially regulated. The results of qRT-PCR verified the expression variation of the 9 genes mentioned above. Our study found that in an inflammatory environment ankylosing spondylitis pathogenesis may be related to activation of the MAPK and TLR signaling pathways.

  4. Clinical course and signs in patients with uveitis associated with ankylosing spondylitis

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    Refik Oltulu

    2013-09-01

    Full Text Available Aim: To evaluate clinical course and signs in patients withuveitis associated ankylosing spondylitis (AS.Methods: In this retrospective study we evaluated thepatients who were diagnosed as uveitis related to AS andfollowed up at the Ophthalmology Department of NecmettinErbakan University Hospital between May 2009 andJune 2012. Demographical features and clinical courseswere assessed.Results: Seventeen eyes of 13 patients were includedin the study. Nine patients (69.2% were male and four(30.8% were female. The mean age at presentation was38.54±9.61 years (range 28-63. Bilateral involvementwas observed in four (30.8% patients. The mean followuptime was 17.46±11.86 months (range 3-36. The meannumber of attacks was 1.15±0.37 (range 1-2. Posteriorsegment manifestation accompanied anterior uveitis inthree eyes (17.6%. Posterior synechia developed in one(7.7% and cataract in one patient (7.7%, cystoid macularedema in two patients (15.4%, and epiretinal membranein one patient (%7.7. The mean final visual acuitywas 0.975±0.07 (range 0.2-1.0.Conclusion: The prognosis of anterior uveitis associatedwith AS is good if the treatment is administered at theappropriate time. However, the posterior segment complicationsmay develop in these patients, treatment andfollow-up should be done in co-operation with the departmentof rheumatology.Key words: Ankylosing spondylitis, uveitis, rheumatology,clinical course

  5. Static and dynamic balance in subjects with ankylosing spondylitis: literature review.

    Science.gov (United States)

    Pompeu, José Eduardo; Romano, Renata Sorroche Lourenço; Pompeu, Sandra Maria Alvarenga Anti; Lima, Sônia Maria Anti Loduca

    2012-01-01

    To analyze the musculoskeletal changes of individuals with ankylosing spondylitis (AS) and their repercussions on postural control, a literature review was carried out in the BIREME and EBSCO HOTS databases and Pubmed site with the following keywords: "ankylosing spondylitis", "postural balance", and "posture". Articles involving human beings, assessing the postural control and balance of individuals with AS, written in English or Portuguese and published between 1999 and 2010, were selected. Of the total number of articles found, only four met the requirements. Of those, three compared the outcomes of patients with AS with data obtained from healthy individuals, and one article assessed individuals with AS. No article used the same method of postural analysis. To assess balance, Berg Balance Scale, Force Plate, and Magnometry were used. The major postural deviations found were increased thoracic kyphosis and hip flexion, which lead to a forward displacement of the body's center of gravity, with knee flexion and ankle plantar flexion as compensation to control balance. Only one author reported worsening of functional balance in subjects with AS. All assessment methods used were considered capable of measuring balance, and no specific scale for patients with AS exists.

  6. Performance of ultrasound to monitor Achilles enthesitis in patients with ankylosing spondylitis during TNF-a antagonist therapy.

    Science.gov (United States)

    Wang, Cong-hua; Feng, Yuan; Ren, Zhen; Yang, Xichao; Jia, Jun-feng; Rong, Meng-yao; Li, Xue-yi; Wu, Zhen-biao

    2015-06-01

    Enthesitis is considered as the primary anatomical lesion in ankylosing spondylitis (AS). We aimed to investigate the potential of ultrasound to detect early changes after TNF-a antagonist therapy of Achilles enthesitis of AS patients. One hundred AS patients with active disease, requiring TNF-a antagonist therapy, were included (etanercept n = 25, infliximab n = 25, adalimumab n = 25, non-biologic disease-modifying antirheumatic drugs (DMARDs) n = 25). Physical examination was performed to evaluate disease activity and detect Achilles enthesitis and/or retrocalcaneal bursitis. Ultrasound of the Achilles enthesitis was performed bilaterally. Follow-up examinations were performed 3 months after the initiation of therapy. Gray scale (GS) scores, Power Doppler (PD) scores, and total additive scores (TS) decreased significantly during TNF-a antagonist therapy but not in traditional non-biologic traditional DMARDs group. The bath ankylosing spondylitis disease activity index (BASDAI), bath ankylosing spondylitis metrology index (BASMI), bath ankylosing spondylitis functional index (BASFI), and Maastricht ankylosing spondylitis enthesitis score (MASES) all showed significant improvements. When three different TNF-a antagonists were analyzed separately, no significant difference was observed in GS, PD, and total scores. Subclinical Achilles enthesitis, detected only with GS ultrasound, is present in a subset of AS patients and a significant improvement can be demonstrated after 3 months of TNF-a antagonist therapy. Doppler ultrasound provides a reliable estimation to monitor the therapeutic response to TNF antagonists in AS patients with Achilles enthesitis. TNF-a antagonists have been shown to be effective in decreasing ultrasound signs of enthesitis after 3 months of therapy in AS patients.

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

    Science.gov (United States)

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

    2014-03-01

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

  8. [Critical study of radiculomedullary and neuromuscular complications of ankylosing spondylitis].

    Science.gov (United States)

    Serratrice, G; Acquaviva, P; Pouget, J; Guerra, L

    1987-03-01

    Medullo-radicular and neuro-muscular involvements of ankylosing spondylarthritis, often reported in an analytic fashion in the literature, deserve to be the subject of a critical study. Various neurological manifestations secondary to exceptional atlo-occipital and sometimes axis-atlas subluxations and medullary lesions as well as syndromes of the cauda equina. The medullary lesions have an epidural origin (3 cases in the literature, 2 cases from the authors) or are secondary to a spondylodiscitis (4 cases in the literature) or secondary to both (1 case reported by the authors). As for syndromes of the cauda equina the authors report 3 cases to be added to the 55 published previously. It concerns always old spondylarthritis. The lesions combine posterior diverticula and lesions of the lamina. The treatment is usually ineffective. A special case is represented by forms with trophic disorders. More debatable are the radicular lesions, which, except for intercostal pain, should be linked to local pain. Electromyographic abnormalities are of no significance. Alterations of the paravertebral muscles viewed on the scanner X have, for now, an uncertain significance. Finally, various associations, without significance such as multiple sclerosis, diffuse muscular lesions and the classic spondylotic pseudo-tabes, should be rejected.

  9. DIFFICULTIeS OF TOTAL HIP REPLACEMENT IN PATIENTS WITH ANKYLOSING SPONDYLITIS (case report

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    R. M. Tikhilov

    2016-01-01

    Full Text Available A distinctive feature of patients with ankylosing spondylitis is the formation of hip ankylosis in an extremely unfavorable functional position combined with upset of sagittal balance of the body along with a thoracolumbar kyphosis. Treatment of these patients poses considerable technical difficulties and is often associated with complications. The authors report a clinical case of a female 40 years old patient with confirmed rhizomelic spondylitis. The patient mainly complained of fixed malposition of the right lower extremity (hip ankylosis in extreme 1450 flexion and 1500 abduction combined with a severe fixed spine deformity (thoracic kyphosis 920, lumbar lordosis 170. Considering significant sagittal balance disorder it was decided to go for a two-stage procedure. Total hip arthroplasty of the right joint was performed at the first stage. At the second stage the authors corrected thoracolumbar spinal deformity by Th12 (type PSO 4 and L2 (type PSO 3 wedge resections and converging resected vertebral bodies by a multilevel fixation system with transpedicular support elements. The interval between the stages was 11 months. Two-stage treatment of this patient al-lowed to avoid adverse postoperative complications and to achieve a significant functional improvement in one year after treatment started. The sum of points before and after the treat-ment amounted respectively to 46 and 79 on Harris Hip Score, 17 and 38 points on Oxford Hip Score (OHS. To summarize, comprehensive treatment with planning of all subsequent steps prior to hip replacement is the method of choice for avoidance of postoperative complications in patients with ankylosing spondylitis accompanied by a significant upset of sagittal balance.

  10. A case of essential thrombocythemia and ankylosing spondylitis treated with a combination of anagrelide, disease-modifying antirheumatic drugs, and etanercept

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    Zeremski Vanja

    2016-01-01

    Full Text Available Introduction. A high platelet count, or thrombocytosis, is either a reactive process or a result of a myeloproliferative disorder. Ankylosing spondylitis is a chronic inflammatory rheumatic disease affecting the spine and sometimes peripheral joints in which reactive mild to moderate thrombocytosis is a common finding. There have been no previously reported cases of essential thrombocythemia associated with ankylosing spondylitis. Case Outline. We report a case of a 32-year-old man with human leukocyte antigen B27-positive ankylosing spondylitis and Janus kinase 2-positive essential thrombocythemia who was treated first with a combination of anagrelide and disease-modifying antirheumatic drugs and, after liver toxicity, with a combination of anagrelide and etanercept (TNF-α antagonist. Both diseases were gradually brought under control. Conclusion. Our case of ankylosing spondylitis and essential thrombocythemia suggests that concomitant etanercept and anagrelide therapy is safe, as well as effective.

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

    OpenAIRE

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

    2005-01-01

    Objective: The combined efficacy of selective and non-selective cyclo-oxygenase-2 (COX-2) inhibition on the axial manifestations of ankylosing spondylitis (AS) in the presence or absence of chronic peripheral arthritis was evaluated.

  12. Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an iberoamerican spondyloarthritis cohort

    OpenAIRE

    Landi, Margarita; Maldonado-Ficco, Hernán; Perez-Alamino, Rodolfo; Maldonado-Cocco, José A.; Citera, Gustavo; Arturi, Pablo; Percival D. Sampaio-Barros; Flores Alvarado, Diana E.; Burgos-Vargas, Rubén; Santos, Elena; Palleiro, Daniel; Gutiérrez,Miguel A; Vieyra-Sousa, Elsa; Pimentel-Santos, Fernando; Paira, Sergio O.

    2016-01-01

    Abstract The aim of the study was to compare clinical manifestations, disease activity, functional capacity, spinal mobility, and radiological findings between men and women from a multicenter, multiethnic Ibero-American cohort of patients with Spondyloarthritis (SpA). This observational cross-section study included 1264 consecutive SpA patients who fulfilled the modified New York criteria for ankylosing spondylitis (AS). Demographic, clinical, and radiologic data were evaluated. Categorical ...

  13. CLINICAL OBSERVATION ON 40 CASES OF ANKYLOSING SPONDYLITIS TREATED WITH ACUPUNCTURE AND CHINESE DRUGS

    Institute of Scientific and Technical Information of China (English)

    JIA Hong-ling; ZHANG Yong-chen

    2005-01-01

    Objective: To observe the clinical therapeutic effect of acupuncture plus Chinese herbal medicines for ankylosing spondylitis (AS). Methods: A total of 80 cases of AS patients were evenly and randomly divided into treatment group and control group. In treatment group, patients were treated with acupuncture of Jiaji (夹脊EX-B 2) and oral administration of Yishen Tongdu Wan (益肾通督丸,Bolus for Reinforcing the Kidney and Dredging Governor Vessesl) and those of control group treated with oral administration of Sulfasalazin (0.5 g, twice daily). Before and after treatment, the thoracic-dilaion scale, Schober test, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), erythrocyte sedimentation rate (ESR) and C-reaction protein (CRP) were detected separately. Results: After 6 months of treatment, of the both 40 cases in treatment and control groups, 27 (67.5%) and 13 (32.5%) were improved remarkably, 11 (27.5%) and 16 (40.0%) effective, and 2 (5.0%) and 11 (27.5%) failed, with the effective rates being 95.0% and 72.5% separately. The therapeutic effect of treatment group was significantly superior to that of control group (P<0.05). After treatment, the thoracic-dilaion scale and Schober test values increased significantly (P<0.05), while BASDAI, BASFI, ESR and CRP lowered considerably (P<0.01, P<0.05). Comparison between two groups indicated that after treatment, the decreased values of BASDAI, BASFI, ESR and CRP of treatment group were significantly lower than those of control group (P<0.01), while those of the thoracic-dilaion scale and Schober test of treatment group were significantly higher than those of control group (P<0.05, P<0.01). Results displayed that both acupuncture combined with Chinese drugs and Sulfasalazin could lower BASDAI, BASFI, ESR and CRP, raise the thoracic-dilaion scale and Schober test values considerably in AS patients, and the therapeutic effect of combined acupuncture and

  14. Differences in clinical presentation of ankylosing spondylitis in men and women

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    Hossain Soleymani Salehabadi

    2016-10-01

    Full Text Available Background: Ankylosing spondylitis (AS is an inflammatory disease that mainly affects axial skeleton of the body and ankylosing spondylitis ligaments around the spine at the junction of the spine are inflamed, because the disease is progressive and can lead to significantly cause of disability and the studies could provide a mechanism for the early detection of the disease or help determine when to start treatment, the difference in clinical presentations of AS in men and women is indicative of potential effect of gender on severity of the disease. This study was conducted with the aim to investigate the effect of gender on severity of AS. Methods: In a cross-sectional study, one hundred and fifteen patients with ankylosing spondylitis who referred to Yazd Rheumatology Clinic between 2001 and 2013 were evaluated. Sampling was performed using non-random convenient method. The most important variables studied included demographic data, clinical presentation, radiographic stage of sacroiliac involvement, and laboratory data extracted from patients’ files and recorded in questionnaires. Results: Both groups according to age at diagnosis, presence of enteritis, peripheral joint involvement and laboratory data such as C-reactive protein (CRP, erythrocyte sedimentation rate (ESR and hemoglobin were matched. Inflammatory neck pain was more prevalent in men than in women (77.2% against 51.8%; P< 0.05. Sacroiliac radiographic study revealed stage 1 involvement in 11.3% of men and 37% of women (P= 0.009, and stage 4 in 27.2% of men and 3.7% of women (P< 0.001, with a significant difference. Conclusion: According to the results of the study, the time between age of onset and age at diagnosis, inflammatory pain in the neck and advanced stage in men than in women was higher. Although these findings suggest that gender may have an impact on the pattern and severity of AS but the time delay in diagnosis as a disease affecting the intensity and pattern should

  15. Improvement of overlapping hidradenitis suppurativa and ankylosing spondylitis after the introduction of adalimumab.

    Science.gov (United States)

    Bosnić, Dubravka; Žarković, Branimir; Barešić, Marko; Zarkovic, Maja; Anić, Branimir

    2016-01-01

    Hidradenitis suppurativa is a chronic inflammatory disorder characterized by occlusion of the follicular pilosebaceous units of the skin. The treatment options are sometimes very limited and unpleasant odor and abundant drainage complicate the disease. Ankylosing spondylitis is a form of seronegative spondyloarthritis with predominantly axial but also peripheral joint involvement. Both of the conditions lower the patient's quality of life and affect everyday activities. We describe a 39-year-old male patient with both diseases treated with different medications with only a modest result. After the initiation of a tumor necrosis factor α (TNF-α) inhibitor (adalimumab) the patient experienced first the musculoskeletal and later on the skin improvement. The introduction of TNF-α inhibitors should be considered early in the treatment of overlapping hidradenitis suppurativa and the spondyloarthritis spectrum of conditions. Available medical data confirm the positive results and beneficial effect on disease course, activity and, most importantly, quality of life.

  16. Progress in spondylarthritis. Progress in studies of the genetics of ankylosing spondylitis.

    Science.gov (United States)

    Brown, Matthew A

    2009-01-01

    The advent of high-throughput SNP genotyping methods has advanced research into the genetics of common complex genetic diseases such as ankylosing spondylitis (AS) rapidly in recent times. The identification of associations with the genes IL23R and ERAP1 have been robustly replicated, and advances have been made in studies of the major histocompatibility complex genetics of AS, and of KIR gene variants and the disease. The findings are already being translated into increased understanding of the immunological pathways involved in AS, and raising novel potential therapies. The current studies in AS remain underpowered, and no full genomewide association study has yet been reported in AS; such studies are likely to add to the significant advances that have already been made.

  17. Acute toxoplasmosis infection in a patient with ankylosing spondylitis treated with adalimumab: a case report

    Directory of Open Access Journals (Sweden)

    M. de Almeida Santos Jr

    2011-06-01

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory disease that affects the axial skeleton, often beginning in the sacroiliac joints, but accompanied also by other signs, including enthesitis, lung fibrosis and eye involvement. AS generally occurs in the second or third decade of life with inflammatory low back pain and has a strong relation with HLA-B27. The objective of the treatment until the end of the 90’s was to ameliorate pain and stiffness and preserve function (1. Nonselective nonsteroidal antiinflammatory drugs (NSAIDs, cyclooxygenase-2 selective inhibitors, and nonpharmalogic interventions, such as physiotherapy, exercise, education, and lifestyle modifications were the basis of the management. Therapy with agents like sulphasalazine was administered for peripheral arthritis (1, 2...

  18. THE POSSIBILITIES AND RESULTS OF INDIRECT COMPARISON OF BIOLOGICAL AGENTS IN ANKYLOSING SPONDYLITIS

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    Sh. F. Erdes

    2016-01-01

    Full Text Available The paper analyzes two matching-adjusted indirect comparison-based investigations of the efficacy of adalimumab (ADA and secukinumab (SCM in active ankylosing spondylitis, which have been recently reported at the EULAR Congress (London, 2016. One study sponsored by AbbVie was conducted to determine the short-term (16-week comparative clinical and economic efficacy of the test drugs and the other was supported by Novartis to reveal long-term (52-week, only clinical efficacy. Both studies have shown that the short-term efficacy ofADAand SCM is practically similar; however, the latter has a better long-term clinical efficacy. A pharmacoeconomic analysis of both drugs used during the first 12 weeks has demonstrated some advantage ofADA. 

  19. rs10865331 associated with susceptibility and disease severity of ankylosing spondylitis in a Taiwanese population.

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    Ya-Feng Wen

    Full Text Available Ankylosing spondylitis (AS is a highly familial rheumatic disorder and is considered as a chronic inflammatory disease. Genetic factors are involved in the pathogenesis of AS. To identify genes which render people susceptible to AS in a Taiwanese population, we selected six single-nucleotide polymorphisms (SNPs from previous genome-wide association studies (GWASs which were associated with AS in European descendants and Han Chinese. To assess whether the six SNPs contributed to AS susceptibility and severity in Taiwanese population, 475 AS patients fulfilling the modified New York Criteria and 527 healthy subjects were recruited. We found that rs10865331 was significantly associated with AS susceptibility and with Bath AS Function Index (BASFI. The AA and AG genotypes of rs10865331 were also significantly associated with a higher erythrocyte sedimentation rate. Our findings provided evidence that rs10865331 is associated AS susceptibility and with disease activity (BASFI in a Taiwanese population.

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

    Directory of Open Access Journals (Sweden)

    Naveen Eipe

    2013-01-01

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

  1. The immunology of ankylosing spondylitis and rheumatoid arthritis: a tale of similarities and dissimilarities.

    Science.gov (United States)

    Inman, R D; El-Gabalawy, H S

    2009-01-01

    Ankylosing spondylitis (AS) and rheumatoid arthritis (RA) are immune-mediated inflammatory joint diseases with the potential for significant target organ damage. Genetic factors play an important role in defining disease susceptibility. Both diseases are mediated in part by TNF, since anti-TNF therapies have proved effective in both AS and RA. Despite their similarities, the genetic elements associated with the respective diseases differ, most notably in HLA associations, with AS being associated with class I HLA alleles and RA associated with class II HLA alleles. AS has a predilection for axial joints whereas RA targets peripheral joints, but the immunological basis of that distinction is unknown. Autoantibody formation is the immunological hallmark of RA, whereas AS is notable for being a "seronegative" disease. Growing knowledge of new aspects of the host immune response (such as innate immune responses and Th17 cells) is adding to new insights into shared mechanisms of pathogenesis between these two diseases.

  2. Acute fulminant drug induced necrotizing pancreatitis in a patient with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Pablo Miramontes

    2015-03-01

    Full Text Available Drug-induced acute necrotizing pancreatitis is a rare adverse event, although it has been reported in association with different drugs, including non-steroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, and analgesic agents commonly used in rheumatology. In different reviews of the pancreotoxicity of drugs, infliximab and etanercept are mentioned among all medications implicated in drug-induced pancreatitis, but clinical cases of acute pancreatitis complicating treatment with these anti-TNF-α agents have been exceptionally reported. We describe a patient with ankylosing spondylitis treated with etanercept, who developed an acute fulminant necrotizing pancreatitis that resulted in death. Doctors should pay close attention to patients taking biologic drugs in which a complaint of abdominal pain lasting for several days with no apparent cause may require a prompt referral for medical consultation.

  3. The natural history of ankylosing spondylitis in the 21st century

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    C. Campana

    2011-06-01

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory disease that affects the axial skeleton and evolves in stiffnes followed by ankylosis and disability. However, it may be difficult to exactly establish the natural history of the disease and the influence of risk factors of progression, since most patients are treated with various pharmacologic or non-pharmacologic agents, which may potentially influence the natural progression of the disease. In this context, we report here a very interesting case of a 40 year old man, presented to our outpatient clinic, 28 years after the onset of AS. Previously for personal reasons, did not choose not to undergo any treatment. This case allows us to evaluate the natural radiological progression of the disease and the influence of predictive risk factors.

  4. [Diagnosis and therapy of axial spondyloarthritis including ankylosing spondylitis (Bechterew's disease)].

    Science.gov (United States)

    Poddubnyy, D; Sieper, J

    2012-07-01

    The term axial spondyloarthritis covers patients with established structural changes visible on x-ray in sacroiliac joints and/or in the spine (classical ankylosing spondylitis) but also patients with non-radiographic axial spondyloarthritis in whom early inflammatory signs of the disease can only be visualized with magnetic resonance imaging (MRI). The MRI technique plays an important role in the diagnosis of this disease and an early diagnosis is normally based on a combination of clinical, laboratory and imaging parameters. Only non-steroidal anti-inflammatory drugs and TNF-α blockers are effective in the treatment of axial spondyloarthritis. Patients with short disease duration and elevated acute phase reactant levels demonstrate best therapy response and, therefore, should be closely followed-up and consistently treated.

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

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    Bernd Raffeiner

    2014-01-01

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

  6. Espondilite anquilosante e uveíte: revisão Ankylosing spondylitis and uveitis: overview

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    Enéias Bezerra Gouveia

    2012-10-01

    Full Text Available O presente trabalho propõe uma revisão de epidemiologia, patogênese, quadro clínico, diagnóstico e tratamento da espondilite anquilosante e sua associação com alteração ocular com a devida condução da doença e suas manifestações. Os autores utilizaram em sua pesquisa os bancos de dados PubMed (MEDLINE, LILACS e Biblioteca do Centro de Estudos de Oftalmologia. A espondilite anquilosante é uma doença inflamatória crônica que acomete preferencialmente o esqueleto axial, podendo evoluir com rigidez e limitação funcional progressiva. Seu início costuma ocorrer por volta da segunda à terceira década de vida, preferencialmente em indivíduos do gênero masculino, caucasianos e HLA-B27-positivos. Sua etiologia e patogênese não são completamente elucidadas, e seu diagnóstico costuma ser tardio. O controle clínico e o tratamento são frequentemente satisfatórios.A uveíte anterior aguda é a manifestação extra-articular mais comum, ocorrendo em cerca de 20%-30% dos pacientes com espondilite anquilosante. Aproximadamente metade dos casos de uveíte anterior aguda está associada à presença do antígeno HLA-B27, podendo ser a primeira manifestação de uma doença reumatológica não diagnosticada, geralmente com boa resposta terapêutica e bom prognóstico. Concluímos que, para melhor avaliação e tratamento dos pacientes com uveíte, é importante maior integração entre oftalmologistas e reumatologistas.The present article reviews the epidemiology, pathogenesis, clinical features, diagnosis, and treatment of ankylosing spondylitis and its association with ocular changes. The authors used the PubMed (MEDLINE, LILACS, and Ophthalmology Library databases. Ankylosing spondylitis is a chronic inflammatory disease that usually affects the axial skeleton and can progress to stiffness and progressive functional limitation. Ankylosing spondylitis usually begins around the second to third decade of life, preferentially in HLA

  7. Improvement of overlapping hidradenitis suppurativa and ankylosing spondylitis after the introduction of adalimumab

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    Bosnić, Dubravka; Žarković, Branimir; Zarkovic, Maja; Anić, Branimir

    2016-01-01

    Hidradenitis suppurativa is a chronic inflammatory disorder characterized by occlusion of the follicular pilosebaceous units of the skin. The treatment options are sometimes very limited and unpleasant odor and abundant drainage complicate the disease. Ankylosing spondylitis is a form of seronegative spondyloarthritis with predominantly axial but also peripheral joint involvement. Both of the conditions lower the patient’s quality of life and affect everyday activities. We describe a 39-year-old male patient with both diseases treated with different medications with only a modest result. After the initiation of a tumor necrosis factor α (TNF-α) inhibitor (adalimumab) the patient experienced first the musculoskeletal and later on the skin improvement. The introduction of TNF-α inhibitors should be considered early in the treatment of overlapping hidradenitis suppurativa and the spondyloarthritis spectrum of conditions. Available medical data confirm the positive results and beneficial effect on disease course, activity and, most importantly, quality of life. PMID:28115784

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

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    Raval Chetankumar

    2010-01-01

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

  9. TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.

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

    Science.gov (United States)

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

    2014-12-01

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

  11. Variables related to work productivity loss in patients with ankylosing spondylitis.

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

    2013-01-01

    The work productivity loss due to ankylosing spondylitis (AS) has become subject of interest because of its socioeconomic impact. In addition to physical limitations, other variables seem to affect the productivity of those patients, who often withdraw early from the labor force. This review was aimed at identifying articles published in English, from January 2001 to December 2011, which assessed those variables in adult patients of both sexes diagnosed with AS, using standardized instruments to measure disease activity and work productivity. Thirty-three articles meeting the inclusion criteria were identified. The work productivity loss of patients with AS proved to be influenced by demographics, emotional, social, cultural, and occupational factors, and lifestyle. Understanding those potential risk factors may contribute to the development of preventive strategies to maintain patients with AS participating in the labor force.

  12. The interleukin (IL)-23/IL-17 axis in ankylosing spondylitis: new advances and potentials for treatment.

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    Jethwa, H; Bowness, P

    2016-01-01

    Ankylosing spondylitis (AS), the most common form of spondyloarthropathy, is a chronic, progressive multi-system inflammatory disorder characteristically affecting the sacroiliac joints and axial skeleton. Although the exact mechanisms underlying the pathogenesis of AS remain to be elucidated, the presence of human leucocyte antigen (HLA)-B27 is known to markedly increase its risk of development. Current treatments include non-steroidal anti-inflammatory drugs (NSAIDs) and tumour necrosis factor (TNF) blockers. In recent years, the interleukin (IL)-23/IL-17 pathway has been shown to have significance in the pathogenesis of AS and treatment modalities targeting this pathway have been shown to be beneficial in various other inflammatory conditions. This review provides an overview of the IL-23/IL-17 pathway in the pathogenesis of AS and summarizes new potential treatments for AS and related inflammatory diseases.

  13. Association of Vitamin D with Disease Activity in Rheumatoid Arthritis and Ankylosing Spondylitis

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    Abdullah Yagiz

    2014-03-01

    Full Text Available Aim: Vitamin D deficiency in autoimmune disorders such as rheumatoid arthritis (RA and ankylosing spondylitis (AS, whether an initiator cause or associated with disease activity is still wondered. The aim of our study is to investigate the association between serum vitamin D levels and disease activity in subjects with RA and AS which are known to be Th1 dominant diseases. Material and Method: The study included the data of 92 patients with RA, 100 patients with AS and 62 healthy controls, which were retrospectively obtained from the patient files. The age, gender, duration of the disease, medications, levels of vitamin D, calcium, C-reactive protein (CRP and erythrocyte sedimentation rate (ESR were recorded. Disease activities were evaluated by Disease Activity Score-28 (DAS28 in patients with RA and Bath Ankylosing Spondylitis Disease Index (BASDAI in patients with AS. Results: Vitamin D levels were low in all groups. In AS patients, there was no statistical negative correlation among vitamin D levels and BASDAI, erythrocyte sedimentation rate (ESR and C-reactive protein (CRP (r=-0.059, p=0.560, r=-0.072, p=0.473, r=-0.112, p=0.268, respectively. In RA patients, there was also no significant negative correlation between vitamin D levels and DAS28 (r=-0.090, p=0.392. Discussion: In our study, low serum vitamin D levels were found in all groups, and it is suggested that vitamin D deficiency may be associated with the disease activity rather than the etiology of RA and AS.

  14. Ankylosing spondylitis: a difficult diagnosis in patients on long-term renal replacement therapy.

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    Piccoli, Giorgina B; Quaglia, Marco; Mezza, Elisabetta; Burdese, Manuel; Lacuzzo, Candida; Bechis, Francesca; Biancone, Luigi; Anania, Patrizia; Maddalena, Emanuela; Jeantet, Alberto; Segoloni, Giuseppe P; Salvarani, Carlo

    2002-01-01

    We report the case of a 48-year-old male, whose musculoskeletal manifestations, previously related to long-term renal replacement therapy (RRT), were diagnosed as ankylosing spondylitis when symptoms changed their pattern on daily hemodialysis (DHD). The patient started RRT in 1981; in 1985 he received a cadaver graft, which failed in 1987. Secondary hyperparathyroidism, amyloid geoids, bilateral carpal tunnel syndrome and high aluminium levels were present. Musculoskeletal pain, reported since 1986, involved feet, heels, hips, shoulders, hands, spine. Symptoms impairing daily life did not improve after parathyroidectomy. He developed chronic hypotension and recurrent atrial fibrillation. In 1994 and 1998, because of thoracic pain, coronarography was performed (normal on both occasions). In June 2000, DHD was started. Equivalent renal clearance increased from 9-12 to 15-17 mL/min. Well-being remarkably improved. In September 2000, musculoskeletal pain worsened and bilateral Achilles tendinitis occurred. The worsening of musculoskeletal symptoms despite the improvements in well-being and other dialysis related symptoms prompted a re-evaluation of the case. The diagnosis of ankylosing spondylitis was based on: history of plantar fasciitis, bilateral Achilles tendinitis, inflammatory spinal pain with limitation of lumbar spine mobility (positive Schober test), radiological evidence of grade 2 bilateral sacroiliitis, presence of HLA-B27. This diagnosis cast light on the episodes of chest pain, explained by enthesopathy at the costosternal and manubriosternal joints and atrial fibrillation, due to HLA-B27 associated impairment in heart conduction. This case exemplifies the difficulty of differential diagnosis of multisystem illness in patients with long RRT follow-up.

  15. Ankylosing spondylitis: The physical exercise as a form of rehabilitation and promoter of quality of life

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    R.M. Costa

    2008-01-01

    Full Text Available Introduction: the main goal of this study was to verify if the practice of physical exercise is related to the quality of life in patients with Ankylosing Spondylitis. Material and methods: it was made a quantitative study, following a correlative and descriptive approach. As a means of data collection it was used a questionnaire that it was organized in two parts, the first one to get information about the social- demographic level, whether if it makes or not rehabilitation and about the practise of exercise and the second one related to the quality of life questionnaire, SF36. For the data treatment, it was used the statistical program SPSS (Statistical Package for Social Sciences, version 12.0. The statistical techniques used were the descriptive and deductive ones. Results: it involved 19 patients with Ankylosing Spondylitis, 10 females and 9 males, whose average age was 46,58 years old. The first symptoms occurred, in average, at the age of 27,53 ; the lapse of time between the disease appearance and the diagnosis was of 6,88 years and the patients presented, in average, 10,83 years of evolution of disease. Concerning physical exercise, the study proved that 10 patients practised it regularly, while the other 9 didn’t practise any type of physical exercise. Conclusions: It was possible to conclude that the age, age of diagnosis and the lapse of time between the disease appearance and the diagnosis influence positive and negative in quality of life and that there are different perceptions regarding the relation between health and physical exercise.

  16. Loss of anterior concavity of the first sacrum can predict spinal involvement in ankylosing spondylitis.

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    Kim, Ji Young; Lee, Seunghun; Joo, Kyung Bin; Song, Yoonah; Joo, Young Bin; Kim, Tae-Hwan

    2016-01-01

    In this study, we evaluated the frequency of squaring of the first sacrum (S1), defined as the loss of anterior concavity, in patients with ankylosing spondylitis (AS). We also determined the interobserver reliability in the assessment of S1 squaring and the relationships of S1 squaring with MRI findings and the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). To this end, we performed a retrospective study of 100 patients with AS (mean age 33.2 years; range 19-57 years) and 100 control patients (mean age 35.6 years; range 19-50 years). Four experienced radiologists independently assessed the presence of S1 squaring in the AS and control groups. The frequencies of S1 squaring as scored by the four observers were 47, 48, 46, and 42 in the AS group and 3, 6, 4, and 6 in the control group. The interobserver agreement among the four observers with respect to S1 squaring was excellent (κ value 0.80) in the AS group and fair to good (κ value 0.61) in the control group. In patients with AS, the presence of S1 squaring showed fair to good agreement with the MRI changes (κ value 0.74). Moreover, the mSASSSs of patients with versus without S1 squaring were significantly different (mean 23.9 vs 7.0, p < 0.001). In conclusion, S1 squaring is relatively common in patients with AS. Moreover, S1 squaring is closely correlated with MRI changes and significantly associated with the mSASSS. Assessment of S1 squaring could be a simple method that is potentially useful for predicting early spinal structural involvement in patients with AS.

  17. Non-radiographic axial spondyloarthritis and ankylosing spondylitis: what are the similarities and differences?

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    Baraliakos, X; Braun, J

    2015-01-01

    The development of the axial spondyloarthritis and ankylosing spondylitis (ASAS) classification criteria has had several implications for our understanding of the entire spectrum of spondyloarthritides (SpA). Going beyond the modified New York criteria, which concentrate on conventional radiographs of the sacroiliac joints (SIJ) for the classification of ankylosing spondylitis, the ASAS criteria add active inflammation of the SIJ as obtained by MRI and human leucocyte antigen (HLA) B27 to classify patients with chronic back pain starting at a young age as axial SpA (axSpA). AxSpA should be considered as one disease that includes AS, the radiographic form, as well as the non-radiographic (nr-axSpA) form. Similarities and differences between these subgroups have been described in 3 studies: 1 local study, 1 national study (German SpA Inception Cohort) and 1 international study mainly conducted to test the efficacy of a tumour necrosis factor α blocker. Most clinical features and assessments of axSpA showed the same prevalence in patients with and without radiographic changes. However, some differences have been observed: the male:female ratio, the proportion of patients with objective signs of inflammation such as bone marrow oedema as detected by MRI, and the proportion of patients with increased levels of C reactive protein were higher in patients with AS. Importantly, these factors have also been identified as prognostic factors for more severe disease in terms of new bone formation. Thus, nr-axSpA may represent an early stage of AS but may also just be an abortive form of a disease which does cause much pain but which may also never lead to structural changes of the axial skeleton. Since the cut-off between nr-axSpA and AS is artificial and unreliable, we think that the term nr-axSpA should not be used for diagnosis but only for classification for historical reasons. PMID:26557375

  18. Non-radiographic axial spondyloarthritis and ankylosing spondylitis: what are the similarities and differences?

    Science.gov (United States)

    Baraliakos, X; Braun, J

    2015-01-01

    The development of the axial spondyloarthritis and ankylosing spondylitis (ASAS) classification criteria has had several implications for our understanding of the entire spectrum of spondyloarthritides (SpA). Going beyond the modified New York criteria, which concentrate on conventional radiographs of the sacroiliac joints (SIJ) for the classification of ankylosing spondylitis, the ASAS criteria add active inflammation of the SIJ as obtained by MRI and human leucocyte antigen (HLA) B27 to classify patients with chronic back pain starting at a young age as axial SpA (axSpA). AxSpA should be considered as one disease that includes AS, the radiographic form, as well as the non-radiographic (nr-axSpA) form. Similarities and differences between these subgroups have been described in 3 studies: 1 local study, 1 national study (German SpA Inception Cohort) and 1 international study mainly conducted to test the efficacy of a tumour necrosis factor α blocker. Most clinical features and assessments of axSpA showed the same prevalence in patients with and without radiographic changes. However, some differences have been observed: the male:female ratio, the proportion of patients with objective signs of inflammation such as bone marrow oedema as detected by MRI, and the proportion of patients with increased levels of C reactive protein were higher in patients with AS. Importantly, these factors have also been identified as prognostic factors for more severe disease in terms of new bone formation. Thus, nr-axSpA may represent an early stage of AS but may also just be an abortive form of a disease which does cause much pain but which may also never lead to structural changes of the axial skeleton. Since the cut-off between nr-axSpA and AS is artificial and unreliable, we think that the term nr-axSpA should not be used for diagnosis but only for classification for historical reasons.

  19. Detection of active sacroiliitis with ankylosing spondylitis through intravoxel incoherent motion diffusion-weighted MR imaging

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    Zhao, Ying-hua [Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, Department of Radiology, Guangzhou (China); Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, Guangzhou (China); Li, Shao-lin; Zhao, Xiang-cheng; Hu, Shao-yong; Liu, Zhen-hua [Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, Department of Radiology, Guangzhou (China); Liu, Zai-yi; Chen, Xin; Liang, Chang-hong [Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, Guangzhou (China); Mei Ms, Ying-jie [Philips Healthcare, Guangzhou (China); Chan, Queenie [Philips Electronics Hong Kong Ltd, Hong Kong (China)

    2015-09-15

    To confirm feasibility and assess intravoxel incoherent motion (IVIM) to differentiate active sacroiliitis and ankylosing spondylitis. Forty-one patients were divided into two groups, an active group (n = 20) and a chronic group (n = 21), according to the Bath Ankylosing Spondylitis (AS) Disease Activity Index (BASDAI) and laboratory parameters. In addition, 21 healthy volunteers were chosen as the control group. Tissue diffusivity (D{sub slow}), perfusion fraction (f), and pseudo-diffusion coefficient (D{sub fast}) values were obtained for all three groups. One-way analysis of variance and receiver operating characteristic analysis were performed for all parameters. There was good interobserver agreement on the measurements between the two observers. The optimal cut-off values (with respective AUC, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio) between active and chronic groups were D{sub slow} = 0.53 x 10{sup -3} mm{sup 2}/s (0.976, 90 %, 95.2 %, 18.9, 0.10) and f = 0.09 (0.545, 20 %, 95.5 %, 4.2, 0.84), and between chronic and control groups were D{sub slow} = 0.22 x 10{sup -3} mm{sup 2}/s (0.517, 9.52 %, 100 %, no number, 0.9) and f = 0.09 (0.935, 95.24 %, 80.95 %, 5, 0.059). D{sub slow} and f of IVIM diffusion-weighted (DW)-MRI in AS show a significant difference in the values of diffusion of water molecules and fractional perfusion-related volume among the three groups. (orig.)

  20. Bone morphogenetic protein 6 polymorphisms are associated with radiographic progression in ankylosing spondylitis.

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    Young Bin Joo

    Full Text Available Nearly 25 genetic loci associated with susceptibility to ankylosing spondylitis (AS have been identified by several large studies. However, there have been limited studies to identify the genes associated with radiographic severity of the disease. Thus we investigated which genes involved in bone formation pathways might be associated with radiographic severity in AS.A total of 417 Korean AS patients were classified into two groups based on the radiographic severity as defined by the modified Stoke' Ankylosing Spondylitis Spinal Score (mSASSS system. Severe AS was defined by the presence of syndesmophytes and/or fusion in the lumbar or cervical spine (n = 195. Mild AS was defined by the absence of any syndesmophyte or fusion (n = 170. A total of 251 single nucleotide polymorphisms (SNPs within 52 genes related to bone formation were selected and genotyped. Odds ratios (OR and 95% confidence interval (95% CI were analysed by multivariate logistic regression controlling for age at onset of symptoms, sex, disease duration, and smoking status as covariates.We identified new loci of bone morphogenetic protein 6 (BMP6 associated with radiographic severity in patients with AS that passed false discovery rate threshold. Two SNPs in BMP6 were significantly associated with radiologic severity [rs270378 (OR 1.97, p = 6.74 × 10(-4 and rs1235192 [OR 1.92, p = 1.17 × 10(-3] adjusted by covariates.This is the first study to demonstrate that BMP6 is associated with radiographic severity in AS, supporting the role wingless-type like/BMP pathway on radiographic progression in AS.

  1. Expression of uncarboxylated matrix Gla protein in ankylosing spondylitis and its significance

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    Han-qing HUANG

    2013-07-01

    Full Text Available Objective To investigate the serum level of uncarboxylated matrix Gla protein (ucMGP in ankylosing spondylitis (AS patients, and to evaluate its diagnostic value and the relation of ucMGP to inflammation and ossification process in AS. Methods Eight-two AS patients and 76 healthy controls were enrolled in this randomized controlled study. The clinical indices (age, gender, course of disease, disease activity, changes in radiographic studies, and indices of bone metabolism or inflammation, including erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, osteocalcin (OC, and bone-specific alkaline phosphatase (BALP were evaluated or measured. The disease activity was assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, and changes in radiographic pictures were evaluated according to the modified Stoke AS Spine Score (mSASSS, and serum level of ucMGP was measured by a competitive ELISA. The relationship between ucMGP and clinical indexes, radiographic scoring, indices in bone metabolism or inflammation was estimated by SPSS software, and the diagnostic value of ucMGP was analyzed by receiver operator characteristic (ROC curve. Results The levels of ESR and CRP in AS patients were higher than those in healthy controls, but the serum ucMGP was lower (2958±654nmol/L compared with healthy controls (4551±1036nmol/L, P0, r=-0.715, P1, r=-0.741, P10, r=-0.776, P<0.01; mSASSS <10, r=-0.297, P=0.028. Conclusion Serum ucMGP may serve as a diagnostic biomarker of AS and progression index of ossification, especially in late stage of AS.

  2. Predictive Factors for the Evolution of Reactive Arthritis to Ankylosing Spondylitis

    Science.gov (United States)

    BANICIOIU-COVEI, S.; VREJU, FA.; CIUREA, P.

    2015-01-01

    Purpose: The goal of this study is to identify the predictive factors involved in the evolution of the reactive arthritis to ankylosing spondylitis by following the presence and degree of sacroiliitis and also the appeareance of acute anterior uveitis.Material and Methods: The study was performed between 01.01.2011- 31.12.2014 on 112 patients, aged between 17 and 47 years old, in evidence of the Rheumatology Clinic of the Clinical Hospital Emergency Craiova. The patients were divided in 2 lots according to the radiological criteria: the first lot included 52 patients diagnosed with reactive arthritis, with the determination of the pathogen agent involved and the demonstration of sacroiliitis first degree by Nuclear Magnetic Resonance (IRM). The second lot included a number of 60 patients diagnosed with reactive arthritis, without presenting significant changes in the sacroiliac joints and at the cervico-dorsal- lumbar spine. Results: In the first batch, the performance of the IRM and monitoring the patients every 6 months over 3 years revealed the progression of sacroiliitis from first degree in which it was at the moment of diagnosing at second degree in a 6 month period. Three years after initiation of therapy for reactive arthritis, the patients from the second batch responded favorably to treatment, the performance of imaging not revealing signs of sacroiliitis.Conclusion: Association of sacroiliitis at baseline proved to be a negative prognostic factor in reactive arthritis, which can suggest the evolution to ankylosing spondylitis, monitoring these patients being necessary for at least 3 years from the point of diagnosing.

  3. The 1957 MRC report on leukaemia and aplastic anaemia in patients irradiated for ankylosing spondylitis

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    Smith, Peter G [London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT (United Kingdom)

    2007-12-15

    The estimation of the carcinogenic effects of exposure to low doses of ionizing radiation has depended primarily on extrapolation from effects seen in two populations exposed to relatively high doses-the survivors of the atomic bomb explosions in Japan and patients treated in the UK with x-rays for the arthritic condition ankylosing spondylitis. The study of the leukaemia risk in over 14000 irradiated spondylitis patients was completed in an astonishingly short period of time in the mid-1950s. The full report of the original study has been difficult to access because it was not published in a journal but only as a Special Report of the UK Medical Research Council. To mark 50 years since this publication this full report is reproduced in this issue of the Journal. This accompanying review describes the background to the study, the principal findings and the further follow-up of the population that documented the risks of cancers in addition to leukaemia associated with the x-ray treatment. The architects of the study were a radiobiologist, Michael Court-Brown, and an epidemiologist, Richard Doll. Their very productive study of the leukaemia risk among spondylitics spawned a lifelong collaboration including further seminal studies of the carcinogenic effects of radiation exposure, which are also summarised in the review. (review)

  4. Long-term safety and efficacy of infliximab for the treatment of ankylosing spondylitis

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    Elalouf O

    2015-11-01

    Full Text Available Ofir Elalouf, Ori Elkayam Department of Rheumatology, Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv, Israel Abstract: The introduction of TNFα blockers has revolutionized the treatment of ankylosing spondylitis (AS. The objectives of this review are to summarize the most up-to-date data on long-term efficacy and safety of infliximab in AS, with special emphasis on axial and extra-articular disease, predictors of response, and radiological response. The general consensus of this literature search was that infliximab is highly efficacious in the treatment of AS. Most studies have demonstrated good clinical outcomes after 3 years of treatment, as measured by Spondyloarthritis International Society response in 75%–85% of treated AS patients. Reports on the long-term effects of infliximab as documented by radiological findings, however, are controversial. While some studies reported a similar progression rate as that of the historical OASIS cohort, others have suggested that infliximab may halt new bone formation. The long-term safety of infliximab is well known, mainly from data stored in national registries. While it has been suggested that side effects of infliximab may be fewer in AS compared to rheumatoid arthritis, data on this issue are sparse, with most of the information on long-term safety pertaining to rheumatoid arthritis. It can however be concluded that the long-term efficacy of infliximab is apparently maintained in AS and with an acceptable safety profile. Keywords: spondylitis, long-term efficacy, safety, TNFα blockers

  5. MAGNETIC RESONANCE IMAGING DIAGNOSIS OF INFLAMMATORY CHANGES OF THE AXIAL SKELETON IN ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    A. V. Smirnov

    2016-01-01

    Full Text Available As of now, magnetic resonance imaging (MRI ranks high in the early diagnosis of inflammatory changes in the musculoskeletal system. The uniqueness of MRI is that this diagnostic technique can detect the signs of active and inactive inflammation at the pre-radiological stage of the disease, i.e. before the onset of radiological symptoms of sacroiliitis and the formation of spinal syndesmophytes. At the same time there is evidence that there is a temporary association between active inflammation and the development of radiological changes in the joints.The detection of bone marrow edema in the subchondral portions of bone tissue is of great importance not only for diagnosing the disease and verifying inflammatory activity, but also for predicting the development of chronic arthritis, choosing a treatment option, and evaluating the efficiency of performed therapy.Based on their long-term experience, the authors provided explanations of the MRI pattern of active and inactive chronic sacroiliitis and spondylitis, which can considerably facilitate the early diagnosis of injury to the sacroiliac joints and vertebral column in patients with ankylosing spondylitis.

  6. Treating ankylosing spondylitis with Xiao Huoluo Dan%小活络丹治疗强直性脊椎炎

    Institute of Scientific and Technical Information of China (English)

    田水

    2014-01-01

    To observe clinical efficacy of Xiao Huoluo Dan on treating ankylosing spondylitis. 56 patients were given Xiao Huoluo Dan, 34 were marked effective, 18 were effective and 4 were invalid, the total efficacy was 92.8%. Xiao Huoluo Dan was effective on ankylosing spondylitis.%观察小活络丹治疗强直性脊椎炎的临床疗效。56例患者采用小活络丹治疗,显效34例,有效18例,无效4例,总有效率达92.8%。小活络丹加味治疗强直性脊椎炎取得较好的疗效。

  7. Coexistence of Diffuse Idiopathic Skeletal Hyperostosis and Late-Onset Ankylosing Spondylitis in a Sixty-year-old Patient

    OpenAIRE

    Zeliha Ünlü; Gülgün Yılmaz; Aslıhan Ulusoy

    2016-01-01

    Diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) are two diseases characterized by ossification of the ligaments and tendons in both the axial skeleton and peripheral sites with very different pathologies. Coexistence of DISH and AS is a rare condition and there are relatively few cases in the English-language literature. In this paper, we report a human leukocyte antigen-B27-negative patient who presented with the typical appearance of DISH on the dorsal radiog...

  8. Association of GSTM1, GSTT1, GSTP1-ILE105VAL and ACE I/D polymorphisms with ankylosing spondylitis.

    Science.gov (United States)

    İnal, Esra Erkol; Görükmez, Orhan; Eroğlu, Selma; Görükmez, Özlem; Solak, Özlem; Topak, Ali; Yakut, Tahsin

    2016-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown origin. The aim of this study is to clarify the relationships between susceptibility and severity of AS and GST-mu1 (GSTM1), GST-theta1 (GSTT1), GST-pi1 (GSTP1)-Ile105Val and angiotensin-converting enzyme (ACE) I/D polymorphisms in AS patients. One hundred thirty-eight AS patients and seventy-one healthy controls were enrolled in this study. Erythrocyte sedimentation rate and C-reactive protein (CRP) levels of the AS patients were recorded. The scores of the numeric rating scale (NRS) pain, the Bath Ankylosing Spondylitis Activity Index, the Bath Ankylosing Spondylitis Metrology Index and the Bath Ankylosing Spondylitis Functional Index were calculated. The genotypes distributions and allele frequencies of GSTM1, GSTT1, GSTP1-Ile105Val and ACE I/D polymorphisms were compared between patients and healthy controls. The Multiplex polymerase chain reaction (PCR) and the PCR-restriction fragment length polymorphism methods were used to detect the polymorphisms of ACE I/D, the GSTT1 and GSTM1 genes and the GSTP1-Ile105Val polymorphism, respectively. There were significantly higher levels of the GSTT1 null and the ACE II genotypes in AS patients compared to those in healthy controls (p = 0.002 and 0.005, respectively). We found significantly higher levels of CRP and the NRS pain scores in the patients with ACE ID or DD genotypes compared to those in the patients with ACE II genotypes (p = 0.005 and 0.035, respectively). The present results showed that genes involved in protection from oxidative stress and ACE gene may influence disease development and course in AS.

  9. Relationship of serum osteoprotegerin with arterial stiffness, preclinical atherosclerosis, and disease activity in patients with ankylosing spondylitis.

    Science.gov (United States)

    Serdaroğlu Beyazal, Münevver; Erdoğan, Turan; Türkyılmaz, Aysegül Kücükali; Devrimsel, Gül; Cüre, Medine Cumhur; Beyazal, Mehmet; Sahin, Ismail

    2016-09-01

    Patients with ankylosing spondylitis (AS) reportedly have a higher mortality and morbidity risk. Osteoprotegerin (OPG) was recently defined as an important cardiovascular (CV) marker in the general population. We aimed to assess the relationship of serum OPG levels with arterial stiffness, carotid intima media thickness (CIMT), and clinical and laboratory data in AS patients. We examined 60 AS patients without CV disease or risk factors and 50 healthy controls. Disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS), whereas functional capacity was evaluated using the Bath Ankylosing Spondylitis Functional Index (BASFI). Serum OPG levels were measured with the enzyme-linked immunosorbent assay. Carotid-femoral pulse wave velocity (PWV) was used as an indicator of arterial stiffness, whereas CIMT (examined via carotid ultrasonography) was used to evaluate preclinical atherosclerosis. The mean serum OPG level, PWV, and CIMT were significantly higher in AS patients than in controls (106.7 ± 50.9 vs. 58.1 ± 12.7 pg/mL; 7.4 ± 1.8 vs. 6.2 ± 1.2 m/s; 0.72 ± 0.13 vs. 0.57 ± 0.07 mm, respectively; P < 0.001 for all). In AS patients, the serum OPG levels were not significantly correlated with PWV and CIMT but were significantly correlated with erthrocyte sedimentation rate, BASFI, and ASDAS. AS patients without CV disease or risk exhibited high OPG levels and increased PWV and CIMT values. Although OPG levels were not significantly correlated with PWV or CIMT, future long-term follow-up studies will help define the predictive value of OPG in these patients.

  10. Rituximab Can Induce Remission in a Patient with Ankylosing Spondylitis Who Failed Anti-TNF-α Agent

    Science.gov (United States)

    AlDhaheri, Fahmi; Almteri, Talal; Dwid, Naji; Majdali, Ahd; Janoudi, Nahed; Almoallim, Hani

    2017-01-01

    Patient: Male, 38 Final Diagnosis: Ankylosing spondylitis Symptoms: Back pain • morning stiffness Medication: — Clinical Procedure: Not applicable Specialty: Rheuamatology Objective: Unusual or unexpected effect of treatment Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease that predominantly affects the axial skeleton. The ability of anti-TNF-α agents to reduce disease activity in patients with axial spondyloarthritis (axSpA), including AS, has been demonstrated in multiple randomized trials and several meta-analyses. Reports on the efficacy of rituximab in treatment of AS have described good results. We report on a patient with AS who failed anti-TNF-α therapy but showed good clinical improvement with rituximab therapy. Case Report: A 38-year-old male patient was diagnosed with AS and showed poor response to sulfasalazine and non-steroidal anti-inflammatory drugs (NSAIDs). Infliximab was initiated with marked improvement as per the Bath ankylosing spondylitis disease activity index (BASDAI). Due to disease flare, the patient was switched to etanercept. He subsequently acquired papillary thyroid cancer and etanercept was discontinued. He underwent a total thyroidectomy followed by radioiodine therapy. For his ongoing active disease, NSAIDs and sulfasalazine were resumed with a lack of response (BASDAI=7.1). Rituximab was started and resulted in significant improvement (BASDAI=2.3). Conclusions: Rituximab can be a potential target therapy for patients who start to lose response to TNF-inhibitors or for those who develop solid malignancies. Further placebo-controlled studies are required. PMID:28179619

  11. Cross-cultural adaptation and validation of the Turkish version of the pain catastrophizing scale among patients with ankylosing spondylitis.

    Science.gov (United States)

    İlçin, Nursen; Gürpınar, Barış; Bayraktar, Deniz; Savcı, Sema; Çetin, Pınar; Sarı, İsmail; Akkoç, Nurullah

    2016-01-01

    [Purpose] This study describes the cultural adaptation, validation, and reliability of the Turkish version of the Pain Catastrophizing Scale in patients with ankylosing spondylitis. [Methods] The validity of the Turkish version of the Pain Catastrophizing Scale was assessed by evaluating data quality (missing data and floor and ceiling effects), principal components analysis, internal consistency (Cronbach's alpha), and construct validity (Spearman's rho). Reproducibility analyses included standard measurement error, minimum detectable change, limits of agreement, and intraclass correlation coefficients. [Results] Sixty-four adult patients with ankylosing spondylitis with a mean age of 42.2 years completed the study. Factor analysis revealed that all questionnaire items could be grouped into two factors. Excellent internal consistency was found, with a Chronbach's alpha value of 0.95. Reliability analyses showed an intraclass correlation coefficient (95% confidence interval) of 0.96 for the total score. There was a low correlation coefficient between the Turkish version of the Pain Catastrophizing Scale and body mass index, pain levels at rest and during activity, health-related quality of life, and fear and avoidance behaviors. [Conclusion] The results of this study indicate that the Turkish version of the Pain Catastrophizing Scale is a valid and reliable clinical and research tool for patients with ankylosing spondylitis.

  12. Treatment of ankylosing spondylitis with [{sup 224}Ra]-Radiumchloride; Therapie der Spondylitis ankylosans mit [{sup 224}Ra]-Radiumchlorid

    Energy Technology Data Exchange (ETDEWEB)

    Reiners, C. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Wuerzburg (Germany); Braun, J. [Rheumazentrum Ruhrgebiet Herne (Germany)

    2001-07-01

    Ankylosing spondylitis (AS) is a chronic disease which in 30-50% of the patients leads to considerable episodes of pain, a remarkable reduction of quality of life and disablement. For treatment mostly nonsteroidal antiphlogistic drugs are used which are able to reduce pain in approximately 80% of the patients only. Those drugs however, have to be withdrawn in approximately 30% of the patients due to its known toxicity (mainly in the gastrointestinal tract). Basis medication (DMARDs) is helpful in a minority of AS patients only. Recently [{sup 224}Ra]-Radiumchloride, which has been used previously between 1955 and 1990, has been made available again for treatment of AS. Whereas biokinetics, radiation exposure and the risk-profile of [{sup 224}Ra]-Radiumchloride are documented well by experimental and clinical data, most of the historical studies about the efficacy of this radiopharmaceutical do not fulfill the requirements of modern therapy studies. Therefore as many patients as possible should be recruited for a prospective long-time Phase IV study. A close and well-coordinated cooperation between rheumatologists and nuclear medicine physicians is needed, when [{sup 224}Ra]-Radiumchloride is used for treatment of AS. (orig.) [German] Die meist chronisch, oft auch in Schueben verlaufende Spondylitis ankylosans (AS) fuehrt bei 30-50% der Patienten zu betraechtlichen Schmerzen und einer nicht selten erheblichen Einschraenkung der Lebensqualitaet und Behinderung. Die am haeufigsten zur Therapie verwendeten nichtsteroidalen Antiphlogistika koennen nur bei etwa 80% der Patienten die Schmerzen lindern. Allerdings muessen diese Medikamente bei 20-30% der AS-Patienten wegen ihrer bekannten Toxizitaet - vor allem im Gastrointestinaltrakt - abgesetzt werden. Basistherapeutika (DMARDs) helfen bei der AS nur sehr begrenzt. Mit [{sup 224}Ra]-Radiumchlorid steht seit kurzem ein bereits in den Jahren 1945-1990 fuer die Behandlung der AS verwendetes Radiopharmakon wieder zur

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

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Sørensen, Inge Juul; Hermann, Kay-Geert A

    2010-01-01

    To investigate construct validity and responsiveness of the novel ankylosing spondylitis (AS) disease activity score (ASDAS) in patients with spondyloarthritis (SpA).......To investigate construct validity and responsiveness of the novel ankylosing spondylitis (AS) disease activity score (ASDAS) in patients with spondyloarthritis (SpA)....

  14. Cross-cultural adaptation and validation of the Portuguese version of "The assessment of knowledge in ankylosing spondylitis patients by a self-administered questionnaire".

    Science.gov (United States)

    da Rocha Lopes, Sofia Manuela; Duarte, José Alberto; Mesquita, Cristina Teresa Torrão Carvalho

    2016-04-01

    Knowledge is an important factor in patients with ankylosing spondylitis regarding the adoption of appropriate behaviours and education. The aim of this study was to culturally adapt and validate "The assessment of knowledge in ankylosing spondylitis patients by a self-administered questionnaire" for the Portuguese population with ankylosing spondylitis. The Portuguese version of "The assessment of knowledge in ankylosing spondylitis patients by a self-administered questionnaire" was administered to a sample of 180 subjects, from which 63 individuals responded. The adaptation process involved translation, back-translation and submission to a committee of experts in the area, culminating with a Portuguese version of the instrument. Next, the scale reliability and validity were assessed. There was a statistically significant decrease from test to retest, although the intra-class correlation coefficient between test and retest was 0.76 (95 % CI 0.61-0.86), which was considered good. From 180 individuals, 63 (35.0 %) subjects were available for the present study. The proportion of individuals that correctly answered each item ranged from 19 to 92 %, corresponding to items 8 and 13, respectively. The mean number of correct answers was 8.5 [mean (SD) = 2.4] in 12 questions. The proposed Portuguese version of the ankylosing spondylitis knowledge scale showed good reliability, reproducibility and construct validity.

  15. Translation, cultural adaptation, and validation of the Bath questionnaires and HAQ-S in Hindi for Indian patients with ankylosing spondylitis.

    Science.gov (United States)

    Dhir, Varun; Kulkarni, Sujay; Adgaonkar, Ashish; Dhobe, Poornima; Aggarwal, Amita

    2012-10-01

    The disease activity and functional impact of ankylosing spondylitis (AS) is currently measured through various questionnaire instruments, the most popular of which are the Bath indices. However, Hindi versions for use in Indian patients are not available. This study aimed to fill this lacuna. Translation and cross-cultural adaptation of the instruments--Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitits Metrology Index (BASMI), Bath Ankylosing Spondylitis Patient Global Score (BAS-G), and Health Assessment Questionnaire-Spondyloarthropathy (HAQ-S)--were done using standard guidelines. These were then self-administered to patients. The BASMI measurements, occiput-to-wall distance, chest expansion (in centimeters), total enthesis count, ESR, and C reactive protein (CRP) were measured. To assess reliability, the patient was called back on day 14, and the questionnaires were again self-administered, and the intra-class correlation coefficient was calculated to assess reliability. Correlation of questionnaire scores with acute phase reactants, measurements, and enthesitis index were used to assess for construct validity. Some modifications were done in the Bath indices and HAQ-S for cross-cultural adaptation. For validation, 41 patients of ankylosing spondylitis with a mean age of 34 years (±10.2) and disease duration of 5.8 years (±6.2) were included. The Bath Ankylosing Spondylitis Functional Index (BASFI), BASDAI, and HAQ-S showed good correlation among themselves (r = 0.69 to 0.84, p Hindi versions of the BASDAI, BASFI, BAS-G, and HAQ-S were found to be valid and reliable for use in Hindi-speaking Indian patients with ankylosing spondylitis.

  16. Spine inflammatory changes in patients with ankylosing spondylitis assessed by magnetic resonance image

    Directory of Open Access Journals (Sweden)

    A G Bochkova

    2008-01-01

    Full Text Available Objective. To develop the optimal mode of spine evaluation with magnetic resonance image (MRl in pts with ankylosing spondylitis (AS and to study relationship between MR! signs of spinal inflammatory lesions (IL, spondylitis duration and clinical features of AS activity. Material and methods. MRl was performed in 36 pts (22 male, 14 female fulfilling the modified NY criteria of AS. Median age of pis was 26 years (range 19 - 55, Median AS duration - 8 years (range 1,8 - 24. 34 (97% pts were HLA-B27 positive. 21 (64% pts had high AS activity - median BASDAI 40 (range 10 - 77. 92% of pts had inflammatory spine pain (VAS>20 mm and 61% of pts had night pain. Median inflammatory pain duration had been defined separately for every part of the spine assessed by MRl. Median duration of axial pain was 36 months (range: 1-240. MR-scanning (Magnetom Symphony, Siemens, 1.5 T was performed inTl, T2 and T2-FS (fat signal suppression modes. IL scoring was done only in 29 pts evaluated in both sagittal and axial planes. We used two scoring methods: 1 individual IL score of the each spine element (vertebral bodies, processes, arches, zygapophyseai, costovertebral and costotransverse joints, ligaments, and 2 separate IL scoring in the vertebral bodies and posterior spinal elements in order "yes/no”. Results. 50 MRl images of different parts of the spine (8 cervical, 30 thoracic and 12 lumbar have been obtained in 36 pts. Spine IL were found in 35 pts. 26% of all IL were revealed in axial planes. 3 pts with short AS duration had IL only on axial slices (zygapophyseai lumbar joints, costotransverse joints, processes. IL were revealed more often in thoracic (average score: 7.1, than in lumbar (3.7 and cervical (2.1 spine. In most (26 from 29 pts, 90% pts IL were found in painful parts of spine. There was no IL score difference between pts(n=12 with low (BASDAI <40 and high (BASDAI>40; n=17 AS activity. Me and range were 4 (1.8-10.3 and 6 (4-16, respectively; p=0

  17. Value of the peripheral blood B-cells subsets in patients with ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    LIN Qu; GU Jie-ruo; LI Tian-wang; ZHANG Fu-cheng; LIN Zhi-ming; LIAO Ze-tao; WEI Qiu-jing; CAO Shuang-yan; LI Li

    2009-01-01

    Background The role of B-cell remains an enigma in the pathogenesis of ankylosing spondylitis(AS).This study aimed to investigate the distributions of B-cells and subsets in peripheral blood of AS patients and observe their changes in etanercept-treated AS patents.Methods We detected the proportions of CD19+ B-cell,naive B-cell(CD19+CD27),memory B-cell(CD19+CD27dim)and plasmablast(CD19+CD27high)in peripheral blood of 66 patients with AS(39 at active stage,27 at stable stage;35patients with peripheral joint involvement,31 patients with axial involvement alone),30 patients with rheumatoid arthritis (RA)and 30 healthy volunteers using flow cytometry.And then we observedthe changes of the above indexes of 39 active AS patients treated with etanercept in a randomized,double-blind,placebo-controlled trial.Results (1)Percentages of CD19+ B-cells in active or peripheral joint involvement AS patients increased more obviously than those in stable or axial involvement alone AS patients(both P=0.001),and percentage of CD19+CD27high B-cells in AS patients with peripheral joint involvement was significantly higher than that in cases with axial involvement alone or healthy volunteers(P=0.005 and 0.006,respectively);(2)The percentage of CD19+ B-cells in AS patients was positively correlated with Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)scores,Patient's Global Assessment(PGA)scores,total back pain scores and nocturnal back pain scores(r=0.270,0.255,0.251 and 0.266,P=0.029,0.039,0.042 and 0.031,respectively);(3)At week 6 and week 12,there were no statistical differences of the percentages of B-cells and subsets between etanercept group and placebo group of AS patients(P>0.05);the percentage of CD19+ B-cells in etanercept group was higher than that in healthy volunteers at week 12(t=3.320,P=0.003).Conclusions Misbalance is present in B-cells and some subsets in peripheral blood of active AS patients with peripheral joint involved.B-cells might play an important

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

    Energy Technology Data Exchange (ETDEWEB)

    Gaspersic, Natasa [University Medical Centre, Department of Rheumatology, Ljubljana (Slovenia); Sersa, Igor [Jozef Stefan Institute, Ljubljana (Slovenia); Jevtic, Vladimir [Medical Faculty, Department of Radiology, Ljubljana (Slovenia); Tomsic, Matija; Praprotnik, Sonja [University Medical Centre, Department of Rheumatology, Ljubljana (Slovenia)

    2008-02-15

    The effects of different therapies on enthesitis/osteitis in active ankylosing spondylitis (AS) were evaluated by magnetic resonance imaging (MRI). The aim was to assess the role of quantitative MRI in the evaluation of AS treatment efficacy. Thirty patients with active spondylitis or bilateral sacroilitis were selected and followed up for 1 year. Ten of the patients were treated only with non-steroidal anti-inflammatory drugs, 10 patients additionally received at baseline an intravenous pulse of glucocorticoids and 10 patients were treated with regular infusions of infliximab. Disease activity was measured according to clinical instruments and laboratory tests. For each patient, one selected inflamed lesion was followed from baseline through control visits quantitatively by diffusion-weighted imaging (DWI) measuring the apparent diffusion coefficient (ADC) and by dynamic contrast-enhanced imaging (DCEI) with evaluation of the enhancement factor (f{sub enh}) and enhancement gradient (g{sub enh}). Clinical and quantitative MRI parameters diminished significantly with regression of the inflammatory activity. The improvement in AS was most pronounced in patients treated with infliximab; after 12 months the ADC diminished from an average of 1.31 to 0.88 x 10{sup -3} mm{sup 2}/s, f{sub enh} from 1.85 to 0.60, and g{sub enh} from 3.09 to 1.40 %/s. Diffusion-weighted imaging and DCEI were shown to be effective in quantifying changes in inflammation in skeletal lesions during the treatment of AS, and could therefore be convenient for assessing treatment efficacy. To the best of our knowledge this is the first time DWI was used to evaluate the activity of skeletal inflammation in rheumatic diseases such as AS. (orig.)

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

    Science.gov (United States)

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

    2014-01-01

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

  20. Value of bath ankylosing spondylitis disease activity index and mini-bath ankylosing spondylitis disease activity index for diagnosis of ankylosing spondylitis%比较BASDAI和mini-BASDAI对强直性脊柱炎病情的判断价值

    Institute of Scientific and Technical Information of China (English)

    杜旭娜; 李晏; 张胜利; 朱剑; 黄烽

    2012-01-01

    Objective To assess the value of bath ankylosing spondylitis disease activity index(BASDAI) and mini-BASDAI for diagnosis of ankylosing spondylitis(AS). Methods Patients with AS were divided into "P+" group and "P-" group according to the involvement of their peripheral joints. BASDAI was used to assess the disease activity of patients with ankylosing spondylitis and mini-BASDAI was calculated by omitting questions 3 and 4 in BASDAI. Results A total of 264 AS patients were included in this study. The BASDAI, mini-BASDAI, BASFI, BASMI, ESR, and CRP were significantly higher in "P+" group than in "P-" group. The value of mini-BASDAI was higher than that of BASDAI in both groups. However, no significant difference was found in other markers of disease activity between the two groups. Conclusion Mini-BASDAI is not advantageous to BASDAI in assessing disease activity of patients without involvement of peripheral joints and BASDAI remains a valid indication.%目的 评价Bath 强直性脊柱炎病情活动指标(bath ankylosing spondylitis disease activity index,BASDAI) 和改良的BASDAI 即mini-BASDAI 在评价无外周关节受累的强直性脊柱炎(ankylosing spondylitis,AS) 的病情活动度时的价值.方法 根据是否有外周关节受累,将患者分为P+ 组(有外周关节受累) 和P- 组(无外周关节受累).采用BASDAI 对患者的疾病活动度进行评价,然后再省略BASDAI 中的第3、4 个问题计算出mini-BASDAI.结果 本研究共纳入264 例AS 患者.有P+ 组的患者其各项炎症指标(BASDAI、miniBASDAI、Bath 强直性脊柱炎功能指数(bath ankylosing spondylitis functionalindex,BASFI)、Bath 强直性脊柱炎计量指数(bath ankylosing spondylitis metrology index,BASMI)、血沉、C- 反应蛋白) 均显著高于P- 组患者.两组mini-BASDAI 值均高于BASDAI,但两者与其他疾病活动度评价指标之间的相关性并无差异,如医生总体评价与BSADAI 的相关系数为0.703,与mini-BASDAI

  1. A 3D assessment and feedback tool for Ankylosing Spondylitis from the perspective of healthcare professionals.

    Science.gov (United States)

    Li, Shijuan; Kay, Stephen; Porter, Stuart

    2016-12-05

    To investigate the utility of 3D visualization technology to augment assessment and feedback for Ankylosing Spondylitis (AS), a visualization prototype was developed, and both subjective and objective measures of current assessment instruments were compared. To verify and establish a base-line for the prototype's effectiveness, motion data and measurement data from a healthy adult in a laboratory environment were collected. To validate the prototype, a qualitative evaluation was undertaken using multiple methods including a pilot study, focus groups, and individual interviews. Research subjects comprised physiotherapists in clinical practice and academia and content analysis of their responses was used to substantiate the findings. The prototype enhanced both assessment and feedback of AS from the physiotherapist's perspective and they believed it to be superior to the current methods used in practice for assessing the condition and in documenting variations for subsequent treatment. The physiotherapists believed that such a system had potential to encourage multidisciplinary working, and to be patient-centric, both with respect to the process of treatment and with regard to the convenience it offered to patients in managing their own condition. 3D visualization of AS symptoms and its treatment via exercise is a valuable technique as demonstrated by the prototype system.

  2. Adipokines, biomarkers of endothelial activation, and metabolic syndrome in patients with ankylosing spondylitis.

    Science.gov (United States)

    Genre, Fernanda; López-Mejías, Raquel; Miranda-Filloy, José A; Ubilla, Begoña; Carnero-López, Beatriz; Blanco, Ricardo; Pina, Trinitario; González-Juanatey, Carlos; Llorca, Javier; González-Gay, Miguel A

    2014-01-01

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

  3. Ankylosing spondylitis: Chinese perspective, clinical phenotypes, and associated extra-articular systemic features.

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    Ho, Huei-Huang; Chen, Ji-Yih

    2013-08-01

    Ankylosing spondylitis (AS) is a common rheumatic disease in the Chinese population, which is the largest population in the world associated with the global burden of health care. Herein we review and report the epidemiology and specific clinical characteristics of Chinese AS. More than 90 % of Chinese AS patients are HLA-B27 positive with the predominant HLA-B*2704 subtype; the incidence of HLA-B27 positivity ranges from 4 to 8 % in the general Chinese population. The first-degree relatives of AS probands often develop atypical AS with relatively mild disease and particularly undifferentiated spondyloarthropathy in females. Chinese AS patients have higher frequencies of juvenile-onset AS and peripheral arthritis. Of extra-articular manifestations, AS patients have earlier onset and more recurrent attacks of HLA-B27-related acute anterior uveitis. Cardiac arrhythmias or other cardiovascular disorders and metabolic syndrome are not infrequently found. Importantly, apical lung diseases in Chinese AS patients are also frequently associated with tuberculosis infection.

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

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    Fernanda Genre

    2014-01-01

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

  5. Is Lumbo-Sacral Angle Related to Plantar Loading Patterns in Patients with Ankylosing Spondylitis?

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    Elif Aydın

    2016-08-01

    Full Text Available Objective: Loss of lumbar lordosis is a clinical feature of ankylosing spondylitis (AS. Pedobarographic analysis assesses the interaction between the foot and the supporting surface. Postural abnormalities can reflect as pressure distribution deviations on pedobarography. The objective of the present study was to assess whether loss of lumbar lordosis detected with lumbo-sacral angle measurement is related to postural control assessed by plantar loading distribution in patients with AS. Materials and Methods: Thirty-two patients (two female, 30 male, mean age: 43.06±7.8 years with the diagnosis of AS, who already had a lateral lumbo-sacral X-ray performed within the past one year, were included in the study. Static and dynamic pedobarographic analyses of the patients were performed. The radiographic measurement of lumbo-sacral angle was done from lateral lumbo-sacral X-rays of the patients. Results: The static pedobarographic measurement revealed that lumbo-sacral angle was significantly correlated with forefoot plantar pressure (p=0.042; r=0.361. In the dynamic assessment, the maximum pressures were lower under the first metatarsal area in patients with lower lumbo-sacral angle (p=0.352; r=0.048. Conclusion: These findings suggest that foot joints may contribute to the compensation mechanism against the postural changes in patients with AS, statically and dynamically.

  6. The diagnostic value of sacroiliac CT for detecting early changes of ankylosing spondylitis

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    Park, Ju Hyun; Park, Ji Seon; Ryu, Kyung Nam [Kyunghee University Medical Center, Seoul (Korea, Republic of); Jin, Wook [East-West Neo Medical Center, Seoul (Korea, Republic of)

    2007-02-15

    We wanted to evaluate the diagnostic value of the various findings on sacroiliac CT for detecting the early changes of ankylosing spondylitis (AS). Between April 2005 and March 2006, 51 sacroiliac CT images with the clinical suspicion of AS, but no definite evidence of AS on the plain radiograph only, were retrospectively reviewed. Finally, 36 patients (mean age: 28.6 years; 34 males and 2 females), who were clinically diagnosed as AS (AS group, n = 26) or they had no evidence of AS (non-AS group, n = 10), were evaluated. Two musculoskeletal radiologists analyzed the presence of marginal irregularity, bony erosion and subchondral sclerosis. A statistical analysis was performed to evaluate the incidence, sensitivity and specificity of each finding. Marginal irregularity was seen in 21 of 26 AS subjects, and in 8 of 10 non-AS subjects. Bony erosion was only seen in 13 of 26 AS subjects. Subchondral sclerosis was observed in 19 of 26 AS subjects and in 8 of 10 non-AS subjects. The sensitivity/specificity for each findings were 72.4%/28.6%, 100%/43.5% and 70.4%/22.2%, respectively. Except for bony erosions, these results showed no statistical significance ({rho} = .006). Bony erosion on CT is a very sensitive finding for the early changes of AS, whereas marginal irregularity or subchondral sclerosis is not so helpful in differentiating AS from non-AS. Attention to these results may further enhance the accurate diagnosis of the early changes in AS.

  7. Early pulmonary involvement in ankylosing spondylitis: Assessment with thin-section CT

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    Turetschek, Karl; Ebner, Wolfgang; Fleischmann, Dominik; Wunderbaldinger, Patrick; Erlacker, Ludwig; Zontsich, Thomas; Bankier, Alexander A

    2000-08-01

    AIM: To determine the frequency and the distribution of early pulmonary lesions in patients with ankylosing spondylitis (AS) and a normal chest X-ray on thin-section CT and to correlate the CT findings with the results of pulmonary function tests and clinical data. MATERIALS AND METHODS: Twenty-five patients with clinically proven AS and no history of smoking underwent clinical examinations, pulmonary function tests (PFT), chest radiography, and thin-section CT. Four of 25 patients (16%), who had obvious signs on plain films suggestive of pre-existing disorders unrelated to AS were excluded. RESULTS: Fifteen of 21 patients (71%) had abnormalities on thin-section CT. The most frequent abnormalities were thickening of the interlobular septa in seven of 21 patients (33%), mild bronchial wall thickening in (6/21, 29%), pleural thickening and pleuropulmonary irregularities (both 29%) and linear septal thickening (6/21, 29%). In six patients there were no signs of pleuropulmonary involvement. Eight of 15 patients (53%) with abnormal and four of six patients (67%) with normal CT findings revealed mild restrictive lung function impairment. CONCLUSION: Patients with AS but a normal chest radiograph frequently have abnormalities on thin-section CT. As these abnormalities are usually subtle and their extent does not correlate with functional and clinical data, the overall routine impact of thin-section CT in the diagnosis of AS is limited. Turetschek, K., (2000)

  8. Hip morphometry of femoroacetabular impingement pattern in patients with ankylosing spondylitis

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    Lee, Jong Yoon; Lee, Eu Gene; Choi, Jung Ah [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2015-06-15

    To analyze hip morphometry of femoroacetabular impingement (FAI) pattern in patients with ankylosing spondylitis (AS) and correlate them with sacroiliitis grades. 384 patients with AS were analyzed regarding demographics, radiologic signs of FAI for hip involvement, and sacroiliitis grades. FAI was classified into 3 types according to alpha angle, lateral center-edge angle and pistol grip deformity. Sacroiliitis was graded according to the New York criteria. Prevalence of FAI morphometry types was determined and evaluated for association with sacroiliitis grades. Statistical analysis regarding numerical variables, including age, sacroiliitis score using t-test, sacroiliitis score in three groups using Kruskal-Wallis test and Mann-Whitney U-test, corrected by Bonferroni methods for post hoc analysis was done. Among 384 patients, 141 (36.7%) had FAI morphometry. Male predominance was found in group with FAI pattern involvement (87.2%) (p = 0.000). Pincer type (20.6%) was the most common. Hip involvement group also showed greater sacroiliitis score (2.49 vs. 1.75, p = 0.000). Combined-type had greater sacroiliitis score compared with others (p = 0.002, 0.003). FAI morphometry was frequent in hips of AS patients (36.7%), especially pincer type, more frequent in male, and associated with significantly greater grade of sacroiliitis; combined type FAI pattern had greater sacroiliitis score.

  9. Intravitreal Triamcinolone Acetonide for Macular Edema in HLA-B27 Negative Ankylosing Spondylitis

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    M.M. Moschos

    2010-12-01

    Full Text Available We report a case of a human leukocyte antigen B27 (HLA-B27-negative patient with cystoid macular edema (CME and ankylosing spondylitis (AS after treatment with triamcinolone acetonide. The patient complained of deterioration of visual acuity of the right eye during the last 10 days. At presentation visual acuity of the right eye was 0.2, and the ophthalmic examination did not reveal any sign of active uveitis. Fluorescein angiography (FA and ocular coherent tomography (OCT showed CME. The left eye was normal with a visual acuity of 0.9. Eight weeks after intravitreal injection of triamcinolone acetonide, visual acuity improved to 0.8 and OCT revealed regression of macular edema. Six months later no recurrence was observed. Our case report indicates for the first time that CME may occur in AS independently of the presence of HLA-B27 and intraocular inflammation. Intravitreal use of triamcinolone acetonide can reduce macular edema and restore visual acuity.

  10. Ankylosing spondylitis in a patient referred to physical therapy with low back pain.

    Science.gov (United States)

    Seif, Gretchen; Elliott, James

    2012-01-01

    Low back pain (LBP) is one of the most common and costly medical conditions in the United States; various studies have reported up to 80% of the adult population will experience a significant episode of LBP sometime within their lifetime. Although many cases of LBP are related to the musculoskeletal system and appropriate for the care of the physical therapist (PT), some episodes of LBP have a systemic cause. Thus, it is the role of the PT to ensure each patient is appropriate for physical therapy intervention throughout the episode of care. When the patient's condition is not appropriate for physical therapy intervention, it is the PT's responsibility to refer the patient to other medical professions to ensure optimal patient care. The purpose of this case report is to describe a patient referred to PT who was diagnosed with ankylosing spondylitis. The patient presented initially to physical therapy with a diagnosis of LBP. However, after several visits her symptoms were inconsistent with mechanical LBP and thus required further medical consultation.

  11. Effects of physical therapy for the management of patients with ankylosing spondylitis in the biological era.

    Science.gov (United States)

    Giannotti, Erika; Trainito, Sabina; Arioli, Giovanni; Rucco, Vincenzo; Masiero, Stefano

    2014-09-01

    Exercise is considered a fundamental tool for the management of ankylosing spondylitis (AS), in combination with pharmacological therapy that with the advent of biological therapy has improved dramatically the control of signs and symptoms of this challenging disease. Current evidence shows that a specific exercise protocol has not been validated yet. The purpose of this review is to update the most recent evidence (July 2010-November 2013) about physiotherapy in AS, analyzing the possible role and synergistic interactions between exercise and biological drugs. From 117 studies initially considered, only 15 were included in the review. The results support a multimodal approach, including educational sessions, conducted in a group setting, supervised by a physiotherapist and followed by a maintaining home-based regimen. Spa exercise and McKenzie, Heckscher, and Pilates methods seem promising in AS rehabilitation, but their effectiveness should be further investigated in future randomized controlled trials (RCTs). When performed in accordance with the American College of Sports Medicine guidelines, cardiovascular training has been proven safe and effective and should be included in AS rehabilitation protocols. Exercise training plays an important role in the biological era, being now applicable to stabilized patients, leading ultimately to a better management of AS by physiatrists and rheumatologists throughout the world. On the basis of the current evidence, further research should aim to determine which exercise protocols should be recommended.

  12. Effects of icariin on cytokine-induced ankylosing spondylitis with fibroblastic osteogenesis and its molecular mechanism.

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    Jia, Chunrong; Liu, Hongxiao; Li, Min; Wu, Zhikui; Feng, Xinghua

    2014-01-01

    The aim of this study is to explore the effects of icariin on cytokine induced ankylosing spondylitis fibroblast osteogenesis type expression and its molecular mechanism. The normal fibroblasts were collected as normal control group, and the fibroblasts of hip joint capsule of AS patients were collected, which were respectively added in fetal bovine serum (group AS), fetal bovine serum and cytokines (BMP-2+TGF-beta 1) (group AS), and cell factor solution (icariin group), and observed of the osteogenic expression of fibroblast, to evaluate the impact of Icariin on it. The ALP activity, the content of collagen, osteocalcin content and cbfa1mRNA and OCmRNA of fibroblast of AS group increased compared to the normal control group and AS control group (P < 0.01), indicating that icariin can significantly inhibit the above changes (P < 0.01). Icariin can inhibit fibroblast further osteogenic differentiation through inhibiting the effect of cytokines on the fibroblast osteogenesis type markers and osteogenic gene expression and osteogenic differentiation.

  13. Arterial stiffness is not increased in patients with short duration rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

    Dzieża-Grudnik, Anna; Sulicka, Joanna; Strach, Magdalena; Siga, Olga; Klimek, Ewa; Korkosz, Mariusz; Grodzicki, Tomasz

    2017-04-01

    Patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have increased cardiovascular (CV) morbidity and mortality. Arterial stiffness is an independent predictor of CV events. The aim of the study was to assess arterial stiffness and inflammatory markers in patients with short duration chronic arthritis. We assessed carotid-femoral pulse wave velocity (PWV), augmentation index (AIx), traditional CV risk factors and inflammatory and endothelial markers in 71 chronic arthritis patients (RA and AS) and in 29 healthy controls. We did not find differences in PWV (for RA, AS and controls, respectively: 10 [8.8-10.9] versus 10.7 [9.1-11.8] versus 9.2 [8.3-11.4] m/s; p = .14) and AIx (for RA, AS and controls, respectively: 24.3 ± 11.5 versus 5.7 ± 12.4 versus 10 ± 12.8%; p = .22). Both groups of arthritis patients had active disease with significantly elevated inflammatory markers compared to controls. There were no correlations between endothelial and inflammatory markers and parameters of arterial stiffness in arthritis patients. When analyzing arthritis patients according to median of PVW, there were no significant differences in inflammatory and endothelial markers. We found that in patients with short duration active RA and AS arterial stiffness was not increased and furthermore, there was no association between markers of systemic inflammation and arterial stiffness.

  14. The risk of asthma in patients with ankylosing spondylitis: a population-based cohort study.

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    Te-Chun Shen

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

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

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

    2005-01-01

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

  16. Evaluation of quantitative sacro-iliac scintigraphy in the early diagnosis of ankylosing spondylitis.

    Science.gov (United States)

    Kjällman, M; Nylén, O; Hansén, M

    1986-01-01

    Over the period 1976-83 the clinical records were studied of 150 patients with the diagnosis of confirmed or possible sacro-iliitis. All these patients had pathologic sacro-iliac indices on quantitative bone scintigraphy. The most recent radiographs of the sacro-iliac joints were examined by two radiologists independently of each other. 103 (68%) patients with a mean duration of symptoms of 6.7 years, had normal radiographs. The frequency of HLA B27 in this group was only 27%, contrary to the expected 90-100% in an ankylosing spondylitis (AS) population. In a follow-up study, 30 patients, who in 1976-79 had normal sacro-iliac joint X-rays, were further investigated. The mean duration of symptoms was 11.3 years. 21 patients (70%) still had normal radiographs of their sacro-iliac joints and the HLA B27 frequency in this group was 28%. Normal radiographs of the sacro-iliac joints, in spite of the long duration of symptoms together with a low frequency of HLA B27, makes the diagnosis of AS most unlikely. This indicates a low specificity for quantitative sacro-iliac scintigraphy in the early diagnosis of AS. In the follow-up study, Calin's screening test for AS was included and was also found to have a low specificity.

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

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    Serbulent Yigit

    2012-01-01

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

  18. The Protective Effect of Chrysanthemum indicum Extract against Ankylosing Spondylitis in Mouse Models

    Science.gov (United States)

    2017-01-01

    In traditional Chinese and Korean homeopathic medicine, Chrysanthemum indicum Linné (Asteraceae) is a time-honored herb, prescribed for the resolution of symptoms associated with inflammatory and hypertensive conditions as well as those affecting the lungs and its associated structures. The goal of this work is to investigate the defensive role of Chrysanthemum indicum extract in fighting ankylosing spondylitis (AS) using mouse models, through which the manifestation and extent of the disease progression were measured with quantitative analysis of the intervertebral joints. Markers of inflammation as well as oxidative stress were also analysed. Western blot was used to quantify the levels of Nuclear Factor-κB (NF-κB) p65, Dickkopf-1 (DKK-1), and sclerostin (SOST). Consequently, the findings of this experiment demonstrated that AS in mice that were given Chrysanthemum indicum extract had lower level of TNF-α, IL-1β, and IL-6 (P inhibiting inflammatory mediators and NF-κB, and increasing DKK-1 and SOST levels.

  19. Remission in ankylosing spondylitis and axial spondyloarthritides: A modern understanding of the problem

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    I. Z. Gaydukova

    2016-01-01

    Full Text Available The paper discusses possible approaches to determining remission in ankylosing spondylitis (AS and other axial spondyloarthritides (axSpA. At present, there is no single definition of the concept of remission in axSpA and AS, which is due to both the diversity of manifestations of axSpA and a large number of tools to measure disease activity and the nonsimultaneous change in the degree of clinical and laboratory symptoms, signs of acute inflammation, as evidenced by imaging techniques, and signs of progressive structural changes in the locomotor apparatus in the same patient. Clinical, laboratory, magnetic resonance imaging, and radiographic remissions in a patient cannot be in time, which in turn affects the choice of optimal therapy.The case report demonstrates problems with treatment correction in a patient who has achieved clinical and laboratory remission in the presence of persistent inflammatory signs in the locomotor apparatus, as shown by imaging techniques. Since the guidelines for the follow-up and treatment of patients with nonradiographic axSpA and AS are similar today, the paper considers remission as a general problem for all subtypes of axSpA.

  20. Clinical Features in Juvenile-Onset Ankylosing Spondylitis Patients Carrying Different B27 Subtypes

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    Yikun Mou

    2015-01-01

    Full Text Available Background. Ankylosing spondylitis (AS is a common rheumatic disease and is characterized by inflammation of the axial skeleton. HLA-B27 is strongly associated with AS. Juvenile-onset AS (JAS with disease onset before 16 years of age differs from adult-onset AS (AAS in many respects. Objective. To compare the clinical features in JAS with different B27 subtypes and analyze the differences between JAS and AAS. Methods. 145 JAS and 360 AAS patients were included. The demographic data, clinical manifestations, laboratory markers, Bath AS indices, and B27 subtypes were recorded. Results. Peripheral arthritis, enthesitis, BASDAI, ESR, and CRP were significantly higher in JAS patients with HLA-B*2704 than those with B27-negative. Enthesitis and ESR were significantly higher in patients with HLA-B*2705 than those with B27-negative. The onset age of HLA-B*2715 group was much earlier than the other groups. The peripheral arthritis, enthesitis, and hip joint involvement in JAS with HLA-B*2704 were significantly higher than those in AAS with HLA-B*2704. Conclusion. JAS with different B27 subtypes had similar features in most of manifestations; JAS and AAS patients with the same subtype could have distinctive courses. Early diagnosis, hip detection, and control of systemic active inflammation in JAS patients will be helpful for improving the prognosis.

  1. Bloqueio cardíaco completo em espondilite anquilosante Complete heart block in ankylosing spondylitis

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    Juan Pablo Restrepo

    2012-10-01

    Full Text Available A espondilite anquilosante é uma doença reumática crônica de homens jovens que afeta principalmente o esqueleto axial e está associada ao HLA-B27 em 90% dos casos. A incidência de envolvimento cardiovascular em casos de espondilite anquilosante varia entre 10%-30%; foram descritos distúrbios de condução em 1%-9% dos pacientes com a doença. A maior parte do grupo acometido demonstra uma relação com doença de longa data. Este é o primeiro relato de bloqueio cardíaco completo em espondilite anquilosante precoce de nosso conhecimento.Ankylosing spondylitis (AS is a chronic rheumatic disease of young men that affects mainly the axial skeleton and is associated with HLA-B27 in 90% of the cases. Incidence of cardiovascular involvement in AS ranges between 10%-30%; conduction disturbances have been described in 1%-9% of the patients with AS. The majority of the series show a relationship with longstanding disease. To our knowledge, this is the first report of complete heart block in early AS.

  2. Biomarkers for diagnosis, monitoring of progression, and treatment responses in ankylosing spondylitis and axial spondyloarthritis.

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    Reveille, John D

    2015-06-01

    With the growing awareness of the impact of chronic back pain and axial spondyloarthritis and recent breakthroughs in genetics and the development of novel treatments which may impact best on early disease, the need for markers that can facilitate early diagnosis and profiling those individuals at the highest risk for a bad outcome has never been greater. The genetic basis of ankylosing spondylitis has been considerably advanced, and HLA-B27 testing has a role in the diagnosis. Knowledge is still incomplete of the rest of the genetic contribution to disease susceptibility, and it is likely premature to use extensive genetic testing (other than HLA-B27) for diagnosis. Serum and plasma biomarkers have been examined extensively in assessing disease activity, treatment response, and as predictors or radiographic severity. For assessing disease activity, other than C-reactive protein and erythrocyte sedimentation rate, the most work has been in examining cytokines (particularly interleukin 17 and 23), matrix metalloproteinase (MMP) markers (particularly MMP3). For assessing those at the highest risk for radiographic progression, biomarkers of bony metabolism, cartilage and connective tissue degradation products, and adipokines have been most extensively assessed. The problem is that no individual biomarkers has been reproducibly shown to assess disease activity or predict outcome, and this area still remains an unmet need, of relevance to industry stakeholders, to regulatory bodies, to the healthcare system, to academic investigators, and finally to patients and providers.

  3. VASCULAR WALL STIFFNESS IN PATIENTS WITH ANKYLOSING SPONDYLITIS: RESULTS OF A MULTICENTER STUDY

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    I. Z. Gaydukova

    2015-01-01

    Full Text Available Objective: to study some vascular wall stiffness parameters in patients with ankylosing spondylitis (AS without clinically manifest cardio­ vascular diseases. Subjects and methods. One hundred and six patients with AS and 21 healthy volunteers without cardiovascular diseases who were matched for age, gender, and cardiovascular risk were examined at two centers. Cardiovascular risk and vascular wall stiffness (augmentation index and pulse wave propagation velocity (PWPV were assessed by oscillography. Results. Vascular wall stiffness was comparable in the patients with AS (at both centers and in the healthy individuals. PWPV was 7.45 (5.4–8.71 m/sec in the AS patients (n = 106 and 8.53 (6.28–9.5 m/sec in the healthy individuals (n = 21; the aortic augmentation in­ dex was 15.6 (7.9–31.1 and 21.1 (10.2–24 %, respectively; p > 0.05 for all. Correlation analysis revealed associations between aug­ mentation index, age, blood pressure, disease activity (BASDAI and spine mobility (BASMI scores. Conclusion. The vascular wall stiffness did not differ between AS patients without cardiovascular diseases and cardiovascular risk­matched healthy individuals. Its parameters were related to age, blood pressure, and disease activity (BASDAI and axial skeleton immobility (BASMI indices. 

  4. Evidence for significant overlap between common risk variants for Crohn's disease and ankylosing spondylitis.

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    Debby Laukens

    Full Text Available BACKGROUND: A multicenter genome-wide association scan for Crohn's Disease (CD has recently reported 40 CD susceptibility loci, including 29 novel ones (19 significant and 10 putative. To gain insight into the genetic overlap between CD and ankylosing spondylitis (AS, these markers were tested for association in AS patients. PRINCIPAL FINDINGS: Two previously established associations, namely with the MHC and IL23R loci, were confirmed. In addition, rs2872507, which maps to a locus associated with asthma and influences the expression of the ORMDL3 gene in lymphoblastoid cells, showed a significant association with AS (p = 0.03. In gut biopsies of AS and CD patients, ORMDL3 expression was not significantly different from controls and no correlation was found with the rs2872507 genotype (Spearman's rho: -0.067. The distribution of p-values for the remaining 36 SNPs was significantly skewed towards low p-values unless the top 5 ranked SNPs (ORMDL3, NKX2-3, PTPN2, ICOSLG and MST1 were excluded from the analysis. CONCLUSIONS: Association analysis using risk variants for CD led to the identification of a new risk variant associated with AS (ORMDL3, underscoring a role for ER stress in AS. In addition, two known and five potentially relevant associations were detected, contributing to common susceptibility of CD and AS.

  5. Level set based vertebra segmentation for the evaluation of Ankylosing Spondylitis

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

    2006-03-01

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

  6. Anthrax toxin receptor 2 gene (ANTXR2) rs4333130 is associated with ankylosing spondylitis.

    Science.gov (United States)

    Ou, Yanjuan

    2015-01-01

    Results of recent published studies on the association between the ANTXR2 rs4333130 polymorphism and the risk of ankylosing spondylitis (AS) have often been conflicting. To make a more precise estimation of the potential relationship, a meta-analysis was performed. We conducted a comprehensive search in the electronic database of PubMed and Embase to retrieve relevant articles. Nine studies including 14,523 cases and 34,421 controls were finally selected in this meta-analysis. ANTXR2 rs4333130 was significantly associated with a decreased risk of AS (OR=0.87; 95% CI, 0.84-0.90; P<0.00001). In the subgroup analysis by race, ANTXR2 rs4333130 was significantly associated with a decreased risk of AS in both Asian (OR=0.80; 95% CI, 0.65-0.99; P=0.04) and Caucasian (OR=0.87; 95% CI, 0.84-0.90; P<0.00001). In the subgroup analysis by HLA-B27 status, HLA-B27 positive individuals with ANTXR2 rs4333130 showed decreased AS risk (OR=0.89; 95% CI, 0.83-0.96; P=0.002). However, HLA-B27 negative individuals with this polymorphism did not showed decreased AS risk (OR=0.96; 95% CI, 0.88-1.06; P=0.44). In conclusion, this meta-analysis suggested a significant association between ANTXR2 rs4333130 polymorphism and AS risk.

  7. Clinical features of Crohn disease concomitant with ankylosing spondylitis: A preliminary single-center study.

    Science.gov (United States)

    Liu, Song; Ding, Jie; Wang, Meng; Zhou, Wanqing; Feng, Min; Guan, Wenxian

    2016-07-01

    Extraintestinal manifestations (EIMs) cause increased morbidity and decreased quality of life in Crohn disease (CD). Ankylosing spondylitis (AS) belongs to EIMs. Very little is known on the clinical features of CD concomitant with AS. This study is to investigate the clinical features of CD patients with AS.We retrospectively collected all CD patients with AS in our hospital, and established a comparison group (CD without AS) with age, sex, and duration of Crohn disease matched. Clinical information was retrieved for comparison.Eight CD + AS patients were identified from 195 CD patients. Sixteen CD patients were randomly selected into comparison group. All CD + AS patients were male, HLA-B27 (+), and rheumatoid factor (-) with an average age of 40.8 ± 4.52 years. Significant correlation between disease activity of CD and AS was revealed (r = 0.857, P = 0.011). Significant correlation between disease activity of CD and functional limitation associated with AS was identified (r = 0.881, P Crohn disease activity index (CDAI), Bath AS disease activity index, and Bath AS functional index(BASFI) scores (r = 0.73-0.93, P Disease activity of CD correlates with disease activity of AS and functional limitation caused by AS. CRP, ESR, and Alb/Glo may serve as biomarkers for disease activity and functional limitation in CD patients concomitant with AS, although future studies are expected.

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

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    Dongquan Shi

    2014-01-01

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

  9. rs657075 (CSF2) Is Associated with the Disease Phenotype (BAS-G) of Ankylosing Spondylitis

    Science.gov (United States)

    Chen, Wei-Chiao; Wei, James Cheng-Chung; Lu, Hsing-Fang; Wong, Henry Sung-Ching; Woon, Peng Yeong; Hsu, Yu-Wen; Huang, Jin-Ding; Chang, Wei-Chiao

    2017-01-01

    Ankylosing spondylitis (AS) is a systemic autoimmune disease mainly affecting the lumbar spine and sacroiliac joints, and exhibits peripheral inflammatory arthropathy. More than 25 loci have been identified as associated with AS. Because both AS and rheumatoid arthritis (RA) are autoimmune diseases that may share some common genetic factors, we therefore examined if the newly identified RA genetic polymorphisms were associated with AS in a Taiwanese population. In this study, we enrolled 475 AS patients and 11,301 healthy subjects from a Taiwanese biobank as controls. Although none of single-nucleotide polymorphisms (SNPs) were associated with the susceptibility to AS, the AS disease index Bath AS Global (BAS-G) clinical phenotype was observed as significantly correlated to the AA genotype of rs657075 (CSF2). The significance remains after gender/age/disease duration adjustment and after group categorization by human leukocyte antigen-B 27 (HLA-B27) genotype. We further investigated the possible functions of rs657075 through bioinformatics approaches. Results revealed that polymorphism of rs657075 is able to influence the expression of acyl-CoA synthetase long-chain family member 6 (ACSL6). In conclusion, our study indicated that rs657075 (CSF2) is strongly associated with the AS disease index Bath AS Global (BAS-G) clinical phenotype. PMID:28054948

  10. Long term investigation of late effects in ankylosing spondylitis patients treated with radium-224

    Energy Technology Data Exchange (ETDEWEB)

    Wick, R.R. [GSF - National Research Center for Environment and Health, Inst. of Radiobiology, Neuherberg (Germany); Nekolla, E.A. [Federal Office for Radiation Protection (BfS), Neuherberg (Germany)

    2005-07-01

    An epidemiological study has been carried out on 1462 ankylosing spondylitis (AS) patients followed since 1971 at the GSF - National Research Center for Environment and Health. The aim of the study was to ascertain the late health effects occurring in these patients who had received repeated intravenous injections of the short lived {alpha}-emitter {sup 224}radium between 1948 and 1975 (excluding patients treated additionally with X-rays). The then usual therapeutic protocol consisted of a total of 10 to 12 injections of 1.036 MBq (28 {mu}Ci) of {sup 224}Ra each, given at weekly intervals. This resulted in a cumulative {alpha}-dose of 0.56 to 0.67 Gy to the marrow-free skeleton (bone surface dose: {proportional_to} 5.5 Gy) of a 70-kg-man (standard man). These patients have been followed together with a control group of 1324 ankylosing spondylitis patients not treated with radioactive drugs and/or X-rays. Up to August 2004, causes of death have been ascertained for 913 exposed patients and 971 controls (mean follow-up time {proportional_to} 26 yr in the exposed group or {proportional_to} 24 yr in the control group). In the exposed group there has been a total of 251 malignant diseases (vs. 277.0 expected cases) and 233 cases (vs. 302.4 exp.) among the controls. In the exposure group 16 cases of kidney cancer (vs. 8.7 cases expected, p = 0.02), 6 cases of liver cancer (vs. 3.3 exp., p = 0.12), and 4 cases of thyroid cancer (vs. 1.1 exp., p = 0.03) were observed. The most striking observation, however, were the 16 cases of leukaemia in the exposure group (vs. 6.5 cases expected, p = 0.001) compared to only 10 cases of leukaemia in the control group (vs. 7.1 cases expected, p = 0.2). Further subclassification of the leukaemias demonstrated a high increase of myeloid leukaemia in the exposure group (10 cases obs. vs. 2.8 cases exp., p <0.001), and particularly, of myeloid leukaemia (7 cases observed vs. 1.7 expected, p = 0.002), whereas in the control group the number

  11. Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an iberoamerican spondyloarthritis cohort.

    Science.gov (United States)

    Landi, Margarita; Maldonado-Ficco, Hernán; Perez-Alamino, Rodolfo; Maldonado-Cocco, José A; Citera, Gustavo; Arturi, Pablo; Sampaio-Barros, Percival D; Flores Alvarado, Diana E; Burgos-Vargas, Rubén; Santos, Elena; Palleiro, Daniel; Gutiérrez, Miguel A; Vieira-Sousa, Elsa; Pimentel-Santos, Fernando; Paira, Sergio O; Berman, Alberto; Barrezueta, Claudia Vera; Vazquez-Mellado, Janitzia; Collantes-Estevez, Eduardo

    2016-12-01

    The aim of the study was to compare clinical manifestations, disease activity, functional capacity, spinal mobility, and radiological findings between men and women from a multicenter, multiethnic Ibero-American cohort of patients with Spondyloarthritis (SpA).This observational cross-section study included 1264 consecutive SpA patients who fulfilled the modified New York criteria for ankylosing spondylitis (AS). Demographic, clinical, and radiologic data were evaluated. Categorical data were compared by X or Fisher's exact tests and continuous variables by ANOVA with post-hoc tests.Primary AS was diagnosed in 1072 patients, psoriatic spondylitis in 147, and spondylitis associated to inflammatory bowel disease (IBD) in 45 patients. Overall, male patients were significantly younger, had longer diagnostic delay, lower disease activity, worse spinal mobility, better quality of life, and more severe radiologic damage. Dactylitis and enthesitis, as well as swollen joint count, were significantly more common among women. In primary AS, there was a marked male predominance (76.2%). Among patients with psoriatic spondylitis, male predominance was lower (57.8%), but was also associated with worse spinal mobility and more severe radiologic damage. In the total population, male patients with primary AS referred higher permanent work disability (13.2% vs 6.9%; P < 0.05), although no difference was observed in psoriatic or IBD spondylitis according to the gender.Among Ibero-American SpA patients, there are some differences in clinical and radiological manifestations, men showing more structural damage, whereas women more active disease. These data suggest that the phenotype of SpA differs between genders. This can influence the subsequent diagnostic approach and therapeutic decisions.

  12. Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an iberoamerican spondyloarthritis cohort

    Science.gov (United States)

    Landi, Margarita; Maldonado-Ficco, Hernán; Perez-Alamino, Rodolfo; Maldonado-Cocco, José A.; Citera, Gustavo; Arturi, Pablo; Sampaio-Barros, Percival D.; Flores Alvarado, Diana E.; Burgos-Vargas, Rubén; Santos, Elena; Palleiro, Daniel; Gutiérrez, Miguel A.; Vieyra-Sousa, Elsa; Pimentel-Santos, Fernando; Paira, Sergio O.; Berman, Alberto; Barrezueta, Claudia Vera; Vazquez-Mellado, Janitzia; Collantes-Estevez, Eduardo

    2016-01-01

    Abstract The aim of the study was to compare clinical manifestations, disease activity, functional capacity, spinal mobility, and radiological findings between men and women from a multicenter, multiethnic Ibero-American cohort of patients with Spondyloarthritis (SpA). This observational cross-section study included 1264 consecutive SpA patients who fulfilled the modified New York criteria for ankylosing spondylitis (AS). Demographic, clinical, and radiologic data were evaluated. Categorical data were compared by X2 or Fisher's exact tests and continuous variables by ANOVA with post-hoc tests. Primary AS was diagnosed in 1072 patients, psoriatic spondylitis in 147, and spondylitis associated to inflammatory bowel disease (IBD) in 45 patients. Overall, male patients were significantly younger, had longer diagnostic delay, lower disease activity, worse spinal mobility, better quality of life, and more severe radiologic damage. Dactylitis and enthesitis, as well as swollen joint count, were significantly more common among women. In primary AS, there was a marked male predominance (76.2%). Among patients with psoriatic spondylitis, male predominance was lower (57.8%), but was also associated with worse spinal mobility and more severe radiologic damage. In the total population, male patients with primary AS referred higher permanent work disability (13.2% vs 6.9%; P < 0.05), although no difference was observed in psoriatic or IBD spondylitis according to the gender. Among Ibero-American SpA patients, there are some differences in clinical and radiological manifestations, men showing more structural damage, whereas women more active disease. These data suggest that the phenotype of SpA differs between genders. This can influence the subsequent diagnostic approach and therapeutic decisions. PMID:28002334

  13. Translation to Brazilian Portuguese, cultural adaptation and reproducibility of the questionnaire "Ankylosing Spondylitis: What do you know?"

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    Aline Orlandi

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: Ankylosing spondylitis (AS generates inflammation and pain in entheses, peripheral joints and the spine. Education regarding AS can improve patients' disability. Thus, it is important to assess patients' knowledge. There is no instrument in the literature for assessing knowledge of AS in Portuguese. The aim here was to translate to the Brazilian Portuguese language, culturally adapt and test the reliability of the questionnaire "Ankylosing Spondylitis: What do you know?" and to correlate the findings with other factors. DESIGN AND SETTING: Original article regarding validation of questionnaire, produced at the Federal University of Sao Paulo (Unifesp. METHODS: For translation and cultural adaptation, Guilleman methodology was used. After the first phase, the reliability was tested on 30 patients. Correlations between these scores and other factors were examined. RESULTS: In the interobserver assessment, the Pearson correlation coefficient and Cronbach's alpha were 0.831 and 0.895, respectively. In the intraobserver evaluation, the intraclass correlation coefficient and Cronbach's alpha were 0.79 and 0.883, respectively. At this stage, the score for area of knowledge A showed correlations with ethnicity and education; the score for area D, with age; the total score and scores for areas A and B with "social aspects" of SF-36; and the score for area D with "pain", "vitality" and "emotional aspects" of SF-36. CONCLUSION: The Brazilian version of the questionnaire "Ankylosing Spondylitis: What do you know?" was created. It is reproducible and correlates with education level, ethnicity and the SF-36 domains "social aspects" and "emotional aspects".

  14. Multicenter validation of the value of BASFI and BASDAI in Chinese ankylosing spondylitis and undifferentiated spondyloarthropathy patients.

    Science.gov (United States)

    Lin, Zhiming; Gu, Jieruo; He, Peigen; Gao, Jiesheng; Zuo, Xiaoxia; Ye, Zhizhong; Shao, Fengmin; Zhan, Feng; Lin, Jinying; Li, Li; Wei, Yanlin; Xu, Manlong; Liao, Zetao; Lin, Qu

    2011-02-01

    The objectives of this study were to evaluate the reliability of Bath ankylosing spondylitis functional index (BASFI) and Bath ankylosing spondylitis disease activity index (BASDAI) in Chinese ankylosing spondylitis (AS) and undifferentiated spondyloarthropathy (USpA) patients. 664 AS patients by the revised New York criteria for AS and 252 USpA patients by the European Spondyloarthropathy Study Group criteria were enrolled. BASDAI and BASFI questionnaires were translated into Chinese. Participants were required to fill in BASFI and BASDAI questionnaires again after 24 h. Moreover, BASDAI and BASFI were compared in AS patients receiving Enbrel or infliximab before and after treatment. For AS group, BASDAI ICC: 0.9502 (95% CI: 0.9330-0.9502, α=0.9702), BASFI ICC: 0.9587 (95% CI: 0.9521-0.9645, α=0.9789). For USpA group, BASDAI ICC: 0.9530 (95% CI: 0.9402-0.9632, α=0.9760), BASFI ICC: 0.9900 (95% CI: 0.9871-0.9922, α=0.9950). In the AS group, disease duration, occipital wall distance, modified Schober test, chest expansion, ESR, and CRP showed significant correlation with BASDAI and BASFI (all P<0.01). In the USpA group, onset age, ESR, and CRP were significantly correlated with BASDAI (all P<0.05), while modified Schober test, ESR, and CRP were significantly associated with BASFI (all P<0.05). The change in BASDAI and BASFI via Enbrel or infliximab treatment showed a significant positive correlation (P<0.01). The two instruments have good reliability and reference value regarding the evaluation of patient's condition and anti-TNF-α treatment response.

  15. The role of Vitamin D in immuno-inflammatory responses in Ankylosing Spondylitis patients with and without Acute Anterior Uveitis

    OpenAIRE

    Mitulescu, TC; Stavaru, C; Voinea, LM; Banica, LM; Matache, C; Predeteanu, D

    2016-01-01

    Hypothesis:Abnormal Vitamin D (Vit D) level could have consequences on the immuno-inflammatory processes in Ankylosing Spondylitis (AS). Aim:The purpose of this study was to analyze the role of Vitamin D in the interplay between immune and inflammation effectors in AS associated-Acute Anterior Uveitis (AAU). Methods and Results:25-hydroxyvitamin D (Vit D), LL-37 peptide, IL-8 and Serum Amyloid A (SAA) were identified and quantified in the serum/ plasma of thirty-four AS patients [eleven AS pa...

  16. Down-Regulation of lncRNA-AK001085 and its Influences on the Diagnosis of Ankylosing Spondylitis

    OpenAIRE

    Li, Xiang; Chai, Wei; Zhang, Guoqiang; Ni, Ming; Chen, Jiying; Dong, Jiyuan; Zhou, Yonggang; Hao, Libo; Bai, Yang; Wang, Yan

    2017-01-01

    Background Long non-coding RNAs (lncRNAs) have been confirmed to play an important role in the development and progression of diseases. Ankylosing spondylitis (AS) is a chronic inflammatory systemic disease and it is hard to be found in early time. The purpose of this study was to investigate the role of lncRNA-AK001085 in the diagnosis of AS. Material/Methods The expression of lncRNA-AK001085 was detected by quantitative real-time polymerase chain reaction (qRT-PCR) analysis. The relationshi...

  17. Coexistence of Diffuse Idiopathic Skeletal Hyperostosis and Late-Onset Ankylosing Spondylitis in a Sixty-year-old Patient

    Directory of Open Access Journals (Sweden)

    Zeliha Ünlü

    2016-12-01

    Full Text Available Diffuse idiopathic skeletal hyperostosis (DISH and ankylosing spondylitis (AS are two diseases characterized by ossification of the ligaments and tendons in both the axial skeleton and peripheral sites with very different pathologies. Coexistence of DISH and AS is a rare condition and there are relatively few cases in the English-language literature. In this paper, we report a human leukocyte antigen-B27-negative patient who presented with the typical appearance of DISH on the dorsal radiograph and also had sacroileitis, suggesting AS. We discussed prognosis of the late-onset case and the interaction of two diseases in this coexistence.

  18. Concurrent Intervention With Exercises and Stabilized Tumor Necrosis Factor Inhibitor Therapy Reduced the Disease Activity in Patients With Ankylosing Spondylitis

    Science.gov (United States)

    Liang, Hui; Li, Wen-Rong; Zhang, Hua; Tian, Xu; Wei, Wei; Wang, Chun-Mei

    2015-01-01

    Abstract Since the use of tumor necrosis factor (TNF) inhibitor therapy is becoming wider, the effects of concurrent intervention with exercises and stabilized TNF inhibitors therapy in patients with ankylosing spondylitis (AS) are different. The study aimed to objectively evaluate whether concurrent intervention with exercises and stabilized TNF inhibitors can reduce the disease activity in patients with AS. A search from PubMed, Web of Science, EMBASE, and the Cochrane Library was electronically performed to collect studies which compared concurrent intervention with exercise and TNF inhibitor to conventional approach in terms of disease activity in patients with AS published from their inception to June 2015. Studies that measured the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Metrology Index (BASMI), and chest expansion as outcomes were included. Two independent investigators screened the identified articles, extracted the data, and assessed the methodological quality of the included studies. Quantitative analysis was performed with Review Manager (RevMan) software (version 5.3.0). A total of 5 studies comprising 221 participants were included in the study. Meta-analyses showed that concurrent intervention with exercises and stabilized TNF inhibitors therapy significantly reduced the BASMI scores (MD, −0.99; 95% CI, −1.61 to −0.38) and BASDAI scores (MD, −0.58; 95% CI, −1.10 to −0.06), but the BASFI scores (MD, −0.31; 95% CI, −0.76 to 0.15) was not reduced, and chest expansion (MD, 0.80; 95% CI, −0.18 to 1.78) was not increased. Concurrent intervention with exercises and stabilized TNF inhibitors therapy can reduce the disease activity in patients with AS. More randomized controlled trials (RCTs) with high-quality, large-scale, and appropriate follow-up are warranted to further establish the benefit of concurrent intervention with

  19. 强直性脊柱炎用药规律研究%Study of drug laws of ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    张建英; 吴波

    2010-01-01

    @@ 强直性脊柱炎(Ankylosing Spondylitis,AS)是一种慢性全身性免疫疾病,多发于青壮年男性,在我国发病率较高,早期多表现为骶髂关节、腰背僵硬或疼痛,晚期可发生脊柱强直、畸形,造成严重功能障碍,严重影响患者生活质量.

  20. How to treat ankylosing spondylitis and nonradiographic axial spondyloarthritis. Key practical messages from the 2015 American College of Rheumatology recommendations.

    Science.gov (United States)

    Uthman, Imad; Noureldine, Mohammad Hassan A; Arayssi, Thurayya; Chalhoub, Nathalie E; Akl, Elie A

    2016-03-24

    A panel of experts commissioned by the American College of Rheumatology have recently reviewed the literature related to the treatment of patients with ankylosing spondylitis and nonradiographic axial spondyloarthritis. They published a set of recommendations for the management of common clinical questions for both active and stable disease, including the appropriate use of nonsteroidal anti-inflammatory drugs, tumor necrosis factor inhibitors, rehabilitation, education, and preventive care. This article summarizes these recommendations and provides key practical messages for physicians taking care of these patients.

  1. Taylor′s approach in an ankylosing spondylitis patient posted for percutaneous nephrolithotomy: A challenge for anesthesiologists

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    Jindal Parul

    2009-01-01

    Full Text Available We describe a patient with long-standing ankylosing spondylitis who underwent percutaneous nephrolithotomy under spinal anesthesia. At preoperative assessment, it was considered that intubation of the trachea was likely to be difficult. Fiberoptic bronchoscopy was attempted, but without success. As the standard technique for spinal anesthesia failed, a variation of the paramedian approach in the lumbosacral approach, also known as Taylor′s approach was successfully attempted. This resulted in adequate sensory and motor blockade for the surgical procedure. The patient did not require airway interventions, but equipment and aids to secure airway were available.

  2. Treatment of type A thoracolumbar fracture in a patient with ankylosing spondylitis by percutaneous kyphoplasty:1 case report%PKP 治疗强直性脊柱炎患者的A型胸腰椎骨折一例

    Institute of Scientific and Technical Information of China (English)

    陈磊; 荆珏华; 田大胜; 钱军; 朱斌

    2016-01-01

    Objective To discuss the treatment of type A thoracolumbar fracture in a patient with ankylosing spondylitis by percutaneous kyphoplasty ( PKP ).Methods A thoracolumbar fracture of a 62-year-old male patient with ankylosing spondylitis was retrospectively analyzed, including clinical manifestations and imaging data before and after the operation. Related literature was reviewed.Results Back pain was relieved significantly, and the thoracolumar imaging was good postoperatively.Conclusions The risk of thoracolunbar fracture in patients with ankylosing spondylitis is high. Misdiagnosis or delayed diagnosis often occurs. Results of conservative treatment may not be good, while PKP is effective for the treatment of type A thoracolumbar fracture.

  3. The application of MR imaging in the detection of hip involvement in patients with ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Zhen-Guo; Zhang, Xue-Zhe; Hong, Wen; Wang, Guo-Chun; Zhou, Hui-Qiong; Lu, Xin; Wang, Wu, E-mail: cjr.wangwu@vip.163.com

    2013-09-15

    Objective: To investigate the changes in hip MR imaging, evaluate the frequency of hip involvement and compare the value of clinical symptoms, radiographs, and MR imaging in the detection of hip involvement in patients with ankylosing spondylitis (AS). Methods: Anteroposterior radiographs of the pelvis, MR imaging of the hip and clinical evaluation were undertaken in 58 patients with definite AS. All patients were followed up 3 years. Annual radiographs and clinical evaluation were carried out. The imaging data were independently assessed by two experienced radiologists who were blinded to patient identity and clinical characteristics. Based on the Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-hip) scoring system, BASRI-hip scores ≥2 were defined as radiological hip involvement. On MR imaging, both acute and chronic inflammatory changes were considered positive signs for hip involvement. Symptomatic hip involvement was defined as current or past pain or limitation of the hip movement. The statistical analysis was performed using the χ{sup 2} test for comparison of sensitivity among clinical symptoms, radiographs, and MR imaging in the detection of hip involvement and the Student's t-test for comparison of disease duration between with and without hip involvement. A P value <0.05 was considered to be statistically significant. For interpreting MRI and radiographs, the percentage of agreement between the two assessors and the kappa coefficients were calculated. Results: On MR imaging, positive changes were detected in 86 (74.1%) hips among 116 hips in all 58 patients. Joint effusion was observed in 73 (62.9%) hips; 23 out of 27 patients who underwent fat-saturated contrast-enhanced T{sub 1}-weighted sequences had abnormal synovial enhancement in bilateral hips. The other abnormal MR findings included subchondral bone marrow edema in 35 (30.2%) hips, enthesitis in 22 (19.0%) hips, fatty accumulation of the bone marrow in 28 (24.1%) hips, bone erosive

  4. Assessment of left ventricular function by tissue Doppler imaging in patients with ankylosing spondylitis

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    Osman Kuloglu

    2012-05-01

    Full Text Available Ankylosing spondylitis (ASpis a chronic, inflammatory and systemic disease affecting pericardium, myocardium and the conduction system of the heart. In this study, we aimed to analyse left ventricular systolic and diastolic functions using tissue Doppler imaging (TDI. 30 patients with ASp and 30 healthy volunteers having the similar demographic characteristics were included. Left ventricular systolic and diastolic functions were assessed by using two dimensional (2D echocardiography, M-mode, pulsed-wave (PW and tissue Doppler echocardiography. The peak systolic velocity (Sm, early diastolic myocardial peak velocity (m, late diastolic myocardial peak velocity (Am, isovolumic acceleration (IVA, myocardial precontraction time (PCTm, myocardial contraction time (CTm, myocardial relaxation time (RTm, and myocardial performance index (MPI were measured at septal and lateral mitral annulus. In conventional echocardiography, end-diastolic interventricular septum and posterior wall diameters were higher in patients with ASp than the control group. The ratio of E/A was significantly lower and deceleration time was significantly prolonged in patients with ASp, but mitral E and A velocities, isovolumic relaxation time and MPI were similar in patient and control group (P>0.05. Left ventricular lateral and septal wall tissue Doppler echocardiography showed that Em, Em/Am ratio and CTm were significantly lower, IVRTm was longer and MPI was higher in patients with ASp. No significant differences were detected between the groups for IVA, Sm, Am, PCTm, PCTm/CTm ratio (P>0.05. We have demonstrated that in patients with ASp, diastolic functions were impaired but systolic functions were preserved by using TDI.

  5. Clinical characteristics and frequency of TLR4 polymorphisms in Brazilian patients with ankylosing spondylitis

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    Natalia Pereira Machado

    Full Text Available ABSTRACT Objectives: Innate immunity is involved in the physiopathology of ankylosing spondylitis (AS, with the participation of Gram-negative bacteria, modulation of human leukocyte antigen (HLA B27 and the involvement of pattern recognition receptors, such as Toll-like receptors (TLRs. The aim of this study was to investigate the clinical characteristics and frequency of TLR4 polymorphisms (Asp299Gly and Thr 399Ile in a cohort of Brazilian patients with AS. Methods: A cross-sectional study was carried out involving 200 patients with a diagnosis of AS and a healthy control group of 200 individuals. Disease activity, severity and functional capacity were measured. The study of TLR4 polymorphisms was performed using the restriction fragment length polymorphism method. HLA-B27 was analyzed by conventional polymerase chain reaction. The IBM SPSS Statistics 20 program was used for the statistical analysis, with p-values less than 0.05 considered significant. Results: Mean age and disease duration were 43.1 ± 12.7 and 16.6 ± 9.2 years, respectively. The sample was predominantly male (71% and non-Caucasian (52%. A total of 66% of the group of patients were positive for HLA-B27. The sample of patients was characterized by moderate functional impairment and a high degree of disease activity. No significant association was found between the two TLR4 polymorphisms and susceptibility to AS. Conclusions: TLR4 polymorphisms 399 and 299 were not more frequent in patients with AS in comparison to the health controls and none of the clinical variables were associated with these polymorphisms.

  6. Decreased Serotonin Levels and Serotonin-Mediated Osteoblastic Inhibitory Signaling in Patients With Ankylosing Spondylitis.

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    Klavdianou, Kalliopi; Liossis, Stamatis-Nick; Papachristou, Dionysios J; Theocharis, Georgios; Sirinian, Chaido; Kottorou, Anastasia; Filippopoulou, Alexandra; Andonopoulos, Andrew P; Daoussis, Dimitrios

    2016-03-01

    Evidence suggests that serotonin is an inhibitor of bone formation. We aimed to assess: 1) serum serotonin levels in patients with ankylosing spondylitis (AS), a prototype bone-forming disease, compared with patients with rheumatoid arthritis (RA) and healthy subjects; 2) the effect(s) of TNFα blockers on serum serotonin levels in patients with AS and RA; and 3) the effect(s) of serum of AS patients on serotonin signaling. Serum serotonin levels were measured in 47 patients with AS, 28 patients with RA, and 40 healthy subjects by radioimmunoassay; t test was used to assess differences between groups. The effect of serum on serotonin signaling was assessed using the human osteoblastic cell line Saos2, evaluating levels of phospho-CREB by Western immunoblots. Serotonin serum levels were significantly lower in patients with AS compared with healthy subjects (mean ± SEM ng/mL 122.9 ± 11.6 versus 177.4 ± 24.58, p = 0.038) and patients with RA (mean ± SEM ng/mL 244.8 ± 37.5, p = 0.0004). Patients with AS receiving TNFα blockers had significantly lower serotonin levels compared with patients with AS not on such treatment (mean ± SEM ng/mL 95.8 ± 14.9 versus 149.2 ± 16.0, p = 0.019). Serotonin serum levels were inversely correlated with pCREB induction in osteoblast-like Saos-2 cells. Serotonin levels are low in patients with AS and decrease even further during anti-TNFα treatment. Differences in serotonin levels are shown to have a functional impact on osteoblast-like Saos-2 cells. Therefore, serotonin may be involved in new bone formation in AS.

  7. Does exercise affect the antioxidant system in patients with ankylosing spondylitis?

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    Günendi, Zafer; Sepici Dinçel, Aylin; Erdoğan, Zeynep; Aknar, Ozlem; Yanpal, Selma; Göğüş, Feride; Atalay, Fatma

    2010-10-01

    We aimed to investigate the effect of regular supervised exercise program on functional status, disease activity, and total antioxidant status (TAS) level in patients with ankylosing spondylitis (AS). Thirty-two patients (mean age: 44 years) with AS were included in the study and divided into two groups. Group 1, the exercise group (n = 16), attended a supervised exercise program that consisted of aerobic, strengthening, and stretching exercises for 1 h a day, five times a week for 3 weeks. Group 2, the control group, received a home exercise program (n:16). Bath AS Activity Index (BASDAI) and Bath AS Functional Index (BASFI) were calculated and serum TAS levels were measured for each patient at 0 and 3 weeks. There was no significant difference in patients' baseline characteristics (age, disease duration, BASFI, and BASDAI scores) between exercise and control groups. In the exercise group, there were significant improvements between pre-exercise and post-exercise assessments in BASFI (2.8 +/- 1,8; 1.7 +/- 1,40, p = 0.004) and BASDAI scores (2.1 +/- 1.7; 1.2 +/- 1.3, p = 0.01). Mean TAS levels were significantly decreased after supervised exercise program (1.48 +/- 0.16 mmol/L; 1.36 +/- 0.20 mmol/L, p = 0.03). In the control group, BASFI score (2.4 +/- 1.7; 2.9 +/- 2.1, p = 0.19), BASDAI score (2.6 +/- 2.2; 3.1 +/- 2.6, p = 0.33), and mean TAS levels (1.38 +/- 0.23 mmol/L; 1.39 +/- 0.20 mmol/L, p = 0.66) did not differ significantly between 0 and 3 weeks. Short-term, supervised exercise program improved functional status and decreased disease activity. However, the mechanism of this beneficial clinical effect does not seem to be through antioxidant activity.

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

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    Senocak, Oezlem E-mail: emine.senocak@deu.edu.tr; Manisali, Metin; Oezaksoy, Dinc; Sevinc, Can; Akalin, Elif

    2003-02-01

    Objective: To analyze the spectrum of the lung parenchyma changes in ankylosing spondylitis (AS) with high resolution computed tomography (HRCT) and correlate the findings with disease duration. Material and methods: Twenty patients (18 male, 2 female) with the diagnosis of AS according to New York criteria were included in the study. None of the patients had history of tuberculosis, prolonged inorganic dust exposure and hospitalization for pneumonia. Seven of the patients were smokers, three patients were ex-smokers, and 10 patients were nonsmokers. The patients were assigned to three groups depending on disease duration. Group 1: patients with disease duration {<=}5 years (n: four patients), group 2: patients with disease duration {>=}6 years but {<=}10 years (n: four patients), group 3: patients with disease duration {>=}11 years (n: 12 patients). HRCT and pulmonary function tests (PFT) were performed in all patients. Results: HRCT demonstrated pathology in 17 patients (85%). Two patients in group 1, 4 patients in group 2 and 11 patients in group 3 had pulmonary parenchyma changes. Emphysema (9/20), septal thickening (9/20) and pleural thickening (9/20) were the most common changes followed by nodule (8/20) and subpleural band formation (7/20). Three patients had apical fibrosis (AF). Septal and pleural thickening (both 4/10) were the most common changes when only nonsmokers were considered. Among nine patients with emphysema three were nonsmokers. Conclusion: There is a wide spectrum in pulmonary parenchyma changes in AS. These changes begin in early stages of the disease and increase with disease duration. Although smoking complicates the spectrum of changes in pulmonary parenchyma, they are predominately in the form of interstitial inflammation.

  9. Evaluating disease activity in patients with ankylosing spondylitis and rheumatoid arthritis using 99mtc-glucosamine

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    Manolios, Nicholas; Ali, Marina; Camden, Bradley; Aflaky, Elham; Pavic, Katrina; Markewycz, Andrew; De Costa, Robert; Angelides, Socrates

    2016-01-01

    Objective To evaluate the clinical utility of a novel radiotracer, 99mTc-glucosamine, in assessing disease activity of both rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Material and Methods: Twenty-five patients with RA (nine males and 16 females) and 12 patients with AS (all male) at various stages of disease were recruited for the study. A clinical history and examination was performed, followed by the measurement of hematological, biochemical, and autoimmune serological parameters to assess disease activity. 99mTc-glucosamine was intravenously administered and scans were compared with other imaging modalities, including plain X-ray, magnetic resonance imaging (MRI), and bone scans. Results In patients with AS, 99mTc-glucosamine scans were more capable of identifying active disease and differentiating between inflammatory and non-inflammatory causes. In patients with RA, 99mTc-glucosamine accumulated at all known sites of disease involvement. Uptake was most pronounced in patients with active untreated disease. The relative tracer activity in the involved joints increased with time compared with that in the adjoining soft tissue, liver, and cardiac blood pool. Using Spearman’s correlation coefficient, there was a positive correlation among glucosamine scan scores, C-reactive protein (p=0.048), and clinical assessment (p=0.003), which was not noted with bone scans. Conclusion The radiotracer was well tolerated by all patients, with no adverse reactions. 99mTc-glucosamine imaging could detect spinal inflammation in AS. With respect to RA, 99mTc-glucosamine was a viable alternative to 99mTc-labeled methylene diphosphonate nuclear bone scans for imaging inflamed joints and had the added advantage of demonstrating a significant clinical correlation between disease activity and scan findings. PMID:27708974

  10. Fecal calprotectin is associated with disease activity in patients with ankylosing spondylitis.

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    Duran, Arzu; Kobak, Senol; Sen, Nazime; Aktakka, Seniha; Atabay, Tennur; Orman, Mehmet

    2016-01-01

    Calprotectin is one of the major antimicrobial S100 leucocyte proteins. Serum calprotectin levels are associated with certain inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus and inflammatory bowel disease. The aim of this study was to investigate serum and fecal calprotectin levels in patients with ankylosing spondylitis (AS) and show their potential relations to the clinical findings of the disease. Fifty-one patients fulfilling the New York criteria of AS and 43 healthy age- and gender-matched volunteers were included in the study. Physical and locomotor system examinations were performed and history data were obtained for all patients. Disease activity parameters were assessed together with anthropometric parameters. Routine laboratory examinations and genetic testing (HLA-B27) were performed. Serum calprotectin levels and fecal calprotectin levels were measured by an enzyme-linked immunosorbent assay. The mean age of the patients was 41.5 years, the mean duration of the disease was 8.6 years, and the delay in diagnosis was 4.2 years. Serum calprotectin levels were similar in both AS patients and in the control group (p=0.233). Serum calprotectin level was correlated with Bath AS disease activity index (BASDAI) and Bath AS functional index (BASFI) (p=0.001, p=0.002, respectively). A higher level of fecal calprotectin was detected in AS patients when compared with the control group. A statistically significant correlation between fecal calprotectin level and BASDAI, BASFI, C-reactive protein and Erythrocyte sedimentation rate were detected (p=0.002, p=0.005, p=0.001, p=0.002, respectively). The results indicated that fecal calprotectin levels were associated with AS disease findings and activity parameters. Calprotectin is a vital disease activity biomarker for AS and may have an important role in the pathogenesis of the disease. Multi-centered prospective studies are needed in order to provide further insight.

  11. Muscle activation patterns and gait biomechanics in patients with ankylosing spondylitis

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    A. Caliri

    2011-09-01

    Full Text Available Patients with ankylosing spondylitis (AS may experience a progressive spinal kyphosis, which induces a forward and downward displacement of the centre of mass (COM of the trunk with consequent use of mechanisms to compensate for the displacement of the trunk. The analysis of patterns of movement gives an important opportunity for follow-up of patients and is an useful tool to plan a therapeutic and rehabilitative program. Objective: The aim of our study was to contribute to the description of abnormalities of gait biomechanics in patients with AS and to individualize, if existing, a typical pattern of these patients. Methods: Five patients with AS (3 men, 2 women were evaluated by gait analysis. Each patient was assessed with dynamic electromyography, with survey of phases of gait cycle and 3D video-analysis of gait related to data of platform (Digivec ® which allows to display real time the force vector of reaction foot-ground overlapping the screen image of patient. Results: The dynamometric platform located the following problems: increasing of the medium-lateral component of the reaction force on the ground in the mild and terminal stance. The anterior-posterior reaction force is diminished in both the initial and the terminal component. The timing of activation of the tibialis anterior results prolonged while the timing of activation of the gastrocnemius medialis results delayed. Conclusion: The patients with AS prefer therefore an eccentric contraction of the tibial anterior in comparison to a concentric contraction of the gastrocnemius medialis, “opting” for a gait strategy that confers greater stability but limited power.

  12. Effect of aquatic exercise on ankylosing spondylitis: a randomized controlled trial.

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    Dundar, U; Solak, O; Toktas, H; Demirdal, U S; Subasi, V; Kavuncu, V; Evcik, D

    2014-11-01

    Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that affects mainly the axial skeleton and causes significant pain and disability. Aquatic (water-based) exercise may have a beneficial effect in various musculoskeletal conditions. The aim of this study was to compare the effectiveness of aquatic exercise interventions with land-based exercises (home-based exercise) in the treatment of AS. Patients with AS were randomly assigned to receive either home-based exercise or aquatic exercise treatment protocol. Home-based exercise program was demonstrated by a physiotherapist on one occasion and then, exercise manual booklet was given to all patients in this group. Aquatic exercise program consisted of 20 sessions, 5× per week for 4 weeks in a swimming pool at 32-33 °C. All the patients in both groups were assessed for pain, spinal mobility, disease activity, disability, and quality of life. Evaluations were performed before treatment (week 0) and after treatment (week 4 and week 12). The baseline and mean values of the percentage changes calculated for both groups were compared using independent sample t test. Paired t test was used for comparison of pre- and posttreatment values within groups. A total of 69 patients with AS were included in this study. We observed significant improvements for all parameters [pain score (VAS) visual analog scale, lumbar flexion/extension, modified Schober test, chest expansion, bath AS functional index, bath AS metrology index, bath AS disease activity index, and short form-36 (SF-36)] in both groups after treatment at week 4 and week 12 (p aquatic exercise group. It is concluded that a water-based exercises produced better improvement in pain score and quality of life of the patients with AS compared with home-based exercise.

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

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

    2015-06-01

    Ankylosing spondylitis (AS) is a severe chronic inflammatory disease that may ultimately result in the development of a 'bamboo‑like' spine. Although the pathological changes that occur in AS have been extensively investigated, the mechanism underlying spinal fusion during AS remains elusive. Differentially expressed genes (DEGs) in paraspinal tissues from patients with AS compared with those from healthy controls were therefore investigated. Polymerase chain reaction (PCR)‑based suppression subtractive hybridization was performed using total mRNA from the supraspinal ligaments of three patients with AS and three patients with spinal fractures as controls. From this, 27 genes were identified in all of the three independent forward libraries, which were defined as DEGs associated with AS. Reverse transcription‑quantitative PCR demonstrated that six DEGs were overexpressed in the tissues from patients with AS compared with those from individuals in the control group, including those encoding transforming growth factor β types I and III receptor, vascular endothelial growth factor, matrix metalloproteinase‑3, core‑binding factor α1 and bone morphogenetic protein 2. Western blot analysis showed increased expression in all six of these proteins in the samples from patients with AS compared with those in the control groups. These findings suggested that changes in the expression of these genes and proteins are associated with the development of spinal fusion during the pathogenesis of AS. Furthermore, these genes may be novel markers of the risk of developing AS, in addition to being targets for the treatment of this disease.

  14. Association Study of IL-12B Polymorphisms Susceptibility with Ankylosing Spondylitis in Mainland Han Population.

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    Li Zhang

    Full Text Available This study aims to determine whether the genetic polymorphisms of IL-12B gene is a susceptibility factor to Ankylosing spondylitis (AS in mainland Han Chinese population.Eight single-nucleotide polymorphisms (SNPs (rs10045431, rs11167764, rs3212227, rs6556412, rs6556416, rs6871626, rs6887695 and rs7709212 in the IL-12B gene were genotyped by iMLDR Assay technology in 400 patients [96% (384/400 HLA-B27(+] and 395 geographically and ethnically matched healthy controls in mainland Han Chinese population. The correlation between IL-12B genetic polymorphisms and AS activity index (BASDAI, BASFI were tested.The significant difference was found in genotype distribution between AS and healthy controls (χ2 = 6.942, P-value = 0.031 of the SNP rs6871626. Furthermore, significant evidence was also detected under the recessive model for minor allele A. The AA genotype carrier had 1.830 fold risk compared with C allele carrier (with CC and AC genotypes [OR (95% CI = 1.830 (1.131-2.961, P-value = 0.014]. Nevertheless, the difference was no longer significant after Bonferroni correction. Subset analysis on cases with HLA-B27(+ did find the same results. Three genotypic groups (AA, CC and CA in rs6871626 site was highly associated with the BASDAI and BASFI (P-value = 0.012 and P-value = 0.023, respectively, after adjustment for effect of age, sex, and disease duration, the P-value was 0.031 and 0.041, respectively. The AA genotype of rs6871626 was also significantly correlated with an increased BASDAI and BASFI compared to the AC and CC genotypes in AS patients.Our findings suggest that rs6871626 may be associated AS susceptibility and with disease activity (BASDAI, BASFI in mainland Han Chinese population.

  15. Tc-99m HIG Scintigraphy in Detection of Active Inflammation in Ankylosing Spondylitis

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    Özhan Özdoğan

    2011-08-01

    Full Text Available Objective: The diagnosis of active inflammation in ankylosing spondylitis (AS is crucial for treatment to delay possible persistent deformities. There are no specific laboratory tests and imaging methods to clarify the active disease. We evaluated the value of Tc-99m human immunoglobulin (HIG scintigraphy in detection of active inflammation. Material and Methods: Twenty-nine patients were included. Tc-99m methylenediphosphonate bone (MDP and HIG scintigraphies were performed within 2-5 day intervals. Two control groups were constituted both for MDP and HIG scintigraphies. Active inflammation was determined clinically and by serologic tests. Both scintigraphies were evaluated visually. Sacroiliac joint index values (SII were calculated. Results: Active inflammation was considered in five (sacroiliitis in 2, sacroiliitis-spinal inflammation in 1, achilles tendinitis in 1, arthritis of coxafemoral joints in 1 patients. HIG scintigraphy demonstrated active disease in all 3 patients with active sacroiliitis. But, it was negative in the rest. The other 2 active cases were HIG negative. Right and left SII obtained from HIG scintigraphy was higher (p<0.05 in clinically active patients than inactive patients. There was not any significant difference between patients with inactive sacroiliitis and normal controls. Right and left SII obtained from bone scintigraphy was higher (p<0.05 in patient group than in control group. Conclusion: Clinically inactive AS patients, behave no differently than normal controls with quantitative sacroiliac joint evaluation on HIG scintigraphy. HIG scintigraphy may be valuable for evaluation of sacroiliac joints in patients with uncertain laboratory and clinical findings. (MIRT 2011;20:52-58

  16. Clinical diversity of ankylosing spondylitis in the real practice of a rheumatologist in Russia (Part 1

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    Evgeny Vladimirovich Volnukhin

    2012-01-01

    Full Text Available Objective: to study the clinical picture of ankylosing spondylitis (AS, the association of its manifestations with the degree of disability in the real practice of a rheumatologist in Russia. Subjects and methods. The investigation enrolled 464 patients with AS, who had consecutively visited rheumatologists for 4 months in 24 cities and towns of the Russian Federation. A specially designed clinical card was filled out for all patients. Later on, the diagnosis of the disease was verified at the Research Institute of Rheumatology, Russian Academy of Medical Sciences, according to the 1984 modified New York criteria and pelvic survey X-ray films were assessed by two independent experts in a blind fashion. Results. The valid diagnosis of AS was confirmed in 330 (71.1% out of all 464 patients included into the study; their mean age was 39.7±10.2 years; the mean duration of disease was 14.6±2.6 years; 86% were men and 14% were women. About half (47% of the patients had peripheral arthritis and 56% had clinical signs of coxitis. The mean BASDAI and BASFI scores were 4.8±2.1 and 4.3±2.6, respectively. 61% of the patients had a BASDAI score of >4.0. Uveitis was the most common extravertebral manifestation (22%. One third of the patients did not work because of health reasons; 45% of the patients changed their work activities due to disease. Conclusion. In Russia, AS is characterized by its high activity, frequent involvement of hip joints and poor functional status in the patients on average 15 years after the onset of the disease. Loss of working capacity was observed in one-third of the patients. In the country, AS is diagnosed very late, on average 9 years after the disease onset.

  17. TREATMENT IN PATIENTS WITH ANKYLOSING SPONDYLITIS IN THE REAL CLINICAL PRACTICE OF A RHEUMATOLOGIST IN RUSSIA

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    Sh F Erdes

    2013-01-01

    Full Text Available Objective: to analyze the treatment of ankylosing spondylitis (AS in the real practice of a rheumatologist in Russia. Subjects and methods. The cross-sectional study included 330 AS patients who had been actively seeking medical advice from rheumatologists during 4 months in 24 cities and towns of the Russian Federation. The therapy performed was studied using the medical history data recorded by physicians in the specially designed clinical chart. Drug intake, its regularity, reasons for discontinuation of medications, and their clinical effect were elucidated in all the patients. The need to intensify the therapy and to use genetically engineered biological agents was determined by disease activity at the time of examination. Results. The medical histories indicated that 62% of the patients received nonsteroidal anti-inflammatory drugs (NSAIDs regularly, 34% had them periodically, and 4% were not treated; two thirds of the patients took diclofenac, nimesulide, or meloxicam. 33, 14, and 9% of the patients used sulfasalazine, methotrexate, and oral glucocorticosteroids, respectively. Sixty (18% patients received tumor necrosis factor-α (TNF-α inhibitors. Different physiotherapeutic methods were used in 30% of cases; only 46% did exercises regularly; as high as 4% of the patients had sanatorium-and-spa treatment. In the physicians' opinion, 81% of the patients needed intensified therapy and 62% did therapy with TNF-α inhibitors. At the same time TNF-α inhibitors were indicated in 38% of the patients according to the ASAS recommendations. Conclusion. In real clinical practice, AS treatment does not always meet the current recommendations: only 62% of the patients received continuous NSAID therapy; disease-modifying antirheumatic drugs were frequently used without any indications. 18% of the patients took TNF-α inhibitors and 38% really needed them.

  18. Classification criteria for psoriatic arthritis and ankylosing spondylitis/axial spondyloarthritis.

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    Rudwaleit, Martin; Taylor, William J

    2010-10-01

    The concept of spondyloarthritides (or spondyloarthropathies, SpAs) that comprises a group of interrelated disorders has been recognised since the early 1970s. While the European Spondyloarthropathy Study Group (ESSG) criteria and the Amor criteria have been developed to embrace the entire group of SpAs, new criteria for psoriatic arthritis have been developed recently. The Classification of Psoriatic Arthritis (CASPAR) study, a large one of more than 1000 patients, led to a new set of validated classification criteria for psoriatic arthritis. Since their publication in 2006 the CASPAR criteria are widely used in clinical studies. In ankylosing spondylitis, the 1984 modified New York criteria have been used widely in clinical studies and daily practice but are not applicable in early disease when the characteristic radiographical signs of sacroiliitis are not visible but active sacroiliitis is readily detectable by magnetic resonance imaging (MRI). This led to the concept of axial SpA that includes patients with and without radiographical damage; candidate criteria for axial SpA were developed based on proposals for a structured diagnostic approach. These criteria were validated in the Assessment of Spondyloarthritis International Society (ASAS) study on new classification criteria for axial SpA, a large international prospective study. In this new criteria, sacroiliitis showing up on MRI has been given as much weight as sacroiliitis on radiographs, thereby also identifying patients with early axial SpA. Both the CASPAR and the ASAS criteria for axial SpA are likely to be of use as diagnostic criteria.

  19. Demographic, clinical, and laboratory features of Turkish patients with late onset ankylosing spondylitis

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    Ahmet Karaarslan

    2015-07-01

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory disease, which typically begins in early decades of life with primarily axial joints involvement. This disease rarely affects patients older than 50 years of age. The aim of this study was to compare and evaluate the demographic, clinical, and laboratory features of late onset and early onset AS patients who were followed up in a single rheumatology center. A total of 339 patients who have been diagnosed with AS according to modified New York criteria were included in the study. The patients whose initial symptoms were observed after 50 years of age were accepted as late onset AS. Out of 339 patients, 27 (7.9% were diagnosed as late onset AS and 312 (92.3% patients were evaluated as early onset AS. Of 27 late onset patients, 10 were male and 17 were female. Delay in the diagnosis was 5.8 years for early onset AS, while it was 3.8 years for late onset AS (p = 0.001. Higher levels of acute phase reactants and more methotrexate (MTX use were detected in early onset AS patients compared to late onset AS (p = 0.001, p = 0.007, respectively. Statistically, there was no difference between these two groups, with regard to disease clinical activity indexes, anthropometric measurement parameters, uveitis and peripheral joint involvement. In this study, we showed that early and late onset AS patients may present with different clinical, genetic, and laboratory features. Late onset AS patients are characterized with lower human leukocyte antigen-B27 sequence, less inflammatory sign, delayed diagnosis, and less MTX and anti-tumor necrosis factor alpha drug usage.

  20. Indicators of the osteoclastogenesis system in men with different clinical types of ankylosing spondylitis

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    T. A. Raskina

    2015-01-01

    Full Text Available Objective: to evaluate the osteoclastogenesis regulatory system – osteoprotegerin/receptor activator of nuclear factor-κβ ligand (OPG/RANKL system – in men with different clinical types of ankylosing spondylitis (AS.Subjects and methods. The osteoclastogenesis regulatory system was studied in 60 men, including 40 patients diagnosed with AS complying with the 1984 New York criteria and 20 men without AS. RANKL, a major stimulant of osteoclastogenesis, and OPG, a decoy receptor that binds RANKL and, accordingly, blocks osteoclastogenesis, were investigated.Results. It was shown that in the patients with AS, RANKL concentrations were normal and the content of OPG and OPG/RANKL ratio proved to be significantly higher than those in the men without AS. The highest OPG concentrations were recorded in patients with the axial form of this disease, its moderate activity and early X-ray stage. No relationship was found between the level of RANKL and the clinical characteristics of AS; however, there was a tendency to a slight increase in its concentration in patients with extraskeletal manifestations of AS, its high activity, high functional class, and late X-ray stage.Conclusion. The considerable increase in OPG levels and OPG/RANKL ratio was ascertained to be associated to the fact that 94% of the patients with late-stage AS characterized by the presence of numerous syndesmophytes. These changes must be compensatory in response to modestly increased RANKL level and enhanced bone resorption.

  1. Effect of Tumor Necrosis Factor Inhibitor Therapy on Osteoclasts Precursors in Ankylosing Spondylitis.

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    Inês P Perpétuo

    Full Text Available Ankylosing Spondylitis (AS is characterized by excessive local bone formation and concomitant systemic bone loss. Tumor necrosis factor (TNF plays a central role in the inflammation of axial skeleton and enthesis of AS patients. Despite reduction of inflammation and systemic bone loss, AS patients treated with TNF inhibitors (TNFi have ongoing local bone formation. The aim of this study was to assess the effect of TNFi in the differentiation and activity of osteoclasts (OC in AS patients.13 AS patients treated with TNFi were analyzed at baseline and after a minimum follow-up period of 6 months. 25 healthy donors were recruited as controls. Blood samples were collected to assess receptor activator of nuclear factor kappa-B ligand (RANKL surface expression on circulating leukocytes and frequency and phenotype of monocyte subpopulations. Quantification of serum levels of bone turnover markers and cytokines, in vitro OC differentiation assay and qRT-PCR for OC specific genes were performed.RANKL+ circulating lymphocytes (B and T cells and IL-17A, IL-23 and TGF-β levels were decreased after TNFi treatment. We found no differences in the frequency of the different monocyte subpopulations, however, we found decreased expression of CCR2 and increased expression of CD62L after TNFi treatment. OC number was reduced in patients at baseline when compared to controls. OC specific gene expression was reduced in circulating OC precursors after TNFi treatment. However, when cultured in OC differentiating conditions, OC precursors from AS TNFi-treated patients showed increased activity as compared to baseline.In AS patients, TNFi treatment reduces systemic pro osteoclastogenic stimuli. However, OC precursors from AS patients exposed to TNFi therapy have increased in vitro activity in response to osteoclastogenic stimuli.

  2. Does body mass index (BMI) influence the Ankylosing Spondylitis Disease Activity Score in axial spondyloarthritis?

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    Rubio Vargas, Roxana; van den Berg, Rosaline; van Lunteren, Miranda; Ez-Zaitouni, Zineb; Bakker, Pauline A C; Dagfinrud, Hanne; Ramonda, Roberta; Landewé, Robert; Molenaar, Esmeralda; van Gaalen, Floris A; van der Heijde, Désirée

    2016-01-01

    Objective Obesity is associated with elevated C reactive protein (CRP) levels. The Ankylosing Spondylitis Disease Activity Score (ASDAS) combines patient-reported outcomes (PROs) and CRP. We evaluated the effect of body mass index (BMI) on CRP and on ASDAS, and studied if ASDAS can be used in obese axial spondyloarthritis (axSpA) patients to assess disease activity. Methods Baseline data of patients with chronic back pain of short duration included in the SPondyloArthritis Caught Early (SPACE) cohort were used. Collected data included BMI and ASDAS. Patients were classified according to the ASAS axSpA classification criteria and BMI (overweight ≥25 and obese ≥30). Correlation and linear regression analyses were performed to assess the relation between BMI and ASDAS. Linear regression models were performed to assess if age or gender were effect modifiers in the relation between BMI and CRP, and between BMI and ASDAS. Results In total, 428 patients were analysed (n=168 axSpA; n=260 no-axSpA). The mean age was 31.1 years, 36.9% were male, 26.4% were overweight and 13.3% obese, median CRP was 3 mg/L and the mean ASDAS was 2.6. Gender was the only factor modifying the relationship between BMI and CRP as BMI had an influence on CRP only in females (β=0.35; p<0.001). Correlations between BMI and CRP or PROs were generally weak, and only significant for CRP in female patients. BMI was not related to ASDAS in axSpA patients. Conclusions ASDAS is not affected by BMI in axSpA patients. Therefore, based on our data it is not necessary to take BMI in consideration when assessing disease activity using ASDAS in axSpA patients. PMID:27403336

  3. Associations between ERAP1 polymorphisms and susceptibility to ankylosing spondylitis: a meta-analysis.

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    Lee, Young Ho; Song, Gwan Gyu

    2016-08-01

    The aim of this study was to determine whether 11 polymorphisms of endoplasmic reticulum aminopeptidase 1 (ERAP1) confer susceptibility to ankylosing spondylitis (AS). The authors conducted meta-analyses on associations between ERAP1 polymorphisms and AS susceptibility by using fixed and random effects models. A total of 19 articles were included in this meta-analysis, which comprised a total of 19,902 AS patients and 39,750 controls. The meta-analysis revealed a significant association between AS and the minor alleles of the rs30187 polymorphism in all study subjects (OR = 1.255, 95 % CI = 1.147-1.373, P = 8.0 × 10(-8)). Stratification by ethnicity led to the identification of a significant association between this polymorphism and AS in European patients (OR = 1.283, 95 % CI = 1.237-1.331, P Meta-analyses of the results for the rs27044, rs10050860, rs2287987, rs17482078, and rs26653 polymorphisms showed the same pattern that was found for rs30187. Interestingly, the rs27037 polymorphism was significantly associated with AS susceptibility in both European and Asian patients. Meta-analysis showed a significant association between AS and the minor alleles of the rs27980 and rs27582 polymorphisms in the East Asian patients (OR = 0.904, 95 % CI = 0.818-0.999, P = 0.047; OR = 0.871, 95 % CI = 0.772-0.982, P = 0.024, respectively) (Table 2). However, these polymorphisms have not been studied in Europeans. This meta-analysis shows that the ERAP1 polymorphisms are associated with the development of AS in Europeans and East Asians.

  4. Bone Mineral Density in Patients with Ankylosing Spondylitis: Incidence and Correlation with Demographic and Clinical Variables

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    Laura MUNTEAN

    2009-12-01

    Full Text Available Objective: To evaluate bone mineral density (BMD in patients with ankylosing spondylitis (AS and determine its correlation with the demographic and clinical characteristics of AS. Patients and Methods: Demographic, clinical and osteodensitometric data were evaluated in a cross-sectional study that included 136 patients with AS. Spine and hip BMD were measured by means of dual energy X-ray absorptiometry (DXA. Using the modified Schober’s test we assessed spine mobility. We examined the sacroiliac, anteroposterior and lateral dorso-lumbar spine radiographs in order to grade sacroiliitis and assess syndesmophytes. Disease activity was evaluated using C-reactive protein (CRP levels and erythrocyte sedimentation rate (ESR. Demographic data and BMD measurements were compared with those of 167 age- and sex-matched healthy controls. Results: Patients with AS had a significantly lower BMD at the spine, femoral neck, trochanter and total hip as compared to age-matched controls (all p<0.01. According to the WHO classification, osteoporosis was present in 20.6% of the AS patients at the lumbar spine and in 14.6% at the femoral neck. There were no significant differences in BMD when comparing men and women with AS, except for trochanter BMD that was lower in female patients. No correlations were found between disease activity markers (ESR, CRP and BMD. Femoral neck BMD was correlated with disease duration, Schober’s test and sacroiliitis grade. Conclusion: Patients with AS have a lower spine and hip BMD as compared to age- and sex-matched controls. Bone loss at the femoral neck is associated with disease duration and more severe AS.

  5. Demographic, clinical, and laboratory features of Turkish patients with late onset ankylosing spondylitis.

    Science.gov (United States)

    Karaarslan, Ahmet; Yilmaz, Hatice; Aycan, Hakan; Orman, Mehmet; Kobak, Senol

    2015-07-22

    Ankylosing spondylitis (AS) is a chronic inflammatory disease, which typically begins in early decades of life with primarily axial joints involvement. This disease rarely affects patients older than 50 years of age. The aim of this study was to compare and evaluate the demographic, clinical, and laboratory features of late onset and early onset AS patients who were followed up in a single rheumatology center. A total of 339 patients who have been diagnosed with AS according to modified New York criteria were included in the study. The patients whose initial symptoms were observed after 50 years of age were accepted as late onset AS. Out of 339 patients, 27 (7.9%) were diagnosed as late onset AS and 312 (92.3%) patients were evaluated as early onset AS. Of 27 late onset patients, 10 were male and 17 were female. Delay in the diagnosis was 5.8 years for early onset AS, while it was 3.8 years for late onset AS (p = 0.001). Higher levels of acute phase reactants and more methotrexate (MTX) use were detected in early onset AS patients compared to late onset AS (p = 0.001, p = 0.007, respectively). Statistically, there was no difference between these two groups, with regard to disease clinical activity indexes, anthropometric measurement parameters, uveitis and peripheral joint involvement. In this study, we showed that early and late onset AS patients may present with different clinical, genetic, and laboratory features. Late onset AS patients are characterized with lower human leukocyte antigen-B27 sequence, less inflammatory sign, delayed diagnosis, and less MTX and anti-tumor necrosis factor alpha drug usage.

  6. Assay of Peripheral Regulatory Vδ1 T Cells in Ankylosing Spondylitis and its Significance

    Science.gov (United States)

    Wang, Hongliang; Sun, Na; Li, Ka; Tian, Jiguang; Li, Jianmin

    2016-01-01

    Background Ankylosing spondylitis (AS) involves inflammation at the sacroiliac joint and spine attachment site. This study aimed to observe the ratio and function of peripheral regulatory Vδ1 T cells in AS patients to investigate their roles in AS pathogenesis. Material/Methods Peripheral blood mononuclear cells (PBMC) were separated by density-gradient centrifugation from AS patients and healthy controls. Flow cytometry was used to determine the ratio between Vδ1 and CD4 T cells of PBMC in AS patients and controls. Flow cytometry sorting (FCS) was used to obtain Vδ1 and naïve CD4 T cells with purity higher than 90%. CFSE staining method was used to detect the effect of Vδ1 T cells on proliferation of naïve CD4 T cells. The effect of Vδ1 T cells on secretion of IFN-γ from naïve CD4 T cells and the ability to secrete IL-10 from Vδ1 T cells were determined by flow cytometry. Results AS patients had significantly lower Vδ1 T cell ratio in PBMC compared to controls (p<0.05), but their CD4 T cell ratio was significantly elevated (p<0.05). Functional assay showed suppression of naïve CD4 T cell proliferation and IFN-γ secretion by peripheral Vδ1 T cells in AS patients (p<0.01). AS patients also had lower IL-10 secreting level from peripheral derived Vδ1 T cells (p<0.01). Conclusions The immune suppression of peripheral Vδ1 T cell in AS patient increases the ratio of peripheral CD4 T cells and IFN-γ level, leading to AS pathogenesis. This immune suppression is mainly due to suppressed IL-10 secretion. PMID:27598263

  7. HLA-B27 subtypes in Turkish patients with ankylosing spondylitis and healthy controls.

    Science.gov (United States)

    Acar, Muradiye; Cora, Tulin; Tunc, Recep; Acar, Hasan

    2012-10-01

    The aim of this study was to determine human leukocyte antigen (HLA)-B27 subtypes frequency in ankylosing spondylitis (AS) and related spondyloartropathy (SpA) patients. Therefore, we investigated the differences in HLA-B27 subtypes between HLA-B27-positive patients and controls. Sixty six patients were included in this study (51 AS and 15 SpA). Thirty-five individuals were diagnosed with leukemia or chronic renal failure, and their donors without any rheumatological problem (no SpA history) were selected as the control group. HLA-B27 subtyping was performed by PCR-SSP (polymerase chain reaction with sequence-specific primer) method in serologically HLA-B27-positive 46 AS patients, 9 SpA patients and control group. When the frequency of HLA-B27 was 4.5% in Turkish population, this frequency was 90.2% in AS patients. Four different HLA-B27 subtypes found in AS patients were B 2705 (65.2%), B 2702 (26.1%), B 2704 (6.5%) and B 2707 (2.2%). In SpA patients, B 2705 and B 2702 found in equal frequency. Five B27 alleles were identified in our control group: B 2705 (54.3%), B 2702 (31.4) %, B 2703 (2.9%), B 2704 (2.9%) and B 2702/B 2705 (8.5%). Both in the patient group and in the control group, we also observed B 2705 as most frequent allele, and B 2702 was second common allele. Our results show that the frequency of HLA-B27 subtypes is not significantly different between patients and controls (P > 0.10).

  8. Predictors of Switching Anti-Tumor Necrosis Factor Therapy in Patients with Ankylosing Spondylitis.

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    Jeong-Won Lee

    Full Text Available The aim of this study was to investigate the potential predictors of switching tumor necrosis factor (TNF-α inhibitors in Korean patients with ankylosing spondylitis (AS. The patients who had been treated with TNF-α inhibitors were divided into two groups depending on whether they had switched TNF-α inhibitors. Demographic, clinical, laboratory, and treatment data at the time of initiation of TNF-α inhibitor treatment were compared between switchers and non-switchers, and within switchers according to the reasons for switching. Of the 269 patients, 70 (23% had switched TNF-α inhibitors once; of these, 11 switched again. The median follow-up time was 52.7 months. Three- and five-year drug survival rates were 52%/48% for infliximab, 62%/42% for etanercept, and 71%/51% for adalimumab, respectively. Switchers were more likely to be prescribed disease-modifying anti-rheumatic drugs than non-switchers. A history of joint surgery and complete ankylosis of the sacroiliac joint was more frequent in switchers. Multivariate Cox's proportional hazard analysis showed that the use of adalimumab as the first TNF-α inhibitor was less likely to lead to switching and complete ankylosis of the sacroiliac joints was more likely to lead to switching. The principal reasons for switching were drug inefficacy and adverse events, but the differences in the clinical data of these two groups of switchers were not significant. In AS patients who are candidates for TNF-α inhibitor therapy, switching may improve the therapeutic outcome based on clinical information.

  9. {sup 18}F-Fluoride PET/CT for detection of sacroiliitis in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Strobel, Klaus [University Hospital, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Cantonal Hospital Lucerne, Nuclear Medicine, Lucerne (Switzerland); Fischer, Dorothee R.; Stumpe, Katrin D.M.; Schulthess, Gustav K. von [University Hospital, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Tamborrini, Giorgio; Kyburz, Diego; Michel, Beat A.; Ciurea, Adrian [University Hospital Zurich, Department of Rheumatology, Zurich (Switzerland); Hesselmann, Rolf G.X.; Johayem, A. [University Hospital Zurich, Radiopharmacy, Zurich (Switzerland)

    2010-09-15

    The aim of this study was to evaluate the performance of {sup 18}F-fluoride-PET/CT (PET/CT) for the diagnosis of sacroiliac joint (SIJ) arthritis in patients with active ankylosing spondylitis (AS). Included in the study were 15 patients with AS according to the modified New York criteria (AS group) and with active disease and 13 patients with mechanical low back pain (MLBP; control group) who were investigated with whole-body {sup 18}F-fluoride PET/CT. The ratio of the uptake in the SIJ and that in the sacrum (SIJ/S) was calculated for every joint. The mean SIJ/S ratio of 30 quantified joints in the AS group was 1.66 (range 1.10-3.07) with PET/CT, and the mean SIJ/S ratio of 26 quantified joints in the MLBP group was 1.12 (range 0.71-1.52). The area under the receiver operating characteristic curve for SIJ arthritis was 0.84. With plain radiography as a the gold standard and taking an SIJ/S ratio of >1.3 as the threshold, the sensitivity, specificity and accuracy on a per patient basis were 80%, 77% and 79%, respectively. On a per SIJ basis, the greatest sensitivity (94%) was found in grade 3 sacroiliitis (n = 16). Our results suggest that quantitative {sup 18}F-fluoride PET/CT may play a role in the diagnosis of sacroiliitis in active AS and is an alternative to conventional bone scintigraphy in times of molybdenum shortage. (orig.)

  10. THE THYROID GLAND STATUS IN PATIENTS WITH ANKYLOSING SPONDYLITIS DURING STANDARD THERAPY AND BIOLOGICAL THERAPY

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    G. R. Akhunova

    2013-01-01

    Full Text Available Aim. To evaluate the condition of the thyroid gland in patients with ankylosing spondylitis (AS during standard therapy and biologicaltherapy (infliximab.Subjects and methods. Twenty-six patients with AS were examined; some of them received biological therapy with infliximab, while the others took non-steroidal anti-inflammatory drugs. The structuralunctional state of thyroid gland was evaluated in all patients. The effect of therapy was evaluated by the ASAS criteria. The efficiency of therapy was evaluated 24 weeks after therapy.Results. In 15.2 % of patients with AS were diagnosed thyroid gland disorders. The level of anti-thyroid antibodies, thyroid stimulating hormone (thyroid function were correlated with active AS (index BASDAI, and the level of anti-thyroid antibodies were correlated with Creactive protein and erythrocyte sedimentation rate, the intensity of pain in the joints, number of swollen joints and inflamed enthesis.Therapy with non-steroidal anti-inflammatory drug is not provided significant effect on the structural and functional state of the thyroidgland, contributing to a downward trend in the level of antibodies to thyroid peroxidase. Treatment with Infliximab reduced the levels ofantibodies to thyroid peroxidase, thyroid stimulating hormone. This treatment was more effective in improving the structural and functionalstate of the thyroid gland.Conclusions. Against the background of the therapy in patients with AS is marked improvement in thyroid function, reduction of antithyroid antibodies, accompanied by a decrease in activity and improvement of clinical and laboratory parameters of AS.

  11. THE THYROID GLAND STATUS IN PATIENTS WITH ANKYLOSING SPONDYLITIS DURING STANDARD THERAPY AND BIOLOGICAL THERAPY

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    G. R. Akhunova

    2014-07-01

    Full Text Available Aim. To evaluate the condition of the thyroid gland in patients with ankylosing spondylitis (AS during standard therapy and biologicaltherapy (infliximab.Subjects and methods. Twenty-six patients with AS were examined; some of them received biological therapy with infliximab, while the others took non-steroidal anti-inflammatory drugs. The structuralunctional state of thyroid gland was evaluated in all patients. The effect of therapy was evaluated by the ASAS criteria. The efficiency of therapy was evaluated 24 weeks after therapy.Results. In 15.2 % of patients with AS were diagnosed thyroid gland disorders. The level of anti-thyroid antibodies, thyroid stimulating hormone (thyroid function were correlated with active AS (index BASDAI, and the level of anti-thyroid antibodies were correlated with Creactive protein and erythrocyte sedimentation rate, the intensity of pain in the joints, number of swollen joints and inflamed enthesis.Therapy with non-steroidal anti-inflammatory drug is not provided significant effect on the structural and functional state of the thyroidgland, contributing to a downward trend in the level of antibodies to thyroid peroxidase. Treatment with Infliximab reduced the levels ofantibodies to thyroid peroxidase, thyroid stimulating hormone. This treatment was more effective in improving the structural and functionalstate of the thyroid gland.Conclusions. Against the background of the therapy in patients with AS is marked improvement in thyroid function, reduction of antithyroid antibodies, accompanied by a decrease in activity and improvement of clinical and laboratory parameters of AS.

  12. Rheumatic patients at work : a study of labour force participations and its determinants in rheumatoid arthritis, ankylosing spondylitis, and juvenile chronic arthritis

    NARCIS (Netherlands)

    Chorus, A.M.J.

    2004-01-01

    This thesis at the University of Maastricht, defended at May 7, 2004, yields several important and new findings with regard to work related quality of life, participation in the labour force and its determinants of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and juvenile chr

  13. Psychometric characteristics of the short form 36 health survey and functional assessment of chronic illness Therapy-Fatigue subscale for patients with ankylosing spondylitis

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    Luo Michelle P

    2011-05-01

    Full Text Available Abstract Background We evaluated the psychometric characteristics of the Short Form 36 (SF-36 Health Survey and the Functional Assessment of Chronic Illness Therapy (FACIT-Fatigue subscale in patients with ankylosing spondylitis (AS. Methods We analyzed clinical and patient-reported outcome (PRO data collected during 12-week, double-blind, placebo-controlled periods of two randomized controlled trials comparing adalimumab and placebo for the treatment of active AS. The Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, and other clinical measures were collected during the clinical trial. We evaluated internal consistency/reliability, construct validity, and responsiveness to change for the SF-36 and FACIT-Fatigue. Results The SF-36 (Cronbach alpha, 0.74-0.92 and FACIT-Fatigue (Cronbach alpha, 0.82-0.86 both had good internal consistency/reliability. At baseline, SF-36 and FACIT-Fatigue scores correlated significantly with Ankylosing Spondylitis Quality of Life scores (r = -0.36 to -0.66 and r = -0.70, respectively; all p Conclusions The SF-36 is a reliable, valid, and responsive measure of health-related quality of life and the FACIT-Fatigue is a brief and psychometrically sound measure of the effects of fatigue on patients with AS. These PROs may be useful in evaluating effectiveness of new treatments for AS. Trial Registration ClinicalTrials.gov: NCT00085644 and NCT00195819

  14. The relation between bone mineral density, bone turnover markers, and vitamin D status in ankylosing spondylitis patients with active disease : a cross-sectional analysis

    NARCIS (Netherlands)

    Arends, S.; Spoorenberg, A.; Bruyn, G. A. W.; Houtman, P. M.; Leijsma, M. K.; Kallenberg, C. G. M.; Brouwer, E.; van der Veer, E.

    2011-01-01

    Osteoporosis is a well recognized complication of ankylosing spondylitis (AS). This study indicates that increased bone turnover, inflammation, and low vitamin D levels are important in the pathophysiology of AS-related osteoporosis, and that bone turnover markers (BTM) are valuable markers to detec

  15. Patient-tailored dose reduction of TNF-alpha blocking agents in ankylosing spondylitis patients with stable low disease activity in daily clinical practice

    NARCIS (Netherlands)

    Arends, S.; van der Veer, E.; Kamps, F. B. S.; Houtman, P. M.; Bos, R.; Bootsma, H.; Brouwer, E.; Spoorenberg, A.

    2015-01-01

    Objective Tumour necrosis factor-alpha (TNF-alpha) blocking agents are very, effective in controlling systemic inflammation and improving clinical assessments in ankylosing spondylitis (AS). In view of potential side effects and high costs of long-term treatment, our aim was to investigate whether d

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

    NARCIS (Netherlands)

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

    2015-01-01

    OBJECTIVES: To evaluate spinal radiographic damage over time and to explore the associations of radiographic progression with patient characteristics and clinical assessments including disease activity in ankylosing spondylitis (AS) patients treated with tumor necrosis factor-alpha (TNF-α) blocking

  17. Investigation of two novel biochemical markers of inflammation, matrix metalloproteinase and cathepsin generated fragments of C-reactive protein, in patients with ankylosing spondylitis

    DEFF Research Database (Denmark)

    Skjøt-Arkil, Helene; Schett, Georg; Zhang, Chen;

    2012-01-01

    Ankylosing spondylitis (AS) is a chronic inflammation of the spine and the sacroiliac joints. Current markers of inflammation, such as C-reactive protein (CRP), are reflecting the production of an acute phase reactant rather than tissue specific inflammation, but the use of CRP as a diagnostic...

  18. Can erosions on MRI of the sacroiliac joints be reliably detected in patients with ankylosing spondylitis? - A cross-sectional study

    DEFF Research Database (Denmark)

    Weber, Ulrich; Pedersen, Susanne J; Østergaard, Mikkel

    2012-01-01

    Erosions of the sacroiliac joints (SIJ) on pelvic radiographs of patients with ankylosing spondylitis (AS) are an important feature of the modified New York classification criteria. However, radiographic SIJ erosions are often difficult to identify. Recent studies have shown that erosions can...

  19. Analysis of sagittal balance using spinopelvic parameters in ankylosing spondylitis patients treated with vertebral column decancellation surgery.

    Science.gov (United States)

    Lin, Bin; Zhang, Wen-Bin; Cai, Tao-yi; Lu, Cheng-Wu; Zhou, Qin; Huang, Zhuanzhi; Yu, Hui

    2015-09-01

    This study was designed to explore the change of spinopelvic parameters after vertebral column decancellation (VCD) for the management of thoracolumbar kyphosis secondary to ankylosing spondylitis (AS). Forty-two AS patients including thirty-six males and six females with thoracolumbar kyphosis, who underwent VCD from April 2005 to June 2012 in our hospital, were retrospectively reviewed. A series of spinopelvic parameters including thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT) and sagittal vertical axis (SVA) measured on preoperative and postoperative free-standing radiographs were obtained and analyzed. Also clinical assessments were performed with the Oswestry disability index (ODI) and the Bath Ankylosing Spondylitis Activity and Function Index (BASDAI and BASFI) so as to seek correlations between radiological parameters and symptoms. Except for pelvic incidence (PI), significant difference was found in all radiological spinopelvic parameters between the preoperative and follow-up values. Furthermore, there was significant improvement in the clinical assessment parameters ODI, BASDAI and BASFI, which all correlated significantly with the postoperative pelvic tilt (PT). The results of this study show that posterior VCD is an effective option to manage sagittal imbalance in AS. In the current series, patients improving LL and PT were found to achieve good clinical outcomes. Overall, our findings show that it is important to quantify sagittal spinopelvic parameters and promote sagittal balance in the surgery for AS.

  20. Elevated serum level of IL-27 and VEGF in patients with ankylosing spondylitis and associate with disease activity.

    Science.gov (United States)

    Lin, Tian-Tian; Lu, Jing; Qi, Chen-Yue; Yuan, Lin; Li, Xiao-Lin; Xia, Li-Ping; Shen, Hui

    2015-05-01

    Interleukin (IL)-27 is an IL-12 family cytokine and exerts a critical role in immune regulation in the context of infection, autoimmunity, and angiogenesis. In this study, we aimed to investigate the possible pathophysiological role of IL-27 and vascular endothelial growth factor (VEGF) in ankylosing spondylitis (AS). One hundred and forty AS patients and 90 healthy controls were included in the current study. The levels of IL-27 and VEGF in serum and synovial fluid (SF) samples were measured by enzyme-linked immunosorbent assay. Erythrocyte sedimentation rate, C-reactive protein, and human leukocyte antigen (HLA)-B27 were measured by standard laboratory techniques. Disease activity in AS was scored with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Hip involvement, peripheral arthritis, and eye involvement were also recorded. The serum levels of IL-27 were remarkably higher in AS patients than healthy groups and significantly correlated with serum levels of VEGF. Furthermore, the serum levels of IL-27 were correlated with BASDAI independent of other markers of inflammation. Elevated serum levels of IL-27 and VEGF were detected in AS patients with peripheral arthritis and HLA-B27 positive. The SF levels of IL-27 and VEGF were significantly higher than serum levels in AS patients with peripheral arthritis. By contrast, levels of IL-27 and VEGF were not increased in AS patients with hip involvement and eye involvement. IL-27 may regulate the immunological or inflammatory process of AS.

  1. A Single Nucleotide Polymorphism in the Il17ra Promoter Is Associated with Functional Severity of Ankylosing Spondylitis.

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    Jose Ramón Vidal-Castiñeira

    Full Text Available The aim of this study was to identify new genetic variants associated with the severity of ankylosing spondylitis (AS. We sequenced the exome of eight patients diagnosed with AS, selected on the basis of the severity of their clinical parameters. We identified 27 variants in exons and regulatory regions. The contribution of candidate variants found to AS severity was validated by genotyping two Spanish cohorts consisting of 180 cases/300 controls and 419 cases/656 controls. Relationships of SNPs and clinical variables with the Bath Ankylosing Spondylitis Disease Activity and Functional Indices BASDAI and BASFI were analyzed. BASFI was standardized by adjusting for the duration of the disease since the appearance of the first symptoms. Refining the analysis of SNPs in the two cohorts, we found that the rs4819554 minor allele G in the promoter of the IL17RA gene was associated with AS (p<0.005. This variant was also associated with the BASFI score. Classifying AS patients by the severity of their functional status with respect to BASFI/disease duration of the 60th, 65th, 70th and 75th percentiles, we found the association increased from p60 to p75 (cohort 1: p<0.05 to p<0.01; cohort 2: p<0.01 to p<0.005. Our findings indicate a genetic role for the IL17/ILRA axis in the development of severe forms of AS.

  2. Sulfasalazine Treatment Suppresses the Formation of HLA-B27 Heavy Chain Homodimer in Patients with Ankylosing Spondylitis.

    Science.gov (United States)

    Yu, Hui-Chun; Lu, Ming-Chi; Huang, Kuang-Yung; Huang, Hsien-Lu; Liu, Su-Qin; Huang, Hsien-Bin; Lai, Ning-Sheng

    2015-12-29

    Human leukocytic antigen-B27 heavy chain (HLA-B27 HC) has the tendency to fold slowly, in turn gradually forming a homodimer, (B27-HC)₂ via a disulfide linkage to activate killer cells and T-helper 17 cells and inducing endoplasmic reticulum (ER) stress to trigger the IL-23/IL-17 axis for pro-inflammatory reactions. All these consequences lead to the pathogenesis of ankylosing spondylitis (AS). Sulfasalazine (SSA) is a common medication used for treatment of patients with AS. However, the effects of SSA treatment on (B27-HC)₂ formation and on suppression of IL-23/IL-17 axis of AS patients remain to be determined. In the current study, we examine the (B27-HC)₂ of peripheral blood mononuclear cells (PBMC), the mean grade of sarcoiliitis and lumbar spine Bath Ankylosing Spondylitis Radiology Index (BASRI) scores of 23 AS patients. The results indicated that AS patients without (B27-HC)₂ on PBMC showed the lower levels of mean grade of sarcoiliitis and the lumbar spine BASRI scores. In addition, after treatment with SSA for four months, the levels of (B27-HC)₂ on PBMCs were significantly reduced. Cytokines mRNA levels, including TNFα, IL-17A, IL-17F and IFNγ, were also significantly down-regulated in PBMCs. However, SSA treatment did not affect the levels of IL-23 and IL-23R mRNAs.

  3. 强直性脊柱炎累及髋关节的X线表现%The X-ray manifestations of ankylosing spondylitis involves hip

    Institute of Scientific and Technical Information of China (English)

    杨卫民

    2013-01-01

    目的:提高数字X线(DR)对强直性脊柱炎累及髋关节的诊断水平。方法12例强直性脊柱炎累及髋关节患者均行DR检查,对其X线表现进行分析。结果12例患者中,双侧髋关节受累8例,单侧受累4例;其X表现髋关节间隙变窄8例,消失2例,骨赘形成9例,髋臼或股骨头囊变2例,骨质疏松4例。结论DR平片是诊断强直性脊柱炎累及髋关节的基本检查方法。%Objective To improve the diagnostic level of ankylosing spondylitis involves hip. Methods 12 cases of hip joint in ankylosing spondylitis involving were examined by DR,analysis of X-ray manifestations of Ankylosing Spondylitis ankylosing spondylitis involving the hip joint. Results In 12 cases,8 cases of bilateral hip involvement,4 cases of unilateral involvement,the X features of hip joint space narrowing 8 cases,disappeared in 2 cases,osteophyte formation of acetabular or femoral head in 9 cases,cyst in 2 cases,4 cases of osteoporosis. Conclusion X-ray film is a basic method in diagnosis of ankylosing spondylitis involves hip.

  4. Anti-TNF-α therapy reduces endothelial cell activation in non-diabetic ankylosing spondylitis patients.

    Science.gov (United States)

    Genre, Fernanda; López-Mejías, Raquel; Miranda-Filloy, José A; Ubilla, Begoña; Mijares, Verónica; Carnero-López, Beatriz; Gómez-Acebo, Inés; Dierssen-Sotos, Trinidad; Remuzgo-Martínez, Sara; Blanco, Ricardo; Pina, Trinitario; González-Juanatey, Carlos; Llorca, Javier; González-Gay, Miguel A

    2015-12-01

    Endothelial dysfunction can be detected by the presence of elevated levels of biomarkers of endothelial cell activation. In this study, we aimed to establish whether correlations of these biomarkers with characteristics of patients with ankylosing spondylitis (AS) exist. We also studied the effect of anti-TNF-α therapy on these biomarkers. Serum sE-selectin, MCP-1 and sVCAM-1 levels were measured by ELISA in 30 non-diabetic AS patients undergoing anti-TNF-α therapy, immediately before and after an infusion of infliximab. Correlations of these biomarkers with clinical features, systemic inflammation, metabolic syndrome and other serum and plasma biomarkers of cardiovascular risk were studied. Potential changes in the concentration of these biomarkers following an infliximab infusion were also assessed. sE-selectin showed a positive correlation with CRP (p = 0.02) and with other endothelial cell activation biomarkers such as sVCAM-1 (p = 0.019) and apelin (p = 0.008). sVCAM-1 negatively correlated with BMI (p = 0.018), diastolic blood pressure (p = 0.008) and serum glucose (p = 0.04). sVCAM-1 also showed a positive correlation with VAS spinal pain (p = 0.014) and apelin (p < 0.001). MCP-1 had a negative correlation with LDL cholesterol (p = 0.026) and ESR (p = 0.017). Patients with hip involvement and synovitis and/or enthesitis in other peripheral joints showed higher levels of MCP-1 (p = 0.004 and 0.02, respectively). A single infliximab infusion led to a significant reduction in sE-selectin (p = 0.0015) and sVCAM-1 (p = 0.04). Endothelial dysfunction correlates with inflammation and metabolic syndrome features in patients with AS. A beneficial effect of the anti-TNF-α blockade on endothelial dysfunction, manifested by a reduction in levels of biomarkers of endothelial cell activation, was observed.

  5. COMPARATIVE EVALUATION OF PATIENTS WITH ANKYLOSING SPONDYLITIS AND NON-RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS

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    I. А. Cherentsova

    2016-01-01

    Full Text Available Objective: to study clinical presentations, disease activity, and functional impairments  in patients with ankylosing spondylitis (AS and non-radiographic axial spondyloarthritis  (nr-axSpA.Subjects and methods. A total of 153 patients were examined in the period 2010 to 2013. They were divided into two groups: 1 119 patients with a valid diagnosis of AS; 2 34 with nr-axSpA. BASDAI, BASFI, BASMI, MASES, erythrocyte sedimentation rate, and HLA-B27 antigen were determined  in both groups. The mean age of the patients was 36.5±0.7 years and 27.0±1.2 years and the disease duration 14.7±0.6 and 4.1±0.5 years in Groups 1 and 2, respectively.Results and discussion. Among the patients with AS and those with nr-axSpA, men accounted  for 68.9 and 70.6%, respectively. The axial type was predominant in both groups (53.7% in Group 1 and 67.6% in Group 2. The mean visual analogue scale (VAS pain score was 40.6±1.6 mm in Group 1 and 31.6±2.4 mm in Group 2 (p < 0.01. High BASDAI was seen in 51.2% of the patients with AS and 41.1% of those with nr-axSpA. Group 2 had significantly lower mean BASDAI values (3.4±0.2  than Group 1 (4.0±0.1.  Functional impairments  by BASFI were more obvious in the patients with AS ((3.2±0.2 than in those with nr-axSpA (1.5±0.2.  BASFI >4 was not noted in Group 2. Higher BASMI scores were found in the patients with AS (1.9±0.1  than in those with nr-axSpA (0.5±0.1. Conclusion. The ASAS criteria for axSpA enable one to establish its diagnosis in the early stage until stable functional impairments  emerge. In the pre-radiographic stage, the patients have lower disease activity and pain.

  6. Adverse events of anti-tumor necrosis factor α therapy in ankylosing spondylitis.

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    Qiang Tong

    Full Text Available This study aims to investigate the prevalence of short-term and long-term adverse events associated with tumor necrosis factor-α (TNF-α blocker treatment in Chinese Han patients suffering from ankylosing spondylitis (AS.The study included 402 Chinese Han AS patients treated with TNF-α blockers. Baseline data was collected. All patients were monitored for adverse events 2 hours following administration. Long-term treatment was evaluated at 8, 12, 52 and 104 weeks follow-up for 172 patients treated with TNF-α blockers.Short-term adverse events occurred in 20.15% (81/402, including rash (3.5%; 14/402, pruritus (1.2%; 5/402, nausea (2.2%; 9/402, headache (0.7%; 3/402, skin allergies (4.0%; 16/402, fever (0.5%; 2/402, palpitations (3.0%; 12/402, dyspnea (0.5%; 2/402, chest pain (0.2%; 1/402, [corrected] abdominal pain (1.0%; 4/402, hypertension (2.2%; 9/402, papilledema (0.5%; 2/402, laryngeal edema (0.2%; 1/402 and premature ventricular contraction (0.2%; 1/402. Long-term adverse events occurred in 59 (34.3%; 59/172 patients, including pneumonia (7.6%; 13/172, urinary tract infections (9.9%; 17/172, otitis media (4.7%; 8/172, tuberculosis are (3.5%; 6/172 [corrected], abscess (1.2%; 2/172, oral candidiasis (0.6%; 1/172, elevation of transaminase (1.7%; 3/172, anemia (1.2%; 2/172, hematuresis (0.6%; 1/172, constipation (2.3%; 4/172, weight loss (0.6%; 1/172, exfoliative dermatitis (0.6%; 1/172. CRP, ESR and disease duration were found to be associated with an increased risk of immediate and long-term adverse events (P<0.05. Long-term treatment with Infliximab was associated with more adverse events than rhTNFR-Fc (P<0.01.This study reports on the prevalence of adverse events in short-term and long-term treatment with TNF-α blocker monotherapy in Chinese Han AS patients. Duration of disease, erythrocyte sedimentation rate, and c-reactive protein serum levels were found to be associated with increased adverse events with anti-TNF-α therapy. Long

  7. Celecoxib and sulfasalazine had negative association with coronary artery diseases in patients with ankylosing spondylitis

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    Wu, Li-Chih; Leong, Pui-Ying; Yeo, Kai-Jieh; Li, Ting-Yu; Wang, Yu-Hsun; Chiou, Jeng-Yuan; Wei, James Cheng-Chung

    2016-01-01

    Abstract The aim of the study is to assess the effects of celecoxib and sulfasalazine on the risk of coronary artery disease (CAD) in patients with ankylosing spondylitis (AS). Using the claims data of Taiwan National Health Insurance (NHI) database, a nationally representative data that contain the medical records of 23 million Taiwan residents, we randomly selected 1 million cohort from the database, and then we enrolled only patients who were newly diagnosed with AS (n = 4829) between year 2001 and 2010, excluding patients who had CAD (ICD-9- CM codes: 410–414) before the diagnosis of AS (n = 4112). According to propensity score matched 1:2 on age, gender, AS duration, Charlson comorbidity index, hypertension, and hyperlipidemia, 236 and 472 patients were included in the case (AS with CAD) and control (AS without CAD) groups, respectively. We used the WHO defined daily dose (DDD) as a tool to assess the dosage of sulfasalazine and celecoxib exposure. Conditional logistic regression was used to estimate the crude and adjusted odds ratios (ORs) and 95% confidence interval (CI) for the risk of CAD associated with use of sulfasalazine and celecoxib. Among 4112 AS patients, 8.4% (346/4112) developed CAD. CAD in AS patients were positively associated with age of 35 to 65, Charlson comorbidities index (CCI), hypertension, and hyperlipidemia. There was no gender difference between case and control groups. After adjustment for age, gender, CCI, hypertension, and hyperlipidemia, sulfasalazine users with an average daily dose ≥ 0.5 DDD (0.5 gm/day) had negative association with CAD events as compared to sulfasalazine nonusers (OR 0.63; 95% CI, 0.40–0.99, P  1.5 DDD, were negatively associated with CAD events, compared to celecoxib nonusers (OR 0.34; 95% CI, 0.13–0.89; P < 0.05). In this 10-year population-based case-control study, 8.4% of AS patients developed CAD. Sulfasalazine usage at an average dose of ≥ 0.5 gm/day demonstrated negative association

  8. IMPACT OF THE SPECIFIC FEATURES OF DISEASE COURSE AND THERAPY ON QUALITY OF LIFE IN PATIENTS WITH ANKYLOSING SPONDYLITIS

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    N. A. Kuznetsova

    2015-01-01

    Full Text Available Objective: to investigate the impact of specific features of the course of ankylosing spondylitis (AS, sociodemographic factors, and therapy on quality of life (QL in patients with this disease. Subjects and methods. The results of studying QL (with the SF-36 questionnaire in 90 adult patients with AS versus 45 healthy individuals (a control group were presented. Within 6 months before study inclusion, 30 patients with AS received only nonsteroidal anti-inflammatory drugs (NSAIDs; 27 – NSAIDs + sulfasalazine (SULF, 15 – NSAIDs + infliximab (INF; 18 (20% patients were not systematically treated and were excluded from the study. A control group comprised 45 apparently healthy volunteers (32 men and 13 women; both groups were matched for gender and age. Results and discussion. The patients with AS were found to have lower physical and psychological QL scores than the controls (p < 0.001. In those with AS, QL worsened as the inflammatory disease activity, functional limitations, articular manifestations and enthesitis increased. Coxitis detected in 76.7% of the patients had a negative effect on rolephysical functioning. The sociodemographic factors were not found to have a statistically significant influence on QL in the patients with AS. The QL scores were higher in the patients taking INF in combination with NSAIDs. Evaluation of the impact of performed drug therapy on QL in the patients receiving SULF versus the controls revealed statistically significant worse scores in all the scales of the SF-36 questionnaire (p < 0.001. In the patients who had NSAIDs only, the QL scores were also worse than those in the control group (p < 0.001. According to the data of the SF-36 questionnaire, a number of QL scores in the patients receiving INF + NSAIDs proved to be similar in the apparently healthy individuals. Thus, the patients with AS have considerably lower physical and psychological QL scores than the healthy people. QL worsens as the inflammatory

  9. Espondilite anquilosante e anestesia Espondilitis anquilosante y anestesia Ankylosing spondylitis and anesthesia

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    Carlos Rogério Degrandi Oliveira

    2007-04-01

    40 años; es rara después de los 50 años. Las mujeres corresponden solamente a la minoría de pacientes. Existe poca información sobre la EA en la literatura anestésica. El objetivo de este artículo fue revisar aspectos de la EA de interés para el anestesiólogo, permitiendo un adecuado manoseo perioperatorio. CONTENIDO: Están definidas las características de la espondilitis anquilosante en cuanto a la clínica y la conducta anestésica. CONCLUSIONES: Los pacientes con enfermedades crónicas de la columna vertebral presentan desafíos específicos para el anestesiólogo. El manoseo de la vía aérea y el acceso al neuro-eje podrán ser difíciles. La preferencia ha sido dada a la anestesia general, incluso con la vía aérea de difícil acceso, evitando la anestesia en el neuro-eje. El grado de involucración de la columna cervical determinará cuanto podrá ser difícil la intubación traqueal. Un cuidado especial debe tenerse para evitar la manipulación excesiva de la columna cervical, lo que podría conllevar al trauma de la médula espinal.BACKGROUND AND OBJECTIVES: Ankylosing spondylitis (AS is a chronic inflammatory disease of the joints, included in the group of seronegative spondyloarthropathies. Its main characteristic is the fusion of the bones in the spine, which causes loss of flexibility of the back and neck. Other large articulations and connective tissues can be affected by the inflammatory process. It affects mainly men between the ages of 20 and 40; it is rare after the age of 50. Women represent a minority of patients. There is little information about AS in the anesthetic literature. The objective of this article was to review the characteristics of AS pertaining anesthesiology for an adequate perioperative handling. CONTENTS: The clinical characteristics of ankylosing spondylitis pertaining to the anesthetic conduct are reviewed. CONCLUSIONS: Patients with chronic diseases of the spine represent specific challenges to the anesthesiologist

  10. Relationship of the sexual functions with the clinical parameters, radiological scores and the quality of life in male patients with ankylosing spondylitis.

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    Sariyildiz, Mustafa Akif; Batmaz, Ibrahim; Dilek, Banu; Inanir, Ahmet; Bez, Yasin; Tahtasiz, Mehmet; Em, Serda; Cevik, Remzi

    2013-03-01

    The aim of this study was to explore the impact of ankylosing spondylitis (AS) and the disease-related variables on the patients' sexual function according to the International Index of Erectile Function (IIEF) scoring system. A total of 70 sexually active male AS patients and 60 healthy controls were enrolled in this study. Their demographic data were evaluated, and the pain was assessed according to the visual analogue scale (VAS). Laboratory tests were conducted in order to measure the C-reactive protein (CRP) and erythrocyte sedimentation rates (ESR) of the patients. The disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional statement was evaluated with the help of the Bath Ankylosing Spondylitis Functional Index (BASFI) and with the scores obtained from the spinal measurements with the Bath Ankylosing Spondylitis Metrology Index (BASMI). The Bath Ankylosing Spondylitis Radiology Index (BASRI) was used to evaluate the radiological damage. The disease-related quality of life was measured with the Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL). The anxiety and depression level of the patients was revealed through the Hospital Anxiety and Depression Scale (HADS). In comparison with the healthy control group, patients with AS had significantly lower scores in each of the 5 domains of the IIEF (p < 0.0001). The BASDAI, BASFI, BASMI, BASRI, ASQoL, HADS scores and CRP levels were negatively correlated with IIEF (p < 0.05). Orgasmic function and sexual desire scores were significantly lower in patients with peripheral arthritis (p < 0.05). No significant correlation was observed with the disease duration, smoking status, pain (VAS), and ESR levels when the total scores and the scores from the domains of IIEF were compared. The multivariate regression analyses indicated that BASFI and BASMI were independently associated with the sexual function. The sexual function is impaired in male patients

  11. Duration of remission after halving of the etanercept dose in patients with ankylosing spondylitis: a randomized, prospective, long-term, follow-up study

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    Nannini C

    2013-01-01

    Full Text Available Fabrizio Cantini, Laura Niccoli, Emanuele Cassarà, Olga Kaloudi, Carlotta NanniniDivision of Rheumatology, Misericordia e Dolce Hospital, Prato, ItalyBackground: The aim of this study was to evaluate the proportion of patients with ankylosing spondylitis maintaining clinical remission after reduction of their subcutaneous etanercept dose to 50 mg every other week compared with that in patients receiving etanercept 50 mg weekly.Methods: In the first phase of this randomized, prospective, follow-up study, all biologic-naïve patients identified between January 2005 and December 2009 as satisfying the modified New York clinical criteria for ankylosing spondylitis treated with etanercept 50 mg weekly were evaluated for disease remission in January 2010. In the second phase, patients meeting the criteria for remission were randomized to receive subcutaneous etanercept as either 50 mg weekly or 50 mg every other week. The randomization allocation was 1:1. Remission was defined as Bath Ankylosing Spondylitis Disease Activity Index < 4, no extra-axial manifestations of peripheral arthritis, dactylitis, tenosynovitis, or iridocyclitis, and normal acute-phase reactants. The patients were assessed at baseline, at weeks 4 and 12, and every 12 weeks thereafter. The last visit constituted the end of the follow-up.Results: During the first phase, 78 patients with ankylosing spondylitis (57 males and 21 females, median age 38 years, median disease duration 12 years were recruited. In January 2010, after a mean follow-up of 25 ± 11 months, 43 (55.1% patients achieving clinical remission were randomized to one of the two treatment arms. Twenty-two patients received etanercept 50 mg every other week (group 1 and 21 received etanercept 50 mg weekly (group 2. At the end of follow-up, 19 of 22 (86.3% subjects in group 1 and 19 of 21 (90.4% in group 2 were still in remission, with no significant difference between the two groups. The mean follow-up duration in group

  12. Ankylosing spondylitis susceptibility and severity--contribution of TNF gene promoter polymorphisms at positions -238 and -308.

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    Sousa, Elsa; Caetano-Lopes, Joana; Pinto, Patrícia; Pimentel, Fernando; Teles, José; Canhão, Helena; Rodrigues, Ana; Resende, Catarina; Mourão, Ana Filipa; Ribeiro, Célia; Pinto, Teresa Laura; Rosa, Carlos Miranda; da Silva, José Alberto Pereira; Branco, Jaime; Ventura, Francisco; Queiroz, Mário Viana; Fonseca, João Eurico

    2009-09-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease in which genetic factors play a central role. The efficacy of TNF blockers has reoriented research in this field in order to explain the influence of TNF in AS pathogenesis. The objective of this study was to access the influence of single nucleotide polymorphisms (SNPs) at positions -308 and -238 of the promoter region of TNF gene on AS susceptibility and prognosis. SNPs were determined by restriction fragment length polymorphisms in patients and controls. AS patients exhibited a decreased frequency of the A allele at position -238 (10%) when compared with controls (18%), suggesting that this could be a protective factor for disease susceptibility. In addition, the -308 GA/AA genotypes were associated with later disease onset in AS patients. These results suggest that TNF gene promoter polymorphisms at positions -238 and -308 could have a small influence on AS susceptibility and prognosis.

  13. Treatment of Ankylosing Spondylitis with Medicated Moxibustion plus Salicylazosulfapyridine and Methotrexate--A Report of 30 Cases

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To evaluate the therapeutic effect of medicated moxibustion plus administration of salicylazosulfapyridine (SASP) and methotrexate (MTX) for treatment of active ankylosing spondylitis (AS).Method: Ninety cases of active AS were randomly assigned to Group A, B and C (N=30 in each group),and treated respectively with SASP and MTX, acupuncture plus SASP and MTX, and composite sulfur (tablet) moxibustion plus SASP and MTX for 3 successive courses (2 months each course with an interval of 5 days). Results: Improvement in sacroiliitis index, Schober test, occipital wall test, finger-ground distance, as well as the erythrocyte sedimentation rate (ESR) and the content of C-reactive protein (CRP) in Group B and C was far superior to that of Group A (P<0.01). Conclusion: Combined use of western medicine with acupuncture or with medicated moxibustion produces a better therapeutic effect than western medicine given alone.

  14. Tumor necrosis factor inhibitor therapy in ankylosing spondylitis: differential effects on pain and fatigue and brain correlates.

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    Wu, Qi; Inman, Robert D; Davis, Karen D

    2015-02-01

    Ankylosing spondylitis is associated with back pain and fatigue and impacts mobility but can be treated with tumor necrosis factor inhibitors (TNFi). The differential effects of TNFi treatment on multiple symptoms and the brain is not well delineated. Thus, we conducted a 2-part study. In study 1, we conducted a retrospective chart review in 129 ankylosing spondylitis patients to assess TNFi effects on pain, fatigue, motor function, mobility, and quality of life (QoL). After at least 10 weeks of TNFi treatment, patients had clinically significant improvements (>30%) in pain (including neuropathic pain), most disease and QoL factors, and normalized sensory detection thresholds. However, residual fatigue (mean = 5.3) was prominent. Although 60% of patients had significant relief of pain, only 22% of patients had significant relief of both pain and fatigue. Therefore, the preferential TNFi treatment effect on pain compared with fatigue could contribute to suboptimal effects on QoL. Part 2 was a prospective study in 14 patients to identify TNFi treatment effects on pain, fatigue, sensory and psychological factors, and brain cortical thickness based on 3T magnetic resonance imaging. Centrally, TNFi was associated with statistically significant cortical thinning of motor, premotor, and posterior parietal regions. Pain intensity reduction was associated with cortical thinning of the secondary somatosensory cortex, and pain unpleasantness reduction was associated with the cortical thinning of motor areas. In contrast, fatigue reduction correlated with cortical thinning of the insula, primary sensory cortex/inferior parietal sulcus, and superior temporal polysensory areas. This indicates that TNFi treatment produces changes in brain areas implicated in sensory, motor, affective, and cognitive functions.

  15. Both baseline clinical factors and genetic polymorphisms influence the development of severe functional status in ankylosing spondylitis.

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    Ruxandra Schiotis

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

  16. Combination use of anti-inflammatory drugs and myorelaxants in the treatment of patients with ankylosing spondylitis in outpatient settings

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    Inna Zurabievna Gaidukova

    2015-01-01

    Full Text Available Objective: to assess different treatment regimens for ankylosing spondylitis (AS. The specific features of using topical and oral nonsteroidal anti-inflammatory drugs (NSAIDs and myorelaxants in outpatient settings were retrospectively analyzed.Subjects and methods. The investigation enrolled 96 AS patients admitted to the Department of Rheumatology, Saratov Regional Clinical Hospital, in 2010 to 2012, who took nimesulide during the last year (at least three 14-day cycles. The patients' mean age was 42.6±10.9 years; disease duration was 11.9±8.2 years; 83.33% were male. The diagnosis of AS was based on the 1984 modified New York criteria. Physical examination (clinical blood analysis, clinical urinalysis, C-reactive protein, total protein, albumins, urea, creatinine, glucose, bilirubin, serum aspartate aminotransferase and alanine aminotransferase was made. AS activity was determined using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI. Axial skeleton mobility and cervical spine rotation were evaluated. Therapy received by the patients at the moment of hospitalization and the attending physicians' recommendations for discharging patients from the hospital were analyzed. Saratov outpatient physicians were interviewed using a questionnaire to specify the aims and procedures of using anti-inflammatory drugs.Results. The outpatient physicians (n=100 were shown to use three-, two-, and one-component therapy in 53.12, 45, and 2% of the AS patients, respectively. Higher lumbar spine mobility and comparably reduced pain were established in the patients receiving threecomponent therapy (a combination of nimesulide 200 mg/day, tizanidine 4–8 mg/day, and topical NSAIDs than those who had NSAIDs only.

  17. Analysis of Killer Cell Immunoglobulin-like Receptor Genes and Their HLA Ligands in Iranian Patients with Ankylosing Spondylitis.

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    Mahmoudi, Mehdi; Jamshidi, Ahmad Reza; Karami, Jafar; Mohseni, Alireza; Amirzargar, Ali Akbar; Farhadi, Elham; Ahmadzadeh, Nooshin; Nicknam, Mohammad Hossein

    2016-02-01

    Ankylosing Spondylitis (AS) is a chronic rheumatic disease which mainly involves the axial skeleton. It seems that non-HLA genes, as well as HLA-B27 gene, are linked to the etiology of the disease. Recently, it has been documented that KIRs and their HLA ligands are contributed to the Ankylosing Spondylitis. The aim of this study was to evaluate the KIR genes and their HLA ligands in Iranian AS patients and healthy individuals. The present study includes 200 AS patient samples and 200 healthy control samples. KIR genotyping was performed using the polymerase chain reaction sequence-specific primer (PCR-SSP) method to type the presence or absence of the 16 KIR genes, 6 known specific HLA class I ligands and also, two pseudogenes. Two KIR genes (KIR-2DL3 and KIR2DL5), and among the HLA ligands, two HLA ligands (HLA-C2Lys80 and HLA-B27) genes were significantly different between case and control groups. In addition, we found some interesting KIR/HLA compound genotypes, which were associated with AS susceptibility. Our results suggest that the AS patients present more activating and less inhibitory KIR genes with combination of their HLA ligands than healthy controls. Once the balance of signal transduction between activating and inhibitory receptors is disturbed, the ability of NK cells to identify and lyse the targets in immune responses will be compromised. Accordingly, imbalance of activating and inhibitory KIR genes by up-regulating the activation and losing the inhibition of KIRs signaling or combination of both might be one of the important factors which underlying the pathogenesis of AS.

  18. Infliximab has no apparent effect in the inner ear hearing function of patients with rheumatoid arthritis and ankylosing spondylitis.

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    Toktas, H; Okur, E; Dundar, U; Dikici, A; Kahveci, O K

    2014-01-01

    Animal studies suggest that tumor necrosis factor (TNF) alpha blockers may pass to the inner ear in adequate concentration. In this prospective study, we aimed to evaluate the effect of infliximab on the inner ear hearing function in patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA). The patients with high disease activity, who were planned to begin infliximab for therapy by physical medicine and rehabilitation department, were referred to ear-nose-throat clinic for consultation. After physical and otoscopic examination, audiological tests were performed. Air conduction thresholds between 250 and 8,000 Hz, bone conduction thresholds between 500 and 4,000 Hz, pure tone average, speech discrimination scores, distortion product otoacoustic emission (DPOAE) were used to evaluate the hearing function. The tests were repeated 2 and 6 months after the initiation of the drug "infliximab." A total of 44 ears of 22 patients (17 males and 5 females) were evaluated. Fifteen patients had a diagnosis of AS, and seven patients had RA. After initiation of infliximab therapy, statistically significant improvement was observed in disease activity scores [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for AS, Disease Activity Score 28 (DAS-28) for RA] after 2 and 6 months (p  0.05). Any problem about the balance, vertigo, or dizziness was not reported from the patients during the treatment period. As a result, our study showed that there was no notable change or deterioration in the hearing function of the patients with AS and RA who were treated with infliximab. Further studies with higher number of patients with AS and RA and also with different TNF alpha inhibitors are needed to make more valid conclusion.

  19. Association study of polymorphisms rs4552569 and rs17095830 and the risk of ankylosing spondylitis in a Taiwanese population.

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    James Cheng-Chung Wei

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammation of the sacroiliac joints, spine and peripheral joints. However, the development of anklosing spondylitis is unclear. Human leukocyte antigens HLA-B27 and ERAP1 have been widely reported to be associated with AS susceptibility. A recent genome-wide association study (GWAS showed that two new susceptibility loci between EDIL3 and HAPLN1 at 5q14.3 (rs4552569 and within ANO6 at 12q12 (rs17095830 contribute to the risk of AS in Han Chinese. In this study, we enrolled 475 AS patients and 475 healthy subjects to assess whether these genetic variations contribute to the susceptibility and the severity of AS in the Taiwanese population. The correlation between genetic polymorphisms, AS activity indexes, (namely, BASDAI, BASFI and BAS-G and AS complications (uveitis and inflammatory bowel disease were tested using the markers, rs4552569 and rs17095830. Although no association between rs4552569/rs17095830 genetic polymorphisms and AS susceptibility/severity was found, a significant association between rs17095830 and inflammatory bowel disease was observed in a Taiwanese population.

  20. Vertebral body or intervertebral disc wedging: which contributes more to thoracolumbar kyphosis in ankylosing spondylitis patients?

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    Liu, Hao; Qian, Bang-Ping; Qiu, Yong; Wang, Yan; Wang, Bin; Yu, Yang; Zhu, Ze-Zhang

    2016-01-01

    Abstract Both vertebral body wedging and disc wedging are found in ankylosing spondylitis (AS) patients with thoracolumbar kyphosis. However, their relative contribution to thoracolumbar kyphosis is not fully understood. The objective of this study was to compare different contributions of vertebral and disc wedging to the thoracolumbar kyphosis in AS patients, and to analyze the relationship between the apical vertebral wedging angle and thoracolumbar kyphosis. From October 2009 to October 2013, a total of 59 consecutive AS patients with thoracolumbar kyphosis with a mean age of 38.1 years were recruited in this study. Based on global kyphosis (GK), 26 patients with GK < 70° were assigned to group A, and the other 33 patients with GK ≥ 70° were included in group B. Each GK was divided into disc wedge angles and vertebral wedge angles. The wedging angle of each disc and vertebra comprising the thoracolumbar kyphosis was measured, and the proportion of the wedging angle to the GK was calculated accordingly. Intergroup and intragroup comparisons were subsequently performed to investigate the different contributions of disc and vertebra to the GK. The correlation between the apical vertebral wedging angle and GK was calculated by Pearson correlation analysis. The duration of disease and sex were also recorded in this study. With respect to the mean disease duration, significant difference was observed between the two groups (P < 0.01). The wedging angle and wedging percentage of discs were significantly higher than those of vertebrae in group A (34.8° ± 2.5° vs 26.7° ± 2.7°, P < 0.01 and 56.6% vs 43.4%, P < 0.01), whereas disc wedging and disc wedging percentage were significantly lower than vertebrae in group B (37.6° ± 7.0° vs 50.1° ± 5.1°, P < 0.01 and 42.7% vs 57.3%, P < 0.01). The wedging of vertebrae was significantly higher in group B than in group A (50.1° ± 5.1° vs 26.7° ± 2.7°, P < 0

  1. Golimumab for the treatment of ankylosing spondylitis: a NICE single technology appraisal.

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    Armstrong, Nigel; Joore, Manuela; van Asselt, Thea; Misso, Kate; Manning, Nathan; Tomini, Florian; Kleijnen, Jos; Riemsma, Rob

    2013-05-01

    As part of the National Institute for Health and Clinical Excellence (NICE) single technology appraisal (STA) process, the Evidence Review Group (ERG) produced a report to comment on the clinical and cost effectiveness of golimumab (Simponi(®), Merck Sharp & Dohme) for the treatment of ankylosing spondylitis (AS) relative to other comparators as presented in the manufacturer's submission (MS) to NICE. The population was those with active disease who had not responded to conventional therapy. The specified comparators were conventional care and two other tumour necrosis factor alpha (TNF-α) inhibitors (adalimumab and etanercept). Outcomes to be considered were disease activity, functional capacity, disease progression, adverse effects of treatment and health-related quality of life (HR-QOL). There were no head-to-head trials comparing TNF-α inhibitors. The submission included one trial of golimumab versus placebo (the GO-RAISE trial) and additionally seven placebo-controlled randomized controlled trials (RCTs) of other TNF-α inhibitor agents (five with etanercept, and two with adalimumab). The results of these trials were generally a statistically significant improvement from each of the TNF-α inhibitors. A Bayesian mixed treatment comparison (MTC) showed there was generally overlap in the 95 % credible intervals (CrIs) between the TNF-α inhibitors. Exceptions included a greater risk of discontinuation of treatment for golimumab than for etanercept (relative risk [RR] 4.30; 95 % CrI 1.01-18.50). The cost-effectiveness analysis (CEA) compared all of these TNF-α inhibitors. Relative effectiveness was informed only by RR of response (proportion achieving at least a 50 % improvement in Bath AS Disease Activity Index [BASDAI] score; BASDAI50) from the MTC. In the base-case analysis, the incremental cost-effectiveness ratio (ICER) of golimumab versus conventional care was £26,597 and adalimumab and etanercept were extendedly dominated by golimumab. The

  2. INVESTIGATION OF A ROLE OF THE IMMUNOGENICITY OF INFLIXIMAB IN THE THERAPY OF ANKYLOSING SPONDYLITIS

    Directory of Open Access Journals (Sweden)

    O. A. Rumyantseva

    2016-01-01

    Full Text Available At present, there are a number of unsolved problems associated with unawareness of the causes and ways to prevent the inefficacy of tumor necrosis factor-α  inhibitors.Objective: to study the causes of secondary inefficacy of infliximab (INF, by analyzing its concentrations and antidrug antibody levels in the serum of ankylosing spondylitis (AS patients receiving long INF,  as well as a possibility to overcome its secondary inefficacy through plasmapheresis.Subjects and methods. 54 patients with active AS (BASDAI > 4 underwent regular long-term  (1-to-10-year treatment with INF 5 mg/kg according to the standard scheme. During the therapy blood samples were taken before a regular INF infusion to quantify the levels of antibodies to the drug and its concentration. According to the efficiency of the drug, two groups were formed: 1 27 (50% patients with INF inefficacy (an exacerbation occurred 2–4 weeks after infusion; 2 27 patients with drug efficacy. The levels of anti-double stranded DNA antibodies and antinuclear factor were estimated in 27 patients to investigate a relationship between the immunogenicity of INF and the presence of autoantibodies in its secondary inefficacy. A plasmapheresis session was carried out in 5 patients before a regular IFN infusion.Results and discussion. Anti-INF antibodies were found in 28 (52% patients, these being more common  in the patients with drug inefficacy than in the others (67 and 37%, respectively; p < 0.05. In the patients with INF inefficacy, anti-INF antibody levels were significantly higher than in those with preserved drug effect (18.33 and 4.67 U/ml, respectively; р < 0.05. Moreover, the serum concentration of INF was not significantly different in these groups (1.6 and 2.96 μg/ml. There was an inverse correlation  between INF concentrations and anti-INF antibodies (r = -0.7; p < 0.05. The level of autoantibodies  did not correlate with that of anti-INF antibodies. Following

  3. 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

    OpenAIRE

    Berdal, Gunnhild; Halvorsen, Silje; van der Heijde, Désirée; Mowe, Morten; Dagfinrud, Hanne

    2012-01-01

    Introduction Pulmonary involvement is a known manifestation in patients with ankylosing spondylitis (AS). However, previous studies have been based on small samples and the reported prevalence and associations with typical clinical features vary. The purpose of this study was to compare pulmonary function (PF) in patients with AS and population controls, and to study associations between PF and disease related variables, cardio-respiratory fitness and demographic variables ...

  4. The imaging diagnostic and research advances of ankylosing spondylitis.%强直性脊柱炎的影像学诊断研究进展

    Institute of Scientific and Technical Information of China (English)

    鲁琳; 周伟生

    2005-01-01

    强直性脊柱炎(ankylosing spondylitis,AS)至今病因不明,缺乏特异的实验室指标,放射学检查是重要诊断方法之一.本文综述了近年来各种影像手段在AS不同病程中的表现和临床应用;并着重介绍X线、MRI的AS分级.

  5. 强直性脊柱炎骶髂关节炎MRI早期诊断%The MRI Early Diagnosis of Sacroiliitis for Ankylosing Spondylitis

    Institute of Scientific and Technical Information of China (English)

    许秋霞

    2012-01-01

    目的 分析强直性脊柱炎(AS)患者骶髂关节炎的MRI征象,提高对强直性脊柱炎患者的早期诊断水平.方法 对37例68个骶髂关节符合1984年修订的纽约临床诊断标准(MNY)[1] AS患者行MRI检查者,分析其MRI征象.结果 强直性脊柱炎骶髂关节炎的早期MRI征象包括:关节软骨不规则增粗、扭曲、信号改变,骨髓水肿,局灶性骨质侵蚀、缺损、中断、囊变.结论 MRI可提高早期强直性脊柱炎(A S)患者骶髂关节炎的诊断水平.%Objective To improve the early diagnosis of ankylosing spondylitis via analysis of sacroiliitis MRI signs of ankylosing spondylitis (AS) patients. Methods Via the MRI examination of 68 sacroiliac joints of 37 AS patients complying with New York clinical diagnostic criteria (MNY) (1) revised in 1984 and analysis of the MRI signs. Results The early sacroiliitis MRI signs of ankylosing spondylitis (AS) patients include: irregular thickening of articular cartilage, distortion, signal changes, bone marrow edema signal changes, and bone erosion, bone defect, bone interruption and bone cystic. Conclusions MRI can improve sacroiliitis diagnosis of early ankylosing spondylitis (AS) patients.

  6. Analysis of X-ray Diagnosis of Early Stage Ankylosing Spondylitis%早期强直性脊柱炎的X线诊断分析

    Institute of Scientific and Technical Information of China (English)

    何彩平

    2016-01-01

    目的:研究早期强直性脊柱炎的X线表现提高此病的早期诊断率。方法结合我院18例经证实早期强直性脊柱炎病例,分析其X线表现。结果强直性脊柱炎早期几乎100%累及骶髂关节,X线表现为双侧对称性发病,关节面骨质硬化,破坏,以髂侧为主,关节间隙改变下段脊柱呈方形改变。结论早期强直性脊柱炎可有较典型X线表现,结合临床表现及生化检查,对于此病的早期发现,减少致残率有重要价值。%Objective To study the early diagnosis rate of the X-ray manifestations of early stage ankylosing spondylitis.Methods Combined with 18 cases of early stage ankylosing spondylitis in our hospital, the X-ray findings were analyzed.ResultsAlmost 100% of ankylosing spondylitis early involvement of the joint, X-ray showed bilateral symmetry of the disease, the joint surface of bone sclerosis, destruction, with the main side of the joint space, the change of the spine of the spine was a square change. ConclusionEarly stage ankylosing spondylitis can have more typical X-ray manifestations, combined with clinical manifestations and biochemical examination, for the early detection of the disease, reduce disability rate is of great value.

  7. An overview of treating ankylosing spondylitis in TCM%中医内治强直性脊柱炎概况

    Institute of Scientific and Technical Information of China (English)

    赵蕾; 曹向阳

    2011-01-01

    强直性脊柱炎( Ankylosing Spondylitis,AS),是以累及脊柱关节和骶髂关节为特征的慢性、进行性、系统性结缔组织血清因性疾病.晚期可发生脊柱及髋关节强直、畸形是致残的主要原因.

  8. 强直性脊柱炎磁共振成像研究进展%Development of Ankylosing Spondylitis by Magnetic Resonance Imaging

    Institute of Scientific and Technical Information of China (English)

    庄儒耀

    2011-01-01

    Ankylosing spondylitis is an unknown cause disease,which is a chronic inflammatory arthritis and autoimmune disease in axial joints and mainly involves in axial joints. MRI can identifv and monitor the active inflammation of the spine and sacroiliac joints. Ankylosing spondylitis affects the peripheral joints and the enthesis, too,and MRI can monitor these activities, too. At the same time, MRI can be used to evaluate occurrence,development and prognosis of axial joints in Ankylosing spondylitis before and after the treatment, evaluate the drug efficacy and predict of prognosis in time, providing evidence for clinical medication.In recent years, new technologies of MRI had been developing very rapidly, and considerable progress in evaluation of ankylosing spondylitis with MRI has been made, and this article reviewed these progresses.%强直性脊柱炎是一种原因不明的以中轴关节慢性炎症为主的自身免疫性疾病,其主要累及中轴关节.磁共振成像(MRI)可以发现和监测脊柱和骶髂关节活动性病变,比其它影像学检查具有更高的敏感性.强直性脊柱炎也累及外周关节和附着点,MRI也可监测其病情活动.同时,MRI可以预测强直性脊柱炎治疗前后中轴关节病变的发生、发展及转归,及时评价药物疗效并预测预后,为临床用药提供依据.近年来,MRI新技术的不断出现,使其评估强直性脊柱炎取得了相当大的进展,本文就此予以综述.

  9. Marginal erosive discovertebral ''Romanus'' lesions in ankylosing spondylitis demonstrated by contrast enhanced Gd-DTPA magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Jevtic, V. [Clinical Radiology Institute, University Clinical Centre, Ljubljana (Slovenia); Kos-Golja, M.; Rozman, B. [Department of Rheumatology, University Clinical Centre, Ljubljana (Slovenia); McCall, I. [Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire (United Kingdom)

    2000-01-01

    Objective. To assess the value of Gd-DTPA magnetic resonance (MR) imaging in the demonstration of marginal destructive discovertebral Romanus lesions in ankylosing spondylitis.Design and patients. A prospective study of Gd-DTPA MR imaging was performed in 39 patients with a clinical diagnosis of ankylosing spondylitis and typical Romanus lesions seen on radiographs of the thoracolumbar spine. MR morphological appearances and signal intensity changes at the discovertebral junctions were analysed and compared with the radiographic findings.Results. Ninety-nine discovertebral junctions with Romanus lesions showed low signal intensity on T1-weighted and high signal on T2-weighted and T1-weighted postcontrast images at the vertebral corners consistent with oedematous hyperaemic inflammatory tissue. There were nine discovertebral junctions with similar MR findings but normal radiographs. Fifty-three discovertebral junctions showed syndesmophyte formation with increased signal intensity on both T1- and T2-weighted images with no contrast enhancement. Sixty-five discovertebral junctions showed a mixture of radiographic features and varied high and low signal changes at the vertebral rim on MR imaging with rims of enhancement in the vertebral body following contrast administration.Conclusion. Gd-DTPA MR imaging demonstrates a variable signal pattern and degree of contrast enhancement which may reflect the evolutionary stages of discovertebral enthesitis in ankylosing spondylitis. MR imaging may identify early erosive changes in radiographically normal vertebra. The role of MR imaging needs further investigation. (orig.)

  10. 强直性脊柱炎患者延续性护理的研究进展%Advances on continuing care in patients with ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    刘艳艳; 孔瑞娜

    2016-01-01

    It reviewed the necessity and the present situation of ankylosing spondylitis continuity of care and countermeasure research progress, and explore suitable continuity care model for China′s current system of medical treatment in patients with ankylosing spondylitis. In order to facilitate the development of targeted services, so as to improve the compliance of treatment of ankylosing spondylitis patients, and improve the patients′quality of life.%本文从强直性脊柱炎延续性护理的必要性及现状与对策研究进展进行综述,探讨适合我国当前医疗体制下强直性脊柱炎患者的延续性护理模式。以利于针对性的开展服务,从而提高强直性脊柱炎患者治疗的依从性、改善患者的生命质量。

  11. Nursing experience and comprehensive treatment of ankylosing spondylitis%强直性脊柱炎的综合治疗及护理体会

    Institute of Scientific and Technical Information of China (English)

    闫海花; 王学志; 张小丽

    2014-01-01

    目的:探讨强直性脊柱炎的综合治疗及护理体会。方法:收治强直性脊柱炎患者59例,对其临床资料进行回顾性分析。结果:在59例患者中,显效30例(50.85%),有效26例(44.07%),无效3例(5.08%)。总有效率94.92%。结论:强直性脊柱炎患者接受积极的综合治疗和护理,可达到满意的治疗效果。%Objective:To explore the nursing experience and comprehensive treatment of ankylosing spondylitis.Methods:59 cases with ankylosing spondylitis were selected.We retrospectively analyzed the clinical data.Results:In 59 patients,30 cases(50.85%) were cured,26 cases(44.07%) were effective,3 cases(5.08%) were invalid.The total efficiency was 94.92%.Conclusion:We give the patients with ankylosing spondylitis with active treatment and care.It can achieve a satisfactory therapeutic effect.

  12. 强直性脊柱炎的X线平片和CT诊断%X-ray plain radiographs and CT diagnosis of ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    段常青

    2016-01-01

    目的:探讨X线平片和CT检查对强直性脊柱炎的诊断价值。方法:收治强直性脊柱炎患者70例作为研究对象,分别给予X线平片检查和CT检查。结果:CT检查确诊率100.0%,明显高于X线平片检查,差异有统计学意义(P<0.05)。结论:CT检查对强直性脊柱炎的诊断率高,且能发现微小病变,灵敏度高。%Objective:To investigate the diagnosis value of X-ray plain radiographs and CT for ankylosing spondylitis.Methods:70 cases of patients with ankylosing spondylitis were as the research object and were given X-ray plain radiographs and CT.Results:The diagnosis rate of CT was 100%,which was significantly higher than that of X-ray plain radiographs,and the difference was statistically significant(P<0.05).Conclusion:The diagnosis rate of CT examination for ankylosing spondylitis was high.It could detect small lesions and it had high sensitivity.

  13. Lack of association between TESPA1 gene polymorphisms (rs1801876, rs2171497, rs4758994, and rs997173) and ankylosing spondylitis in a Chinese population.

    Science.gov (United States)

    Liu, Si; Liu, Li; Wu, Shanshan; Yang, Ting; Pan, Faming; Laslett, Laura; Xia, Guo; Hu, Yanting; Fan, Dazhi; Ding, Ning; Xu, Shengqian; Cai, Guoqi; Wang, Li; Xin, Lihong

    2014-12-01

    We investigated whether TESPA1 gene polymorphisms were associated with increased risk of developing ankylosing spondylitis (AS). We also studied whether TESPA1 gene interacts with environmental factors. A total of 494 patients with AS and 478 matched healthy controls were genotyped for four SNPs (rs1801876, rs2171497, rs4758994, and rs997173) in the TESPA1 gene. We found no evidence of association between these SNPs and AS susceptibility, and between their haplotypes and the disease. But, patients with rs1801876 GA, GG, and AA genotypes had significantly different Bath Ankylosing Spondylitis Functional Index (BASFI) scores (p = 0.023). There were significantly different visual analogue scale (VAS) night pain assessment scores (p = 0.040) and BASFI scores (p = 0.023) among different genotypes at rs2171497 locus. There were also significantly different chest expansion scores (p = 0.042) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores (p = 0.014) among different genotypes at rs997173 locus. For multiple testing, Bonferroni correction was performed. After Bonferroni correction, clinical characteristics of these three loci showed association between different genotype groups. These findings indicated that the TESPA1 gene is not involved in AS genetic predisposition in the Han Chinese population; however, it may play an important role in the clinical characteristics of AS.

  14. Analyses on the Reason of Misdiagnosis of Ankylosing Spondylitis Thoracic Fracture%强直性脊柱炎胸椎骨折误诊原因探析

    Institute of Scientific and Technical Information of China (English)

    李现林; 王秋生; 王景辉

    2011-01-01

    Objective: Analyse ankylosing spondylitis thoracic spine fracture misdiagnosed reasons. Methods: One example fallibility of ankylosing spondylitis thoracic obsolete merger fresh fractures of the clinical data were retrospectively analyzed, and CT, MR examination results are discussed. Results: After the case was consulted, most experts consider for suppurative spondylitis or spinal tuberculosis, operation demonstrated it was old fractures merger organization of hematoma. Conclusion: Vertebral fracture diagnosed with difficult situations, in addition to identify suppurative spondylitis, spinal tuberculosis and spinal tumor outside, still should consider the possibility of organization of hematoma.%目的:探讨强直性脊柱炎胸椎骨折误诊的原因.方法:对1例误诊的强直性脊柱交胸椎陈旧合并新鲜骨折的临床资料进行回顾性分析,并就CT、MR检查结果进行讨论.结果:本病例经会诊后,多数专家考虑为化脓性脊椎炎或是脊柱结核,术中证实为陈旧骨折并椎旁血肿机化.结论:椎体骨折诊断有疑难情况时,除了鉴别化脓性脊椎炎、脊柱结核和脊柱肿瘤外,还应考虑血肿机化的可能性.

  15. Vertebral fractures in patients with ankylosing spondylitis. A retrospective analysis of 66 patients; Wirbelfrakturen bei Patienten mit Spondylitis ankylosans. Eine retrospektive Analyse von 66 Patienten

    Energy Technology Data Exchange (ETDEWEB)

    Altenbernd, J.; Bitu, S.; Lemburg, S.; Peters, S.; Nicolas, V.; Heyer, C.M. [Berufsgenossenschaftliches Klinikum Bergmannsheil, Bochum (Germany). Inst. fuer Diagnostische Radiologie, Interventionelle Radiologie und Nuklearmedizin; Seybold, D. [Berufsgenossenschaftliches Klinikum Bergmannsheil, Bochum (Germany). Chirurgische Klinik und Poliklinik; Meindl, R. [Berufsgenossenschaftliches Klinikum Bergmannsheil, Bochum (Germany). Abt. Neurotraumatologie und Rueckenmarksverletzte

    2009-01-15

    Purpose: Retrospective analysis of vertebral fractures in patients with ankylosing spondylitis (AS) for the evaluation of associations with mortality, concurrent neurological deficits, and other complications. Materials and Methods: Image analysis (conventional radiographs, CT, MRI) was applied to all patients with AS admitted between 1997 and 2007 due to vertebral fractures to determine fracture location and classification. Patient characteristics, trauma mechanism, neurological symptoms, and other complications were documented. Results: 66 patients (54 male, age 64 {+-} 11 years) were enrolled in the study. 74 % of patients suffered from minor trauma. 51 % and 56 % had cervicothoracic and thoracolumbar fractures, respectively, while 8 % had multi-level fractures. 63 % of patients suffered combined vertebrodiscal fractures. 70 % revealed neurological symptoms, significantly correlating with spinal stenosis (p = 0.024; Odds ratio 4.265) and hyperlordosis (p = 0.014; OR 4.806). 68 % developed complications with non-combined fractures (p =.042; OR 4.954) and paravertebral hematomas (p =.009; OR 16.969) representing independent risk factors. The female gender (p = 0.005; OR 15.617) and conservative therapy (p = 0.040; OR.094) exerted significant influence on the mortality rate. Conclusion: Vertebral fractures frequently occur in patients with AS after minor trauma and often lead to neurological symptoms, which in turn are associated with spinal stenosis and hyperlordosis. Paravertebral hematomas and non-combined fractures are accompanied by higher incidences of other complications. The female gender entails a higher mortality rate. (orig.)

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

    Science.gov (United States)

    Westerveld, L A; Verlaan, J J; Oner, F C

    2009-02-01

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

  17. Association of variants at 1q32 and STAT3 with ankylosing spondylitis suggests genetic overlap with Crohn's disease.

    Directory of Open Access Journals (Sweden)

    Patrick Danoy

    Full Text Available Ankylosing spondylitis (AS is a common inflammatory arthritic condition. Overt inflammatory bowel disease (IBD occurs in about 10% of AS patients, and in addition 70% of AS cases may have subclinical terminal ileitis. Spondyloarthritis is also common in IBD patients. We therefore tested Crohn's disease susceptibility genes for association with AS, aiming to identify pleiotropic genetic associations with both diseases. Genotyping was carried out using Sequenom and Applied Biosystems TaqMan and OpenArray technologies on 53 markers selected from 30 Crohn's disease associated genomic regions. We tested genotypes in a population of unrelated individual cases (n = 2,773 and controls (n = 2,215 of white European ancestry for association with AS. Statistical analysis was carried out using a Cochran-Armitage test for trend in PLINK. Strong association was detected at chr1q32 near KIF21B (rs11584383, P = 1.6 × 10(-10, odds ratio (OR = 0.74, 95% CI:0.68-0.82. Association with disease was also detected for 2 variants within STAT3 (rs6503695, P = 4.6 × 10(-4. OR = 0.86 (95% CI:0.79-0.93; rs744166, P = 2.6 × 10(-5, OR = 0.84 (95% CI:0.77-0.91. Association was confirmed for IL23R (rs11465804, P = 1.2 × 10(-5, OR = 0.65 (95% CI:0.54-0.79, and further associations were detected for IL12B (rs10045431, P = 5.2 × 10(-5, OR = 0.83 (95% CI:0.76-0.91, CDKAL1 (rs6908425, P = 1.1 × 10(-4, OR = 0.82 (95% CI:0.74-0.91, LRRK2/MUC19 (rs11175593, P = 9.9 × 10(-5, OR = 1.92 (95% CI: 1.38-2.67, and chr13q14 (rs3764147, P = 5.9 × 10(-4, OR = 1.19 (95% CI: 1.08-1.31. Excluding cases with clinical IBD did not significantly affect these findings. This study identifies chr1q32 and STAT3 as ankylosing spondylitis susceptibility loci. It also further confirms association for IL23R and detects suggestive association with another 4 loci. STAT3 is a key signaling molecule within the Th17 lymphocyte differentiation pathway and further enhances the case for a major role of

  18. Golimumab for the treatment of ankylosing spondylitis : a NICE single technology appraisal

    NARCIS (Netherlands)

    Armstrong, Nigel; Joore, Manuela; van Asselt, Thea; Misso, Kate; Manning, Nathan; Tomini, Florian; Kleijnen, Jos; Riemsma, Rob

    2013-01-01

    As part of the National Institute for Health and Clinical Excellence (NICE) single technology appraisal (STA) process, the Evidence Review Group (ERG) produced a report to comment on the clinical and cost effectiveness of golimumab (Simponi(®), Merck Sharp & Dohme) for the treatment of ankylosing sp

  19. X-ray and CT imaging diagnosis of the ankylosing spondylitis%强直性脊柱炎的X线及CT影像学诊断

    Institute of Scientific and Technical Information of China (English)

    王凤娟; 周裕晓

    2014-01-01

    目的:探讨强直性脊柱炎的X线及 CT表现。方法收集98例强直性脊柱炎患者的 X线及CT资料。结果92例有骶髂关节表现异常,包括:早期关节面侵蚀、骨皮质局限性增厚、硬化,关节间隙正常;后期关节面呈虫蚀样改变,关节面皮质密度不规则增高,关节间隙增宽或变窄,最终关节间隙消失,骨性强直;其中12例髋关节、骶髂关节及腰椎均有不同程度异常。结论 X线及CT检查已成为诊断强直性脊柱炎的重要途径。%Objective To investigate the X-ray and CT imaging of ankylosing spondylitis. Methods X-ray and CT data of 98 patients with ankylosing spondylitis were collected and analyzed. Re-sults Sacroiliac joints in 92 cases were abnormal:in early stage,articular face was affected and the bone cortex incrassated and osteosclerosis partly,joint space was normal;in late stage,vermiform de-struction of bone was seen in articular face,the density of cortex was heighten irregular,joint space wid-en or narrow,and at last the joint space vanished,the joint ankylosed. Among them,the 12 cases of hip,sacroiliac joints and lumbar vertebra were abnormal. Conclusions X-ray and CT imaging diagnosis of ankylosing spondylitis is an important way .

  20. Better short-term clinical response to etanercept in Chinese than Caucasian patients with active ankylosing spondylitis.

    Science.gov (United States)

    Chou, Chung-Tei; Tsai, Chang-Youh; Liang, Tung-Hua; Chang, Te-Ming; Lai, Chen-Hung; Wei, Cheng-Chung; Chen, Kun-Hung; Lin, Shih-Chang; Yu, Chia-Li; Liou, Lieh-Bang; Luo, Shue-Fen; Lee, Chyou-Shen; Hsue, Yin-Tzu; Huang, Chung-Ming; Chen, Jiunn-Hong; Lai, Ning-Sheng; Cheng, He-Hsiung; Cheng, Tien-Tsai; Lai, Han-Ming; Tsai, Wen-Chan; Yen, Jeng-Hsien; Lu, Ling-Ying; Chang, Chung-Pei

    2010-12-01

    Tumor necrosis factor-alpha (TNF-α) inhibitors including etanercept have been demonstrated to be very effective in severe ankylosing spondylitis (AS) in Caucasian patients. However, clinical efficacy of etanercept to treat active AS in Chinese patients has not been reported. In this study, a prospective, open-label trial of etanercept (25 mg BIW), involving 46 AS patients from 16 medical centers of Taiwan, was conducted. Questionnaire was utilized to record demographic data and clinical parameters, including Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Global Index (BASGI), Assessment in Ankylosing Spondylitis (ASAS) 20, 50, and 70, and others, before and at different time intervals after etanercept treatment. Laboratory tests including blood chemistry, hematology, urine analysis, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were done at baseline and at weeks 4, 8, and 12. In this 12-week study, etanercept demonstrated rapid and significant improvement in the ASAS20 response criteria (91.3%), at as early as 2 weeks of therapy (71.3%). Partial remission of AS was achieved in 49.3% of patients after 12 weeks of treatment. Disease activity (BASDAI) and function (BASFI) were also significantly improved after 12 weeks etanercept treatment (p expansion (2.77 ± 1.69 cm versus 3.56 ± 1.82 cm, p = 0.0004) and lumbar flexion (2.11 ± 2.76 cm versus 2.58 ± 3.42 cm, p = 0.0075) and significant reduction of occiput-to-wall distance (6.59 ± 7.14 cm versus 5.32 ± 6.65 cm, p = 0.0006) were also demonstrated. Both ESR and CRP declined significantly after patients were treated with etanercept. There were no severe adverse effects during the treatment period. Etanercept is generally safe, well tolerated, and effective in Chinese patients with severe AS. Clinical efficacy, including partial remission and BASDAI, is even better in Chinese than in Caucasian patients. Further study is required to assess long-term efficacy

  1. Clinical study on misdiagnosed patients with ankylosing spondylitis%强直性脊柱炎患者误诊的临床探讨

    Institute of Scientific and Technical Information of China (English)

    王宋鑫; 姚乐阳

    2015-01-01

    Objective: 49 cases of misdiagnosed patients with ankylosing spondylitis (Ankylosing Spondylitis, AS) were analyzed to explore the common causes of misdiagnosis patients with ankylosing spondylitis in order to reduce misdiagnosis, disability rate and the pain of patients. Methods: 49 cases of misdiagnosed patients with ankylosing spondylitis from September,2011 to September,2013 were selected for statistical analysis,and the misdiagnosis were discussed.Results:Misdiagnosis of spine related diseases was accounted for 69.4%; peripheral joint disease was accounted for 10.2%, rheumatoid was accounted for 10.2%,the other was accounted for 10.2%. Conclusion: in the emphasis for the main performance and spinal disease, the other clinical manifestations l outside spinal at the same time cannot be ignored. It should be fully understood, early treatment must be done to reduce the suffering of patients and the quality of life.%目的:通过对49例强直性脊柱炎(Ankylosing Spondylitis,AS)被误诊者进行分析,探讨强直性脊柱炎患者被误诊的常见原因,减少误诊,减轻减少致残率,减轻患者的痛苦。方法:对2011年9月—2013年9月收治的49例强直性脊柱炎被误诊者进行统计分析,并将其误诊情况进行探讨。结果:误诊为脊柱相关疾病占69.4%;外周关节疾患占10.2%,类风湿占10.2%;其他占10.2%。结论:在强调脊柱发病为主要表现的同时,不能忽略脊柱外的其他临床表现。要充分了解,及早治疗,减少患者痛苦,提高其生活质量。

  2. Health-related quality of life in Turkish patients with ankylosing spondylitis: impact of peripheral involvement on quality of life in terms of disease activity, functional status, severity of pain, and social and emotional functioning.

    Science.gov (United States)

    Yılmaz, Ozlem; Tutoğlu, Ahmet; Garip, Yeşim; Ozcan, Esra; Bodur, Hatice

    2013-05-01

    Ankylosing spondylitis (AS) affects sacroiliac joints at early stages and may involve the axial skeleton at later stages of disease. Peripheral involvement usually occurs in lower extremities. When it develops early in the disease course, it is a predictor of more aggressive disease. The aim of this study is to evaluate health-related quality of life (HRQoL) in AS and to assess the impact of peripheral involvement on HRQoL domains in terms of disease activity, functional status, pain, and social and emotional functioning. Seventy-four AS patients were included. Peripheral involvement was present in 51.35 % of the patients. In 65.79 % of these cases the hips, in 31.58 % the knees, in 18.42 % the shoulders and in 13.16 % the ankles were affected. Patients were evaluated by Ankylosing Spondylitis Quality of Life (ASQoL), Short Form-36 (SF-36), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS) and Bath Ankylosing Spondylitis Functional Index (BASFI). ASQoL was strongly correlated with ASDAS, BASDAI, BASFI, and Bath Ankylosing Spondylitis Metrology Index (BASMI), severity of total pain, night pain, fatigue, morning stiffness and ESR. ASDAS and BASDAI showed the strongest correlation with ASQoL. Severity of total pain, functional status and severity of night pain followed it, respectively. Patients with peripheral involvement scored significantly lower in all subgroups of SF36 and significantly higher in ASDAS, BASDAI, BASFI, BASMI and ASQoL scores and levels of pain, night pain, fatigue and morning stiffness. Peripheral involvement is associated with more active disease and functional disability and has a negative influence on HRQoL including physical, social and emotional functioning.

  3. Criptosporidiose em paciente com espondilite anquilosante usando adalimumabe Cryptosporidiosis in a patient with ankylosing spondylitis treated with adalimumab

    Directory of Open Access Journals (Sweden)

    Fernando Augusto Chiuchetta

    2010-06-01

    Full Text Available A criptosporidiose é uma doença parasitária causada pelo protozoário Cryptosporidium sp. Observou-se um aumento no número de diagnósticos realizados nos últimos vinte anos, principalmente em pacientes que apresentam imunodeficiências como a síndrome da imunodeficiência humana adquirida e as imunodeficiências induzidas como em pacientes transplantados e nos que necessitam realizar hemodiálise frequentemente. Relata-se o caso de um jovem com espondilite anquilosante que, usando adalimumabe, apresentou diarreia devido à criptosporidiose.Cryptosporidiosis is a parasitic disease caused by a protozoan called Cryptosporidium sp. An increased number of diagnoses were made in the last 20 years, especially in patients with immunodeficiency like the acquired human immunodeficiency syndrome and induced immunodeficiency, such as in transplant patients and those who need frequent hemodialysis, has been observed. We report the case of a young patient with ankylosing spondylitis treated with adalimumab who developed chronic diarrhea secondary to cryptosporidiosis

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

    Science.gov (United States)

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

    2014-06-01

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

  5. Novel non-HLA-susceptible regions determined by meta-analysis of four genomewide scans for ankylosing spondylitis

    Indian Academy of Sciences (India)

    Jinxian Huang; Chao Li; Haixia Xu; Jieruo Gu

    2008-04-01

    We identified novel non-HLA-susceptible regions for ankylosing spondylitis (AS) by applying the genome-search-meta-analysis (GSMA) method to combine the previous four AS genomewide scan studies including 479 families with 1175 affected individuals. Three original genomescans were mainly analysed for Caucasian families and one analysed for Han Mongolian families. Ten bins had both Psumrnk and Pord < 0.05, suggesting these bins most likely contain AS-linked loci. The 10 bins are 6.2, 16.3, 6.1, 3.3, 6.3, 16.4, 10.5, 17.1, 2.5 and 2.9. The most significant result of linkage was on chromosome 6p22.3–p21.1 (bin 6.2, Psumrnk < 0.000417), where HLA loci are located. By addition of a genome scan of Chinese origin, our GSMA result further confirmed the HLA loci as the greatest susceptible region to AS and suggested that non-HLA loci chromosome 16q, 3p, 10q, 2p, 2q and 17p, may also contain AS-linked loci. The novel loci identified in our result give hints to further studies.

  6. Down-Regulation of lncRNA-AK001085 and its Influences on the Diagnosis of Ankylosing Spondylitis.

    Science.gov (United States)

    Li, Xiang; Chai, Wei; Zhang, Guoqiang; Ni, Ming; Chen, Jiying; Dong, Jiyuan; Zhou, Yonggang; Hao, Libo; Bai, Yang; Wang, Yan

    2017-01-02

    BACKGROUND Long non-coding RNAs (lncRNAs) have been confirmed to play an important role in the development and progression of diseases. Ankylosing spondylitis (AS) is a chronic inflammatory systemic disease and it is hard to be found in early time. The purpose of this study was to investigate the role of lncRNA-AK001085 in the diagnosis of AS. MATERIAL AND METHODS The expression of lncRNA-AK001085 was detected by quantitative real-time polymerase chain reaction (qRT-PCR) analysis. The relationship between its expression and clinicopathologic characteristics was also analyzed. Meanwhile the correlation between lncRNA-AK001085 expression and diseases activity indexes was estimated. In addition, the value of it in the diagnosis of AS was explored through establishing receiver operating characteristic (ROC) curve. RESULTS Serum lncRNA-AK001085 expression was decreased in patients with AS compared with healthy individuals. And its expression was proved to be influenced by ever cigarette smoker, exercise level and occupational activity level. Besides, the correlation of the expression of lncRNA-AK001085 and disease activity indexes (BASDI, ASDAS, ESR, CRP) were all negative, which suggested that the lncRNA-AK001085 was significantly lower in patients with a high disease activity score. It might showed that the expression of lncRNA-AK001085 affected the activity of AS. CONCLUSIONS LncRNA-AK001085 was down-regulated in AS patients and it could be an independent diagnostic indicator.

  7. Effect of infliximab on quality of life in patients with ankylosing spondylitis according to sf-36 questionnaire data

    Directory of Open Access Journals (Sweden)

    Tatyana Alekseevna Raskina

    2013-01-01

    Full Text Available Objective: to evaluate the effect of infliximab (INF on quality of life (QL in patients with ankylosing spondylitis (AS, by analyzing the results of a SF-36 questionnaire survey. Subjects and methods. Sixty-six male patients, diagnosed with AS (according to the 1984 modified New-York criteria in its extensive or end stage with a high activity (BASDAI ≥4.0, were followed up. All the patients were divided into 2 groups according to the option of disease-modifying antirheumatic drug therapy: 1 16 patients who received combination therapy with INF given as a standard regimen at 0, 2, and 6 weeks followed by a regimen of 5 mg/kg body weight and nonsteroidal anti-inflammatory drugs (NSAIDs in standard doses every 8 weeks; 2 50 patients who had monotherapy with NSAIDs in the same doses. QL was assessed using the Short-Form 36 (SF-36 questionnaire in patients with AS. Results. The scales evaluating physical health showed the greatest group differences in pain intensity (38.42%; p<0.0001 and the least in the general health status (24.48%; p<0.001. Those assessing mental health displayed statistically significant group differences in vital activity (24.78%; p<0.01.Conclusion. The patients receiving monotherapy with NSAIDs were found to have lower scores in all SF-36 scales than those on combination therapy with INF and NSAIDs.

  8. Effect of infliximab on quality of life in patients with ankylosing spondylitis according to sf-36 questionnaire data

    Directory of Open Access Journals (Sweden)

    Tatyana Alekseevna Raskina

    2013-10-01

    Full Text Available Objective: to evaluate the effect of infliximab (INF on quality of life (QL in patients with ankylosing spondylitis (AS, by analyzing the results of a SF-36 questionnaire survey. Subjects and methods. Sixty-six male patients, diagnosed with AS (according to the 1984 modified New-York criteria in its extensive or end stage with a high activity (BASDAI ≥4.0, were followed up. All the patients were divided into 2 groups according to the option of disease-modifying antirheumatic drug therapy: 1 16 patients who received combination therapy with INF given as a standard regimen at 0, 2, and 6 weeks followed by a regimen of 5 mg/kg body weight and nonsteroidal anti-inflammatory drugs (NSAIDs in standard doses every 8 weeks; 2 50 patients who had monotherapy with NSAIDs in the same doses. QL was assessed using the Short-Form 36 (SF-36 questionnaire in patients with AS. Results. The scales evaluating physical health showed the greatest group differences in pain intensity (38.42%; p<0.0001 and the least in the general health status (24.48%; p<0.001. Those assessing mental health displayed statistically significant group differences in vital activity (24.78%; p<0.01.Conclusion. The patients receiving monotherapy with NSAIDs were found to have lower scores in all SF-36 scales than those on combination therapy with INF and NSAIDs.

  9. Comparison of radiography, computed tomography and magnetic resonance imaging in the detection of sacroiliitis accompanying ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Wei; Feng Feng; Yang Hongzen; Jiang Ming [Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Dion, E.; Genant, H.K. [Department of Radiology, Musculoskeletal Section and Osteoporosis and Arthritis Research Group, University of California San Francisco, CA 94143-0628 (United States)

    1998-06-01

    Objective. To compare magnetic resonance (MR) imaging, computed tomography (CT), and radiography in the detection of sacroiliitis accompanying ankylosing spondylitis (AS). Design and subjects. Nine volunteers and 24 patients were recruited. Radiography, CT, and MR imaging were completed within a 1-week period in 24 patients with AS. In precontrast MR examination, spin-echo T1, fast spin-echo T2, and gradient echo with rephasing T2* images were obtained without fat saturation using a 0.3-T imager for all volunteers and patients. Postcontrast MR examination was performed using the same precontrast SE T1 sequence for patients with AS. Results and conclusions. MR imaging directly showed the normal cartilage in all 16 sacroiliac joints of the 8 volunteers. In the 24 patients with AS, cartilage abnormalities were observed in 42 sacroiliac joints. More diagnoses of sacroiliitis were made using MR and CT imaging than using radiography (P<0.001). Therefore, low-field-strength MR can be useful in detecting early sacroiliitis in patients with AS. MR imaging was able to reveal early cartilage changes and bone marrow edema, which could not be found by either CT or radiography. (orig.) With 5 figs., 4 tabs., 36 refs.

  10. Imaging examination of ankylosing spondylitis%强直性脊柱炎的影像学检查

    Institute of Scientific and Technical Information of China (English)

    蒋业清

    2010-01-01

    @@ 强直性脊柱炎(ankylosing spondylitis,AS)是血清阴性脊柱关节病(spondylarthropathy,SpA)的亚型之一,是一种慢性致残性风湿类疾病.主要特征有炎性后背痛、脊柱运动受限、外周关节炎、肌腱附着端炎和前葡萄膜炎等.本病在中国汉族人群中的发病率约为0.2%-0.54%[1].其主要自然转归是功能限制及致残,且其程度为预示AS患者治疗总费用高低的最重要因素.因此维持或者改进患者功能障碍的治疗,将具有减低AS治疗费用的巨大潜力[2],而且可提升患者的生活质量.

  11. 强直性脊柱炎的实验室检查%Laboratory Check of Ankylosing Spondylitis

    Institute of Scientific and Technical Information of China (English)

    李曙晨; 张丽丽; 杨春玲

    2006-01-01

    强直性脊柱炎(ankylosing spondylitis,AS)是一种中轴骨骼系统的慢性炎症性疾病,累及骶髂关节和脊柱,骶髂关节炎的存在是其特征。该病致残率高,5a~10a内致残率达到30%~40%。在我国,AS的患病率为30%左右。目前,我国有400多万患者,其中95%是17岁~30岁的青壮年,男性与女性之比为5:1。该病在胶东半岛属常见病。AS的实验室检查虽无特异性和标记性指标。

  12. Long-term efficiency of infliximab in patients with ankylosing spondylitis: real life data confirm the potential for dose reduction

    Science.gov (United States)

    Heldmann, F; van den Bosch, F; Burmester, G; Gaston, H; van der Horst-Bruinsma, I E; Krause, A; Schmidt, R; Schneider, M; Sieper, J; Andermann, B; van Tubergen, A; Witt, M; Braun, J

    2016-01-01

    Objective To analyse the treatment outcome of patients with ankylosing spondylitis (AS) in the European AS infliximab cohort (EASIC) study after a total period of 8 years with specific focus on dosage and the duration of intervals between infliximab infusions. Methods EASIC included patients with AS who had received infliximab for 2 years as part of the ASSERT trial. After that period, rheumatologists were free to change the dose or the intervals of infliximab. Clinical data were status at baseline, end of ASSERT and for a total of 8 years of follow-up. Results Of the initially 71 patients with AS from EASIC, 55 patients (77.5%) had completed the 8th year of anti-tumour necrosis factor (TNF) treatment. Of those, 48 patients (87.3%) still continued on infliximab. The mean infusion interval increased slightly from 6 to 7.1±1.5 weeks, while 45.8% patients had increased the intervals up to a maximum of 12 weeks. The mean infliximab dose remained stable over time, with a minimum of 3.1 mg/kg and a maximum of 6.4 mg/kg. In patients receiving 85% patients still remained on the same treatment, without any major safety events. Furthermore, both the infusion intervals and also the mean infliximab dose were modestly reduced in ≥70% of the patients without the loss of clinical efficiency. PMID:27493791

  13. Serum DKK-1 level in the development of ankylosing spondylitis and rheumatic arthritis: a meta-analysis.

    Science.gov (United States)

    Zhang, Li; Ouyang, Hui; Xie, Zhen; Liang, Zhi-Hui; Wu, Xiong-Wen

    2016-04-22

    To explore the association of serum Dickkopf-1 (DKK-1) levels with the development of ankylosing spondylitis (AS) and rheumatic arthritis (RA) in humans, databases including PubMed, EBSCO, Springerlink, Ovid, WANFANG and China National Knowledge Infrastructure (CNKI) were searched to identify relevant studies. On the basis of rigorous inclusion and exclusion criteria, case-control studies of the relationships between serum DKK-1 levels and AS and RA published before December 2014 were enrolled. Statistical analyses were performed using Comprehensive Meta-analysis 2.0 (CMA 2.0). Seven case-control trials with a total of 300 AS patients, 136 RA patients and 232 healthy controls were included in this study. Meta-analysis results revealed that DKK-1 serum levels were significantly higher in AS patients than in normal controls (standard mean differences (s.m.d.)=0.301, 95% confidence interval (CI)=0.094-0.507, P=0.004), whereas no significant difference in DKK-1 serum levels was observed between RA patients and healthy controls (s.m.d.=0.798, 95% CI=-2.166-3.763, P=0.598). Serum DKK-1 level may be closely related to the development of AS but not of RA.

  14. Up-regulation of soluble P-selectin predicates its prognostic value in patients with ankylosing spondylitis.

    Science.gov (United States)

    Zhou, Xianwei; Li, Wuyin; Ding, Qiang

    2015-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory disease with a high rate of disability. To find a proper prognosis marker is helpful for the treatment of AS. The purpose of this study was to investigate whether soluble P selectin (SP selectin) exerted effects on the prognosis of AS patients. Firstly, we detected the expression level of SP selectin in 85 AS patients and 60 normal subjects using quantitative real-time-polymerase chain reaction (QRT-PCR) assay. The result demonstrated that SP-selectin was over expressed in AS patients compared with healthy controls and the difference was significant (P < 0.05). Chi-square test was used to estimate whether SP selectin was associated with clinicopathologic characteristics. The factors of stages (P = 0.002), HLA-B27 (P = 0.002), ESR (P = 0.001) and C-reactive protein (P = 0.000) were considered to be related to the expression of SP selectin, which indicated that SP-selectin might be involved in the development of AS. Besides, the prognosis of AS patients after treatment was explored and analyzed via Cox regression analysis. The analysis suggested that ESR and SP selectin both served as independent prognostic biomarkers for AS (HR = 2.069, 95% CI = 1.049-4.080; HR = 4.562, 95% CI = 1.766-11.784). Taken together, our study revealed that not only the level of SP selectin was upregulated, but also SP selectin could predict the prognosis of AS patients.

  15. Non-­‐pharmacological treatment of ankylosing spondylitis: Barriers to effective implementation of recommendations in Morocco

    Directory of Open Access Journals (Sweden)

    Abderrazak Hajjioui

    2014-05-01

    Full Text Available This cross-sectional study aimed to describe non--‐pharmacological treatment modalities in Moroccan patients with ankylosing spondylitis (AS, and to approach physical therapy implementation barriers. 61 patients with AS according to New York classification criteria were included in the study. Socio-demographic data and clinical characteristics were collected and different therapeutic modalities, including physical therapy were investigated. The mean age of the patients was 38.20 (SD 12.36 years with a male/female ratio of 1.5. 55 (90% patients received pharmacological therapy, 37 (60.7% received physical therapy, 5(8.2% underwent surgery and 36 (59% tried at least one type of complementary medicine (medicine plants, sand baths, acupuncture, fire needles, and cupping. Patients’ major expectations from physical therapy were improving their functional status (86.5%, and reducing their pain (59.5%. Most patients (86.49% were satisfied of their physical therapy and 56.8% practiced home exercises. Reasons for nonattendance to physical therapy for the remaining 24 patients were nonprescription (58.3%, lack of financial resources (20.8%, geographical remoteness from rehabilitation centers (4% and lack of motivation (17%. Non-pharmacological treatment, especially based on exercise and education, is an integral part of the comprehensive management of AS. However, it is not efficiently implemented in Morocco and more effort should be made to develop this both efficient and relatively inexpensive component of AS treatment.

  16. IGF-1 and ADMA Levels Are Inversely Correlated in Nondiabetic Ankylosing Spondylitis Patients Undergoing Anti-TNF-Alpha Therapy

    Directory of Open Access Journals (Sweden)

    Fernanda Genre

    2014-01-01

    Full Text Available Like rheumatoid arthritis, ankylosing spondylitis (AS is also an inflammatory disease associated with accelerated atherosclerosis and the presence of metabolic syndrome (MeS features. AS patients often display osteoporosis as well as new bone formation. Insulin-like growth factor 1 (IGF-1 is a protein involved in both inflammation and bone metabolism. In the present study we assessed whether disease activity, systemic inflammation, MeS features, adipokines, and biomarkers of endothelial activation were associated with IGF-1 and insulin-like growth factor binding protein-3 (IGFBP-3 levels in a series of 30 nondiabetic AS patients without CV disease undergoing TNF-α antagonist-infliximab therapy. All determinations were made in the fasting state, immediately before an infliximab infusion. Although no association of IGF-1 and IGFBP-3 levels with angiopoietin-2 or osteopontin was found, an inverse correlation between IGF-1 levels and asymmetric dimethylarginine (ADMA, an endogenous endothelial nitric oxide synthase inhibitor that impairs nitric oxide production and secretion promoting endothelial dysfunction, was found (r=-0.397; P=0.04. However, no significant association was found between IGF-1 and IGFBP-3 levels and disease activity, systemic inflammation, metabolic syndrome features, or adipokines. In conclusion, in nondiabetic patients with AS undergoing periodic anti-TNF-α therapy, IGF-1 and ADMA are inversely correlated.

  17. A rare co-segregation-mutation in the insulin receptor substrate 1 gene in one Chinese family with ankylosing spondylitis.

    Directory of Open Access Journals (Sweden)

    Ju Rong

    Full Text Available Ankylosing spondylitis (AS; MIM 106300 is a common rheumatic disease with strong genetic components affecting approximately 0.3% of the population. The exact genetic mechanism of AS remains elusive. Our previous study showed that AS could be transmitted in an autosomal dominant inheritance mode and a 6-cM candidate region located on the chromosome 2q36.1-36.3 was mapped in a Chinese family. Mutation screening was conducted within the candidate region in the family and other AS by sequencing, and the novel mutation will be further validated in other AS families, sporadic cases and healthy controls by mass spectrometry. We identified a rare non-synonymous mutation (Arg580Gly in insulin receptor substrate 1 (IRS1 co-segregated with disease phenotype in patients of the family, which was not found in other AS families, sporadic patients and healthy controls. In the study, we found a rare non-synonymous mutation in IRS1 co-segregation in one Chinese family with AS, which indicated a new candidate disease causative gene for AS.

  18. Targeted delivery of an antigenic peptide to the endoplasmic reticulum: application for development of a peptide therapy for ankylosing spondylitis.

    Directory of Open Access Journals (Sweden)

    Hui-Chun Yu

    Full Text Available The development of suitable methods to deliver peptides specifically to the endoplasmic reticulum (ER can provide some potential therapeutic applications of such peptides. Ankylosing spondylitis (AS is strongly associated with the expression of human leukocytic antigen-B27 (HLA-B27. HLA-B27 heavy chain (HC has a propensity to fold slowly resulting in the accumulation of misfolded HLA-B27 HC in the ER, triggering the unfolded protein response, and forming a homodimer, (B27-HC2. Natural killer cells and T-helper 17 cells are then activated, contributing to the major pathogenic potentials of AS. The HLA-B27 HC is thus an important target, and delivery of an HLA-B27-binding peptide to the ER capable of promoting HLA-B27 HC folding is a potential mechanism for AS therapy. Here, we demonstrate that a His6-ubiquitin-tagged Tat-derived peptide (THU can deliver an HLA-B27-binding peptide to the ER promoting HLA-B27 HC folding. The THU-HLA-B27-binding peptide fusion protein crossed the cell membrane to the cytosol through the Tat-derived peptide. The HLA-B27-binding peptide was specifically cleaved from THU by cytosolic ubiquitin C-terminal hydrolases and subsequently transported into the ER by the transporter associated with antigen processing. This approach has potential application in the development of peptide therapy for AS.

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

    Science.gov (United States)

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

    2012-07-01

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

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

    Science.gov (United States)

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

    2014-08-01

    The present meta-analysis of relevant case-control studies was conducted to investigate the possible relationships between genetic variations in the killer cell immunoglobulin-like receptor (KIR) gene clusters of the human KIR gene family and susceptibility to ankylosing spondylitis (AS). The following electronic databases were searched for relevant articles without language restrictions: the Web of Science, the Cochrane Library Database, PubMed, EMBASE, CINAHL, the Chinese Biomedical Database (CBM) and Chinese National Knowledge Infrastructure (CNKI) databases, covering all papers published until 2013. STATA statistical software was adopted in this meta-analysis as well. We also calculated the crude odds ratios (OR) and its 95% confidence intervals (95 % CI). Seven case-control studies with 1,004 patients diagnosed with AS and 2,138 healthy cases were implicated in our meta-analysis, and 15 genes in the KIR gene family were also evaluated. The results of our meta-analysis show statistical significance between the genetic variations in the KIR2DL1, KIR2DS4, KIR2DS5 and KIR3DS1 genes and an increased susceptibility to AS (KIR2DL1: OR 7.82, 95% CI 3.87-15.81, P0.05). The current meta-analysis provides reliable evidence that genetic variations in the KIR gene family may contribute to susceptibility to AS, especially for the KIR2DL1, KIR2DS4, KIR2DS5 and KIR3DS1 genes.

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

    Science.gov (United States)

    Gyurcsik, Zsuzsanna Némethné; András, Anita; Bodnár, Nóra; Szekanecz, Zoltán; Szántó, Sándor

    2012-12-01

    Physical therapy in ankylosing spondylitis (AS) is important for maintaining or improving mobility, fitness, functioning, and global health. It also plays a role in the prevention and management of structural deformities. 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 spine, and pelvic-, upper-, and lower-extremity exercises, stretching with joint prevention strategies and functional exercises. In AS, pain intensity recorded on a 10-cm visual analog scale (VAS), BASFI, BASDAI, modified Schober index, chest expansion and occiput-to-wall distance values showed significant correlation with disease activity. The 3-month physical therapy improved several subjective and functional parameters, and markedly reduced pain intensity and spine stiffness. A complex, individualized physical therapy program may be useful and should be introduced to AS patients in order to maintain and increase spine mobility, preserve functional capacity, decrease the pain and stiffness.

  2. Effects of home-based exercise intervention on health-related quality of life for patients with ankylosing spondylitis: a meta-analysis.

    Science.gov (United States)

    Liang, Hui; Zhang, Hua; Ji, Haiyan; Wang, Chunmei

    2015-10-01

    The objective of this paper was to objectively evaluate the effectiveness of home-based exercise interventions for improving health-related quality of life in patients with ankylosing spondylitis (AS). Databases including PubMed, Web of Science, EMBASE, Ovid-Medline, and The Cochrane Library were electronically searched published from inception through October 2014 involving home-based exercise intervention in AS patients. Studies that measured the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), depression and pain as outcomes were included. Studies involving patients with multiple diseases or received combinations of other interventions were excluded. Two independent investigators screened the identified articles, extracted the data, and assessed the methodological quality of the included studies. Qualitative descriptions were conducted, and quantitative analysis was performed with RevMan software (version 5.2). A total of six studies comprising 1098 participants were included in the study. Meta-analyses showed that home-based exercise interventions significantly reduced the BASFI scores (MD = -0.39, 95 % CI -0.57, -0.20, p = 0.001), BASDAI scores (MD = -0.50, 95 % CI -0.99, -0.02, p = 0.04), depression scores (MD = -2.31, 95 % CI -3.33, -1.30, p = 0.001), and for pain scores because of different evaluation methods among these studies; therefore, a subgroup analysis should be conducted for comparison. The results show that home-based exercise interventions can effectively improve the health-related quality of life in patients with AS. The benefit and clinical performance of home-based exercise care requires further investigation by a series of multicenter, large-sample size randomized controlled trails.

  3. In axial spondyloarthritis, never smokers, ex-smokers and current smokers show a gradient of increasing disease severity - results from the Scotland Registry for Ankylosing Spondylitis (SIRAS).

    Science.gov (United States)

    Jones, Gareth T; Ratz, Tiara; Dean, Linda E; Macfarlane, Gary J; Atzeni, Fabiola

    2016-11-29

    Objectives To examine the relationship between smoking, smoking cessation, and disease characteristics/quality of life (QoL) in spondyloarthritis. Methods The Scotland Registry for Ankylosing Spondylitis collects data from clinically diagnosed patients with spondyloarthritis. Clinical data, including Bath Ankylosing Spondylitis indices of disease activity (BASDAI) and function (BASFI), was obtained from medical records. Postal questionnaires provided information on smoking status and QoL (Ankylosing Spondylitis QoL questionnaire; ASQoL). Linear and logistic regression quantified the effect of smoking, and smoking cessation, on various disease-specific and QoL outcomes, adjusting for age, sex, deprivation, education and alcohol status. Results are presented as regression coefficients (β) or odds ratios (OR) with 95% confidence intervals. Results 946 participants provided data (male 73.5%, mean age 52yrs). Current smoking was reported by 22%, and 38% were ex-smokers. Ever smokers experienced poorer BASDAI (β = 0.5; 0.2 to 0.9) and BASFI (β = 0.8; 0.4 to 1.2), and reported worse QoL (ASQoL, β = 1.5; 0.7 to 2.3). Compared to current smokers, ex-smokers reported lower disease activity (BASDAI, β = -0.5; -1.0 to -0.04) and significantly better QoL (ASQoL, β = -1.2; -2.3 to -0.2). They also were more likely to have a uveitis history (OR = 2.4; 1.5 to 3.8). Conclusions Smokers with spondyloarthritis experience worse disease than never smokers. However, we provide new evidence that, among smokers, smoking cessation is associated with lower disease activity and better physical function and QoL. Clinicians should specifically promote smoking cessation as an adjunct to usual therapy in patients with spondyloarthritis. This article is protected by copyright. All rights reserved.

  4. OPTIMIZATION OF X-RAY DIAGNOSIS OF ANKYLOSING SPONDYLITIS IN CLINICAL PRACTICE: IMPORTANCE OF A PLAIN X-RAY FILM OF THE PELVIS

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    A. V. Smirnov

    2015-01-01

    Full Text Available Ankylosing spondylitis (AS is a disease whose main clinical manifestation  is an inflammatory lesion in the axial skeleton with its gradual ankylosing. The peak incidence of AS occurs at a young age; and, if there is no timely adequate therapy, its disability rates are virtually as high as 50% ten years after disease onset, which determines the social importance of this disease The diagnosis of AS is based on its characteristic  clinical presentation  and the compulsory detection  of sacroiliitis on pelvic radiography. However, the existing reports of the X-ray stages of sacroiliac joint injuries in the literature provide little evidence and frequently misinterpret  radiographic changes. Based on their long-term  experience, the authors give expanded explanations of the standard X-ray stages of sacroiliitis and other radiographic signs that can make a diagnostic search in AS easier.

  5. Proposal for levels of evidence schema for validation of a soluble biomarker reflecting damage endpoints in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, and recommendations for study design

    DEFF Research Database (Denmark)

    Maksymowych, W.P.; Fitzgerald, O.; Wells, G.A.

    2009-01-01

    arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). We also aimed to generate consensus on minimum standards for the design of longitudinal studies aimed at validating biomarkers. METHODS: Before the meeting, the Soluble Biomarker Working Group prepared a preliminary framework...... and discussed various models for association and prediction related to the statistical strength domain. In addition, 3 Delphi exercises addressing longitudinal study design for RA, PsA, and AS were conducted within the working group and members of the Assessments in SpondyloArthritis International Society (ASAS...

  6. Inflammatory lesions of the spine on magnetic resonance imaging predict the development of new syndesmophytes in ankylosing spondylitis: evidence of a relationship between inflammation and new bone formation

    DEFF Research Database (Denmark)

    Maksymowych, Walter P; Chiowchanwisawakit, Praveena; Clare, Tracey;

    2009-01-01

    OBJECTIVE: To determine whether a vertebral corner that demonstrates an active corner inflammatory lesion (CIL) on magnetic resonance imaging (MRI) in patients with ankylosing spondylitis (AS) is more likely to evolve into a de novo syndesmophyte visible on plain radiography than is a vertebral...... corner that demonstrates no active inflammation on MRI. METHODS: MRI scans and plain radiographs were obtained for 29 patients recruited into randomized placebo-controlled trials of anti-tumor necrosis factor alpha (anti-TNFalpha) therapy. MRI was conducted at baseline, 12 or 24 weeks (n = 29), and 2...

  7. 48例强直性脊柱炎病人的护理干预%Nursing interventions for 48 patients with ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    张建华; 李亚琴; 杨晓丽

    2010-01-01

    @@ 强直性脊柱炎(ankylosing spondylitis,AS)是一种慢性进行性疾病,主要侵犯骶髂关节、脊柱骨突、脊柱旁软组织及外周关节,并可伴发关节外表现,严重者可发生脊柱畸形和关节强直[1].发病年龄多为13岁~31岁,男性多发.

  8. Concurrent Intervention With Exercises and Stabilized Tumor Necrosis Factor Inhibitor Therapy Reduced the Disease Activity in Patients With Ankylosing Spondylitis: A Meta-Analysis.

    Science.gov (United States)

    Liang, Hui; Li, Wen-Rong; Zhang, Hua; Tian, Xu; Wei, Wei; Wang, Chun-Mei

    2015-12-01

    Since the use of tumor necrosis factor (TNF) inhibitor therapy is becoming wider, the effects of concurrent intervention with exercises and stabilized TNF inhibitors therapy in patients with ankylosing spondylitis (AS) are different. The study aimed to objectively evaluate whether concurrent intervention with exercises and stabilized TNF inhibitors can reduce the disease activity in patients with AS. A search from PubMed, Web of Science, EMBASE, and the Cochrane Library was electronically performed to collect studies which compared concurrent intervention with exercise and TNF inhibitor to conventional approach in terms of disease activity in patients with AS published from their inception to June 2015. Studies that measured the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Metrology Index (BASMI), and chest expansion as outcomes were included. Two independent investigators screened the identified articles, extracted the data, and assessed the methodological quality of the included studies. Quantitative analysis was performed with Review Manager (RevMan) software (version 5.3.0). A total of 5 studies comprising 221 participants were included in the study. Meta-analyses showed that concurrent intervention with exercises and stabilized TNF inhibitors therapy significantly reduced the BASMI scores (MD, -0.99; 95% CI, -1.61 to -0.38) and BASDAI scores (MD, -0.58; 95% CI, -1.10 to -0.06), but the BASFI scores (MD, -0.31; 95% CI, -0.76 to 0.15) was not reduced, and chest expansion (MD, 0.80; 95% CI, -0.18 to 1.78) was not increased. Concurrent intervention with exercises and stabilized TNF inhibitors therapy can reduce the disease activity in patients with AS. More randomized controlled trials (RCTs) with high-quality, large-scale, and appropriate follow-up are warranted to further establish the benefit of concurrent intervention with exercises and TNF inhibitors for

  9. 强者性脊柱炎38例分析%Clinical analysis of ankylosing spondylitis :a report of 38 cases

    Institute of Scientific and Technical Information of China (English)

    吴建农; 张晓

    2002-01-01

    Background: Ankylosing spondylitis(AS) is a chronic inflammatory disease that affects the joints between the vertebrae of the spine, and the joints between the spine and the pelvis. It eventually causes the affected vertebrae to fuse or grow together.The special cause and therapy for this disease is unknown. It is past to think the AS is a kind of less spinal column disease.Along with progress in study of rheumatology at our country,AS is considered a kind of commonly encountered disease in China.

  10. The Cost of Ankylosing Spondylitis in the UK Using Linked Routine and Patient-Reported Survey Data.

    Directory of Open Access Journals (Sweden)

    Roxanne Cooksey

    Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory arthritis which typically begins in early adulthood and impacts on healthcare resource utilisation and the ability to work. Previous studies examining the cost of AS have relied on patient-reported questionnaires based on recall. This study uses a combination of patient-reported and linked-routine data to examine the cost of AS in Wales, UK.Participants in an existing AS cohort study (n = 570 completed questionnaires regarding work status, out-of-pocket expenses, visits to health professionals and disease severity. Participants gave consent for their data to be linked to routine primary and secondary care clinical datasets. Health resource costs were calculated using a bottom-up micro-costing approach. Human capital costs methods were used to estimate work productivity loss costs, particularly relating to work and early retirement. Regression analyses were used to account for age, gender, disease activity.The total cost of AS in the UK is estimated at £19016 per patient per year, calculated to include GP attendance, administration costs and hospital costs derived from routine data records, plus patient-reported non-NHS costs, out-of-pocket AS-related expenses, early retirement, absenteeism, presenteeism and unpaid assistance costs. The majority of the cost (>80% was as a result of work-related costs.The major cost of AS is as a result of loss of working hours, early retirement and unpaid carer's time. Therefore, much of AS costs are hidden and not easy to quantify. Functional impairment is the main factor associated with increased cost of AS. Interventions which keep people in work to retirement age and reduce functional impairment would have the greatest impact on reducing costs of AS. The combination of patient-reported and linked routine data significantly enhanced the health economic analysis and this methodology that can be applied to other chronic conditions.

  11. Late-onset ankylosing spondylitis and spondylarthritis: an update on clinical manifestations, differential diagnosis and pharmacological therapies.

    Science.gov (United States)

    Toussirot, Eric

    2010-07-01

    Ankylosing spondylitis (AS) and spondylarthritis (SpA) are generally observed in young male patients but can be diagnosed in the elderly. These cases correspond to late-onset or late-diagnosed AS or SpA. The clinical presentation may be either typical axial disease with a more severe illness compared with young-onset disease, or peripheral oligoarthritis of the lower limbs with pitting oedema (late-onset peripheral spondylarthropathy). New criteria for axial SpA including MRI-determined modifications of the sacroiliac joints may help the clinician with diagnosis. The treatment options for late-onset/-diagnosed AS include the same drugs as those taken by patients with young-onset AS, i.e. NSAIDs, sulfasalazine and anti-tumour necrosis factor (TNF)-alpha agents. Anti-TNFalpha agents are very effective drugs in young-onset AS and SpA. However, the effectiveness and safety of this drug class has not been specifically evaluated in elderly AS/SpA patients, and caution is therefore required with use of these drugs in elderly patients with co-morbidities and/or polypharmacy. In particular, careful evaluation for the risk of infection and cardiovascular events is recommended before initiating anti-TNFalpha agents in this age category. However, safety data from elderly patients with rheumatoid arthritis seem reassuring. With the increasing life expectancy and the new diagnostic modalities for axial (and peripheral) SpA, it is likely that the number of patients (diagnosed) with late-onset AS/SpA will increase. Thus, the clinician must be familiar with the clinical characteristics and particularities of this group of inflammatory rheumatic diseases.

  12. A multicenter report of biologic agents for the treatment of secondary amyloidosis in Turkish rheumatoid arthritis and ankylosing spondylitis patients.

    Science.gov (United States)

    Pamuk, Ömer Nuri; Kalyoncu, Umut; Aksu, Kenan; Omma, Ahmet; Pehlivan, Yavuz; Çağatay, Yonca; Küçükşahin, Orhan; Dönmez, Salim; Çetin, Gözde Yıldırım; Mercan, Rıdvan; Bayındır, Özün; Çefle, Ayşe; Yıldız, Fatih; Balkarlı, Ayşe; Kılıç, Levent; Çakır, Necati; Kısacık, Bünyamin; Öksüz, Mustafa Ferhat; Çobankara, Veli; Onat, Ahmet Mesut; Sayarlıoğlu, Mehmet; Öztürk, Mehmet Akif; Pamuk, Gülsüm Emel; Akkoç, Nurullah

    2016-07-01

    In this multicenter, retrospective study, we evaluated the efficacy and safety of biologic therapies, including anti-TNFs, in secondary (AA) amyloidosis patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA). In addition, the frequency of secondary amyloidosis in RA and AS patients in a single center was estimated. Fifty-one AS (39M, 12F, mean age: 46.7) and 30 RA patients (11M, 19F, mean age: 51.7) with AA amyloidosis from 16 different centers in Turkey were included. Clinical and demographical features of patients were obtained from medical charts. A composite response index (CRI) to biologic therapy-based on creatinine level, proteinuria and disease activity-was used to evaluate the efficacy of treatment. The mean annual incidence of AA amyloidosis in RA and AS patients was 0.23 and 0.42/1000 patients/year, respectively. The point prevalence in RA and AS groups was 4.59 and 7.58/1000, respectively. In RA group with AA amyloidosis, effective response was obtained in 52.2 % of patients according to CRI. RA patients with RF positivity and more initial disease activity tended to have higher response rates to therapy (p values, 0.069 and 0.056). After biologic therapy (median 17 months), two RA patients died and two developed tuberculosis. In AS group, 45.7 % of patients fulfilled the criteria of good response according to CRI. AS patients with higher CRP levels at the time of AA diagnosis and at the beginning of anti-TNF therapy had higher response rates (p values, 0.011 and 0.017). During follow-up after anti-TNF therapy (median 38 months), one patient died and tuberculosis developed in two patients. Biologic therapy seems to be effective in at least half of RA and AS patients with AA amyloidosis. Tuberculosis was the most important safety concern.

  13. Decreased physical activity and cardiorespiratory fitness in adults with ankylosing spondylitis: a cross-sectional controlled study.

    Science.gov (United States)

    O'Dwyer, Tom; O'Shea, Finbar; Wilson, Fiona

    2015-11-01

    The health benefits of physical activity (PA) in the general population are numerous; however, few studies have measured PA among adults with ankylosing spondylitis (AS). The aims of this study were to: (1) objectively measure the PA levels and cardiorespiratory fitness of adults with AS and compare these to population controls, and (2) examine the relationships between PA, cardiorespiratory function and condition-specific outcomes. This cross-sectional study included participants (>18 years) meeting the modified New York criteria for AS, and matched population controls. Exclusion criteria were the presence of comorbidities limiting PA, or recent changes in medication usage. Participants completed clinical questionnaires assessing disease activity, physical function and quality of life. Tri-axial accelerometers recorded habitual PA over 1 week. Cardiorespiratory fitness was assessed by submaximal treadmill test with breath-by-breath gas analysis and heart rate monitoring. Thirty-nine adults with AS and 39 controls were recruited. The AS group spent significantly less time performing vigorous-intensity PA than controls [mean difference (95 % CI) 1.8 min/day (1.2-2.7)] and performed significantly fewer bouts of health-enhancing PA [1.7 min/day (1.1-2.5)]. The AS group had significantly lower predicted VO(2MAX) than controls [6.0 mL kg(-1) min(-1) (1.8-10.1)]. PA was associated with aerobic capacity. Sedentary time was associated with disease activity and physical function. Adults with AS participate in less health-enhancing PA than population controls. Fewer than half meet PA recommendations, despite exercise being a key component of AS management. Explorations of PA behaviour and strategies to increase PA participation are needed.

  14. IL23R gene confers susceptibility to ankylosing spondylitis concomitant with uveitis in a Han Chinese population.

    Directory of Open Access Journals (Sweden)

    Hongtao Dong

    Full Text Available PURPOSE: The interleukin-23 receptor (IL-23R has been shown to be associated with ankylosing spondylitis (AS in many different populations. This study examined whether IL-23R polymorphisms were associated with susceptibility to this disease in a Chinese Han population. METHODS: Three single-nucleotide polymorphisms (SNP, rs7517847, rs11209032, and rs17375018, were genotyped in 291 AS patients and 312 age-, sex-, and ethnically matched healthy controls using a polymerase chain reaction (PCR restriction fragment length polymorphism (RFLP assay. RESULTS: The genotype and allele frequencies of rs17375018, rs7517847, and rs11209032 were not different between the patients with AS and the healthy controls. On the one hand, stratification analysis indicated that the rs17375018 GG genotype and the G allele were increased in AS patients who were HLA-B27 positive (corrected p = 0.024, odds ratio [OR] 2.35, 95% CI 1.30-4.24; p c = 0.006, OR 1.98, 95% CI 1.28-3.07, respectively. On the other hand, the analysis according to clinical characteristics showed a significantly increased prevalence of the homozygous rs17375018 GG genotype and the G allele in patients with AS and uveitis compared with the controls (p c = 0.024 and p c = 0.024, respectively. In addition, haplotype analysis performed with the SHEsis platform revealed no significant difference concerning the haplotypes between AS patients and healthy controls. CONCLUSIONS: In this study, the results suggested that the rs17375018 of IL23R was positively associated with HLA-B27-positive AS and that the rs17375018 GG of IL-23R was associated with AS concomitant with uveitis. We found no evidence for an association between the other two SNPs of IL-23R and AS.

  15. The effect of smoking on clinical and radiographic variables, and acute phase reactants in patients with ankylosing spondylitis.

    Science.gov (United States)

    Sakellariou, Grigorios T; Anastasilakis, Athanasios D; Kenanidis, Eustathios; Potoupnis, Michael; Tsiridis, Eleftherios; Savvidis, Matthaios; Kartalis, Nikolaos; Sayegh, Fares E

    2015-12-01

    To investigate the association between smoking and clinical, inflammatory and radiographic parameters in patients with ankylosing spondylitis (AS). One hundred and six tumour necrosis factor inhibitor naïve patients with AS were included in the study. The erythrocyte sedimentation rate, C-reactive protein, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI) and modified Stroke AS Spine Score (mSASSS) were assessed cross-sectionally for each patient. Smoking history was obtained, and smoking pack years were calculated. Current smokers had significantly higher BASDAI (p < 0.001) and a trend for higher BASFI (p = 0.059). Ever smokers had significantly higher BASFI (p = 0.035) and a trend for higher mSASSS (p = 0.063) compared to never smokers. Pack years (smoking intensity) were positively correlated with duration of inflammatory back pain (r = 0.628, p < 0.001), BASFI (r = 0.443, p < 0.001) and mSASSS (r = 0.683, p < 0.001). Multivariate regression analyses showed that current smoking was independently associated with a higher BASDAI score [regression coefficient (B) = 14.75, p < 0.001] and increasing pack years were independently associated with higher mSASSS (B = 0.26, p = 0.005). In patients with AS, current smoking was strongly and independently associated with higher disease activity, and cumulative smoking exposure with more radiographic spinal damage. In AS smokers, smoking cessation should be strongly recommended.

  16. Comparative Efficacy and Acceptability of Anti-TNF-Alpha Therapy in Ankylosing Spondylitis: A Mixed-Treatments Comparison

    Directory of Open Access Journals (Sweden)

    Yehua Wang

    2016-09-01

    Full Text Available Background: Tumor necrosis factor α (TNFα antagonists, namely, golimumab, adalimumab, infliximab, etanercept and certolizumab have been prescribed to alleviate and treat ankylosing spondylitis (AS. However, the lack of comparative evidence does not enable us to make constructive recommendations particularly for AS patient populations. Methods: Eligible controlled trials regarding the above 5 anti-TNFα therapies were searched electronically through PubMed, Embase and Cochrane until April 1, 2015. Odds ratios (ORs were estimated and compared for efficacy (ASAS20, ASAS40, ASAS5/6 responses and ASAS partial remission and acceptability (serious adverse effects (SAE among the anti-TNFα reagents. Results: Totally, 25 trials with 2989 participants were incorporated in this mixed treatment comparison. All the 5 TNFα blockers achieved better ASAS20, ASAS40, ASAS5/6 and ASAS-PR responses than the placebo. Furthermore, there was no significant distinction existed among inter-drug comparisons, except that unfavorable effects induced by certolizumab seemed to be less severe than those by etanercept (OR = 0.22, 95% CI: 0.05-0.93. Apart from that, etanercept was estimated to arrive at the most favorable ASAS20 response (90.6% and SAE (83.6%, while infliximab seemed to accomplish the best ASAS40 (83.6% and ASAS-PR responses (77.3%. In addition, adalimumab was estimated to rank the highest ASAS5/6 response (75.0%. Conclusions: Etanercept, infliximab and adalimumab might be prioritized among the commonly recognized 5 anti-TNFα therapies specific for AS patients, though existing evidence did not suffice to confirm significant superiority among the above 5 anti-TNFα reagent.

  17. Antibodies Directed against a Peptide Epitope of a Klebsiella pneumoniae-Derived Protein Are Present in Ankylosing Spondylitis

    Science.gov (United States)

    Tinazzi, Elisa; Moretta, Francesca; D’Angelo, Salvatore; Olivieri, Ignazio; Lunardi, Claudio

    2017-01-01

    Ankylosing spondylitis (AS) is a chronic inflammatory arthritis of unknown origin. Its autoimmune origin has been suggested but never proven. Several reports have implicated Klebsiella pneumoniae as a triggering or perpetuating factor in AS; however, its role in the disease pathogenesis remains debated. Moreover, despite extensive investigations, a biomarker for AS has not yet been identified. To clarify these issues, we screened a random peptide library with pooled IgGs obtained from 40 patients with AS. A peptide (AS peptide) selected from the library was recognized by serum IgGs from 170 of 200 (85%) patients with AS but not by serum specimens from 100 healthy controls. Interestingly, the AS peptide shows a sequence similarity with several molecules expressed at the fibrocartilaginous sites that are primarily involved in the AS inflammatory process. Moreover, the peptide is highly homologous to a Klebsiella pneumoniae dipeptidase (DPP) protein. The antibody affinity purified against the AS peptide recognizes the autoantigens and the DPP protein. Furthermore, serum IgG antibodies against the Klebsiella DPP121-145 peptide epitope were detected in 190 of 200 patients with AS (95%), 3 of 200 patients with rheumatoid arthritis (1.5%) and only 1 of 100 (1%) patients with psoriatic arthritis. Such reactivity was not detected in healthy control donors. Our results show that antibodies directed against an epitope of a Klebsiella pneumoniae-derived protein are present in nearly all patients with AS. In the absence of serological biomarkers for AS, such antibodies may represent a useful tool in the diagnosis of the disease. PMID:28135336

  18. Increased risk of ischemic stroke in young patients with ankylosing spondylitis: a population-based longitudinal follow-up study.

    Directory of Open Access Journals (Sweden)

    Chia-Wei Lin

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

  19. Impact of gender, work, and clinical presentation on diagnostic delay in Italian patients with primary ankylosing spondylitis.

    Science.gov (United States)

    Bandinelli, F; Salvadorini, G; Delle Sedie, A; Riente, L; Bombardieri, S; Matucci-Cerinic, M

    2016-02-01

    The variability of demographic, social, genetic, and clinical factors might influence the time between the onset of symptoms and the diagnosis [diagnostic delay (DD)] of ankylosing spondylitis (AS) in different geographic areas. Different clinical manifestations in men and women affected by AS might indicate a possible role of gender in DD. The aim of the present study was to investigate the influence of demographic, social, genetic, and clinical factors on DD and the differences of DD between men and women related to the presence of different demographic, social, clinical, and genetic parameters in an Italian cohort of primary AS patients. A total of 135 Italian primary AS patients (45 female and 90 male, 27.9 ± 0.89 years old at onset) were studied. The DD, gender, education and work (manual or non-manual) levels, and type of first clinical presentation (inflammatory back pain, arthritis, enthesitis) at onset, family history of AS, and HLA B27 presence were analyzed. The DD (8.744 mean ±0.6869) was significantly higher in men (p = 0.0023), in axial presentation (p = 0.0021), and in manual work (even if with low significance, p = 0.047). The lower DD in women in comparison to that in men was likely related to higher education (p = 0.0045) and work (p = 0.0186) levels, peripheral involvement (p = 0.0009), and HLA B27 positivity (p = 0.0231). DD was higher in AS patients: male, employed in manual jobs, and with axial symptoms at onset. In men, DD seemed to be negatively influenced by lower level of education and work, axial clinical presentation, and HLA B27.

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

    Science.gov (United States)

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

    2014-07-01

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

  1. 强直性脊柱炎的治疗%Current treatment and future progress of ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    文琼芳; 黄烽

    2016-01-01

    Ankylosing spondylitis (AS)is a chronic,progressive,inflammatory disorder that mainly affects axial skeleton.Researches of the etiology and pathogenesis of AS in the past years greatly contributed to the rapid progress in diagnosis and treatment.Meanwhile,the combination of standardized use of traditional agents and TNF alpha inhibitors has rewritten the medical history of AS.Early,adequate and regular therapy and functional exercise can inhibit inflammation,delay the radiographic progression and new bone formation immediately.Further studies are required to confirm the efficacy and safety of novel biological agents.%强直性脊柱炎(AS)是一种主要累及中轴骨骼和肌腱附着点的慢性炎症性疾病.随着对AS病因及发病机制的研究深入,AS诊断和治疗进展迅速.传统治疗药物的规范化治疗、新型治疗药物尤其是肿瘤坏死因子α(TNF-α)抑制剂的出现,正在改写AS药物治疗历史.早期、足量、规律药物治疗和功能锻炼是迅速抑制炎症、延缓新骨形成和影像学进展的重要方法.新型生物制剂治疗的有效性和安全性有待进一步研究证实.

  2. Estimation of disease activity in patients with ankylosing spondylitis in the real practice of a rheumatologist in Russia (Part 2

    Directory of Open Access Journals (Sweden)

    Evgeny Vladimirovich Volnukhin

    2012-01-01

    Full Text Available Objective: to compare different methods for estimating ankylosing spondylitis (AS activity in the real practice of a rheumatologist in the Russian Federation. Subjects and methods. The investigation enrolled 464 patients with AS, who had consecutively visited rheumatologists for 4 months in 24 cities and towns of Russia. A specially designed clinical card was filled out for all patients. BASDAI and ASDAS scores were estimated by a physician and erythrocyte sedimentation rate (ESD and C-reactive protein (CRP were measured in all the patients. Mini-BASDAI scores were determined in patients with axial AS. The diagnosis of the disease was verified at the Research Institute of Rheumatology, Russian Academy of Medical Sciences, according to the 1984 modified New York criteria, by including X-ray film estimation. All activity assessment methods were compared. Results. The valid diagnosis of AS was confirmed in 330 (71.1% out of all 464 patients included into the study; axial AS was present in 178 of them; their mean age was 39.7+10.2 years; the mean duration of disease was 14.6+2.6 years; 86% were men and 14% were women. About 61 and 74% of the patients (n = 178 had high BASDAI and mini-BASDAI scores, respectively; 88% had high and very high ASDAI (ESR scores; the mean ESR (Westergren method was 33.8+29 mm/h and CRP (n = 249 was 30 mg/l. Conclusion. On assessing the activity of disease, rheumatologists are primarily oriented to total activity scores and blood acutephase indicators (ESR and CRP in real clinical practice. Patients with high disease activity calculated from BASDAI and ASDAS scores proved to be more. In its turn, ASDAS more frequently reveals high AS activity than BASDAI.

  3. Changes in gene expression profiles of the hip joint ligament of patients with ankylosing spondylitis revealed by DNA chip.

    Science.gov (United States)

    Xu, Ling; Sun, Qingwen; Jiang, Songmin; Li, Jia; He, Chongru; Xu, Weidong

    2012-10-01

    To investigate the pathogenesis of abnormal ossification of the hip ligament in patients with ankylosing spondylitis (AS) by comparing gene expression profiles of the hip ligament in patients with AS to those in normal persons using DNA microarray technology, we studied 18 patients with AS (case group) who underwent total hip arthroplasty in our department from March 1, 2009 to January 31, 2010 and compared them with 6 patients with femoral neck fracture (control group) who underwent total hip replacement. We screened the first five patients in each group with the HumanWG-6 v3.0 Expression BeadChip. Compared to the control group, 519 genes in the case group showed statistically significant differences. Among these, there were 238 upregulated genes and 196 downregulated genes. Gene Ontology (GO) classification showed that differential genes in the hip joint ligaments of patients with AS were involved in immunity, cell adhesion, membrane transport, sugar metabolism, polysaccharide synthesis and metabolism, and cell motility. The Kyoto Encyclopedia of Genes and Genomes classification showed that these differential genes were involved in B cell receptor signaling pathways, adherens junction, protein export, fructose and mannose metabolism, T cell receptor signaling pathways, keratin sulfate biosynthesis, N-glycan biosynthesis, and regulation of the actin cytoskeleton. We tested 2 genes from the screened differential genes in 18 case patients and 6 control cases using real-time polymerase chain reaction. The results demonstrated that the expression of the B4GALT3 gene in the case group was 15.32 times higher than that in the control group (P hip joint ligament ossification.

  4. Association between ankylosing spondylitis and the miR-146a and miR-499 polymorphisms.

    Directory of Open Access Journals (Sweden)

    Hui Ying Xu

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

  5. A functional variant of PTPN22 confers risk for Vogt-Koyanagi-Harada syndrome but not for ankylosing spondylitis.

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    Qi Zhang

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

  6. Effect of HLA-B*27 and its subtypes on clinical manifestations and severity of ankylosing spondylitis in Iranian patients.

    Directory of Open Access Journals (Sweden)

    Sasan Fallahi

    2013-12-01

    Full Text Available The aim of this study was to assess the role of HLA-B*27 and it's subtypes in determining severity and clinical manifestations of ankylosing spondylitis (AS.A total of 163 AS patients were assessed for clinical manifestations and severity using structured questionnaires. HLA-B*27 screening and B*27 sub-typing were performed by PCR.One hundred twenty two patients (74.8% were B*27 positive. The male to female ratio, peripheral arthritis, steroid use, intense dorsal kyphosis and decrease of cervical slope had a significantly higher frequency in B*27 positive patients compared to B*27 negative ones (p=0.01, 0.001, 0.01, 0.04 and 0.04, respectively. However, the age of diagnosis was significantly lower in B*27 positive patients (p=0.005. Trend in uveitis and some severity markers including: BASMI and ASQoL were toward higher values in B*27 positive group with no significant difference. After controlling confounding variables, significant relationship was found only between B*27 and BASMI (p=0.01. B*27 subtypes in patients were included B*2705: 48.4%, B*2702: 42.6%, B*2704: 5.7% and B*2707: 3.3%. No significant differences were seen for severity markers and clinical manifestations between subtypes; although trend toward lower values of severity markers, less intense dorsal kyphosis and less decrease of cervical slope were observed in B*2704 and B*2707 versus other polymorphisms.Clinical features and severity of AS is influenced by HLA-B*27. Trend toward higher severity markers in B*2705 and B*2702 versus other polymorphisms might be subject of interest for evaluation in other ethnicities with concentration to other novel susceptibility genes co-inherited in each B*27 subtype.

  7. The effect of TNF-alpha blockers on psychometric measures in ankylosing spondylitis patients: a preliminary observation.

    Science.gov (United States)

    Arısoy, Ozden; Bes, Cemal; Cifci, Cigdem; Sercan, Mustafa; Soy, Mehmet

    2013-07-01

    There is a high co-morbidity between chronic inflammatory disorders and depression. Proinflammatory cytokines like TNF-α seem to play a central role in the pathogenesis of these disorders, and its neutralization provides a potent treatment for inflammatory disorders. Few studies showed that TNF-α blockers also caused an improvement in depressive symptoms associated with these chronic inflammatory disorders. To evaluate the effectiveness of TNF-α blockers on symptoms of ankylosing spondylitis (AS), depression, anxiety and quality of life, 9 AS patients resistant to classical therapy were enrolled and followed-up at 2nd and 6th weeks after a TNF-α blocker was started. Hamilton Depression and Anxiety Scales (HAM-D, HAM-A), Hospital Depression and Anxiety Questionnaire (HAD), Quality of Life Scale (SF36) and AS severity index (BASDAI) were applied to the patients at weeks 0, 2 and 6. ESR and CRP were evaluated to monitor biological disease activity. There was a significant reduction in HAM-D (p = 0.00), HAM-A (p = 0.00), HAD anxiety scores (p = 0.02) and a significant improvement in SF36 physical function (p = 0.00), physical role limitations (p = 0.00), bodily pain (p = 0.05), general health (p = 0.01), vitality (p = 0.03) and emotional role limitations (p = 0.00) subscales, BASDAI scores (p = 0.00), ESR (p = 0.00) and CRP (p = 0.00). Change in clinical disease activity (BASDAI) was not correlated with change in depression-anxiety scores, while change in biological disease activity (CRP) was correlated with change in depression-anxiety scores. TNFα blockers may have a potential antidepressant effect besides its anti-inflammatory effect that seems to be independent of its clinical effect.

  8. MRI findings of sacroiliitis in ankylosing spondylitis: roles of MPGR and delayed post-contrast T1-weighted images

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    Jeon, Eui Yong; Joo, Kyung Bin; Koo, Ja Hong; Moon, Won Jin; Hahm, Chang Kok; Kim, Tae Hwan; Kim, Seong Yoon [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-10-01

    For early diagnosis of sacroiliitis in spondyloarthropathy, the MRI findings of sacroiliitis, roles of MPGR(multiplanar Gradient Recalled Acquisition in Steady State), and delayed post-contrast T1-weighted images were evaluated. Twenty six patients with seronegative spondyloarthropathy(Probable clinical diagnosis of ankylosing spondylitis) were grouped as either less than radiographic grade 1(group A) or more than grade 2(group B). The MRI findings of both sacroiliac joints were evaluated in every patient, and predominant sites were determined. The two groups were then compared. In 17 patients, the number of enhancing panni seen on early and delayed post-contrast T1-weighted images was counted and compared between the two groups. Panni were found in all cases, and in both groups, predominant patterns of involvement were the lower and iliac aspects of the sacroiliac joints in both groups; in group A, the synovial joints and punctate pannus were predominantly involved, and in group B, the ligamentous joints as well as the synovial joints and linear pannus. In group B, More periarticular fat accumulation than periarticular osteitis was found. For the evaluation of changes in joint space, MPGR images were superior to spin echo images. For the delineation of enhancing pannus less than radiographic grade I, delayed post-contrast images were statistically superior to those which were early post-contrast. MRI can detect early sacroiliitic change according to the predominant sites of involvement, and deslyed post-contrast images play a role in the diagnosis of early sacroiliitis. MPGR imaging is good for the evaluation of joint space change.

  9. Validity aspects of erythrocyte sedimentation rate and C-reactive protein in ankylosing spondylitis: a literature review.

    Science.gov (United States)

    Ruof, J; Stucki, G

    1999-04-01

    The preliminary core set for endpoints in disease controlling antirheumatic therapy includes acute phase reactants. The objective of this clinically oriented literature review was to examine and compare the validity of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in ankylosing spondylitis (AS) clinical trials. A MEDLINE search was performed covering the years 1967 through April 1998. AS studies were identified and selected if they included ESR and/or CRP and either presented data about their relation with disease activity or were designed as longitudinal clinical trials. Additional studies were identified by scrutinizing references cited in the retrieved studies. The selected studies were examined for truth (association with disease activity), discriminative power (sensitivity to change and discrimination between active and inactive treatment in longitudinal clinical trials), and feasibility (e.g., applicability and costs) of ESR and CRP in AS. We identified 12 articles on the association of ESR and/or CRP with disease activity and 13 longitudinal clinical trials reporting ESR and/or CRP data. Although the applied definitions or disease activity proved very inhomogenous, there was some evidence that both acute phase reactants are correlated with disease activity. In terms of discriminative capacity the available data are inconclusive. Relevant feasibility aspects are general availability, technically simple measurement, and an advantage in the cost of ESR and central laboratory facilities for CRP. Acute phase reactants do not comprehensively represent the disease process in AS. Their worth in AS clinical trials is limited. Based on the currently existing data neither measure is clearly superior in terms of validity. When selecting an acute phase reactant, feasibility aspects may be most relevant in choice of measure.

  10. Treatment of 28 cases of ankylosing spondylitis with combination of Chinese traditional and western medicine%中西医结合治疗强直性脊柱炎28例

    Institute of Scientific and Technical Information of China (English)

    张二中

    2014-01-01

    通过对28例强直性脊柱炎运用中西医结合治疗后,取得较好疗效。%Based on 28 cases of ankylosing spondylitis treated by combination of Chinese traditional and western medicine, has a good curative effect.

  11. Clinical Observation on 37 Cases of Ankylosing Spondylitis Treated with Gubi No.1%骨痹Ⅰ号治疗强直性脊柱炎37例疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈涛; 李洁怡

    2003-01-01

    @@ 强直性脊柱炎(Ankylosing Spondylitis,简称AS),以前也有人称类风湿性脊柱炎或中枢性类风湿性关节炎,现已将其从类风湿性关节炎中分离出来,列为独立性疾病.

  12. Comparison of non-radiographic axial spondyloarthritis and ankylosing spondylitis patients - baseline characteristics, treatment adherence, and development of clinical variables during three years of anti-TNF therapy in clinical practice

    DEFF Research Database (Denmark)

    Wallman, Johan K; Kapetanovic, Meliha C; Petersson, Ingemar F

    2015-01-01

    BACKGROUND: The relationship between non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) is currently debated. Using observational data from the South Swedish Arthritis Treatment Group register, we thus aimed to compare clinical development and treatment adherence...

  13. Predictors of treatment response and drug continuation in 842 patients with ankylosing spondylitis treated with anti-tumour necrosis factor: results from 8 years' surveillance in the Danish nationwide DANBIO registry

    DEFF Research Database (Denmark)

    Glintborg, Bente; Østergaard, Mikkel; Krogh, Niels Steen;

    2010-01-01

    To use prospectively registered data from the Danish nationwide rheumatological database (DANBIO) to describe disease activity, clinical response, treatment duration and predictors of drug survival (ie, number of days individual patients maintained treatment) and clinical response among patients ...... with ankylosing spondylitis (AS) receiving their first treatment series with a tumour necrosis factor a (TNFa) inhibitor....

  14. Predictors of treatment response and drug continuation in 842 patients with ankylosing spondylitis treated with anti-tumour necrosis factor: results from 8 years' surveillance in the Danish nationwide DANBIO registry

    DEFF Research Database (Denmark)

    Glintborg, Bente; Østergaard, Mikkel; Krogh, Niels Steen;

    2010-01-01

    To use prospectively registered data from the Danish nationwide rheumatological database (DANBIO) to describe disease activity, clinical response, treatment duration and predictors of drug survival (ie, number of days individual patients maintained treatment) and clinical response among patients ...... with ankylosing spondylitis (AS) receiving their first treatment series with a tumour necrosis factor α (TNFα) inhibitor....

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

    Directory of Open Access Journals (Sweden)

    Lin-Fen Hsieh

    2014-01-01

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

  16. Genetic polymorphisms of stromal interaction molecule 1 associated with the erythrocyte sedimentation rate and C-reactive protein in HLA-B27 positive ankylosing spondylitis patients.

    Directory of Open Access Journals (Sweden)

    James Cheng-Chung Wei

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

  17. 强直性脊柱炎的治疗指南介绍%Guidelines and progress in the treatment of ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    于刚; 张江林

    2014-01-01

    Ankylosing spondylitis ( AS ) is a chronic inlfammatory and progressive disease with the spine and peripheral joints involved, which is the prototype of spondyloarthritis ( SPA ). Non-drug therapy, drug therapy and surgical treatment can be chosen for AS, among which drug therapy is considered as the most important one. Non-steroidal anti-inlfammatory drugs ( NSAIDs ), disease-modifying antirheumatic drugs ( DMARDs ), biological agents, corticosteroids and other drugs are used to treat AS. In order to standardize the treatment of AS, the European League against Rheumatism ( EULAR ) and the Assessments in Ankylosing Spondylitis International Society ( ASAS ) updated the recommendations for the management of AS in 2010, and the rheumatism branch of Chinese Medical Association also updated the guidelines for the evaluation and management of AS in the same year. The treatment principles, aims, non-drug therapy, drug therapy and surgical treatment of AS are updated in the 2 recommendations. The treatment of AS and SPA are summarized in this article based on the above guidelines and research in recent years.

  18. JARID1A, JMY, and PTGER4 polymorphisms are related to ankylosing spondylitis in Chinese Han patients: a case-control study.

    Directory of Open Access Journals (Sweden)

    Wei Chai

    Full Text Available Susceptibility to ankylosing spondylitis (AS is largely genetically determined. JARID1A, JMY and PTGER4 have recently been found to be associated with AS in patients of western European descent. We aim to examine the influence of JARID1A, JMY, and PTGER4 polymorphisms on the susceptibility to and the severity of ankylosing spondylitis in Chinese ethnic majority Han population. This work can lead the clinical doctors to intervene earlier. Blood samples were drawn from 396 AS patients and 404 unrelated healthy controls. Both the AS patients and the controls are Han Chinese. The AS patients are classified based on the severity of the disease. Thirteen tag single nucleotide polymorphisms (tagSNPs in JARID1A, JMY and PTGER4 are selected and genotyped. Frequencies of different genotypes and alleles are analyzed among the different severity AS patients and the controls. The rs2284336 SNP in JARID1A, the rs16876619 and rs16876657 SNPs in JMY are associated with susceptibility of AS. The rs11062357 SNP in JARID1A, the rs2607142 SNP in JMY and rs10440635 in PTGER4 are related to severity of AS. Haplotype analyses indicate PTGER4 is related to susceptibility to AS; JARID1A and JMY are related to severity of AS.

  19. Effects of Pilates, McKenzie and Heckscher training on disease activity, spinal motility and pulmonary function in patients with ankylosing spondylitis: a randomized controlled trial.

    Science.gov (United States)

    Roşu, Mihaela Oana; Ţopa, Ionuţ; Chirieac, Rodica; Ancuta, Codrina

    2014-03-01

    The optimal management of ankylosis spondylitis (AS) involves a combination of nonpharmacologic and pharmacologic treatment aiming to maximize health-related quality of life. The primary objective of our study was to demonstrate the benefits of an original multimodal exercise program combining Pilates, McKenzie and Heckscher techniques on pulmonary function in patients with AS, while secondary objectives were to demonstrate the benefits of the same program on function and disease activity. This is a randomized controlled study on ninety-six consecutive patients with AS (axial disease subset), assigned on a 1:1 rationale into two groups based on their participation in the Pilates, McKenzie and Heckscher (group I) or in the classical kinetic program (group II). The exercise program consisted of 50-min sessions performed 3 times weekly for 48 weeks. Standard assessments were done at week 0 and 48 and included pain, modified Schober test (mST) and finger-floor distance (FFD), chest expansion (CE) and vital capacity (VC), as well as disease activity Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional Bath Ankylosing Spondylitis Functional Index (BASFI) and metrology index Bath Ankylosing Spondylitis Metrology Index (BASMI). Groups were comparable at baseline; we demonstrated significant improvement between baseline and after 48 weeks of regular kinetic training for all AS-related parameters in both groups. However, significant improvement was found in pain, lumbar spine motility (mST, FFD), BASFI, BASDAI and BASMI in AS performing the specific multimodal exercise program at the end of study (p = 0.001). Although there were significant improvements in CE in both groups as compared to baseline (group I, p = 0.001; group II, p = 0.002), this parameter increased significantly only in group I (p = 0.001). VC measurements were not significantly changed at the end of the study (group I, p = 0.127; group II, p = 0.997), but we found significant differences

  20. Spondylitis Association of America

    Science.gov (United States)

    ... News Magazine, Brochures, and more... Latest News A Biosimilar Version of Enbrel Gains FDA Approval September Is ... FDA Advisory Committee Unanimously Recommends Approval of a Biosimilar Version of Humira (Adalimumab) for Ankylosing Spondylitis, Psoriatic ...

  1. Ankylosing spondylitis diagnosis in US patients with back pain: identifying providers involved and factors associated with rheumatology referral delay.

    Science.gov (United States)

    Deodhar, Atul; Mittal, Manish; Reilly, Patrick; Bao, Yanjun; Manthena, Shivaji; Anderson, Jaclyn; Joshi, Avani

    2016-07-01

    This study aimed to identify providers involved in diagnosing ankylosing spondylitis (AS) following back pain diagnosis in the USA and to identify factors leading to the delay in rheumatology referrals. The Truven Health MarketScan® US Commercial Database was searched for patients aged 18-64 years with back pain diagnosis in a non-rheumatology setting followed by AS diagnosis in any setting during January 2000-December 2012. Patients with a rheumatologist visit on or before AS diagnosis were considered referred. Cox regression was used to determine factors associated with referral time after adjusting for age, sex, comorbidities, physician specialty, drug therapy, and imaging procedures. Of 3336 patients included, 1244 (37 %) were referred to and diagnosed by rheumatologists; the others were diagnosed in primary care (25.7 %), chiropractic/physical therapy (7 %), orthopedic surgery (3.8 %), pain clinic (3.6 %), acute care (3.4 %), and other (19.2 %) settings. Median time from back pain diagnosis to rheumatology referral was 307 days and from first rheumatologist visit to AS diagnosis was 28 days. Referred patients were more likely to be younger (hazard ratio [HR] = 0.986; p HR = 1.15; p = 0.0163), diagnosed with uveitis (HR = 1.49; p = 0.0050), referred by primary care physicians (HR = 1.96; p HR = 1.55; p HR = 1.33; p HR = 1.40; p = 0.0036), and to have had spinal/pelvic X-ray prior to referral (HR = 1.28; p = 0.0003). During 2000-2012, most patients with AS were diagnosed outside of rheumatology practices. The delay before referral to rheumatology was 10 months; AS diagnosis generally followed within a month. Earlier referral of patients with AS signs and symptoms may lead to more timely diagnosis and appropriate treatment.

  2. Leishmaniose tegumentar em paciente com espondilite anquilosante utilizando adalimumabe Cutaneous leishmaniasis in a patient with ankylosing spondylitis using adalimumab

    Directory of Open Access Journals (Sweden)

    Kirla Wagner Poti Gomes

    2012-06-01

    Full Text Available A leishmaniose é uma antropozoonose causada por espécies de Leishmania e pode apresentar-se de diversas formas clínicas, dependendo da interação parasita-hospedeiro. O fator de necrose tumoral-α (TNF-α é uma citocina essencial para o controle de infecções, especialmente contra parasitas intracelulares como a Leishmania. A terapia anti-TNF-α tem importante papel no tratamento de doenças reumáticas, mas o uso desses antagonistas está relacionado ao aumento de infecções. Relatamos o primeiro caso de leishmaniose cutânea no Brasil em uma paciente portadora de espondilite anquilosante em uso de adalimumabe e metotrexato. Acreditamos que neste caso não houve relação entre o uso de anti-TNF-α e a leishmaniose cutânea, pois a doença estava limitada a apenas uma úlcera, que cicatrizou completamente após o tratamento. Mais estudos, entretanto, são necessários para entender melhor a possível associação entre agentes anti-TNF-α e leishmaniose.Leishmaniasis is an anthropozoonosis caused by species of Leishmania and can have different clinical presentations, depending on the parasite-host relationship. Tumor necrosis factor-α (TNF-α is a cytokine essential to infection control, especially against intracellular parasites such as Leishmania. Anti-TNF-α strategies have had a marked impact on the treatment of rheumatic diseases, but the clinical use of those antagonists has been accompanied by an increased report of infections. We report the first case of cutaneous leishmaniasis in a patient with ankylosing spondylitis treated with adalimumab and methotrexate in Brazil. We believe that, in this case, there was no association between the anti-TNF-α treatment and cutaneous leishmaniasis, because the disease was limited to only one ulcer that healed completely after treatment. More studies, however, are necessary to better understand the possible relationship between anti-TNF-α agents and leishmaniasis.

  3. Height and weight are correlated with lumbar spinal bone mineral contents and densities in Chinese adolescents with early ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    MA Xing; HU Yun-yu; MA Xiang-dong; WANG Quan-ping; LI Xiao-juan; LU Rong; WANG Jun; XU Xin-zhi

    2004-01-01

    Objective: To explore the possible factors influencing lumbar spinal bone mineral contents and bone mineral densities in Chinese adolescents with early ankylosing spondylitis(AS). Methods: Thirty-one male Chinese adolescent outpatients with early AS were included and compared with 31 age-matched male controls. Age (year), height (cm), total body weight (kg) together with body mass index (BMI, kg/m2 ) of all subjects and disease duration (month), BASMI,BASFI, BASDAI, SASSS as well as ESR (mm/h) of AS patients were obtained. Lumbar2-4 bone mineral content (L2-4BMC, g) and lumbar2-4 areal bone mineral density (L2-4 BMD, g/cm2 ) were evaluated using dual-energy X-ray absorptiometry (DEXA) with Lunar DPX-IQ device and lumbar2-4 volumetric bone mineral apparent density (L2-4 BMAD, g/cm3 )was subsequently calculated. Correlation and multiple regression analyses were performed. Results: Compared with 31 agematched male controls, AS patients had significantly lower L2-4 BMD [ (0. 984 ± 0.142) g/cm2 vs ( 1.055 ± 0. 137) g/cm2,P = 0.049 ] and L2- 4 BMAD [ (0. 1527 ± 0. 0173) g/cm3 vs (0. 1630 ± 0. 0195) g/cm3, P = 0. 032 ]. In AS patients,multiple regression analysis identified that only the factor of height was significantly correlated with L2- 4 BMC ( R = 0. 673,P = 0.000) and the factor of weight had predominant influences on L2-4 BMD ( R = 0. 620, P = 0. 000) as well as L2-4BMAD (R=0.510, P = 0.003). Conclusion: The young patients with early AS had marked reduction in lumbar spine bone mineral densities, which indicated an important primary event leading to osteoporosis. Positive effects of height and weight on lumbar spine bone mass and densities could expectantly make favorable contributions to early prevention of AS associated bone loss and subsequent osteoporosis.

  4. Association Between Dentin Matrix Protein 1 (rs10019009) Polymorphism and Ankylosing Spondylitis in a Chinese Han Population from Shandong Province

    Institute of Scientific and Technical Information of China (English)

    Jian-Min Liu; Ya-Zhou Cui; Geng-Lin Zhang; Xiao-Yan Zhou; Jing-Xiang Pang; Xue-Zheng Wang; Jin-Xiang Han

    2016-01-01

    Background:Ankylosing spondylitis (AS) is the most common rheumatic condition that is slowly progressive and predominantly affects adolescents.Pathological bone formation associated with AS is an important cause of disability.The aim of the study was to investigate the possible involvement of the genes related to endochondral ossification and ectopia ossification in genetic susceptibility to AS in a