What are axial spondyloarthritis and ankylosing spondylitis?

2016 ◽  
Author(s):  
Stefan Siebert ◽  
Sengupta Raj ◽  
Alexander Tsoukas
Keyword(s):  
Ankylosing Spondylitis ◽  
Inflammatory Arthritis ◽  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Negative Impact ◽  
Sacroiliac Joints ◽  
Chronic Inflammatory Arthritis ◽  
The Past ◽  
Assessment And Treatment

Ankylosing spondylitis (AS) is a chronic inflammatory arthritis affecting mainly the sacroiliac joints and spine, resulting in pain, stiffness, and reduced movement. AS has a major negative impact on patients’ quality of life. AS is part of a larger group of related spondyloarthritis (SpA) conditions and patients with AS often have extra-articular manifestations of these conditions. Over the past decade, there have been major advances in the understanding of the genetics and pathophysiology of the disease. Advances in imaging have allowed patients to be diagnosed without having to develop the radiographic structural damage that characterize AS, resulting in the concept of axial spondyloarthritis (axSpA). Together with the development of highly effective TNF inhibitors, these advances have transformed the management and outlook of patients with this condition. It is hoped that further advances in diagnosis, assessment and treatment of axSpA will lead to further progress in future.

scholarly journals INTERLEUKIN (IL) 12, IL-23 AND IL-23 RECEPTOR IN ANKYLOSING SPONDYLITIS PATHOPHYSIOLOGY

2015 ◽  
Vol 24 (1) ◽  
pp. 5-13
Author(s):  
Marius Cherciu ◽  
◽  
Laura Ioana Cherciu ◽  
Mihai Bojinca ◽  
Teodora Serban ◽  
...  
Keyword(s):  
T Cells ◽  
Ankylosing Spondylitis ◽  
Inflammatory Arthritis ◽  
Serum Levels ◽  
Nucleotide Polymorphisms ◽  
Sacroiliac Joints ◽  
Single Nucleotide ◽  
Chronic Inflammatory Arthritis ◽  
Point Of Interest

Ankylosing spondylitis (AS) is a chronic inflammatory arthritis which involves mainly the spine and the sacroiliac joints, but also the peripheral joints and non-articular structures. IL-12 and IL-23 are heterodimeric cytokines sharing a common p40 subunit. Studies showed than IL-12 is essential for Th1 differentiation while IL-23 promotes a particular subset of T cells characterized by IL-17 production, called Th17. Since the association of IL-23R with AS was reported, the scientific interest has focused on identifying new single nucleotide polymorphisms (SNPs), present in the coding genes for IL-12/IL-23 subunits and their receptors, that increase the susceptibility for AS. Another point of interest for researchers was to investigate if the identified gene variants modify the gene expression of the respective interleukins and/or their receptors, whether that refers to their mRNA expression, their serum levels or the expression of the receptors on the surface of T cells. Given the increasing amount of data that suggests the pivotal role of the IL-23/Th17 axis in AS pathophysiology, new promising therapies, designed to interfere with these pathways, are now in development.

scholarly journals SCIENTIFIC AND METHODOLOGICAL ASPECTS AND PRACTICAL EXPERIENCE FOR THE FORMATION OF THE EVIDENTIAL BASE OF HAZARD TO HEALTH IN THE POPULATION IN THE ZONE OF INFLUENCE OF WASTE FROM THE PAST ECONOMIC ACTIVITY

2019 ◽  
Vol 96 (11) ◽  
pp. 1038-1044 ◽  
Author(s):  
N. V. Zaitseva ◽  
Irina V. May ◽  
S. V. Klein ◽  
S. S. Khankharev ◽  
A. A. Boloshinova
Keyword(s):  
Heavy Metals ◽  
Drinking Water ◽  
Negative Impact ◽  
Health Hazard ◽  
Harmful Effect ◽  
Morbidity Rate ◽  
Atmospheric Air ◽  
The Past ◽  
Zone Of Influence

There are described an algorithm and methods for collecting the evidential base for causing hazard to the health of the population of Zakamensk (the Republic of Buryatia) in the zone of influence of the waste of the past activities of the Dzhidinsky tungsten-molybdenum combine. The source of danger is lying sands, containing a complex of toxic heavy metals - lead, cadmium, manganese, nickel, chromium, etc. The algorithm for the formation of the evidential base included: a general analysis of the sanitary and hygienic situation; assessment in the dynamics of the quality of atmospheric air, drinking water, soil, food; assessment of the risk to the health of the population; epidemiological studies; in-depth clinical surveys of a representative group of city residents (280 people). In the blood of the examinees, heavy metals were identified as biological markers of the exposure. There was evaluated a complex of the response (effect) adequate to effects of laboratory markers. By methods of mathematical statistics there was established the presence of reliable relationships in the system “source of hazard - the quality of the environment - exposure to risk factors - health status.” The hazard to the health of a citizen, due to the negative impact of the factor, was considered to be proven if it was possible to build a continuous step-by-step logical chain of relationships between the source of the harmful effect, the quality of the habitat and the establishment of the fact of the disease. The quality of the habitat of the population of Zakamensk was shown to give rise in unacceptable risks to the health of residents. The main influencing factor is the pollution of atmospheric air, local food products and drinking water from public and private wells. Risks are realized in terms of a level of the primary morbidity rate of the population of the respiratory diseases, endocrine system, digestive organs that is relatively high compared to the matched area. The relationship between health hazard and environmental factors has been fully proved in 14% of the surveyed persons. At the same time, the territory was shown not be characterized as a zone of “ecological disaster” or “an emergency environmental situation”.

Axial Spondyloarthritis and New Bone Formation

2021 ◽  
Vol 30 (04) ◽  
pp. 311-318
Author(s):  
Uta Syrbe
Keyword(s):  
Bone Formation ◽  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Clinical Symptoms ◽  
Research Work ◽  
New Bone Formation ◽  
Sacroiliac Joints ◽  
Spine Mobility ◽  
Vertebral Bodies ◽  
Inflammatory Changes

AbstractAxial spondyloarthritis is an inflammatory disease of the axial skeleton. Its pathogenesis is only partly understood. At the beginning, there are inflammatory changes in the sacroiliac joints which are followed by inflammation in vertebral bodies and in facet joints. Low back pain occurring in the morning hours is the dominant clinical symptom. In the early phase, inflammatory changes are detectably by MRI. Inflammation promotes a process of joint remodelling in the sacroiliac joints which leads to erosions, sclerosis and bony bridging, i. e. ankylosis, which are detectable by X-ray. In the spine, vertical osteophytes developing at sites of previous inflammation connect vertebral bodies as syndesmophytes. Additional ossification of longitudinal ligaments contributes to the so-called bamboo spine. Ossification of the spine promotes fixation of a severe kyphosis of the thoracic spine which strongly impairs spine mobility and quality of life. High disease activity seems a prominent risk factor for development of structural damage. However, although NSAIDs improve clinical symptoms, they do not reduce new bone formation. In contrast, TNFα and IL-17 inhibitors seem to retard new bone formation apart from their clinical efficacy. Research work of the last years identified immunological pathways of inflammation. However, the trigger and cellular components of the immune reaction in the bone marrow are still poorly defined. Osteoclasts are involved in the destruction of the subchondral bone, while osteoblasts facilitate new bone formation and cartilage ossification. This review gives an overview about diagnostics and therapy of axSpA and about risk factors for the development of structural damage. Concepts about the immune pathogenesis and joint remodeling in AS are given under recognition of genetic and histopathological studies.

An Integrative Approach to the Assessment and Treatment of Inflammatory Conditions

2017 ◽  
Author(s):  
Mark Liponis ◽  
Bettina Martin
Keyword(s):  
Integrative Approach ◽  
The Past ◽  
Inflammatory Conditions ◽  
Improved Outcomes ◽  
Targeted Treatments ◽  
Great Progress ◽  
Assessment And Treatment ◽  
The Many ◽  
Made In

The past two decades have seen great progress in recognizing the importance of inflammation in medicine. Increased focus on inflammation in both prevention and treatment has improved outcomes and quality of life in chronic diseases. Science has improved our understanding of inflammation’s many causes and effects on health, and many advances have been made in the availability of targeted therapeutic options for treating inflammation. This chapter gives an overview of recognizing the many causes of inflammation, its many targeted treatments strategies, and the questions that still surround it. It discusses several integrative approaches to reducing inflammation, including exercise, diet, and different strategies for managing sleep, mood, and stress, such as meditation and massage.

scholarly journals Validation of the Ankylosing Spondylitis Quality of Life assessment tool in patients with non-radiographic axial spondyloarthritis

2020 ◽  
Author(s):  
Bengt Hoepken ◽  
Daniel Serrano ◽  
Kristina Harris ◽  
Mark C. Hwang ◽  
John Reveille
Keyword(s):  
Quality Of Life ◽  
Ankylosing Spondylitis ◽  
Outcome Measure ◽  
Axial Spondyloarthritis ◽  
Test Theory ◽  
Life Assessment ◽  
Cumulative Distribution ◽  
Phase Iii ◽  
Meaningful Change

Abstract Purpose To evaluate the psychometric performance of the Ankylosing Spondylitis Quality of Life (ASQoL) scale in patients with non-radiographic axial spondyloarthritis (nr-axSpA) to assess its appropriateness as an outcome measure in future clinical studies. Methods Patients with active axSpA from a Phase III, randomized, double-blind, placebo-controlled trial (RAPID-axSpA, NCT01087762) were included (N = 325). Modified New York (mNY) classification criteria were used to classify patients as having ankylosing spondylitis or nr-axSpA; those with nr-axSpA were further categorized based on objective signs of inflammation. Psychometric properties of the ASQoL were assessed/documented using a mixture of modern psychometric methods and classical test theory methods. These included exploratory factor analysis and item response theory models to assess the domain structure, test the utility of a single domain relative to subdomains, assess bias, and generate statistics to guide an empirical scoring algorithm. The reliability and validity of scores were evaluated via internal consistency, test–retest reliability, concurrent validity, and known-groups validity. Score responsiveness was assessed via anchor-based clinically meaningful change, supplemented with empirical cumulative distribution function visualizations. Results The ASQoL data were defined by four domains. However, a four-domain solution was found to be inferior to a bifactor solution in which the four domains were included within a total domain. Scoring statistics supported a unit-weighted total score. Within the nr-axSpA population with objective signs of inflammation, the ASQoL mean score had adequate reliability, validity, and ability to detect clinically meaningful change. Conclusions Our findings suggest that the ASQoL is an appropriate outcome measure in interventional clinical trials in patients with nr-axSpA.

scholarly journals Characteristics and burden of disease in patients with radiographic and non-radiographic axial Spondyloarthritis: a comparison by systematic literature review and meta-analysis

RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e001108 ◽  
Author(s):  
Clementina López-Medina ◽  
Sofia Ramiro ◽  
Desirée van der Heijde ◽  
Joachim Sieper ◽  
Maxime Dougados ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ankylosing Spondylitis ◽  
Treatment Effect ◽  
Burden Of Disease ◽  
Clinical Presentation ◽  
Axial Spondyloarthritis ◽  
Pooled Analysis ◽  
Treatment Modalities ◽  
Disease Treatment

ObjectivesTo compare the clinical characteristics, burden of disease (eg, disease activity, function, quality of life), treatment modalities and treatment effect in patients with radiographic and non-radiographic axial Spondyloarthritis (r-axSpA and nr-axSpA).MethodsA systematic literature review (2009–2018) was performed using the participants, intervention, comparator and outcomes methodology. Studies reporting outcomes (clinical presentation, burden of disease, treatment modalities and treatment effect) of both r-axSpA and nr-axSpA were included. A pooled analysis was performed (standardised means difference and relative risk for continuous and binary variables, respectively) and random or fixed effects methods were used depending on the heterogeneity of the studies.Results60 studies out of 787 references were included. Pooled analysis showed that, compared with patients with nr-axSpA, patients with r-axSpA were more frequently men (69.6% vs 53.6%), smokers (37.7% vs 31.1%) and had higher mean disease duration (8.6 vs 5.0 years) and longer time to diagnosis (6.1 vs 4.2 years). Peripheral manifestations were more prevalent in nr-axSpA, while uveitis and structural damage on MRI of the sacroiliac joints were more prevalent in r-axSpA. C-reactive protein and the Bath Ankylosing Spondylitis Mobility Index were higher in r-axSpA, while Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index and Ankylosing Spondylitis Quality of Life were similar in both groups. No significant differences were found with regard to treatment effect.ConclusionsPatients with r-axSpA and nr-axSpA share a similar clinical presentation except for peripheral involvement, which is more prevalent among nr-axSpA. Except for a more impaired mobility in r-axSpA, both groups showed a comparable burden of disease, treatment modalities and treatment effect.

scholarly journals Predictors of Assessment of Spondyloarthritis International Society (ASAS) Health Index in Axial Spondyloarthritis and Comparison of ASAS Health Index between Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Data from the Catholic Axial Spondyloarthritis COhort (CASCO)

2019 ◽  
Vol 8 (4) ◽  
pp. 467 ◽  
Author(s):  
Hong Ki Min ◽  
Jennifer Lee ◽  
Ji Hyeon Ju ◽  
Sung-Hwan Park ◽  
Seung-Ki Kwok
Keyword(s):  
Regression Analysis ◽  
Health Status ◽  
Ankylosing Spondylitis ◽  
Alcohol Consumption ◽  
International Society ◽  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Economic Status ◽  
Linear Regression Analysis ◽  
Health Index

The Assessment of Spondyloarthritis International Society (ASAS) health index (HI) is a novel tool for approaching disability, health, and functioning in spondyloarthritis (SpA). In the present study we compared ASAS HI between patients with ankylosing spondylitis (AS) and those with nonradiographic axial SpA (nr-axSpA). In addition, we identified predictors of ASAS HI. We designed this cross-sectional study using data from the Catholic Axial Spondyloarthritis COhort (CASCO), a prospective cohort from a single tertiary hospital. We compared baseline characteristics, including ASAS HI, between AS and nr-axSpA, and determined the frequency of each item constituting the ASAS HI. We used linear regression analysis to identify factors associated with ASAS HI. Total of 357 patients with axSpA—261 with AS and 96 with nr-axSpA—were included in analysis. AS patients were older and had higher ASAS HI than nr-axSpA. Among ASAS HI items, pain (item No. 1) and energy/drive (item No. 5) were the most common areas for which axSpA patients experienced discomfort. ASAS HI correlated with other SpA-related parameters such as BASDAI, ASDAS, and BASFI. Multivariable regression analysis of the axSpA group showed that high NSAID intake and mSASSS were positively associated with ASAS HI, whereas higher economic status and alcohol consumption were negatively associated with ASAS HI. Results were consistent in the AS group on subgroup analysis, whereas alcohol consumption was the only factor significantly associated with ASAS HI in the nr-axSpA group. In the present cohort study, patients with AS had poorer health status (higher ASAS HI) than those with nr-axSpA. Items proposed by AS patients (items No. 1 and 5) were the most frequently checked areas as axSpA patients feel discomfort, and this support that ASAS HI could practically assess actual discomfort of axSpA patient. ASAS HI was well correlated with known disease parameters, including activity, function, and quality of life; therefore, ASAS HI could be used in the future to represent the health status of SpA in a systematic way. Spinal structural damage (higher mSASSS), high NSAID intake, alcohol consumption, and economic status were predictors of ASAS HI in patients with axSpA, especially those with AS.

scholarly journals Sexual Quality of Life in Patients with Axial Spondyloarthritis in the Biologic Treatment Era

2019 ◽  
Vol 46 (9) ◽  
pp. 1075-1083 ◽  
Author(s):  
Kari Hansen Berg ◽  
Gudrun Elin Rohde ◽  
Anne Prøven ◽  
Esben Esther Pirelli Benestad ◽  
Monika Østensen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Activity Index ◽  
Statistical Tests ◽  
Linear Regression Analysis ◽  
Biologic Treatment ◽  
Sexual Quality Of Life

Objective.To examine the relationship between demographics, disease-related variables, treatment, and sexual quality of life (SQOL) in men and women with axial spondyloarthritis (axSpA).Methods.AxSpA patients were consecutively recruited from 2 rheumatology outpatient clinics in southern Norway. A broad spectrum of demographics, disease, treatment, and QOL data were systematically collected. SQOL was assessed using the SQOL-Female (SQOL-F) questionnaire (score range 18–108). Appropriate statistical tests were applied for group comparison, and the association between independent variables and SQOL-F was examined using multiple linear regression analysis.Results.A total of 360 (240 men, 120 women) axSpA patients with mean age 45.5 years and disease duration 13.9 years were included. Seventy-eight percent were married/cohabiting, 26.7% were current smokers, 71.0% were employed, 86.0% performed > 1-h exercise per week, and 88.0% were HLA-B27–positive. Mean (SD) values for disease measures were C-reactive protein (CRP) 8.5 (12.1) mg/l, Bath Ankylosing Spondylitis Disease Activity Index 3.1 (2.1), Bath Ankylosing Spondylitis Global Score (BAS-G) 3.8 (2.5), Bath Ankylosing Spondylitis Functional Index 2.7 (2.2), and Health Assessment Questionnaire 0.6 (0.5). The proportion of patients using nonsteroidal antiinflammatory drugs was 44.0%, synthetic disease-modifying antirheumatic drugs (DMARD) 5.0%, and biologic DMARD 24.0%. Mean (SD) total sum score for SQOL was 76.6 (11.3). In multivariate analysis, female sex, increased body mass index, measures reflecting disease activity (BAS-G and CRP), and current biologic treatment were independently associated with a lower SQOL.Conclusion.Our data suggest that inflammation in patients with axSpA even in the biologic treatment era reduces SQOL.

Sign in / Sign up

Export Citation Format

Share Document