scholarly journals Sacroiliac radiographic progression in recent onset axial spondyloarthritis: the 5-year data of the DESIR cohort

2017 ◽  
Vol 76 (11) ◽  
pp. 1823-1828 ◽  
Author(s):  
Maxime Dougados ◽  
Alexandre Sepriano ◽  
Anna Molto ◽  
Miranda van Lunteren ◽  
Sofia Ramiro ◽  
...  
Keyword(s):  
New York ◽  
Structural Damage ◽  
Radiographic Progression ◽  
Axial Spondyloarthritis ◽  
Human Leukocyte ◽  
Hla B27 ◽  
Recent Onset ◽  
Leukocyte Antigen ◽  
Radiographic Changes ◽  
Generalised Estimating Equations

ObjectiveTo estimate sacroiliac joint radiographic (X-SIJ) progression in patients with axial spondyloarthritis (axSpA) and to evaluate the effects of inflammation on MRI (MRI-SIJ) on X-SIJ progression.MethodsX-SIJ and MRI-SIJ at baseline and after 2 and 5 years in patients with recent onset axSpA from the DESIR cohort were scored by three central readers. Progression was defined as (1) the shift from non-radiographic (nr) to radiographic (r) sacroiliitis (by modified New York (mNY) criteria) or alternative criteria, (2) a change of at least one grade or (3) a change of at least one grade but ignoring a change from grade 0 to 1. The effects of baseline inflammation on MRI-SIJ on 5-year X-SIJ damage (mNY) were tested by generalised estimating equations.ResultsIn 416 patients with pairs of baseline and 5-year X-SIJ present, net progression occurred in 5.1% (1), 13.0% (2) and 10.3% (3) respectively, regarding a shift from nr-axSpA to r-axSpA (1), a change of at least one grade (2) or a change of at least one grade but ignoring a change from grade 0 to 1 (3). Baseline MRI-SIJ predicted structural damage after 5 years in human leukocyte antigen-B27 (HLA-B27) positive (OR 5.39 (95% CI 3.25 to 8.94)) and in HLA-B27 negative (OR 2.16 (95% CI 1.04 to 4.51)) patients.ConclusionsFive-year progression of X-SIJ damage in patients with recent onset axSpA is limited but present beyond measurement error. Baseline MRI-SIJ inflammation drives 5-year radiographic changes.

Epidemiology of axial spondyloarthritis

2016 ◽  
Author(s):  
Lianne Gensler ◽  
Michael Weisman ◽  
Liron Caplan
Keyword(s):  
External Validity ◽  
Inflammatory Arthritis ◽  
Axial Spondyloarthritis ◽  
Strong Association ◽  
Human Leukocyte ◽  
Epidemiological Studies ◽  
Hla B27 ◽  
Sacroiliac Joints ◽  
Leukocyte Antigen ◽  
Inflammatory Bowel

Axial spondyloarthritis (axSpA) is an inflammatory arthritis of the sacroiliac joints and spine. The prototype is ankylosing spondylitis, the radiographic form of the disease; however, more recently, an earlier or less-differentiated presentation has been described termed non-radiographic axial spondyloarthritis (nr-axSpA). Extra-articular manifestations commonly include anterior uveitis, inflammatory bowel disease, and psoriasis. There is a strong association with the human leukocyte antigen B27 (HLA-B27) allele, and the prevalence of the disease tends to follow the frequency of the allele. Epidemiological studies in axSpA are relevant in the population studied and therefore have limited external validity. This chapter describes the epidemiology of axSpA.

Top-Ten Tips for Effective Imaging of Axial Spondyloarthritis

2019 ◽  
Vol 23 (04) ◽  
pp. 376-391
Author(s):  
Monique Reijnierse ◽  
Iris Eshed ◽  
Floris van Gaalen
Keyword(s):  
Early Diagnosis ◽  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Human Leukocyte ◽  
Sacroiliac Joints ◽  
Leukocyte Antigen ◽  
Treatment Regimens ◽  
Current Review ◽  
Chronic Inflammatory Condition ◽  
New Treatment

AbstractAxial spondyloarthritis (axSpA) is a chronic inflammatory condition that encompasses ankylosing spondylitis as well as nonradiographic axSpA and can lead to chronic pain, structural damage, and disability. The disease is strongly associated with the presence of human leukocyte antigen-B27. Early diagnosis of axSpA is significant due to new treatment regimens leading to reduction of inflammation and potentially delaying disease progression. Imaging of the sacroiliac joints and the spine plays an important role in the early diagnosis of spondyloarthritis. In the current review, the top-ten tips for the effective imaging of axSpA are presented to help both radiologists and rheumatologists in using imaging properly and effectively in their clinical practice.

Spinal Radiographic Progression and Predictors of Progression in Patients With Radiographic Axial Spondyloarthritis Receiving Ixekizumab Over 2 Years

2021 ◽  
pp. jrheum.210471
Author(s):  
Désirée van der Heijde ◽  
Mikkel Østergaard ◽  
John D. Reveille ◽  
Xenofon Baraliakos ◽  
Andris Kronbergs ◽  
...  
Keyword(s):  
Radiographic Progression ◽  
Axial Spondyloarthritis ◽  
Hla B27 ◽  
Link Type ◽  
Long Term Effect ◽  
Structural Progression ◽  
Measuring Change ◽  
Treatment Predictors ◽  
Radiographic Changes

Objective To evaluate the long-term effect of ixekizumab on radiographic changes in the spine in patients with radiographic axial spondyloarthritis (r-axSpA) by measuring change from baseline through 2 years in modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) and to identify potential predictors of progression. Methods This study evaluates patients from COAST-V (NCT02696785, bDMARD-naive) and COAST-W (NCT02696798, TNFi-experienced) who had mSASSS data at baseline in the originating studies and 108 weeks after baseline in the extension study COAST-Y (NCT03129100). We examined the proportion of patients who did not have spinal radiographic progression through 2 years (108 weeks) of treatment with ixekizumab (80 mg every 2 or 4 weeks) and the change from baseline to year 2 in mSASSS. Potential predictors of spinal radiographic progression were also evaluated. Results Among patients with evaluable radiographs who were originally assigned to ixekizumab (N=230), mean (SD) change in mSASSS from baseline at year 2 was 0.3 (1.8). The proportion of non-progressors over 2 years was 89.6% if defined as mSASSS change from baseline <2 and 75.7% if defined as mSASSS change from baseline ≤0. Predictors of structural progression at year 2 (mSASSS change >0) were age ≥40, baseline syndesmophytes, HLA-B27 positivity and male gender. Week 52 inflammation in SPARCC spine was also a predictor of radiographic progression at year 2 in patients with MRI-data in COAST-V (N=109). Conclusion The majority of patients with r-axSpA receiving ixekizumab had no radiographic progression in the spine through 2 years of treatment. Predictors were generally consistent with previous studies.

scholarly journals Prevalence of HLA-B27 in Patients with Ankylosing Spondylitis in Qatar

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
M. H. Abdelrahman ◽  
S. Mahdy ◽  
I. A. Khanjar ◽  
A. M. Siam ◽  
H. A. Malallah ◽  
...  
Keyword(s):  
New York ◽  
Major Histocompatibility Complex ◽  
Ankylosing Spondylitis ◽  
Human Leukocyte Antigen ◽  
Human Leukocyte ◽  
Hla B27 ◽  
Cross Sectional ◽  
Leukocyte Antigen ◽  
Histocompatibility Complex ◽  
Class 1

Background and Objectives. The human leukocyte antigen HLA-B27 is a class 1 antigen of the major histocompatibility complex and is strongly associated with ankylosing spondylitis (AS). The purpose of the present study is to investigate the distribution of HLA-B27 in patients with AS of different ethnic groups in Qatar.Design and Setting. Study design was cross-sectional and the setting was rheumatology clinics of Hamad General Hospital in Qatar where most of ankylosing spondylitis patients are followed up.Patients and Methods. Patients with diagnosis of AS who met the New York modified criteria for AS were tested for HLA-B27. 119 patients were tested for HLA-B27: 66 Arabs, 52 Asians (Indians, Pakistanis, Bengalis, and Iranians), and one Western (Irish).Results. Of all the individuals, 82 were positive (69%) for HLA-B27. Among the Arabs, 49/66 were positive (74%). Among the Asians, 32/52 were positive (61%). Furthermore, Qatari patients (10 males and one female) 9 were positive (82%), 14/19 Jordanians/Palestinians were positive, and 9/10 (90%) Egyptians were positive. Among the Asians, 19/26 Indians were positive (73%), which was similar to the Arabs.Conclusion. HLA-B27 in our small group of Arabs is present in 74%. Comparison with other data will be presented in detail.

scholarly journals A Nationwide Questionnaire Survey on the Prevalence of Ankylosing Spondylitis and Non-Radiographic Axial Spondyloarthritis in Japan

2021 ◽  
Author(s):  
Yuri Matsubara ◽  
Yosikazu Nakamura ◽  
Naoto Tamura ◽  
Hideto Kameda ◽  
Kotaro Otomo ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Clinical Features ◽  
Axial Spondyloarthritis ◽  
Age Of Onset ◽  
Human Leukocyte ◽  
Hla B27 ◽  
Lower Prevalence ◽  
Nationwide Study ◽  
Leukocyte Antigen ◽  
Positive Rate

Abstract Objective This nationwide study aimed to reveal the prevalence of ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-ax SpA), and the positive rate of human leukocyte antigen (HLA) among these patients in Japan. Methods The first survey was conducted in 2221 randomly selected facilities (26.3%) in September, 2018, where the patients with AS/nr-ax SpA were taken care of from January to December, 2017. We estimated the total number of these patients using response and extraction rate. A second survey was conducted in 117 facilities (49.8%) to assess for HLA-B 27 positivity rate and clinical features. Results The estimated total number of the patients with AS and nr-ax SpA were 3200 (95% confidence interval [CI]: 2400–3900) and 800 (530–1100), suggesting that the prevalence of AS and nr-ax SpA in general population were 2.6/100,000 (0.0026%) and 0.6/100,000 (0.0006%), respectively. Although 55.5 % (76/137) of patients with AS were HLA-B27 positive, those whose age of onset was estimated to be over 50 years tended to undergo less HLA-B27 testing. Conclusion This study revealed the lower prevalence of AS/nr-ax SpA in Japan, compared to those in other countries. Further studies are required to reveal the association of HLA-B27 with the clinical features.

scholarly journals 1267Prevalence and HLA-B27 Positivity Rate among Patients with Ankylosing Spondylitis/Non-Radiographic Axial Spondyloarthritis in Japan

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Yuri Matsubara ◽  
Yosikazu Nakamura ◽  
Tetsuya Tomita
Keyword(s):  
Ankylosing Spondylitis ◽  
Axial Spondyloarthritis ◽  
Age Of Onset ◽  
Human Leukocyte ◽  
Nationwide Survey ◽  
Hla B27 ◽  
Sacroiliac Joints ◽  
Radiographic Findings ◽  
Leukocyte Antigen ◽  
To Receive

Abstract Background Ankylosing spondylitis (AS) causes severe chronic inflammation of the spine and sacroiliac joints, leading to severe physical dysfunctions. Non-radiographic axial spondyloarthritis (nr-ax SpA) is a newly categorized disease in SpA that shows SpA without definite radiographic findings in sacroiliac joint. Although human leukocyte antigen (HLA) positivity is related to these diseases, little is known about the prevalence of these diseases and HLA-B27 positivity in Japan. Methods A nationwide survey was conducted from January to December 2017. 2221/8456 facilities (26.3%) were selected randomly as a target sample, comprising all three departments: orthopedics, pediatrics, and rheumatology. We estimated the number of these patients by using response and extraction rate, and calculated the HLA-B27 positivity rate. Results We estimated the prevalence of AS and nr-ax SpA as 2.6/100,000 (0.0026%) and 0.6/100,000 (0.0006%), respectively. HLA-B27 test was performed in 60% of patients with AS, of which 55.5% being HLA-B27 positive; however, they were less likely to receive HLA-B27 test if their estimated age of onset was over 50 years. Conclusions The prevalence in AS and nr-ax SpA and their HLA-B27 positivity rate in Japan were lower compared to other countries. Further studies will be required to reveal the association between HLA-B27 and the clinical features. Key messages The prevalence of AS and nr-ax SpA in Japan are estimated to be 2.6/100,000 (0.0026%) and 0.6/100,000 (0.0006%), respectively, and are lower than those in other countries. In addition, HLA-B27 positivity rate was lower.

scholarly journals Evaluation of the change in structural radiographic sacroiliac joint damage after 2 years of etanercept therapy (EMBARK trial) in comparison to a contemporary control cohort (DESIR cohort) in recent onset axial spondyloarthritis

2017 ◽  
Vol 77 (2) ◽  
pp. 221-227 ◽  
Author(s):  
Maxime Dougados ◽  
Walter P Maksymowych ◽  
Robert B M Landewé ◽  
Anna Moltó ◽  
Pascal Claudepierre ◽  
...  
Keyword(s):  
New York ◽  
Sacroiliac Joint ◽  
Axial Spondyloarthritis ◽  
Joint Damage ◽  
Control Group ◽  
Progression Rate ◽  
Recent Onset ◽  
Link Type ◽  
Factor Therapy ◽  
Adjusted Least Squares

ObjectiveTo compare 2 years of radiographic sacroiliac joint (SIJ) changes in patients with recent onset axial spondyloarthritis (axSpA) receiving etanercept in a clinical trial (EMBARK) to similar patients not receiving biologics in a cohort study (DESIR).MethodsEndpoints were changes at week 104 per the modified New York (mNY) grading system in total SIJ score (primary endpoint) and net percentage of patients with progression defined three ways. Treatment effect was analysed with and without adjustment for baseline covariates.ResultsAt 104 weeks, total SIJ score improved in the etanercept group (n=154, adjusted least-squares mean change: –0.14) and worsened in the control group (n=182, change: 0.08). The adjusted difference between groups (etanercept minus control) was –0.22 (95% CI –0.38 to –0.06), p=0.008. The net percentage of patients with progression was significantly lower in the etanercept versus the control group for two of three binary endpoints: –1.9% versus 1.6% (adjusted difference for etanercept minus control: –4.7%,95% CI –9.9 to 0.5, p=0.07) for change in mNY criteria; –1.9% versus 7.8% (adjusted difference: –18.2%,95% CI –30.9 to –5.6, p=0.005) for change ≥1 grade in ≥1 SIJ; and –0.6% versus 6.7% (adjusted difference: –16.4%,95% CI –27.9 to –5.0, p=0.005) for change ≥1 grade in ≥1 SIJ, with shift from 0 to 1 or 1 to 0 considered no change.ConclusionDespite the slow radiographic SIJ progression rate over 2 years in axSpA, this study suggests a lower rate of progression in the SIJ with etanercept than without anti-tumour necrosis factor therapy.Trial registration numbersNCT01258738, NCT01648907; Post-results.

scholarly journals Evaluation of the performances of ‘typical’ imaging abnormalities of axial spondyloarthritis: results of the cross-sectional ILOS-DESIR study

RMD Open ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e000918 ◽  
Author(s):  
Anna Molto ◽  
Laure Gossec ◽  
Marie-Martine Lefèvre-Colau ◽  
Violaine Foltz ◽  
Romain Beaufort ◽  
...  
Keyword(s):  
New York ◽  
Chronic Back Pain ◽  
Axial Spondyloarthritis ◽  
Diagnostic Feature ◽  
Likelihood Ratios ◽  
Cross Sectional ◽  
Recent Onset ◽  
And Performance ◽  
And Gender ◽  
Sensitivity Specificity

ObjectiveTo evaluate the prevalence and performance as axial Spondyloarthritis (axSpA) diagnostic feature of radiographic and MRI lesions ‘typical’ of axSpA of the sacroiliac joint (SIJ) and spine in a mechanical chronic back pain (CBP) population and in an axSpA cohort.MethodsCross-sectional multicentre study. Patients: (1) recent onset axSpA (DESIR cohort) and (2) mechanical non-axSpA CBP matched for age and gender (ILOS study). Imaging: radiographs and MR scans were performed identically in both groups. All images were centrally read, blinded for diagnosis and for other imaging findings in the same patient. Statistical analysis: prevalence of lesions ‘typical of axSpA’ were compared in both groups. Sensitivity, specificity and positive likelihood ratios (LR+) of each lesion (and combination of lesions) were calculated.ResultsA total of 98 patients with CBP were included, and compared with 100 patients with recent onset axSpA. SIJ lesions were consistently more frequent in the axSpA group (35.0% vs 11.8% p<0.001, 35.0% vs 8.4% p<0.001% and 32.0% vs 10.0%. p<0.001 for modified New York criteria, MRI sacroiliitis and ≥3 erosions of the SIJ on MRI, respectively), and performed well (LR+ for ≥3 erosions 3.0 (95% CI 1.6 to 5.8)). Spine lesions were comparable across groups: radiographic lesions were rare, while all MRI lesions were frequent.ConclusionOur study confirms that ‘typical’ lesions can also be observed in patients with non-axSpA CBP but that SIJ lesions by all modalities remain the most valuable for diagnosis, including structural lesions of the SIJ. This suggests the potential interest of adding MRI SIJ structural lesions in the definition of MRI abnormalities for axSpA classification.

scholarly journals HLA-B27 antigen frequency among suspected Spondyloarthropathy patients attaining a tertiary level hospital of Bangladesh

2015 ◽  
Vol 40 (3) ◽  
pp. 102-106 ◽  
Author(s):  
A Nessa ◽  
S Tabassum ◽  
S Sultana
Keyword(s):  
Healthy Subjects ◽  
Age Groups ◽  
Human Leukocyte ◽  
Disease Association ◽  
Control Group ◽  
Hla B27 ◽  
Leukocyte Antigen ◽  
Male Preponderance ◽  
Antigen Frequency ◽  
Medical University

Human leukocyte antigen B27 (HLA-B27), a class I molecules of the major histocompatibility complex has a strong disease association with different types of spondarthropathies (SpA). The strength of this disease association varies markedly among racial and ethnic populations. The present study aimed to identify the HLA-B27 antigen frequencies among suspected SpA patients as well as healthy Bangladeshi individuals. The frequency of HLA-B27 was determined in 1500 patients and 1000 healthy subjects attending the Bangabandhu Sheikh Mujib Medical University (BSMMU). HLAB 27 typing was done by microlymphocytotoxicity test using commercial kit. A total of 738 (49.2%) suspected SpA patients and 107 (10.7%) healthy subjects tested positive for HLA-B27 antigen with higher frequency among younger age groups (54.9%, 52.4% and 56.2% in 0-14 years, 15-24 years and 25–34 years of age respectively). The male female positivity was almost same (11.4% and 9.6%) among control group, but in patient group it was 53.0% and 41.2% respectively. The findings of this hospital based study showed a high frequency of HLA-B27 among suspected SpA patients with male preponderance which is comparable with neighboring countries.Bangladesh Med Res Counc Bull 2014; 40 (3): 102-106

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