scholarly journals AB0512 CLINICAL AND RADIOLOGICAL FEATURES OF SHOULDER INVOLVEMENT IN SPONDYLARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1283.2-1283
Author(s):  
C. Ines ◽  
H. Ferjani ◽  
K. Maatallah ◽  
S. Miri ◽  
H. Hajji ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Joint Involvement ◽  
X Rays ◽  
Subacromial Space ◽  
Reactive Protein ◽  
Radiological Features ◽  
Asas Criteria

Background:Peripheral joint involvement is frequent among patients with peripheral spondylarthritis (SA). However, the root joint involvement, such as hip involvement, has been described as being associated with axial spondylarthritis, while data for shoulder involvement are scarce. Cuff tendonitis and enthesitis are common features in the shoulder in patients with SA.Objectives:This study aimed to identify the prevalence of shoulder involvement in SA patients and describe its clinical and radiological features.Methods:We conducted a retrospective study including SA patients, all fulfilling the assessment of Spondyloarthritis International Society (ASAS) criteria.For all patients, we collected the following data: Age, the clinical presentation of SA, the inflammatory biomarkers C-reactive protein (CRP), and the disease activity assessed by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).Regarding shoulder involvement, we assessed the following items: tenderness, mobility, rotator cuff tests, as well as the results of X-ray and Ultrasound examination (US).Results:We included one hundred and thirty-one SA patients (mean age 39,77 years). Among them, sixty-two percent were male. Ten percent of patients were smokers, 46,6% had the peripheral beginning of the disease. Fourteen patients complained of shoulder pain. The majority of them were male.X-rays showed no abnormalities (n=2), while a destructive form was noted in (n=7).Rotator cuff rupture or enthesopathy was also revealed by the reduction of subacromial space (n=5), condensation of the greater tuberosity (n=3), crooked aspect of the acromion (n=2), and Moloney’s line disruption(n=1).US showed no abnormalities (n=1), supraspinatus tendinopathy (n=5), supraspinatus transfixing tear (n=1), infraspinatus tendinopathy (n=2), supraspinatus enthesopathy (n=2), infraspinatus enthesopathy (n=1), moderate synovitis (n=1), subacromiodeltoid bursitis (n=1).Shoulder involvement was correlated significantly with the peripheral beginning of SA (P < 0.05). There were no significant differences in gender, tobacco use, CRP value, and the disease activity between the two groups (P > 0.05).Conclusion:The shoulder involvement was rare in our study. It is characterized by cuff tendonitis and enthesitis, especially in supraspinatus insertion. However, the glenohumeral synovitis was uncommon in our series, even in the peripheral form of the disease.References:[1]Hip and Shoulder Involvement and Their Management in Axial Spondyloarthritis: a Current Review Clementina López-Medina1,2,3,4 & M. Carmen Castro-Villegas1,2,3 & Eduardo Collantes-Estévez1,2,3, 23 July 2020.Acknowledgements:I would like to thank all the authors listed above, for they helped me make writing my first abstract less harder.Disclosure of Interests:None declared.

scholarly journals POS0924 PREDICTORS OF 1-YEAR TREATMENT RESPONSE AMONG UPADACITINIB-TREATED PATIENTS WITH ANKYLOSING SPONDYLITIS: A POST HOC ANALYSIS OF SELECT-AXIS 1

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 723-724
Author(s):  
M. Magrey ◽  
S. Ramiro ◽  
M. Pinheiro ◽  
T. Gao ◽  
F. Ganz ◽  
...  
Keyword(s):  
Back Pain ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Pain Score ◽  
Activity Index ◽  
Disease Activity Index ◽  
Inactive Disease ◽  
Low Disease Activity ◽  
Reactive Protein ◽  
Asas Criteria

Background:Upadacitinib (UPA) is an oral Janus kinase inhibitor that has demonstrated efficacy and safety among patients with ankylosing spondylitis (AS) in the phase 2/3 SELECT-AXIS 1 study.1 If identified, early predictors of treatment response may inform treat-to-target strategies and optimize patient outcomes in AS.Objectives:To determine whether baseline (BL) characteristics or early responses predict clinical response at 1 year in UPA-treated patients with AS.Methods:In the double-blind, randomized, placebo (PBO)-controlled SELECT-AXIS 1 study, patients received UPA 15 mg once daily or PBO until Week 14.1 At Week 14, PBO-treated patients switched to UPA 15 mg; patients originally randomized to UPA continued UPA therapy. Data from patients in the PBO and UPA arms were combined based on overall exposure to UPA; in the switch arm, exposure was defined as current visit minus 14 weeks (time of switch). The following outcomes were assessed at 1 year: Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ASDAS[CRP]) inactive disease (ID; <1.3) and low disease activity (LDA; <2.1), Assessment of SpondyloArthritis International Society (ASAS) partial remission (PR), and ≥40% improvement in ASAS criteria (ASAS40) response. The ability of BL characteristics, efficacy at Week 12, and back pain at Week 12 to predict 1-year outcomes was assessed using a univariable logistic regression model generating odds ratios (ORs; 95% confidence intervals). LASSO regression was used to select the best-fitted multivariable model at Week 12 for each outcome measure.Results:Among 187 patients who received or switched to UPA 15 mg, 70 (37.4%), 134 (71.7%), 73 (39.0%), and 131 (70.1%) achieved ASDAS(CRP) ID, ASDAS(CRP) LDA, ASAS PR, and ASAS40, respectively, following 1 year of UPA treatment. No meaningful predictors of 1-year efficacy outcomes were identified based on BL demographics (including disease duration, gender, and human leukocyte antigen B27 status) or BL disease characteristics (including ASDAS, Bath Ankylosing Spondylitis Disease Activity Index, and CRP levels). In univariable analyses, Week 12 responses based on several disease activity measures and patient-reported outcomes (PROs), including reductions (much better improvement [MBI], ≥30/≥50/≥70% reduction, or improvement) in back pain score, along with lower scores for back pain at Week 12, were associated with the achievement of ASDAS(CRP) ID, ASDAS(CRP) LDA, ASAS PR, and ASAS40 at 1 year (Figure 1). In a multivariable analysis, improvement from BL to Week 12 in back pain score consistently predicted several efficacy outcomes at 1 year.Conclusion:In upadacitinib-treated patients with AS, improvement in PROs and reduction in back pain score at 12 weeks predicted clinical outcomes at 1 year.References:[1]van der Heijde D, et al. Lancet 2019;394:2108–17.Figure 1.Association between Week 12 response or back pain at Week 12 and achievement of efficacy outcomes at 1 year (univariable analysis)All ASDAS scores are calculated using C-reactive proteinASDAS CII: change from BL ≥1.1; ASDAS MI: change from BL ≥2.0; MBI back pain: ≥2-point reduction in absolute score and ≥33% reduction from BL on a 0–10 NRSASAS, Assessment of SpondyloArthritis International Society; ASAS40, ≥40% improvement in ASAS criteria; ASDAS, Ankylosing Spondylitis Disease Activity Score; BASDAI50, ≥50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index; BL, baseline; CI, confidence interval; CII, clinically important improvement; ID, inactive disease; LDA, low disease activity; MBI, much better improvement; MI, major improvement; NRS, numeric rating scale; OR, odds ratio; PR, partial remissionAcknowledgements:AbbVie funded this study; contributed to its design; participated in data collection, analysis, and interpretation of the data; and participated in the writing, review, and approval of the abstract. No honoraria or payments were made for authorship. Medical writing support was provided by Laura Chalmers, PhD, of 2 the Nth (Cheshire, UK), and was funded by AbbVie.Disclosure of Interests:Marina Magrey Consultant of: Consultant for Janssen and Novartis; member of advisory boards for Eli Lilly, Janssen, Novartis, and UCB, Grant/research support from: AbbVie, Sofia Ramiro Consultant of: AbbVie, Eli Lilly, MSD, Novartis, Sanofi, and UCB, Grant/research support from: MSD, Marcelo Pinheiro Consultant of: AbbVie, Eli Lilly, Janssen, and Novartis, Tianming Gao Employee of: AbbVie employee and may own stock or options, Fabiana Ganz Employee of: AbbVie employee and may own stock or options, In-Ho Song Employee of: AbbVie employee and may own stock or options, Ana Biljan Employee of: AbbVie employee and may own stock or options, Nigil Haroon Consultant of: AbbVie, Amgen, Eli Lilly, Janssen, MSD, Novartis, Pfizer, and UCB, Martin Rudwaleit Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, Roche, and UCB

scholarly journals AB0840 DIAGNOSIS VALUE OF INTERLEUKIN 23 IN SPONDYLOARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1443.3-1444
Author(s):  
L. Kharrat ◽  
M. Slouma ◽  
A. Tezeghdenti ◽  
W. Dkhili ◽  
R. Dhahri ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls ◽  
Reactive Protein ◽  
Asas Criteria ◽  
The Mean ◽  
Interleukin 23

Background:Interleukin 23 (IL-23) is a pivotal pro-inflammatory cytokine in the Th17/IL-23 axis which became the center of attention in researches during these last decades, especially during spondyloarthritis (1).Objectives:We aimed to study the diagnosis value of IL-23 serum in spondyloarthritis.Methods:We conducted a case-control study, including 144 subjects divided into 2 groups:-G1: 72 patients meeting the Assessment of SpondyloArthritis International Society (ASAS) criteria for spondyloarthritis (SA)-G2: 72 healthy controls matched for age and sex.For each SA patient we collected the following parameters: BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), ASDAS (Ankylosing Spondylitis Disease Activity Score), BASFI (Bath Ankylosing Spondylitis Functional Index), and BASRI (Bath Ankylosing Spondylitis Radiology Index).The IL-23 level was measured using Enzyme-linked immunosorbent assay (ELISA).Erythrocyte Sedimentation rate (ESR) and C-reactive protein (CRP) were also measured.We performed a ROC analysis and computed the air under the curve (AUC) at IL-23 to diagnose SA patients.Statistical analysis was performed using “IBM SPSS Statistics” software version 25.Results:The study included 57 men and 15 women. The mean age was 44.84 ± 13.42 years. The mean age at the onset of the disease was 35.97 ± 12.88 years. The disease duration was 8.54 ± 7.7 years.Seventy-nine per cent of our patients had axial radiographic spondyloarthritis (n=57). Peripheral involvement was found in 45.8% (n=33). Eighteen patients had both axial and peripheral involvement concomitantly. Psoriasis was found in 36.1% of the cases (n=26).The mean BASDAI and ASDAS-CRP were 3.21 ± 1.64 and 3.05 ± 1.51, respectively.The mean was BASFI 3.88 ± 2.69. The mean was BASRI 5.26 ± 4.14.The mean ESR and CRP were 36.74 ± 29.38 mm/hr and 20.45 ± 25.19 mg/dL, respectively.IL-23 level was significantly higher in patients compared to healthy controls (23.1 ± 2.72 pg/mL and 5.02 ± 0.59 pg/mL, respectively, p<0.0001).As shown in Figure 1, the AUC value to distinguish between spondyloarthritis and healthy control was 0.705 (p<0.0001). IL-23 cut-off was 7.96 pg/mL (Sensibility= 69.4%, specificity=98.6%).Figure 1.AUC at IL-23 between SA patients 0.705 (p<0.0001) Nevertheless, no correlation was found between serum IL-23 levels and the following parameters: ESR, CRP, BASDAI, ASDAS-CRP, BASFI and BASRI.Conclusion:As reported to previous studies, our study showed that IL-23 is significantly higher in SA patients (2).Interestingly, IL-23 was able to distinguish between SA patients and healthy controls with a cut-off of 7.96 pg/mL. This finding suggests that IL-23 may be practical for the diagnosis of SA.References:[1]K V, D E. IL-23 Responsive Innate-Like T Cells in Spondyloarthritis: The Less Frequent They Are, the More Vital They Appear [Internet]. Vol. 17, Current rheumatology reports. Curr Rheumatol Rep; 2015 [cité 13 avr 2020]. Disponible sur: https://pubmed.ncbi.nlm.nih.gov/25874346/[2]Wang X, Lin Z, Wei Q, Jiang Y, Gu J. Expression of IL-23 and IL-17 and effect of IL-23 on IL-17 production in ankylosing spondylitis. Rheumatol Int. sept 2009;29(11):1343-7.Disclosure of Interests:None declared

scholarly journals AB0669 PARTICULARITIES OF TUNISIAN FEMALE AXIAL SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1629.2-1629
Author(s):  
K. Ben Abdelghani ◽  
Y. Gzam ◽  
A. Fazaa ◽  
S. Miladi ◽  
K. Ouenniche ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Activity Index ◽  
Age At Onset ◽  
Disease Onset ◽  
Disease Activity Index ◽  
Reactive Protein ◽  
Significant Difference ◽  
The Mean

Background:Axial spondyloarthritis (ax-SpA) is a chronic rheumatic disease that mainly affects men. However, the female form of ax-SpA remains insufficiently studied.Objectives:The aim of this study was to determine the clinical characteristics, the disease activity and the functional impact of female ax-SpA in comparison with male ax-SpA.Methods:This is a retrospective study including patients diagnosed with ax-SpA fulfilling the criteria of the Assessment of SpondyloArthritis international Society (ASAS) 2009.Clinical parameters, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Bath ankylosing spondylitis disease activity index (BASDAI) and Bath ankylosing spondylitis functional index (BASFI) were compared between groups of female and male ax-SpA.Results:Two hundred ax-SpA patients were included with 31% of female (n=62) and a mean age of 43,3 ± 11,2 years.The mean age at onset of symptoms was 31,8 ± 8,9 years for women and 25,3 ± 9,1 years for men (p <0,0001). The mean age at diagnosis was 36,4 ± 9,6 years for women and 31,7 ± 10,4 years for men (p = 0,003). Ax-SpA with juvenile onset was noted in 1,7% of women and 12,1% of men (p = 0,02). Male ax-SpA were significantly more smokers (46.8% vs 5.4%; p <0.001). The mean duration of morning stiffness was 11,3 ± 9,2 minutes for women versus 21,6 ± 19,3 minutes for men (p = 0,005).The mean ESR was 42,4 ± 29,8 mm for women and 28,3 ± 23,4 mm for men (p = 0,001). Radiographic sacroiliitis was present in 69,3% of women versus 84,7% of men (p = 0,01). The use of anti-TNF alpha was less frequent in women (29% vs 48,5%; p = 0,01).Our study didn’t found a statistically significant difference in peripheral manifestations, extraarticular manifestations, CRP, BASDAI and BASFI between the two groups.Conclusion:Female ax-SpA seems to have a better prognosis than male with older age in disease onset, less inflammation, less radiographic sacroiliitis and less use of biological treatments.References:[1]Rusman T, et al. Curr Rheumatol Rep. 2018; 20(6).[2]Siar N, et al. Curr Rheumatol Rev. 2019;Disclosure of Interests:None declared

Usefulness of composite indices in the assessment of joint involvement in systemic lupus erythematosus patients: correlation with ultrasonographic score

Lupus ◽  
2019 ◽  
Vol 28 (3) ◽  
pp. 383-388
Author(s):  
F Ceccarelli ◽  
C Perricone ◽  
E Cipriano ◽  
L Massaro ◽  
F Natalucci ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Disease Activity Index ◽  
Joint Involvement ◽  
Joint Activity ◽  
Systemic Lupus ◽  
Inflammatory Status ◽  
Composite Indices

Specific indices are not available to evaluate systemic lupus erythematosus (SLE) joint involvement; indeed, the application of indices validated for rheumatoid arthritis has been suggested. We evaluated the usefulness of organ specific composite indices, i.e. the Disease Activity Score on 28 joints (DAS28), Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI), and the ratio of swollen to tender joints (STR), to assess SLE joint activity by analyzing the correlation between these indices and ultrasonography (US) inflammatory status. We evaluated SLE patients with arthralgia and/or arthritis: the above-mentioned indices were calculated and the SLE Disease Activity Index 2000 (SLEDAI-2k) was applied to assess global disease activity. US of I–V metacarpophalangeal, I–V proximal interphalangeal, wrist, and knee bilateral was performed. Synovial effusion/hypertrophy and power Doppler findings were scored according to a semi-quantitative scale (0–3) to obtain an inflammatory total score (0–216). One hundred and six patients (M/F 7/99, median age 49.5 years (IQR 17.0), median disease duration 8.5 years (IQR 17.0)) were enrolled. We identified a positive correlation between US score and DAS28-CRP ( r = 0.3, p = 0.007), STR ( r = 0.42, p = 0.0005), SDAI ( r = 0.33, p = 0.02), CDAI ( r = 0.29, p = 0.03); US score reflected different levels of clinimetric joint activity. In conclusion, we suggest the ability of composite indices in detecting SLE joint inflammation and their possible real-life use.

scholarly journals Serum C-reactive protein level does not correlate with Crohn’s Disease Activity Index

2010 ◽  
Vol 5 ◽  
pp. 274-278
Author(s):  
Maciej Kohut ◽  
Katarzyna Kozioł ◽  
Emilia Olek ◽  
Anna Koclęga ◽  
Marek Hartleb
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Protein Level ◽  
Activity Index ◽  
Disease Activity Index ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Crohn’S Disease Activity

scholarly journals Altered Bacterial-Fungal Interkingdom Networks in the Guts of Ankylosing Spondylitis Patients

mSystems ◽  
2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Ming Li ◽  
Bingbing Dai ◽  
Yawei Tang ◽  
Lei Lei ◽  
Ningning Li ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Large Scale ◽  
Activity Index ◽  
Disease Activity Index ◽  
Rrna Gene ◽  
Human Gut ◽  
Reactive Protein ◽  
Inflammatory Drugs ◽  
Bacteria And Fungi

ABSTRACT Intestinal bacterial dysbiosis has been increasingly linked to ankylosing spondylitis (AS), which is a prototypic and best studied subtype of spondyloarthritis (SpA). Fungi and bacteria coexist in the human gut and interact with each other. Although they have been shown to contribute actively to health or disease, no studies have investigated whether the fungal microbiota in AS patients is perturbed. In this study, fecal samples from 22 AS patients, with clinical and radiographic assessments, and 16 healthy controls (HCs) were collected to systematically characterize the gut microbiota and mycobiota in AS patients by 16S rRNA gene- and ITS2-based DNA sequencing. Our results showed that the microbiota of AS patients was characterized by increased abundance of Proteobacteria and decreased Bacteroidetes, which was contributed by enrichment of Escherichia-Shigella, Veillonella, Lachnospiraceae NK4A136 group, and reduction of Prevotella strain 9, Megamona, and Fusobacterium. The gut mycobiota of AS patients was characterized by higher levels of Ascomycota, especially the class of Dothideomycetes, and decreased abundance of Basidiomycota, which was mainly contributed by the decease of Agaricales. Compared to HCs, decreased ITS2/16S biodiversity ratios and altered bacterial-fungal interkingdom networks were observed in AS patients. Compared with nonsteroidal anti-inflammatory drugs (NSAIDs), treating AS patients with biological agents induced obvious changes in the gut mycobiota, and this result was highly associated with disease activity indexes, including AS disease activity index (ASDAS) C-reactive protein (asCRP), erythrocyte sedimentation rate (ESR), and Bath AS disease activity index (BASDAI). In addition, altered mycobiota in AS patients was also found associated with the degree of radiographic damage. IMPORTANCE The human gut is colonized by diverse fungi (mycobiota), and fungi have long been suspected in the pathogenesis of SpA. Our study unraveled a disease-specific interkingdom network alteration in AS, suggesting that fungi, or the interkingdom interactions between bacteria and fungi, may play an essential role in AS development. However, our study is limited by sample size, and in-depth mechanism studies and additional large-scale investigations characterizing the gut mycobiome in AS patients are needed to form a foundation for research into the relationship between mycobiota dysbiosis and AS development.

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