scholarly journals Inflammatory biomarkers, disease activity and spinal disease measures in patients with ankylosing spondylitis after treatment with infliximab

2007 ◽  
Vol 67 (4) ◽  
pp. 511-517 ◽  
Author(s):  
S Visvanathan ◽  
C Wagner ◽  
J C Marini ◽  
D Baker ◽  
T Gathany ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Clinical Response ◽  
Activity Index ◽  
Disease Activity Index ◽  
Infliximab Treatment ◽  
Reactive Protein ◽  
Biomarker Analysis ◽  
Magnetic Resonance Imaging Mri ◽  
Spinal Inflammation

Objective:To evaluate the relationship between biomarker levels and disease activity and the spinal inflammation detected by magnetic resonance imaging (MRI) in patients with ankylosing spondylitis (AS).Methods:Patients with AS were randomly assigned in a 3:8 ratio to receive infusions of placebo or 5 mg/kg infliximab at weeks 0, 2, 6, 12 and 18. Sera were collected for biomarker analysis at weeks 0, 2 and 24 and were analysed for levels of interleukin-6 (IL-6), vascular endothelial growth factor (VEGF) and C-reactive protein (CRP). Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores and pre- and post-gadolinium T1 and short τ inversion recovery MRIs were collected at baseline and week 24.Results:Significantly greater reductions in IL-6, VEGF and CRP were observed at weeks 2 and 24 in the infliximab group compared with the placebo group (all p<0.001). Baseline IL-6 levels >7.38 pg/ml and CRP levels >1.5 mg/dl were associated with increased rates of clinical response after 24 weeks. Multiple regression analyses showed that reductions from baseline to week 2 in IL-6, but not CRP or VEGF, were significantly associated with reductions in MRI activity and BASDAI scores from baseline to week 24 in the infliximab group (p<0.001).Conclusions:Significant reductions in IL-6, VEGF and CRP were observed with infliximab compared with placebo. High levels of baseline IL-6 and CRP were associated with clinical response after infliximab treatment. Early reductions in IL-6 were significantly associated with improvements in disease activity and the spinal inflammation detected by MRI.

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

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.

scholarly journals Serum chitotriosidase and neopterin levels in patients with ankylosing spondylitis

2019 ◽  
Vol 11 ◽  
pp. 1759720X1983232 ◽  
Author(s):  
Ferdi Yavuz ◽  
Bilge Kesikburun ◽  
Özlem Öztürk ◽  
Ümüt Güzelküçük
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Activity Index ◽  
Multiple Logistic Regression Analysis ◽  
Disease Activity Index ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Positive Correlations ◽  
Positive Significant Correlation

Background: The aim of this study was to assess the serum chitotriosidase (ChT) and neopterin levels in patients with ankylosing spondylitis (AS) and to evaluate whether serum ChT and neopterin levels are related to disease activity. Methods: A total of 86 patients with AS were included in the study. Patients were divided into two groups based on Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores: The active AS patients group included 40 patients who had a BASDAI score ⩾4. The inactive AS patients group included 46 patients who had a BASDAI score <4. We compared the serum level of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), ChT and neopterin between the two groups. Results: Active AS patients had significantly higher ESR, CRP, serum ChT and neopterin levels compared with the inactive AS patients group ( p < 0.05). Positive correlations were found between serum ChT levels and ESR ( r = 0.87, p = 0.005), and CRP levels ( r = 0.86, p = 0.006). Also, there was a positive significant correlation between serum ChT levels and BASDAI scores ( r = 0.67, p = 0.03). No correlation was found between serum neopterin levels and the BASDAI scores, ESR, and CRP levels ( p > 0.05). Higher disease activity (BASDAI score ⩾4) was found to be associated with ChT ( p = 0.012) in the multiple logistic regression analysis. Conclusion: The present study emphasized that serum ChT levels can be useful in the determination of the disease activity of AS patients.

scholarly journals The serum C-reactive protein to prealbumin ratio and fibrinogen to prealbumin ratio are two relevant indicators for evaluating the disease activity of ankylosing spondylitis

2021 ◽  
Vol 19 ◽  
pp. 205873922110140
Author(s):  
Kai Zhang ◽  
Junhao Wang ◽  
Jinhong Chen ◽  
Zhi Li ◽  
Zhaohui Lou
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Activity Index ◽  
Area Under The Curve ◽  
Test Group ◽  
Disease Activity Index ◽  
Biological Indicators ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Spearman Test

The C-reactive protein to prealbumin ratio (CPR) and fibrinogen to prealbumin ratio (FPR) in serum are two emerging biomarkers. The purpose of this study is to explore the relationship between these two markers and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Scores (ASDAS). A total of 163 patients with AS and 120 healthy examinees were included in this study. The t-test and Mann-Whitney U ranking test were used to analyze the differences between groups. The spearman-test was used to analyze the correlation between erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), fibrinogen (Fib), prealbumin (PAlb), CPR, FPR, and AS disease activity in the test group. We generated the receiver operating characteristic curves (ROC) of CPR and FPR and determined the discriminating ability by calculating the area under the curve (AUC). Compared with the healthy group, ESR ( p < 0.001), CRP ( p < 0.001), Fib ( p < 0.001), CPR ( p < 0.001), and FPR ( p < 0.001) of AS patients were significantly increased, while PAlb was significantly reduced. CPR and FPR were more correlated to ASDAS-CRP. CPR was positively correlated with CRP, ESR, BASDAI, and ASDAS-CRP in AS patients ( r = 0.959, p < 0.001, r = 0.717, p < 0.001, r = 0.704, p < 0.001, r = 0.763, p < 0.001). FPR was positively correlated with CRP, ESR BASDAI, and ASDAS-CRP in AS patients ( r = 0.779, p < 0.001, r = 0709, p < 0.001, r = 0.551, p < 0.001, r = 0.763, p < 0.001). ROC showed that the AUC levels of CPR and FPR were high (AUC = 0.952 and AUC = 0.893). CPR and FPR are two promising new biological indicators for assessing disease activity in AS patients.

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 Male smokers with HLA-B27 positivity, SI joints inflammation have more radiological damages and higher prevalence of AS while females have higher BASDAI scores: observations from cluster analyses of a group of SpA patients

2016 ◽  
Vol 16 (2) ◽  
pp. 42-47
Author(s):  
Shirley Chiu Wai Chan ◽  
Helen Hoi Lun Tsang ◽  
Chak Sing Lau ◽  
Ho Yin Chung
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Blood Parameters ◽  
Spinal Mobility ◽  
Lumbosacral Spine ◽  
Hla B27 ◽  
Cluster Analyses ◽  
Magnetic Resonance Imaging Mri

AbstractObjectivesTo describe the clinical characteristics and the relations with disease activity, functional status, and syndesmophytes formation in patients with axial spondyloarthritis (AxSpA) by categorizing them into different groups.MethodsOne hundred and sixty three patients with AxSpA were recruited. Clinical and blood parameters were collected. Patients were asked to complete the self-assessment questionnaires, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Functional Index (BASFI). Spinal mobility was measured according to Bath Ankylosing Spondylitis Metrology Index (BASMI). Radiographs of cervical and lumbosacral spine were performed for modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Radiological sacroiliitis was scored for ankylosing spondylitis (AS). Magnetic resonance imaging (MRI) of the sacroiliac (SI) joints was performed for spondyloarthritis research consortium of Canada (SPARCC) MRI inflammation score. Two-way cluster analyses were performed to determine the relationships between the parameters.ResultsTwo cluster models were built using SPARCC scores of different scorers. Results were similar. The group of patients with highest mSASSS (20.33 vs 20.33) and prevalence radiological AS (85% vs 86%) were male patients (75% vs 75%), positive for HLA-B27 (70.0% vs 66.7%), smokers (87.5% vs 97.2%), and higher SPARCC SI joints score (5.32 vs 3.17). Higher BASDAI was observed among female sex. BASMI varies little but the group with highest BASMI (3.60 vs 3.62) also had highest mSASSS (20.33 vs 20.33).ConclusionOur data showed that male smokers with HLA-B27 positivity and SI joints inflammation have more radiological damage and higher prevalence of AS, consistent with known poor prognosis factors.

scholarly journals Visceral Fat Reflects Disease Activity in Patients with Ankylosing Spondylitis

2014 ◽  
Vol 37 (3) ◽  
pp. 186
Author(s):  
Mesut Aydin ◽  
Fatma Aydin ◽  
Murat Yuksel ◽  
Abdulkadir Yildiz ◽  
Nihat Polat ◽  
...  
Keyword(s):  
New York ◽  
Adipose Tissue ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Visceral Adipose Tissue ◽  
Visceral Fat ◽  
Activity Index ◽  
Disease Activity Index ◽  
Infliximab Treatment ◽  
Visceral Adipose

Purpose: Response to infliximab treatment diminishes as body mass index (BMI) increases in patients with ankylosing spondylitis (AS). The purpose of the study was to determine if diminished response to infliximab treatment in patients with AS could be associated with increased visceral adipose tissue rather than increased BMI. Methods: Twenty six AS patients (21 males and five females) who fulfilled the modified New York criteria and who were currently receiving infliximab treatment were enrolled in the study. Pain was measured by the visual analogue scale (VAS). The disease activity and functional status were assessed by the Bath AS Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI). The Bath AS Metrology Index (BASMI) was used to evaluate mobility restrictions. Weight and visceral body composition were measured without shoes in light indoor clothes using a bio-impedance meter. Results: There was a significant correlation between visceral adipose tissue amount and disease activity under infliximab treatment. In correlation analysis, visceral fat showed significant correlations between BASDAI (r=0.545, p=0.004) and VAS (r=0.458, p=0.019). Total body fat also showed a significant correlation with BASDAI (r=0.463, p=0.017). Conclusion: A significant correlation was found between visceral adipose tissue amount and disease activity in patients with AS.

scholarly journals Diagnostic Performance of Red Cell Distribution Width in Adult Iraqi Patients with Ankylosing Spondylitis

Arthritis ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Faiq I. Gorial ◽  
Ali M. Hassan
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Complete Blood Count ◽  
Activity Index ◽  
Disease Activity Index ◽  
Red Cell ◽  
Cell Distribution ◽  
C Reactive Protein ◽  
Distribution Width ◽  
Reactive Protein

Background. Ankylosing spondylitis (AS) is a chronic, progressive inflammatory rheumatic disease that leads to structural damage, functional impairment, and decrease in the quality of life. Red cell distribution width (RDW) is a part of the complete blood count (CBC) and estimates erythrocyte variability. Objective. To analyse RDW in patients with AS and to evaluate the relationships with acute phase reactants (APRs) and disease activity index. Patients and Methods. A total of 100 patients with AS (78 males and 22 females) were diagnosed according to the modified New York classification criteria for AS and 146 (99 males: 47 females) healthy individuals matched in age and sex as controls enrolled in the study. Demographic data, disease activity scores using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), medical history, C-reactive protein (CRP), erythrocytes sedimentation rate (ESR), and complete blood count (CBC) were measured. Results. The mean age for patients and controls was 38.0 ± 9.0 and 35.8 ± 9.0 years, respectively (p=0.057). RDW was significantly higher in patients with AS compared with controls (14.133 ± 1.613 versus 12.299 ± 1.031, p < 0.001). There was a direct correlation of RDW with both ESR and CRP (P < 0.001); RDW had r=0.38 for C-reactive protein (CRP) and r=0.413 for ESR. Also BASDAI was directly correlated with RDW (r=0.326 p<0.001). RDW was a valid measure to differentiate between patients with AS and controls (AUC=0,84, p<0.001) and at optimum cut-off value>13% has highest accuracy (78.9%) with very good sensitivity test (81%) and NPV (85.6%) as well as good specificity (77.4%) and PPV (71.1%). Conclusion. RDW was higher in AS patients compared with controls and was directly correlated with ESR, CRP, and BASDAI. RDW was a valid simple measure with good accuracy to differentiate between patients with AS and controls.

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