scholarly journals Combination of ankylosing spondylitis with combined autoinflammatory skin lesions (clinical observation and literature review)

2021 ◽  
Vol 15 (4) ◽  
pp. 81-86
Author(s):  
D. A. Dibrov ◽  
T. V. Korotaeva ◽  
S. O. Krasnenko ◽  
M. M. Urumova ◽  
L. S. Kruglova ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Hidradenitis Suppurativa ◽  
Clinical Case ◽  
Clinical Observation ◽  
Axial Spondyloarthritis ◽  
Skin Lesions ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Acne Conglobata ◽  
Choice Of Therapy

We present a clinical case of combination of axial spondyloarthritis (axSpA) and chronic recurrent skin lesions in the form of acne conglobata, hidradenitis suppurativa (HS) with fistulous tracts formation. During the diagnostic search, the following diseases were considered: HS, SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis), PASS syndrome (pyoderma gangrenosum, acne, ankylosing spondylitis, HS). The choice of therapy in this patient and the possibility of using biologic disease-modifying antirheumatic drugs for axSpa and concomitant autoinflammatory skin process are discussed.

scholarly journals Eligibility criteria for biologic disease-modifying antirheumatic drugs in axial spondyloarthritis: going beyond BASDAI

RMD Open ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e001145 ◽  
Author(s):  
Jose Marona ◽  
Alexandre Sepriano ◽  
Santiago Rodrigues-Manica ◽  
Fernando Pimentel-Santos ◽  
Ana Filipa Mourão ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Activity Index ◽  
High Disease Activity ◽  
Inactive Disease ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Eligibility Criteria ◽  
Disease Modifying

ObjectivesTo compare definitions of high disease activity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in selecting patients for treatment with biologic disease-modifying antirheumatic drugs (bDMARDs).MethodsPatients from Rheumatic Diseases Portuguese Register (Reuma.pt) with a clinical diagnosis of axial spondyloarthritis (axSpA) were included. Four subgroups (cross-tabulation between ASDAS (≥2.1) and BASDAI (≥4) definitions of high disease activity) were compared regarding baseline characteristics and response to bDMARDs at 3 and 6 months estimated in multivariable regression models.ResultsOf the 594 patients included, the majority (82%) had both BASDAI≥4 and ASDAS ≥2.1. The frequency of ASDAS ≥2.1, if BASDAI<4 was much larger than the opposite (ie, ASDAS <2.1, if BASDAI≥4): 62% vs 0.8%. Compared to patients fulfilling both definitions, those with ASDAS ≥2.1 only were more likely to be male (77% vs 51%), human leucocyte antigen B27 positive (79% vs 65%) and have a higher C reactive protein (2.9 (SD 3.5) vs 2.1 (2.9)). Among bDMARD-treated patients (n=359), responses across subgroups were globally overlapping, except for the most ‘stringent’ outcomes. Patients captured only by ASDAS responded better compared to patients fulfilling both definitions (eg, ASDAS inactive disease at 3 months: 61% vs 25% and at 6 months: 42% vs 25%).ConclusionThe ASDAS definition of high disease activity is more inclusive than the BASDAI definition in selecting patients with axSpA for bDMARD treatment. The additionally ‘captured’ patients respond better and have higher likelihood of predictors thereof. These results support using ASDAS≥2.1 as a criterion for treatment decisions.

scholarly journals Immediate Effect of Baricitinib on Arthritis and Biological Disease-Modifying Antirheumatic Drug-Induced Psoriasis-Like Skin Lesions in Two Patients with Rheumatoid Arthritis

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Yoshifumi Tada ◽  
Nobuyuki Ono ◽  
Syuichi Koarada
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Events ◽  
Certolizumab Pegol ◽  
Skin Lesions ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Drug Induced ◽  
Beneficial Effects ◽  
Disease Modifying ◽  
Disease Modifying Antirheumatic Drug

Biological disease-modifying antirheumatic drugs (bDMARDs) are very effective for treating rheumatoid arthritis (RA). However, they sometimes induce adverse events such as psoriasis-like skin lesions. We describe psoriasis-like skin lesions that developed simultaneously with an RA flare in patient 1 during treatment with abatacept and in patient 2 soon after starting certolizumab pegol. The skin lesions persisted in patient 2 despite stopping certolizumab. Baricitinib was initiated because of RA flare and resulted in immediate beneficial effects on arthritis as well as skin lesions. The RA went into remission in both patients, and the psoriasis-like skin lesions disappeared within four weeks (patient 1) and three months (patient 2).

scholarly journals The effect of comedication with conventional synthetic disease modifying antirheumatic drugs on TNF inhibitor drug survival in patients with ankylosing spondylitis and undifferentiated spondyloarthritis: results from a nationwide prospective study

2015 ◽  
Vol 74 (6) ◽  
pp. 970-978 ◽  
Author(s):  
Elisabeth Lie ◽  
Lars Erik Kristensen ◽  
Helena Forsblad-d'Elia ◽  
Tatiana Zverkova-Sandström ◽  
Johan Askling ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Cox Regression ◽  
Time Dependent ◽  
Sensitivity Analyses ◽  
Tnf Inhibitor ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Drug Survival ◽  
Undifferentiated Spondyloarthritis ◽  
Disease Modifying

ObjectiveTo assess the effect of comedication with conventional synthetic disease modifying antirheumatic drugs (csDMARDs) on retention to tumour necrosis factor inhibitor (TNFi) therapy in patients with ankylosing spondylitis (AS) and undifferentiated spondyloarthritis (uSpA).MethodsData on patients with a clinical diagnosis of AS or uSpA starting treatment with adalimumab, etanercept or infliximab as their first TNFi during 2003–2010 were retrieved from the Swedish national biologics register and linked to national population based registers. Five-year drug survival was analysed by Cox regression with age, sex, baseline csDMARD comedication, TNFi type, prescription year and covariates representing frailty and socioeconomic status. AS and uSpA were analysed separately. Sensitivity analyses included models with csDMARD as a time-dependent covariate and adjustments for additional potential confounders.Results1365 patients with AS and 1155 patients with uSpA were included, of whom 40.8% versus 50.3% used csDMARD comedication at baseline. In the unadjusted analyses superior drug survival was observed for patients using versus not using csDMARD comedication among patients with AS (p<0.001) but not among patients with uSpA (p=0.175). In the multivariable Cox regression analyses comedication with csDMARD was associated with better retention to TNFi therapy both in AS (HR 0.71, p<0.001) and uSpA (HR 0.82, p=0.020). The results were similar with csDMARD comedication as a time-dependent covariate, and the associations were retained when adjusting for erythrocyte sedimentation rate, C-reactive protein, patient global, swollen joints, uveitis, psoriasis and inflammatory bowel disease.ConclusionsIn this large register study of patients with AS and uSpA, use of csDMARD comedication was associated with better 5-year retention to the first TNFi.

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

2016 ◽  
Vol 144 (1-2) ◽  
pp. 81-84 ◽  
Author(s):  
Vanja Zeremski ◽  
Aleksandar Savic ◽  
Tatjana Ilic ◽  
Ivana Milosevic ◽  
Marina Maksimovic ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Essential Thrombocythemia ◽  
Liver Toxicity ◽  
Human Leukocyte ◽  
Janus Kinase ◽  
Common Finding ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Leukocyte Antigen ◽  
Disease Modifying

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-? 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.

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