Format
Sort by
Items per page

Send to

Choose Destination

Search results

Items: 1 to 20 of 13871

1.
Medicine (Baltimore). 2018 Sep;97(39):e12609. doi: 10.1097/MD.0000000000012609.

Can ultrasound be an assessment tool for sagittal spine mobility and chest expansion in patients with ankylosing spondylitis?

Author information

1
Bezmialem Vakif University.
2
Medipol University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey.

Abstract

We aimed to examine whether ultrasound (US) is useful for evaluating spinal mobility and chest expansion in ankylosing spondylitis (AS) patients and determine a cutoff value to identify reduced sagittal lumbar mobility.Our cross-sectional study included 50 AS patients and 50 controls. Metric measurements and Bath AS indices were measured in AS patients. The distance between C6-C7, T11-T12, and L4-L5 vertebrae was measured, and the difference and percentage of difference between erect position and maximal cervical and lumbar flexion was calculated (T11-T12dif, T11-T12%, L4-L5dif, L4-L5%, T+L dif, T+L%). Intercostal divergence was measured 1.5 cm away on the left from the sternocostal space during maximum inhalation and maximum exhalation, and the difference and percentage of difference between them was calculated (ICdif, IC%).All metric measurements were lower in the AS group except for tragus-to-wall distance. T11-T12dif, T11-T12%, L4-L5dif, T+L dif, and T+L% values were higher in the control group, while other US measurements did not differ between the groups. All US measurements except ICdif and IC% correlated with the Bath AS Metrology Index.Thus, US may be used for assessing spinal mobility in patients with AS. T11-T12dif <0.79 cm may show decreased lumbar sagittal mobility.

PMID:
30278577
PMCID:
PMC6181605
DOI:
10.1097/MD.0000000000012609
[Indexed for MEDLINE]
Free PMC Article
Icon for Wolters Kluwer Icon for PubMed Central
2.
Curr Sports Med Rep. 2018 Sep;17(9):302-307. doi: 10.1249/JSR.0000000000000518.

Exercise for Athletes With Inflammatory Arthritis.

Author information

1
Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, UT.

Abstract

Advances in pharmacologic management of inflammatory conditions have allowed those living with these conditions to pursue fitness activities previously difficult due to functional limitations. With that said, many patients with inflammatory arthritis are still not active enough. In this article, we review specific exercise recommendations for a number of inflammatory conditions with a focus on overall health promotion and cardiovascular disease risk reduction, discuss exercise as an adjunct to pharmacologic disease management, and review potential risks of sport participation for athletes with inflammatory arthritis conditions.

PMID:
30204634
DOI:
10.1249/JSR.0000000000000518
[Indexed for MEDLINE]
Icon for Wolters Kluwer
3.
Medicine (Baltimore). 2018 Aug;97(35):e12136. doi: 10.1097/MD.0000000000012136.

MMP-8 single-nucleotide polymorphisms are related to ankylosing spondylitis in Chinese Han population.

Author information

1
Department of Graduate School, Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
2
Department of Pediatric Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
3
Department of Administrative Affairs Office, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
4
School of Life Sciences, Northwest University, Xi'an, Shaanxi, China.
5
Department of Pelvic and Acetabular Surgery, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.

Abstract

Ankylosing spondylitis (AS) is an extreme form of inflammatory arthritis which always leads to bony fusion of vertebral and chronic pain of back. A lot of genes including interleukin, matrix metalloproteinases (MMPs), and endoplasmic reticulum aminopeptidase were found associated with AS. MMP family members were involved in the autoimmune disease and orthopedic diseases such as rheumatoid arthritis and osteoarthritis, while few studies concentrated on the correlation between single-nucleotide polymorphisms (SNPs) in MMP and AS. In addition, there is no report on the relationship between MMP-8 and AS. To investigate the association between SNPs in MMP-8 and AS, we recruited 268 patients with AS and 654 healthy people to conduct a case-control study. Five SNPs including rs3740938, rs2012390, rs1940475, rs11225394, and rs11225395 of MMP-8 gene were genotyped. It was found rs3740938 of MMP-8 was associated with an increased risk of AS under the dominant model and additive model after adjustment for gender and age by performing logistic regression analysis (odds ratio [OR] = 1.49, 95% confidence interval [CI] = 1.02-2.18, P = .038; OR = 1.37, 95% CI = 1.01-1.87, P = .042, respectively). Moreover, haplotype "GGTCA" was associated with an increased risk of AS without adjustment for age and gender (OR = 1.75, 95% CI = 1.05-2.92, P = .032), while no positive result was found after adjustment for age and gender. Based on our results, our study indicates significant association between SNPs of MMP-8 and AS risk in a Chinese Han population and these results provide the first evidence that MMP-8 is correlated with AS.

PMID:
30170451
DOI:
10.1097/MD.0000000000012136
[Indexed for MEDLINE]
Free full text
Icon for Wolters Kluwer
4.
Medicine (Baltimore). 2018 Aug;97(34):e11925. doi: 10.1097/MD.0000000000011925.

Posterior surgical treatment of ankylosing spondylitis with spinal tuberculosis: A case series and long-term follow-up.

Author information

1
Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, China.

Abstract

This retrospective cohort study aimed to evaluate the clinical outcomes of posterior surgical treatment of ankylosing spondylitis (AS) with spinal tuberculosis (STB). This was a retrospective study including 12 patients treated between January 2004 and April 2014 for AS with STB at our department. All patients underwent 1-stage posterior internal fixation, debridement, and bone fusion. The patients were evaluated based on the American Spinal Injury Association (ASIA), kyphotic Cobb angle, and the visual analog score (VAS). All patients were followed up for an average of 42.7 ± 13.2 months after surgery and bone fusion was achieved 6.8 ± 1.3 months. According to ASIA, 2 cases were rated as Grade D, 10 cases were Grade E at last follow-up. The average preoperative Cobb angle was 26.7 ± 7.6° (range 15-36) and the average postoperative Cobb angle was 7.8 ± 1.2° (range 6-9). The mean latest follow-up Cobb angle was 9.1 ± 1.0° (range 6-10). Compared with the average preoperative Cobb angle, there were significant differences regarding the kyphotic Cobb angle measured postoperatively and at final follow-up (P < .05). The VAS significantly was considerably improved between the preoperative and the last clinical visits. These positive results demonstrate that 1-stage surgical treatment for AS with STB by posterior debridement, fusion, and instrumentation can be an effective and feasible treatment method for this specific condition. It should be noted that it is necessary to carry out antiosteoporosis treatment and perform long-segmental instrumentation in order to obtain spinal stabilization.

PMID:
30142806
PMCID:
PMC6112899
DOI:
10.1097/MD.0000000000011925
[Indexed for MEDLINE]
Free PMC Article
Icon for Wolters Kluwer Icon for PubMed Central
5.
Medicine (Baltimore). 2018 Aug;97(34):e11605. doi: 10.1097/MD.0000000000011605.

A rare, acute neurologic deterioration associated with the overactive autoimmune response of ankylosing spondylitis after cervical laminoplasty: A case report.

Author information

1
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, China.

Abstract

RATIONALE:

We report a rare, acute neurological deterioration after cervical laminoplasty due to post-decompression spinal cord edema associated with ankylosing spondylitis in a 52-year old male patient. The patient was diagnosed with cervical spondylotic myelopathy due to ossification of the posterior longitudinal ligament which was complicated by ankylosing spondylitis. A cervical laminoplasty was performed, adversely resulting in paraparesis and loss of tactile sense. An emergency CT scan following the first laminoplasty revealed that the spinal cord compression due to spinal cord swelling and limited-expansion in cervical canal space. The abnormal pathological state of ankylosing spondylitis may have aggravated spinal cord re-perfusion and increased edema after decompression.

PATIENT CONCERNS:

Paraparesis and loss of tactile sense after the surgery immediately.

DIAGNOSES:

Acute neurological deterioration after cervical laminoplasty.

INTERVENTIONS:

A second emergency surgery was performed to remove the C2-C5 laminae.

OUTCOMES:

Six months later, the patient had experienced slight improvement in neurological function.

LESSONS:

Abnormal spinal cord immune inflammatory reaction associated with ankylosing spondylitis and limited decompression may lead to acute neurological deterioration. The potential overactive inflammatory response following surgery in the patients with autoimmune rheumatoid disease should be carefully considered in spinal surgery. Timely diagnosis and treatment may benefit these patients.

PMID:
30142754
PMCID:
PMC6112925
DOI:
10.1097/MD.0000000000011605
[Indexed for MEDLINE]
Free PMC Article
Icon for Wolters Kluwer Icon for PubMed Central
6.
Rev Assoc Med Bras (1992). 2018 Apr;64(4):379-383. doi: 10.1590/1806-9282.64.04.379.

Spine surgery in patients with ankylosing spondylitis.

Author information

1
Neurosurgery resident - Universidade Estadual de Campinas, Unicamp, Campinas-SP, Brasil.
2
Neurosurgery Professor - Universidade Estadual de Campinas, Unicamp, Campinas-SP, Brasil.
3
Neurosurgeon - Universidade Estadual de Campinas, Unicamp, Campinas-SP, Brasil.

Abstract

INTRODUCTION:

Ankylosing spondylitis (AS) is an idiopathic seronegative spondyloartropathy that involves mainly the axial skeleton and the sacroiliac joints. AS promotes biomechanical changes in the spine that predispose to fractures, spinal deformity and spondylodiscitis. The aim of this article is to report the clinical and laboratorial characteristics of patients with AS who underwent spinal surgery at our Institution.

METHODS:

Retrospective review of medical charts of patients who had AS and underwent spinal interventions.

RESULTS:

Nine patients were found and eight were included in the present study. There were three men and six women and the patients' mean age was 57 years old. All patients had pain at the involved spinal level and one patient had tetraparesis due to cervical myelopathy. Acute-phase proteins were positive in six patients (75%), and HLA-B27 was found in two patients (25%). Four patients had the radiological diagnosis of spondylodiscitis (50%) and underwent a spinal disc biopsy. They were all characterized as having aseptic spondylodiscitis. Three patients were free of pain with analgesics in their last follow-up and one patient had only partial solution of his pain. Three additional patients had spinal fractures surgically treated (37.5%) and one patient was operated because of a cervical kyphotic deformity (12.5%). There were no deaths or surgical complications in this series.

CONCLUSIONS:

the majority of our clinical and laboratories findings were discrepant with the medical literature. These differences may be secondary to regional characteristics or by the fact that our population included only those patients who underwent spinal surgery.

PMID:
30133619
DOI:
10.1590/1806-9282.64.04.379
[Indexed for MEDLINE]
Free full text
Icon for Scientific Electronic Library Online
7.
Rheumatology (Oxford). 2018 Oct 1;57(10):1871-1872. doi: 10.1093/rheumatology/key239.

Comment on: Managing morbidity and treatment-related toxicity in patients with ankylosing spondylitis.

Author information

1
Department of Internal Medicine, Division of Rheumatology, Eskisehir Osmangazi University, Eskisehir, Turkey.
PMID:
30107558
DOI:
10.1093/rheumatology/key239
[Indexed for MEDLINE]
Icon for Silverchair Information Systems
8.
Medicine (Baltimore). 2018 Aug;97(31):e11677. doi: 10.1097/MD.0000000000011677.

Role of TNFRSF1A and TNFRSF1B polymorphisms in susceptibility, severity, and therapeutic efficacy of etanercept in human leukocyte antigen-B27-positive Chinese Han patients with ankylosing spondylitis.

Author information

1
Department of Rheumatism and Immunity, The First Affiliated Hospital of Anhui Medical University.
2
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University Hefei, Anhui, China.

Abstract

The successful therapeutic use of anti-TNF biological agents in patients with ankylosing spondylitis (AS) indicates that tumor necrosis factor-α (TNF-α) and tumor necrosis factor receptor (TNFR) genes are involved in the pathogenesis of AS. TNF-α exerts its biological activity by binding to its cell surface receptors (p55 TNF-α receptor [TNFRI, encoded by the Tumor Necrosis Factor Receptor Superfamily Member 1A (TNFRSF1A)] and p75 receptor [TNFRII, encoded by the Tumor Necrosis Factor Receptor Superfamily Member 1B (TNFRSF1B)]. TNFRSF1A and TNFRSF1B may be related to AS, but the relevant studies are still limited. Therefore, we aim to explore the association between TNFRSF1A and TNFRSF1B polymorphisms and susceptibility and short- and long-term response to anti-TNF treatment in human leukocyte antigen-B27 (HLA-B27)-positive Chinese Han patients with AS.A total of 215 HLA-B27-positive patients with AS and 216 HLA-B27-positive matched controls were enrolled and genotyped for rs767455, rs2234649, and rs1061622. A subset of 50 AS patients was also studied for the association of these polymorphisms with the short- and long-term response to etanercept assessed by Assessment in Ankylosing Spondylitis 20 (ASAS20) and Assessment in Ankylosing Spondylitis 40 (ASAS40).Our data showed that rs767455 was associated with the susceptibility of AS, G allele of rs767455 exhibited an association with the risk of developing AS (OR = 1.63 (1.04-2.55), P = .032). Rs1061622 polymorphism was associated with total back pain and chest expansion. Only rs1061622 was significantly associated with long-term efficacy of etanercept: the TG genotype of rs1061622 worsened ASAS20 and ASAS40 responses at 12 months (P = .021 and .041, respectively).The results suggest that TNFRSF1A and TNFRSF1B polymorphisms were associated with susceptibility, severity, and the long-term therapeutic efficacy of etanercept of patients with AS.

PMID:
30075559
PMCID:
PMC6081148
DOI:
10.1097/MD.0000000000011677
[Indexed for MEDLINE]
Free PMC Article
Icon for Wolters Kluwer Icon for PubMed Central
9.
Complement Ther Clin Pract. 2018 Aug;32:187-194. doi: 10.1016/j.ctcp.2018.07.001. Epub 2018 Jul 6.

Cupping therapy for treating ankylosing spondylitis: The evidence from systematic review and meta-analysis.

Author information

1
Department of Pharmacy, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
2
Department of Traditional Chinese Medicine, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China.
3
Department of Pharmacy, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
4
Department of Bone and Jount Surgery, Shanghai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China. Electronic address: qinghuang51@yahoo.com.

Abstract

OBJECTIVE:

Cupping therapy has been widely used in Eastern Asia, the Middle East, or Central and North Europe to manage the symptom of ankylosing spondylitis (AS). The aim of this systematic review was to review data from randomized controlled trials (RCTs) of cupping therapy for treating patients with AS.

METHODS:

Databases that were searched from their inception until December 2017 included: MEDLINE, CINAHL, EMBASE, AMED, Cochrane Central Register of Controlled Trials, four Chinese databases [Chinese BioMedical Database, China National Knowledge Infrastructure, Wan-Fang Data, and the Chinese WeiPu Database], KoreaMed, The Korean National Assembly Library, Japana Centra Revuo Medicina (http://www.jamas.gr.jp/) and CiNii. In this systematic review, only RCTs that were related to the effects of cupping therapy on managing AS were included. A quantitative synthesis of RCTs will be conducted using RevMan 5.3 software. Study selection, data extraction, and validation were performed independently by two reviewers. Quantitative analysis of RCTs were performed using RevMan 5.3 software, and cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials.

RESULTS:

A total of 5 RCTs met the inclusion criteria, and most were of low methodological quality. Participants in cupping therapy plus Western medicine group showed significantly greater improvements in the response rate [RR = 1.13, 95%CI (1.06, 1.22), p < 0.01] with low heterogeneity (Chi2 = 2.88, p = 0.41, I2 = 0%). Moreover, when compared with western medicine alone, meta-analysis indicated favorable statistically significant effects of cupping therapy plus western medicine on the Bath Ankylosing Spondylitis Functional Index (BASFI) [MD = -16.63, 95%CI (-17.75, -15.51), p < 0.01] and Bath Ankylosing Disease Activity Index (BASDAI) [MD = -9.93, 95%CI (-10.34, -9.52), p < 0.01], with low heterogeneity (Chi2 = 0.32, p = 0.85, I2 = 0% in BASFI; (Chi2 = 2.46, p = 0.29, I2 = 19% in BASDAI). Furthermore, when compared with western medicine alone, meta-analysis demonstrated statistically significant effects of cupping therapy plus western medicine on the serum level of ESR [MD = -1.28, 95% CI (-1.44, -1.13), p < 0.01] and the serum level of CRP [MD = -3.97, 95%CI (-4.71, -3.22), p < 0.01], with low heterogeneity (Chi2 = 0.50, p = 0.78, I2 = 0% in the serum level of ESR; Chi2 = 0.19, p = 0.91, I2 = 0% in the serum level of CRP).

CONCLUSION:

Taken together, only weak evidence supported the hypothesis that cupping therapy had potential benefits for patients with AS.

KEYWORDS:

Ankylosing spondylitis; Cupping therapy; Meta-analysis; Systematic review

PMID:
30057049
DOI:
10.1016/j.ctcp.2018.07.001
[Indexed for MEDLINE]
Icon for Elsevier Science
10.
Acta Gastroenterol Belg. 2018 Apr-Jun;81(2):327-329.

A case of unusual histiocytic colitis in a chronic alcoholic obese patient with ankylosing spondylitis.

Author information

1
Department of Gastroenterology, Hôpital Saint-Joseph, Gilly, Belgium.
2
Department of Pathology, Cliniques universitaires Saint-Luc, Brussels, Belgium.

Abstract

A 64 year-old Caucasian man was first investigated 21 years ago for persistent diarrhoea. A colonoscopy revealed an erosive pancolitis with unusual vacuolated macrophages. Characteristics of ulcerative colitis or Crohn's disease were absent. Similar findings were observed consistently over the following years. A treatment with Sulfasalazine, Methotrexate or Budesonide was efficient. Histiocytic colitis is rare, and the various causes and different diagnoses are reviewed. The cause for the chronic pancolitis in this obese chronic alcoholic remains unknown at the time of writing. Links to the dyslipidaemia and chronic ankylosing spondylitis presented by the patient are possible hypotheses worth investigating further.

KEYWORDS:

ankylosing spondylitis; chronic colitis; dyslipidaemia; histiocytes

PMID:
30024706
[Indexed for MEDLINE]
11.
Medicine (Baltimore). 2018 Jul;97(29):e11540. doi: 10.1097/MD.0000000000011540.

The comparative efficacy of group- versus home-based exercise programs in patients with ankylosing spondylitis: Protocol for a meta-analysis.

Liang H1,2, Tian X3, Liu XL3, Wang SY2,4, Dai Y1,2, Kang L1,2, Chen LS1,2, Jin LF1,2.

Author information

1
Department of Nursing, the First People's Hospital of Yunnan Province.
2
The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China.
3
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing.
4
Department of Rheumatology and Immunology, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China.

Abstract

BACKGROUND:

Ankylosing spondylitis (AS) is an important factor to not only cause employment obstacle, but also result in serious social economic load. Several randomized controlled trials investigated the efficacy of group- versus home-based exercise programs in patients with AS. This systematic review will collect and summarize the available evidence to realize the effectiveness of group- and home-based programs in patients with AS.

METHODS:

A search in PubMed, Web of Science, EMBASE, and the Cochrane Library will be electronically performed by 2 independent investigators to capture all potential studies comparing group- and home-based in patients with AS. The time limit of search will be from their inception to April 2018. Two independent investigators provide their agreement in presencial meeting for a final selection, and at a later stage, the articles will be reviewed in full-text by the all authors. Quantitative analysis will be performed with Review Manager (RevMan) software (version 5.3.0).

RESULTS:

This meta-analysis will provide a high-quality synthesis of current evidence of group- versus home-based exercise programs in patients with AS.

CONCLUSION:

The conclusion of our meta-analysis will provide the evidence which program is an effective intervention for patient with AS.

PMID:
30024543
PMCID:
PMC6086499
DOI:
10.1097/MD.0000000000011540
[Indexed for MEDLINE]
Free PMC Article
Icon for Wolters Kluwer Icon for PubMed Central
12.
Medicine (Baltimore). 2018 Jul;97(27):e11265. doi: 10.1097/MD.0000000000011265.

A retrospective study of transcutaneous electrical nerve stimulation for chronic pain following ankylosing spondylitis.

Author information

1
Department of Spine Surgery.
2
Department of Intensive Medicine/Orthopedics, the Fourth People's Hospital of Shaanxi, Xi'an, Shaanxi, China.

Abstract

This study investigated the effect of transcutaneous electrical nerve stimulation (TENS) for the treatment of patients with chronic pain after ankylosing spondylitis (AS).A total of 72 eligible patients with chronic pain following AS were included. All included patients received exercise and were assigned to a treatment group and a control group equally. In addition, patients in the treatment group also underwent TENS therapy. All patients were treated for a total of 6 weeks. The primary outcome of pain intensity was measured by visual analog scale (VAS). The secondary outcomes included degree of functional limitation, as assessed by Bath Ankylosing Spondylitis Functional Index (BASFI); and quality of life, as evaluated by Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire. All outcomes were assessed before and after 6 weeks treatment. Furthermore, adverse events were also recorded.After 6-week treatment, patients in the treatment group did not show more promising outcomes in pain reduction, as measured by VAS (P = .08); functional evaluation, as evaluated by BASFI (P = .19); as well as quality of life, as assessed by ASQoL (P = .18), compared with patients in the control group. No adverse events occurred in both groups.This study did not exert encouraging outcomes in patients with chronic pain following AS after 6-week treatment.

PMID:
29979392
PMCID:
PMC6076202
DOI:
10.1097/MD.0000000000011265
[Indexed for MEDLINE]
Free PMC Article
Icon for Wolters Kluwer Icon for PubMed Central
13.
Medicine (Baltimore). 2018 Jul;97(27):e11250. doi: 10.1097/MD.0000000000011250.

Differences in carotid atherosclerosis between patients with ankylosing spondylitis treated with tumor necrosis factor-α antagonists and healthy matched controls.

Author information

1
Hospitalist Service, "Campus Bio-Medico" University, Rome.
2
Radiology Department, S Maria della Misericordia Hospital, Urbino.
3
Division of Cardiology, Faculty of Medicine and Psychology, University of Rome "Sapienza," Sant'Andrea Hospital.
4
Immunorheumatology Unit, "Campus Bio-Medico" University, Rome, Italy.

Abstract

An increased vascular risk is present in patients with ankylosing spondylitis (AS). In this report, we evaluate the presence and grade of atherosclerosis in patients with AS, uninterruptedly treated with tumor necrosis factor-α (TNF-α) antagonists for 2 years, in comparison to that in a nontreated group of healthy controls.Fourteen patients with AS and 14 healthy controls underwent carotid sonography to measure intima-media thickness (IMT) and to evaluate the presence of plaque. Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index scores, erythrocyte sedimentation rate, C-reactive protein, glycemia, total cholesterol, and triglyceride levels were also recorded.Patients with AS showed significantly lower values of mean and maximum IMT at the level of the common carotid (P = .02 and .04, respectively) and the carotid bulb (P = .0006 and .0005, respectively) compared to those of healthy controls. They also had a number of carotid plaques significantly lower than that of healthy controls (P = .02). No differences were found in IMT values at the level of internal carotid between the 2 populations.The significantly lower carotid atherosclerosis found in patients with AS treated with TNF antagonists than in healthy controls shows the important complementary role of this treatment in reducing vascular disease progression probably by decreasing inflammation.

PMID:
29979389
PMCID:
PMC6076036
DOI:
10.1097/MD.0000000000011250
[Indexed for MEDLINE]
Free PMC Article
Icon for Wolters Kluwer Icon for PubMed Central
14.
Lancet. 2018 Jul 14;392(10142):134-144. doi: 10.1016/S0140-6736(18)31362-X. Epub 2018 Jun 29.

Efficacy and safety of continuing versus withdrawing adalimumab therapy in maintaining remission in patients with non-radiographic axial spondyloarthritis (ABILITY-3): a multicentre, randomised, double-blind study.

Author information

1
Department Clinical Immunology and Rheumatology, Amsterdam Rheumatology & Clinical Immunology Center, Amsterdam, Netherlands; Department of Rheumatology, Zuyderland Medical Center, Heerlen, Netherlands. Electronic address: landewe@rlandewe.nl.
2
Department of Gastroenterology, Infectious Diseases, and Rheumatology, Charité Universitätsmedizin Berlin, Berlin, Germany.
3
Seattle Rheumatology Associates, Swedish Medical Center and University of Washington, Seattle, WA, USA.
4
Department of Immunology, Toronto Western Hospital, Toronto, ON, Canada.
5
Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada.
6
Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, Portland, OR, USA.
7
National Institute for Health Research, Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
8
Department of Medicine, Division of Rheumatology, Case Western Reserve University School of Medicine at MetroHealth Medical Center, Cleveland, OH, USA.
9
Rheumazentrum Ruhrgebiet, Herne, Germany.
10
AbbVie, North Chicago, IL, USA.

Abstract

BACKGROUND:

Success of treatment withdrawal in patients with non-radiographic axial spondyloarthritis who are in remission remains unknown. The ABILITY-3 study explored the ability to withdraw adalimumab treatment in patients with non-radiographic axial spondyloarthritis who achieved sustained clinical remission after open-label treatment with adalimumab.

METHODS:

ABILITY-3 was a multicentre, two-period study done in 107 sites in 20 countries. We enrolled adult patients (≥18 years) diagnosed with non-radiographic axial spondyloarthritis, fulfilling Assessment of SpondyloArthritis international Society classification criteria but not the modified New York radiologic criterion, who had objective evidence of active inflammation, active disease, and inadequate response to at least two non-steroidal anti-inflammatory drugs. Patients who achieved Ankylosing Spondylitis Disease Activity Score (ASDAS) inactive disease (<1·3) with open-label adalimumab (40 mg subcutaneously every other week for 28 weeks) at weeks 16, 20, 24, and 28 were randomly assigned (1:1) using an interactive voice or web response system to 40-week, double-blind treatment with adalimumab (continuation) or placebo (withdrawal). The primary efficacy endpoint was the proportion of patients who did not experience a flare (defined as ASDAS ≥2·1 at two consecutive visits) during the double-blind period. Patients who flared were rescued with open-label adalimumab. This study is registered with ClinicalTrials.gov, number NCT01808118.

FINDINGS:

Between June 27, 2013, and October 22, 2015, 673 patients were enrolled to the study. The trial completed on April 14, 2017. Of 673 enrolled patients, 305 (45%) achieved sustained remission and were randomly assigned to double-blind treatment (152 patients to adalimumab and 153 to placebo). A greater proportion of patients continuing adalimumab than those receiving placebo did not experience a flare (107 [70%] of 152 patients vs 72 [47%] of 153 patients; p<0·0001) up to and including week 68. Among 673 patients receiving adalimumab at any time, 516 (77%) patients reported an adverse event and 28 (4%) experienced a serious adverse event. The most common adverse events in both the adalimumab and placebo groups were nasopharyngitis (25 [16%] vs 20 [13%]), upper respiratory tract infection (20 [13%] vs 12 [8%]), and worsening of axial spondyloarthritis (ten [7%] vs 21 [14%]).

INTERPRETATION:

In patients with active non-radiographic axial spondyloarthritis who achieved sustained remission with adalimumab, continued therapy was associated with significantly fewer patients flaring than was treatment withdrawal.

FUNDING:

AbbVie.

PMID:
29961640
DOI:
10.1016/S0140-6736(18)31362-X
[Indexed for MEDLINE]
Icon for Elsevier Science
15.
16.
Int J Mol Sci. 2018 Jun 27;19(7). pii: E1890. doi: 10.3390/ijms19071890.

Systemic Inflammatory Response and Atherosclerosis: The Paradigm of Chronic Inflammatory Rheumatic Diseases.

Author information

1
First Department of Propaedeutic and Internal Medicine and Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, GR-115 27 Athens, Greece. aridakater@yahoo.gr.
2
First Department of Propaedeutic and Internal Medicine and Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, GR-115 27 Athens, Greece. athanprot@gmail.com.
3
First Department of Propaedeutic and Internal Medicine and Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, GR-115 27 Athens, Greece. george.kitas@nhs.net.
4
First Department of Propaedeutic and Internal Medicine and Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, GR-115 27 Athens, Greece. psfikakis@med.uoa.gr.

Abstract

Patients with Chronic Inflammatory Rheumatic diseases (CIRD) are at increased risk of cardiovascular disease (CVD), ascribed not only to classical risk factors, but also to the presence of chronic systemic inflammatory response. &Alpha;therosclerosis, the cornerstone of CVD, is known to be accelerated in CIRD; rheumatoid arthritis promotes atheromatosis and associates with preclinical atherosclerosis equivalent to Diabetes Mellitus, which also seems to apply for systemic lupus erythematosus. Data on ankylosing spondylitis and psoriatic arthritis, albeit more limited, also support an increased CV risk in these patients. The association between inflammation and atherosclerosis, has been thoroughly investigated in the last three decades and the role of inflammation in the pathogenesis and progression of atherogenesis has been well established. Endothelial dysfunction, oxidative stress in vascular endothelial cells and macrophage accumulation, toll-like receptor signaling, NLPR-3 formation and subsequent pro-inflammatory cytokine production, such as TNFa, IL-1&beta;, IL-6, and TNF-like cytokine 1A, are few of the mechanisms implicated in the atherogenic process. Moreover, there is evidence that anti-inflammatory biologic drugs, such as anti-TNF and anti-IL1&beta; agents, can decelerate the atherogenic process, thus setting new therapeutic targets for early and effective disease control and suppression of inflammation, in addition to aggressive management of classical CV risk factors.

KEYWORDS:

ankylosing spondylitis; atherosclerosis; cardiovascular disease; inflammation; lupus; psoriatic arthritis; rheumatoid arthritis

PMID:
29954107
PMCID:
PMC6073407
DOI:
10.3390/ijms19071890
[Indexed for MEDLINE]
Free PMC Article
Icon for Multidisciplinary Digital Publishing Institute (MDPI) Icon for PubMed Central
17.
World Neurosurg. 2018 Sep;117:e475-e482. doi: 10.1016/j.wneu.2018.06.053. Epub 2018 Jun 18.

Clinical and Radiographic Results After Posterior Wedge Osteotomy for Thoracolumbar Kyphosis Secondary to Ankylosing Spondylitis: Comparison of Long and Short Segment.

Author information

1
Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Nanjing, China; Medical School of Southeast University, Nanjing, China.
2
Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Nanjing, China. Electronic address: qianbangping@163.com.
3
Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.

Abstract

OBJECTIVE:

To compare the efficacy of long and short segment instrumentation after pedicle subtraction osteotomy (PSO) for thoracolumbar kyphosis caused by ankylosing spondylitis (AS).

METHODS:

Sixty-four consecutive AS patients were analyzed and divided into groups according to length of instrumentation. We defined short segment instrumentation (SSI) as construct length <7 levels (≤3 levels above and below the osteotomy) (n = 17). By contrast, long segment instrumentation (LSI) was defined as construct length ≥7 levels (≥4 levels above and ≥3 levels below the osteotomy) (n = 47). Both groups were matched cohorts. Radiographs were analyzed for correction, ossification, and complications.

RESULTS:

Correction loss in global kyphosis (GK) and lumbar lordosis (LL) of the LSI group was slightly higher than that of SSI group. Notably, a significantly higher modified Stokes Ankylosing Spondylitis Spinal Score (mSASSS) was noted in the SSI group. Pearson correlation analysis demonstrated that thoracic and lumbar spine mSASSS were significantly associated with correction loss in GK and LL, respectively. Two cases of proximal junctional kyphosis and 1 case of rod fracture occurred in the LSI group.

CONCLUSIONS:

Both approaches were able to maintain sustained surgical outcomes. Short segment instrumentation is recommended for AS patients with bridging syndesmophytes. Long constructs are better indicated for patients without fully ossified anterior longitudinal ligaments. Nevertheless, extension of the length of instrumentation might not prevent complications such as proximal junctional kyphosis or rod fracture in patients without fully ossified vertebrae.

KEYWORDS:

Ankylosing spondylitis; Bridging syndesmophytes; Loss of correction; Modified Stokes Ankylosing Spondylitis Spinal Score; Pedicle subtraction osteotomy; Short segment instrumentation

PMID:
29920395
DOI:
10.1016/j.wneu.2018.06.053
[Indexed for MEDLINE]
Icon for Elsevier Science
18.
Mol Med Rep. 2018 Aug;18(2):1263-1270. doi: 10.3892/mmr.2018.9136. Epub 2018 Jun 6.

Identification of genes and signaling pathways associated with the pathogenesis of juvenile spondyloarthritis.

Author information

1
Department of Orthopedics, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China.
2
Department of Plastic and Reconstructive Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China.
3
Department of Spine Surgery, Zhangqiu People's Hospital, Jinan, Shandong 250200, P.R. China.
4
School of Life Sciences, Shanghai University, Shanghai 200444, P.R. China.
5
Department of Orthopedics, Fourth Hospital of Changsha, Changsha, Hunan 410006, P.R. China.
6
Department of Rheumatism Immunity, People's Liberation Army General Hospital, Beijing 100700, P.R. China.
7
Department of Orthopedics, Shanghai Zhoupu Hospital, Shanghai 201318, P.R. China.

Abstract

The aim of the present study was to identify key genes and signaling pathways associated with the pathogenesis of juvenile spondyloarthritis (JSA). The gene expression profile dataset GSE58667, including data from 15 human whole blood samples collected from 11 patients with JSA and four healthy controls, was analyzed to identify differentially expressed genes (DEGs) associated with disease characteristics. Additionally, Gene Ontology term and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses of the DEGs were performed. Protein‑protein, microRNA‑transcription factor and chemical‑gene interaction networks were constructed. A total of 326 DEGs, 196 upregulated and 130 downregulated, were identified. DEGs, including C‑X‑C motif chemokine ligand 5 (CXCL5), BCL2 interacting protein 3 like (BNIP3L), dual specificity phosphatase 5 (DUSP5) and tumor protein p53 (TP53) were enriched in functions associated with apoptosis, the cell cycle and immune responses. KEGG pathway enrichment analysis revealed that pathways associated with inflammation and the mitogen‑activated protein kinase 1 (MAPK) signaling pathway were the most enriched by DEGs. The results of the present study indicated that the MAPK signaling pathway and four genes, including CXCL5, BNIP3L, DUSP5 and TP53, may be implicated in the pathogenesis of JSA.

PMID:
29901120
PMCID:
PMC6072139
DOI:
10.3892/mmr.2018.9136
[Indexed for MEDLINE]
Free PMC Article
Icon for Spandidos Publications Icon for PubMed Central
19.
J Trace Elem Med Biol. 2018 Sep;49:91-97. doi: 10.1016/j.jtemb.2018.05.001. Epub 2018 May 3.

Effect of anti-rheumatic treatment on selenium levels in inflammatory arthritis.

Author information

1
Department of Medical Biochemistry, Innlandet Hospital Trust, Lillehammer, Norway. Electronic address: Gia.Deyab@sykehuset-innlandet.no.
2
Lillehammer Hospital for Rheumatic Diseases, Norway.
3
Inland Norway University of Applied Sciences, Elverum, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway.
4
Department of Public Health, Faculty of Nursing sciences, Oslo and Akershus University College, Oslo, Norway.
5
Department of Medical Biochemistry, Innlandet Hospital Trust, Lillehammer, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway.
6
University Hospital, Ullevål, Norway; Institute of Clinical Sciences, University of Oslo, Norway.
7
Department of Medical Biochemistry, Oslo University Hospital, Ullevål, Norway.
8
Lab1 AS, Sandvika, Norway.
9
Department of Medicine, Innlandet Hospital Trust, Lillehammer, Norway.
10
Department of Biology, Faculty of Sciences-l, Lebanese University, Beirut, Lebanon.
11
Lillehammer Hospital for Rheumatic Diseases, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway; Harvard Medical School, Boston, USA; Brigham and Women's Hospital, Boston, USA.

Abstract

OBJECTIVES:

The reason for increased cardiovascular risk in inflammatory arthritis (IA) is unclear. Interestingly, selenium-deficiency is suspected to contribute to the development of cardiovascular disease (CVD) in the general population. Although the reference range of serum selenium (s-selenium) is 50-120 μg/L, there are indications that levels up to 85 μg/L might not be sufficient for optimal cardioprotection. Our aim was to examine s-selenium levels in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS), to evaluate the effect of anti-rheumatic treatment on s-selenium levels, and to assess relationships between s-selenium levels and clinical and laboratory parameters including markers of disease activity and CVD risk.

METHODS:

We examined 64 patients with RA, 40 with PsA and 26 with AS starting with methotrexate (MTX) monotherapy or anti-tumor necrosis factor therapy (anti-TNF) with or without methotrexate (anti-TNF ± MTX) due to active disease. S-selenium, inflammatory biomarkers, endothelial function (EF) and other variables were examined at baseline and after 6 weeks and 6 months of treatment.

RESULTS:

In the total IA group, s-selenium increased within 6 weeks of anti-rheumatic treatment, and thereafter the levels remained stable until the end of the 6 months follow-up period. There were no significant differences in s-selenium changes between the three diagnostic groups and between the two treatment regimens. Changes in s-selenium were negatively related to changes in C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), but there were no significant relationships to any other of the examined risk parameters for CVD including EF.

CONCLUSION:

IA patients had s-selenium within the reference range, but below the level that might be necessary for optimal CVD protection. Anti-rheumatic treatment had a relatively rapid and sustained effect on s-selenium levels. The increase in s-selenium was related to reduction in inflammatory activity. In theory, anti-rheumatic drugs might improve s-selenium levels through inhibition of pro-inflammatory processes or through other mechanisms. Although we have not revealed any significant relationships between s-selenium and CVD risk parameters, the role of suboptimal s-selenium levels in pathogenesis of premature CVD in IA cannot be ruled out.

KEYWORDS:

Anti-tumor necrosis factor; Inflammatory arthritis; Methotrexate; Selenium

PMID:
29895378
DOI:
10.1016/j.jtemb.2018.05.001
[Indexed for MEDLINE]
Icon for Elsevier Science
20.
Int J Immunogenet. 2018 Aug;45(4):190-200. doi: 10.1111/iji.12366. Epub 2018 Jun 4.

Association of CD14 and macrophage migration inhibitory factor gene polymorphisms with inflammatory microRNAs expression levels in ankylosing spondylitis and polyarthralgia.

Author information

1
Central Laboratory for Stem Cell Research & Translational Medicine, CLRD, Deccan College of Medical Sciences, Hyderabad, Telangana, India.
2
Department of Orthopedics, Owaisi Hospital and Research Centre, Deccan College of Medical Sciences, Hyderabad, Telangana, India.

Abstract

This study aimed to investigate the genetic basis of ankylosing spondylitis (AS) and polyarthralgia (PA) conditions among Indian subjects through genotyping two immune regulatory genes CD14 (-159C>T) and MIF (-173G>C) and find their association with the expression levels of three circulating inflammatory miRNAs. This investigation may provide early genetic cause of these two forms of arthritis and more optimal biological targets to predict early therapeutic outcomes. A total of 140 patients (AS: 70 and PA: 70) and 156 controls were recruited from Indian population. CD14 and MIF genotyping was performed using ARMS-PCR. Expression level of three inflammatory miRNAs (miRNA-146a, miRNA-155 and miRNA-181) was quantified using RT-qPCR. C/T genotype of CD14 gene was found to cause 2.06-fold risk of developing AS (CI 1.06-5.98, p = .04) as compared to others and G/C genotype in MIF also shown significant variation between AS and control subjects. In PA subjects, CD14 genotypes (C/T) was found to be associated with disease susceptibility and G/C genotype of MIF gene polymorphism showed 4.71-fold risk of developing PA (CI 2.58-8.62, p = .0001). The study also revealed significant upregulation of miRNA-155 expression in AS subjects (p = .0001) with more than 1.3-fold difference between AS and PA as compared to the control subjects. miRNA-155 had strong association with AS patients with CD14 genotypes (p < .05) than PA and control subjects. This study provides better understanding of the mechanisms and disease susceptibility for MIF and CD14 genetic variants and inflammatory miRNAs networks involved in AS and PA.

KEYWORDS:

CD14 and MIF gene polymorphism; Polyarthralgia; ankylosing spondylitis; miRNA expression

PMID:
29863307
DOI:
10.1111/iji.12366
[Indexed for MEDLINE]
Icon for Wiley

Supplemental Content

Loading ...
Support Center