308 results on '"Syndesmophyte"'
Search Results
2. Axial Spondyloarthritis
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Baraliakos, Xenofon, McGonagle, Dennis, Braun, Jürgen, and Stone, John H., editor
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- 2023
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3. Psoriatic Arthritis
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Helliwell, Philip, Coates, Laura C., Gladman, Dafna, and Stone, John H., editor
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- 2023
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4. Radiographic involvement of cervical facet joints in ankylosing spondylitis: a longitudinal analysis in correlation with vertebral body lesions
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Tae-Han Lee, Seunghun Lee, Bon San Koo, Kyung Bin Joo, and Tae-Hwan Kim
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Ankylosing spondylitis ,Facet joint ,Radiography ,Syndesmophyte ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background The inability to assess structural changes in facet joints is a limitation of established radiographic scoring systems for ankylosing spondylitis (AS). We compared radiographic evidence of ankylosis in cervical facet joints and cervical vertebral bodies in patients with AS. Methods We analysed longitudinal data collected from 1106 AS patients and assessed 4984 spinal radiographs obtained up to 16 years of follow-up. Comparisons between cervical facet joints and cervical vertebral bodies focused on the presence of ankylosis, which was defined by at least one facet joint exhibiting complete ankylosis (according to the method of de Vlam) or at least one vertebral body with a bridging syndesmophyte (according to the modified Stoke Ankylosing Spondylitis Spinal Score [mSASSS]). Ankylosis was assessed over time using spinal radiographs collected during follow-up periods stratified in 4-year increments. Results Patients with cervical facet joint ankylosis had higher cervical mSASSS, sacroiliitis grades, and inflammatory markers, with more prevalent hip involvement and uveitis. Overall, the numbers of spinal radiographs indicating ankylosis were comparable between cervical facet joints (17.8%) and cervical vertebral bodies (16.8%), and they usually presented together (13.5%). We observed similar proportions of radiographs with ankylosis only in cervical facet joints (4.3%) and cervical vertebral bodies (3.3%). As damage progressed, configurations with both cervical facet joint ankylosis and bridging syndesmophytes became more predominant with longer follow-up times, while configurations with cervical facet joint ankylosis only or bridging syndesmophytes only were less frequently observed. Conclusions Evidence of cervical facet joint ankylosis appears as often as bridging syndesmophytes on routine AS spinal radiographs. Presence of cervical facet joint ankylosis should be considered because it may have a higher disease burden.
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- 2023
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5. MICA*019 Allele and Soluble MICA as Biomarkers for Ankylosing Spondylitis in Taiwanese.
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Wang, Chin-Man, Tan, Keng-Poo, Jan Wu, Yeong-Jian, Lin, Jing-Chi, Zheng, Jian-Wen, Yu, Alice L, Wu, Jian-Ming, and Chen, Ji-Yih
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AS ,HLA-B27 ,MICA ,soluble MICA ,syndesmophyte - Abstract
MICA (major histocompatibility complex class I chain-related gene A) interacts with NKG2D on immune cells to regulate host immune responses. We aimed to determine whether MICA alleles are associated with AS susceptibility in Taiwanese. MICA alleles were determined through haplotype analyses of major MICA coding SNP (cSNP) data from 895 AS patients and 896 normal healthy controls in Taiwan. The distributions of MICA alleles were compared between AS patients and normal healthy controls and among AS patients, stratified by clinical characteristics. ELISA was used to determine soluble MICA (sMICA) levels in serum of AS patients and healthy controls. Stable cell lines expressing four major MICA alleles (MICA*002, MICA*008, MICA*010 and MICA*019) in Taiwanese were used for biological analyses. We found that MICA*019 is the only major MICA allele significantly associated with AS susceptibility (PFDR = 2.25 × 10-115; OR, 14.90; 95% CI, 11.83-18.77) in Taiwanese. In addition, the MICA*019 allele is associated with syndesmophyte formation (PFDR = 0.0017; OR, 1.69; 95% CI, 1.29-2.22) and HLA-B27 positivity (PFDR = 1.45 × 10-33; OR, 28.79; 95% CI, 16.83-49.26) in AS patients. Serum sMICA levels were significantly increased in AS patients as compared to healthy controls. Additionally, MICA*019 homozygous subjects produced the highest levels of sMICA, compared to donors with other genotypes. Furthermore, in vitro experiments revealed that cells expressing MICA*019 produced the highest level of sMICA, as compared to other major MICA alleles. In summary, the MICA*019 allele, producing the highest levels of sMICA, is a significant risk factor for AS and syndesmophyte formation in Taiwanese. Our data indicate that a high level of sMICA is a biomarker for AS.
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- 2021
6. Syndesmophyte Growth in Ankylosing Spondylitis: from Laboratory to Bedside.
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Ward, Michael M. and Tan, Sovira
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Purpose of Review: This study aims to review recent studies on risk factors for syndesmophyte growth in ankylosing spondylitis (AS) and on treatment effects. Recent Findings: New genetic studies, including a genome-wide association study, provided only limited evidence of specific genetic associations with radiographic severity. Measures of inflammation, including vertebral osteitis and C-reactive protein level, were strongly associated with radiographic progression, while studies of adipokines had mixed results. Mesenchymal stem cells from HLA-B27 positive AS patients were found to promote vertebral ossification via a pathway of B27 misfolding, retinoic acid receptor-β activation, and increased bone alkaline phosphatase. Low vertebral trabecular bone density is associated with syndesmophyte growth, with reciprocal effects when bridged. Several observational studies suggested radiographic severity was reduced by treatment with tumor necrosis factor inhibitors, particularly when longer than 2 years. Summary: Syndesmophyte development in AS is the result of a complex, incompletely understood, interplay of inflammatory and mechanical factors. [ABSTRACT FROM AUTHOR]
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- 2023
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7. The Influence of Adipokines on Radiographic Damage in Inflammatory Rheumatic Diseases.
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Toussirot, Eric
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RHEUMATISM ,ADIPOKINES ,FIBRODYSPLASIA ossificans progressiva ,RESISTIN ,PSORIATIC arthritis ,RHEUMATOID arthritis - Abstract
Inflammatory rheumatic diseases (IRDs) are complex immune-mediated diseases that are characterized by chronic inflammation of the joints. Rheumatoid arthritis (RA) and spondyloarthritis (SpA), including axial SpA (ax SpA) and psoriatic arthritis (PsA), are the most common forms of IRD. Both RA and ax SpA are characterized by a chronic course with progressive structural modifications, namely, cartilage damage and bone erosions in RA and osteoproliferative changes with spinal ossifications in ax SpA. The adipose tissue is involved in the pathophysiology of IRDs via the release of several proteins, namely, adipokines. Several adipokines with pro-inflammatory effects have been identified, such as leptin, adiponectin, visfatin and resistin. In this review, we discuss the role that adipokines may play in the structural modifications of the peripheral joints and/or axial skeleton. In RA, the role of leptin in structural damage remains controversial, while adiponectin and its high-molecular-weight isoform are known to have an influence on the development of bone erosions and radiographic progression. Resistin also appears to be a potent detrimental adipokine for the joints in RA. In ax SpA, visfatin seems to be an attractive candidate for radiographic progression, while leptin and adiponectin have negative effects on radiographic progression. [ABSTRACT FROM AUTHOR]
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- 2023
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8. Genetic effects of B3GNT2 on ankylosing spondylitis susceptibility and clinical manifestations in Taiwanese
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Chin-Man Wang, Yeong-Jian Jan Wu, Jing-Chi Lin, Li-Yu Huang, Jianming Wu, and Ji-Yih Chen
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B3GNT2 ,Ankylosing spondylitis ,Polymorphism ,Syndesmophyte ,Medicine (General) ,R5-920 - Abstract
Background/Purpose: The intergenic SNP rs10865331 at 2p15 was identified as a major risk factor for ankylosing spondylitis (AS) susceptibility in genome-wide association studies (GWAS). B3GNT2 gene regulates polylactosamine synthesis is potentially functionally relevant to AS disease development. We investigated whether SNP rs10865331 and two B3GNT2 SNPs (rs11900673 and rs1136151) are associated with AS susceptibility and disease severity in Taiwanese. Methods: Distributions of genotypes, alleles, and haplotypes of three SNPs were compared between 1,472 AS patients and 2,117 healthy blood donors and among AS patients stratified by clinical characteristics. Results: The intergenic SNP rs10865331 was significantly associated with AS (PFDR = 1.02E-05) in Taiwanese. In AS patients stratified by positivity of HLA-B27 and syndesmophyte formation, all three B3GNT2 locus SNPs (rs11900673, rs1136151, and rs10865331) were significantly associated with syndesmophyte formation among HLA-B27 positive AS patients. Haplotype analyses revealed that the “CTA” (rs11900673C/rs1136151T/rs10865331A) haplotype was significantly associated with AS susceptibility (Padj = 0.0177) and syndesmophyte formation (Padj = 0.016) in HLA-B27 positive patients. In contrast, “TCG” (rs11900673T/rs1136151C/rs10865331G) haplotype showed protection against AS development (Padj = 0.0005 for HLA-B27 positive and Padj = 0.004 for HLA-B27 negative, respectively) and syndesmophyte formation (Padj = 0.0017) in HLA-B27 positive patients. Furthermore, B3GNT2 mRNA expressions were negatively associated with erythrocyte sedimentation rate (ESR, P = 0.0103), C-reactive protein (CRP, P = 0.0353), Bath ankylosing spondylitis functional index (BASFI, P = 0.0171), and syndesmophyte formation (P = 0.0148). Conclusion: Our data suggest that B3GNT2 gene may contribute to AS development and affect AS severity by interacting with HLA-B27 in Taiwanese.
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- 2022
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9. Genetic effects of B3GNT2 on ankylosing spondylitis susceptibility and clinical manifestations in Taiwanese.
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Wang, Chin-Man, Jan Wu, Yeong-Jian, Lin, Jing-Chi, Huang, Li-Yu, Wu, Jianming, and Chen, Ji-Yih
- Abstract
Background/purpose: The intergenic SNP rs10865331 at 2p15 was identified as a major risk factor for ankylosing spondylitis (AS) susceptibility in genome-wide association studies (GWAS). B3GNT2 gene regulates polylactosamine synthesis is potentially functionally relevant to AS disease development. We investigated whether SNP rs10865331 and two B3GNT2 SNPs (rs11900673 and rs1136151) are associated with AS susceptibility and disease severity in Taiwanese.Methods: Distributions of genotypes, alleles, and haplotypes of three SNPs were compared between 1,472 AS patients and 2,117 healthy blood donors and among AS patients stratified by clinical characteristics.Results: The intergenic SNP rs10865331 was significantly associated with AS (PFDR = 1.02E-05) in Taiwanese. In AS patients stratified by positivity of HLA-B27 and syndesmophyte formation, all three B3GNT2 locus SNPs (rs11900673, rs1136151, and rs10865331) were significantly associated with syndesmophyte formation among HLA-B27 positive AS patients. Haplotype analyses revealed that the "CTA" (rs11900673C/rs1136151T/rs10865331A) haplotype was significantly associated with AS susceptibility (Padj = 0.0177) and syndesmophyte formation (Padj = 0.016) in HLA-B27 positive patients. In contrast, "TCG" (rs11900673T/rs1136151C/rs10865331G) haplotype showed protection against AS development (Padj = 0.0005 for HLA-B27 positive and Padj = 0.004 for HLA-B27 negative, respectively) and syndesmophyte formation (Padj = 0.0017) in HLA-B27 positive patients. Furthermore, B3GNT2 mRNA expressions were negatively associated with erythrocyte sedimentation rate (ESR, P = 0.0103), C-reactive protein (CRP, P = 0.0353), Bath ankylosing spondylitis functional index (BASFI, P = 0.0171), and syndesmophyte formation (P = 0.0148).Conclusion: Our data suggest that B3GNT2 gene may contribute to AS development and affect AS severity by interacting with HLA-B27 in Taiwanese. [ABSTRACT FROM AUTHOR]- Published
- 2022
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10. The Influence of Adipokines on Radiographic Damage in Inflammatory Rheumatic Diseases
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Eric Toussirot
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adipokines ,rheumatoid arthritis ,axial spondyloarthritis ,bone erosion ,syndesmophyte ,Biology (General) ,QH301-705.5 - Abstract
Inflammatory rheumatic diseases (IRDs) are complex immune-mediated diseases that are characterized by chronic inflammation of the joints. Rheumatoid arthritis (RA) and spondyloarthritis (SpA), including axial SpA (ax SpA) and psoriatic arthritis (PsA), are the most common forms of IRD. Both RA and ax SpA are characterized by a chronic course with progressive structural modifications, namely, cartilage damage and bone erosions in RA and osteoproliferative changes with spinal ossifications in ax SpA. The adipose tissue is involved in the pathophysiology of IRDs via the release of several proteins, namely, adipokines. Several adipokines with pro-inflammatory effects have been identified, such as leptin, adiponectin, visfatin and resistin. In this review, we discuss the role that adipokines may play in the structural modifications of the peripheral joints and/or axial skeleton. In RA, the role of leptin in structural damage remains controversial, while adiponectin and its high-molecular-weight isoform are known to have an influence on the development of bone erosions and radiographic progression. Resistin also appears to be a potent detrimental adipokine for the joints in RA. In ax SpA, visfatin seems to be an attractive candidate for radiographic progression, while leptin and adiponectin have negative effects on radiographic progression.
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- 2023
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11. Axial Imaging in Spondyloarthritis.
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Mohan V and Hwang MC
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- Humans, Spondylarthritis diagnostic imaging, Spine diagnostic imaging, Spine pathology, Magnetic Resonance Imaging methods, Tomography, X-Ray Computed methods, Axial Spondyloarthritis diagnostic imaging
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Imaging plays a crucial role in diagnosing and forecasting treatment outcomes in axial spondyloarthritis. Conventional radiography may overlook patients in the initial stages of the disease, while MRI is sensitive in identifying inflammation early on. Computed tomography reliably detects structural abnormalities. Practicing rheumatologists must possess a fundamental understanding of interpreting both active inflammatory and structural lesions in axial spondyloarthritis., Competing Interests: Disclosure V. Mohan and M.C. Hwang have no financial or nonfinancial disclosures relevant to the content of this article., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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12. S100A4 is elevated in axial spondyloarthritis: a potential link to disease severity
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Barbora Šumová, Lucie Andrés Cerezo, Hana Hulejová, Klára Prajzlerová, Michal Tomčík, Kristýna Bubová, Jan Štěpán, Mária Filková, Tereza Kropáčková, Mariam Grigorian, Karel Pavelka, Jiří Vencovský, and Ladislav Šenolt
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S100A4 ,Axial spondyloarthritis ,Disease severity ,Disease duration ,Syndesmophyte ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background S100A4 is a member of calcium binding S100 protein family well known for its role in cancer progression and metastasis. Nevertheless, S100A4 also serves as a negative regulator of bone formation. Dickkopf-1 (DKK-1), marker of bone remodelling, is also implicated in the process of syndesmophyte formation in ankylosing spondylitis. The aim of our study was to evaluate plasma levels of S100A4 in patients with axial spondyloarthritis and to determine the potential association of S100A4 with disease severity, clinical manifestations and with bone changes in a cross-sectional study. Methods Fifty-eight patients with axial spondyloarthritis and 40 healthy controls were studied. Biological samples were analysed for S100A4 and Dickkopf-1. Disease activity was assessed according to the Bath Ankylosing Spondylitis Disease Activity Index. C-reactive protein (CRP) was used as a marker of inflammation. Radiographic damage was assessed using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Results The plasma levels of S100A4 were significantly higher in patients with axial spondyloarthritis compared to heathy controls (p
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- 2020
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13. Alcohol consumption as a predictor of the progression of spinal structural damage in axial spondyloarthritis: data from the Catholic Axial Spondyloarthritis COhort (CASCO)
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Hong Ki Min, Jennifer Lee, Ji Hyeon Ju, Sung-Hwan Park, and Seung-Ki Kwok
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Axial spondyloarthritis ,Alcohol ,mSASSS ,Syndesmophyte ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background The purpose of the present study was to demonstrate whether alcohol consumption could predict spinal structural damage in axial spondyloarthritis (axSpA) in a prospective cohort study. Methods AxSpA patients were enrolled from a single tertiary hospital in a prospective cohort. Baseline data were collected, and 2-year follow-up radiographic data were collected. We analyzed the progression of spinal structural damage in 278 axSpA patients and grouped them into alcohol drinkers and non-drinkers. Baseline and follow-up characteristics were compared between the two groups. Univariable and multivariable logistic regression analyses were performed to reveal predictors of spinal structural damage. Results Changes in modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) and syndesmophyte count over the 2-year period were more prominent in the alcohol drinker group than in the non-drinker group (2.7 ± 3.6 vs 1.5 ± 2.8, P = 0.007, 0.9 ± 1.3 vs 0.4 ± 1.2, P = 0.003). The alcohol drinker group showed more frequent significant mSASSS changes (≥ 2 units for 2 years follow-up) and new syndesmophyte/progression of pre-existing syndesmophytes than the non-drinker group (60.7% vs 29.2%, P
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- 2019
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14. Low bone mineral density predicts the formation of new syndesmophytes in patients with axial spondyloarthritis
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Hyoung Rae Kim, Yeon Sik Hong, Sung-Hwan Park, Ji Hyeon Ju, and Kwi Young Kang
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Axial spondyloarthritis ,Ankylosing spondylitis ,Bone mineral density ,Syndesmophyte ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background This study aimed to investigate whether the presence of low bone mineral density (BMD) in patients with axial spondyloarthritis (axSpA) predicts formation of new syndesmophytes over 2 years. Methods One hundred and nineteen patients fulfilling the imaging arm of the Assessment of SpondyloArthritis International Society axSpA criteria were enrolled. All patients were under 50 years of age. The modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) was assessed by two trained readers blinded to the patients’ data. BMD (lumbar spine, femoral neck or total hip) at baseline was assessed using dual-energy absorptiometry. Low BMD was defined as Z score ≤ − 2.0. Spinal radiographic progression was defined as worsening of the mSASSS by ≥ 2 points over 2 years. Logistic regression analyses were performed to identify predictors associated with development of new syndesmophytes and spinal radiographic progression. Results At baseline, 19 (16%) patients had low BMD. New syndesmophytes had developed in 22 (21%) patients at 2-year follow-up. New syndesmophyte formation after 2 years occurred more in patients with low BMD than in those with normal BMD (p = 0.047). In the multivariable analysis, current smoking, existing syndesmophytes and low BMD at baseline were associated with spinal radiographic progression (OR (95% CI) 3.0 (1.1, 7.7), 4.6 (1.8, 11.8) and 3.6 (1.2, 11.2), respectively). The presence of syndesmophytes at baseline and low BMD were predictors of new syndesmophytes over the following 2 years (OR (95% CI) 5.5 (2.0, 15.2) and 3.6 (1.1, 11.8), respectively). Conclusions Low BMD and existing syndesmophytes at baseline were independently associated with the development of new syndesmophytes in young axSpA patients.
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- 2018
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15. Loss and gain of bone in spondyloarthritis: what drives these opposing clinical features?
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Clunie, Gavin and Horwood, Nicole
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The breadth of bone lesion types seen in spondyloarthritis is unprecedented in medicine and includes increased bone turnover, bone loss and fragility, osteitis, osteolysis and erosion, osteosclerosis, osteoproliferation of soft tissues adjacent to bone and spinal skeletal structure weakness. Remarkably, these effects can be present simultaneously in the same patient. The search for a potential unifying cause of effects on the skeleton necessarily focuses on inflammation arising from the dysregulation of immune response to microorganisms, particularly dysregulation of T
H 17 lymphocytes, and the dysbiosis of established gut and other microbiota. The compelling notion that a common antecedent pathological mechanism affects existing bone and tissues with bone-forming potential (entheses), simultaneously with variable effect in the former but bone-forming in the latter, drives basic research forward and focuses our awareness on the effects on these bone mechanisms of the increasing portfolio of targeted immunotherapies used in the clinic. [ABSTRACT FROM AUTHOR]- Published
- 2020
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16. Trabecular bone loss contributes to radiographic spinal progression in patients with axial spondyloarthritis.
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Jung, Joon-Yong, Kim, Moon-Young, Hong, Yeon Sik, Park, Sung-Hwan, and Kang, Kwi Young
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To investigate the longitudinal relationship between trabecular bone loss and spinal progression in axial spondyloarthritis (axSpA). Patients enrolled in the Incheon Saint Mary's axSpA prospective observational cohort were evaluated. The number of syndesmophytes was assessed by two trained readers at baseline and at 2 and 4 years follow-up. Trabecular bone loss was assessed using the trabecular bone score (TBS). Disease activity measures included the BASDAI, ASDAS, CRP, and ESR. The relationship between trabecular bone loss and radiographic damage was investigated using generalized estimating equation models with 2 year time lags. Of the 245 patients included (80% males; mean (SD) age, 37 (12) years), 26 (11%) had mild trabecular bone loss (1.23–1.31) and 25 (10%) had severe trabecular bone loss (≤1.23) at baseline. Trabecular bone loss was associated with longitudinal radiographic spinal progression. Those with severe trabecular bone loss at baseline had an average 0.42 more syndesmophytes/2 years than those with normal TBS. Multivariate analysis revealed that severe trabecular bone loss compared with normal TBS resulted in an additional 0.4 syndesmophytes over 2 years. Adjusting for significant clinical factors revealed that both mild and severe trabecular bone loss were independent risk factors for new syndesmophyte formation over the next 2 years (OR [95% CI] = 2.4 [1.1–5.1]) and OR [95% CI] = 4.0 [1.6–9.7], respectively). Trabecular bone loss is longitudinally associated with spinal progression of axSpA. The more severe the trabecular bone loss, the stronger the effect on the progression of the spine. [ABSTRACT FROM AUTHOR]
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- 2020
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17. Evaluation of the diagnostic performance of 18F-NaF positron emission tomography/computed tomography in patients with suspected ankylosing spondylitis according to the Assessment of SpondyloArthritis International Society criteria.
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Son, Seung Min, Kim, Keunyoung, Pak, Kyoungjune, Kim, Seong-Jang, Goh, Tae Sik, and Lee, Jung Sub
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RESEARCH , *ANKYLOSING spondylitis , *SODIUM compounds , *RESEARCH methodology , *RETROSPECTIVE studies , *MEDICAL cooperation , *EVALUATION research , *SPONDYLOARTHROPATHIES , *COMPARATIVE studies - Abstract
Background Context: Positron emission tomography (PET) is a potential imaging technique for the diagnosis of AS. The visualization of physiological change makes PET potentially suitable for early detection of inflammatory processes, even before anatomical changes occur. Thus, PET might provide specificity via the use of receptor targeting tracers and allows quantification of disease activity in order to accurately monitor therapeutic effects.Purpose: To examine fluorine-18 sodium fluoride (18F-NaF) PET/computed tomography (PET/CT) findings in patients with inflammatory low back pain and evaluate the utility of this modality in the diagnosis of ankylosing spondylitis (AS) according to the Assessment of SpondyloArthritis International Society (ASAS) criteria.Study Design: Retrospective cohort study.Patients Sample: Sixty-eight patients who underwent 18F-NaF PET/CT imaging between April 2015 and April 2017 for evaluation of inflammatory low back pain.Outcome Measures: We defined AS-positive lesions on PET/CT as symmetric sacroiliac joint uptake that suggests sacroiliitis, syndesmophytes on the spine, and enthesopathy at any site.Methods: All patients were evaluated using the ASAS criteria and assigned to either the AS or the control group. The diagnostic criteria of AS on PET/CT images were defined as 18F-NaF PET/CT images with at least one of AS-positive findings.Results: The diagnostic rate of AS was 72.1% among the 68 patients according to the ASAS criteria. The baseline characteristics between the two groups differed significantly in terms of serum C-reactive protein levels and the presence of human leucocyte antigen-B27. Compared to the control group, in the AS group, 39 patients (79.5%) exhibited typical 18F-NaF PET/CT-positive findings, such as enthesopathy (65.3%, p=.003), syndesmophytes (61.2%, p=.006) and symmetric sacroiliitis (67.3%, p=.001). PET-positive findings had significantly higher area under the curve values than did single 18F-NaF PET/CT- positive findings, and they had the best performance for concordant diagnosis according to the ASAS criteria.Conclusions: 18F-NaF PET/CT yielded significantly different findings between the two groups according to the ASAS criteria and is useful for diagnosing AS. [ABSTRACT FROM AUTHOR]- Published
- 2020
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18. Effects of 1-year anti-TNF-α therapies on bone mineral density and bone biomarkers in rheumatoid arthritis and ankylosing spondylitis.
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Gulyás, Katalin, Horváth, Ágnes, Végh, Edit, Pusztai, Anita, Szentpétery, Ágnes, Pethö, Zsófia, Váncsa, Andrea, Bodnár, Nóra, Csomor, Péter, Hamar, Attila, Bodoki, Levente, Bhattoa, Harjit Pal, Juhász, Balázs, Nagy, Zoltán, Hodosi, Katalin, Karosi, Tamás, FitzGerald, Oliver, Szücs, Gabriella, Szekanecz, Zoltán, and Szamosi, Szilvia
- Subjects
- *
BONE density , *ANKYLOSING spondylitis , *RHEUMATOID arthritis , *PARATHYROIDECTOMY , *BLOOD proteins , *BONE growth , *BIOTHERAPY , *DUAL-energy X-ray absorptiometry - Abstract
Objectives: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have been associated with generalized and localized bone loss. We conducted a comprehensive study using imaging (dual-energy X-ray absorptiometry, DXA) and laboratory biomarkers in order to determine bone health and to study the effects of anti-tumor necrosis factor (TNF) biologics in RA and AS. Patients and methods: Thirty-six RA and 17 AS patients undergoing 1-year etanercept (ETN) or certolizumab-pegol (CZP) therapy were studied. Bone density was assessed by DXA at baseline and after 12 months. Serum C-reactive protein (CRP), calcium, phosphate, parathyroid hormone (PTH), vitamin D3, osteocalcin, procollagen type I N-propeptide (P1NP), C-terminal telopeptide (βCTX), osteoprotegerin, sclerostin (SOST), Dickkopf-1 (DKK-1), soluble receptor activator nuclear kappa B ligand (sRANKL), and cathepsin K (cathK) levels were determined at baseline and after 6 and 12 months. Results: TNF-α inhibition was clinically effective. Anti-TNF-α halted further bone loss over 1 year. In general, anti-TNF therapy significantly increased P1NP, SOST levels, and the P1NP/βCTX ratios, while decreased DKK-1 and CathK production at different time points in most patient subsets. In the full cohort and in RA, baseline and/or 12-month bone mineral density (BMD) at multiple sites exerted inverse relationships with CRP and βCTX, and positive correlation with SOST. In AS, L2-4 BMD after 1-year biologic therapy inversely correlated with baseline βCTX, while femoral neck BMD rather showed inverse correlations with CRP. Conclusions: Anti-TNF therapy slowed down generalized bone loss, in association with clinical improvements, in both diseases. TNF blockade may enhance bone formation and suppress joint destruction. Anti-TNF therapy may act inversely on DKK-1 and SOST. Independent predictors of BMD were SOST and βCTX in RA, whilst CRP in AS. Key Points • One-year anti-TNF therapy halted generalized bone loss in association with clinical improvement in arthritides. • Anti-TNF therapy may inversely act on DKK-1 and SOST. • Independent predictors of BMD were SOST and βCTX in RA, while CRP in AS. [ABSTRACT FROM AUTHOR]
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- 2020
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19. Genetic effects of B3GNT2 on ankylosing spondylitis susceptibility and clinical manifestations in Taiwanese
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Jing Chi Lin, Yeong Jian Jan Wu, Ji Yih Chen, Chin Man Wang, Li Yu Huang, and Jianming Wu
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Syndesmophyte ,medicine.medical_specialty ,Ankylosing spondylitis ,medicine.diagnostic_test ,business.industry ,Haplotype ,Intergenic SNP ,Single-nucleotide polymorphism ,General Medicine ,N-Acetylglucosaminyltransferases ,medicine.disease ,Gastroenterology ,C-Reactive Protein ,Asian People ,Erythrocyte sedimentation rate ,Internal medicine ,Humans ,Medicine ,Genetic Predisposition to Disease ,Spondylitis, Ankylosing ,business ,BASFI ,HLA-B27 Antigen ,Genome-Wide Association Study ,Genetic association - Abstract
Background/Purpose The intergenic SNP rs10865331 at 2p15 was identified as a major risk factor for ankylosing spondylitis (AS) susceptibility in genome-wide association studies (GWAS). B3GNT2 gene regulates polylactosamine synthesis is potentially functionally relevant to AS disease development. We investigated whether SNP rs10865331 and two B3GNT2 SNPs (rs11900673 and rs1136151) are associated with AS susceptibility and disease severity in Taiwanese. Methods Distributions of genotypes, alleles, and haplotypes of three SNPs were compared between 1,472 AS patients and 2,117 healthy blood donors and among AS patients stratified by clinical characteristics. Results The intergenic SNP rs10865331 was significantly associated with AS (PFDR = 1.02E-05) in Taiwanese. In AS patients stratified by positivity of HLA-B27 and syndesmophyte formation, all three B3GNT2 locus SNPs (rs11900673, rs1136151, and rs10865331) were significantly associated with syndesmophyte formation among HLA-B27 positive AS patients. Haplotype analyses revealed that the “CTA” (rs11900673C/rs1136151T/rs10865331A) haplotype was significantly associated with AS susceptibility (Padj = 0.0177) and syndesmophyte formation (Padj = 0.016) in HLA-B27 positive patients. In contrast, “TCG” (rs11900673T/rs1136151C/rs10865331G) haplotype showed protection against AS development (Padj = 0.0005 for HLA-B27 positive and Padj = 0.004 for HLA-B27 negative, respectively) and syndesmophyte formation (Padj = 0.0017) in HLA-B27 positive patients. Furthermore, B3GNT2 mRNA expressions were negatively associated with erythrocyte sedimentation rate (ESR, P = 0.0103), C-reactive protein (CRP, P = 0.0353), Bath ankylosing spondylitis functional index (BASFI, P = 0.0171), and syndesmophyte formation (P = 0.0148). Conclusion Our data suggest that B3GNT2 gene may contribute to AS development and affect AS severity by interacting with HLA-B27 in Taiwanese.
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- 2022
20. The role of smoking in the development and progression of structural damage in axial SpA patients: A systematic review and meta-analysis.
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Akar, Servet, Kaplan, Yusuf Cem, Ecemiş, Sertaç, Keskin-Arslan, Elif, Gercik, Önay, Gücenmez, Sercan, and Solmaz, Dilek
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META-analysis , *LONGITUDINAL method , *ANKYLOSING spondylitis , *SMOKING cessation , *CROSS-sectional method - Abstract
Objective: The objective of this study was to determine whether smoking was associated with the cumulative radiographic spinal damage and radiographic progression in patients with ankylosing spondylitis (AS). Thus, we conducted a systematic review and meta-analysis of the available studies to date. Methods: An electronic search was conducted from inception to June 21, 2016, in EMBASE, the MEDLINE/ PubMed Cochrane Central Register of Controlled Trials databases. Cross-sectional and longitudinal cohort studies investigating the association between smoking and cumulative spinal structural damage or radiographic progression were included. The outcome of interest was the presence of syndesmophytes in cross-sectional studies and radiographic progression in longitudinal studies. The quality assessment was done using the Agency for Healthcare Research and Quality checklist. The authors of potentially relevant studies were contacted regarding the unpublished data. Data from eligible cross-sectional studies were extracted and arranged in a 2x2 table. The odds ratios (ORs) and 95% confidence intervals (CIs) for the dichotomous outcome of interest were computed. Results: The combined data of eight eligible cross-sectional studies for the assessment of association between smoking and cumulative spinal structural damage suggested a significant association (OR, 2.02; 95% CI, 1.51-2.70). No significant heterogeneity was detected between studies (I2=23.0%, p=0.25). The heterogeneity of the longitudinal study data did not permit us to undertake a meta-analysis. Hence, a qualitative review was performed. Conclusion: The results of our meta-analysis show that smoking is associated with increased cumulative spinal structural damage in patients with AS. Therefore, rheumatologists should encourage patients with AS to quit smoking. [ABSTRACT FROM AUTHOR]
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- 2019
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21. Aortic-vertebral interaction in ankylosing spondylitis: syndesmophyte development at the juxta-aortic vertebral rim.
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Tan, Sovira, Dasgupta, Abhijit, Flynn, John A., and Ward, Michael M.
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Objectives: The aorta inhibits paravertebral ossification in diffuse idiopathic skeletal hyperostosis. We investigated if syndesmophytes in ankylosing spondylitis (AS) occurred less often at the vertebral rim near the aorta.Methods: We performed thoracolumbar CT scans in 60 subjects in this cross-sectional study. The mid-thoracic spine was also scanned in 22 subjects. We divided the rim of each intervertebral disc space (IDS) into 72 angular sectors, each of 5°. We computed syndesmophyte height in each sector, and the distance from the sector to the aorta. We evaluated if syndesmophyte size or frequency in a sector was associated with its distance from the aorta.Results: In the 180° region of the vertebral rim centered on the sector closest to the aorta, syndesmophyte height and/or frequency varied with the distance of the sector to the aorta, with the lowest frequency and smallest mean syndesmophyte height at the sector along the rim nearest the aorta. Additionally, syndesmophytes were less common in subjects and at IDSs where the aorta was anatomically closer to the vertebra. No syndesmophytes were present in the sector closest to the aorta in subjects whose aorta-vertebral distance was less than 2 mm, but syndesmophytes were progressively more common among subjects whose aortas lay further from the rim.Conclusions: Syndesmophytes occurred less commonly and were smaller at the thoracolumbar vertebral rim near the aorta. These findings suggest that mechanical factors extrinsic to the spine and not solely vertebral inflammation, influence syndesmophyte development in AS. [ABSTRACT FROM AUTHOR]- Published
- 2019
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22. Predisposition of six well-characterized microRNAs to syndesmophytes among Chinese patients with ankylosing spondylitis.
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Wenxue Yang, Xiaoping Yan, Qisheng Xia, Qingwen Tao, Xiaowei Gan, Yingze Zhang, Zhihua Chen, and Weiping Kong
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ANKYLOSING spondylitis , *MICRORNA , *GENE expression , *C-reactive protein , *HLA histocompatibility antigens - Abstract
Objectives: We quantified the expression of six well-characterized microRNAs (miRNAs) in peripheral blood mononuclear cells to see whether they can predispose to syndesmophytes in ankylosing spondylitis (AS) patients. Methods: This is a cross-sectional study involving 46 AS patients (23/23 with/without syndesmophytes) and 22 healthy controls. miRNAs expression was quantified by real-time PCR. Results: Six examined miRNAs were comparably expressed between AS patients without syndesmophytes and healthy controls (p>.05). Relative to AS patients without syndesmophytes, patients with syndesmophytes had significantly higher levels of miR-29a, miR-335-5p, miR-27a and let-7i (p=.001, .002, .013 and .029, respectively). Nine significant contributors associated with syndesmophytes in AS, including smoking, AS duration, human leukocyte antigen B27, erythrocyte sedimentation rate, C-reactive protein, miR-335-5p, miR-27a, miR-218 and sacroiliitis, were identified. The addition of miR-335-5p, miR-27a and miR-218 can significantly improve the accuracy of baseline risk factors. Based on the nine significant contributors, a nomogram was constructed, with good prediction accuracy (C-index: 0.86, p<.001). Conclusion: We provide evidence for the predisposition of miR-335-5p, miR-27a and miR-218 to syndesmophytes in AS patients, indicating a contributory role of miRNAs in the pathogenesis of syndesmophytes. Further validation is warranted. [ABSTRACT FROM AUTHOR]
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- 2019
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23. Association between facet joint ankylosis and functional impairment in patients with radiographic axial spondyloarthritis
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Kwi Young Kang, Sung-Hwan Park, Yeon Sik Hong, Moon Young Kim, and Joon-Yong Jung
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musculoskeletal diseases ,Orthodontics ,Syndesmophyte ,Facet (geometry) ,Ankylosing spondylitis ,business.industry ,Intraclass correlation ,Reproducibility of Results ,musculoskeletal system ,medicine.disease ,Severity of Illness Index ,Spine ,Zygapophyseal Joint ,Facet joint ,Anesthesiology and Pain Medicine ,Lumbar ,medicine.anatomical_structure ,Rheumatology ,Spondylarthritis ,Ankylosis ,Humans ,Medicine ,Spondylitis, Ankylosing ,business ,BASFI - Abstract
Objectives To investigate the occurrence of facet joint ankylosis in the spine of patients with radiographic axial spondyloarthritis (r-axSpA) using low dose computed tomography (ldCT), and to examine the association between facet joint ankylosis and functional impairment. Methods A group of 126 patients with r-axSpA was selected from Incheon Saint Mary's axSpA observational cohort and whole spine ldCT data were examined. Facet joint (right and left, C2–S1) ankylosis was scored from 0–46 (total). The presence of facet joint ankylosis was assessed by two readers, each blinded to the patient data. The inter-reader reliability of facet joint ankylosis scoring was assessed using intraclass correlation coefficients (ICCs). The CT Syndesmophyte Score (CTSS) was assessed. Lumbar spinal mobility was evaluated using the modified Schober test. Functional impairment was measured using the Bath AS functional index (BASFI). Results The ICCs of ankylosed facet joint scores at the cervical, thoracic, lumbar and whole spine were 0.84, 0.88, 0.92 and 0.90, respectively. Facet joint ankylosis was most common in the thoracic spine. Scores for the whole spine correlated positively with the ASDAS, mSASSS and the syndesmophyte score. Multivariate analysis revealed that facet joint ankylosis was significantly associated with decreased lumbar motion. For both readers, the scores for the whole spine were independently associated with BASFI after adjusting for syndesmophyte score and disease activity. Conclusions Facet joint ankylosis in patients with r-axSpA was associated with functional impairment and spinal mobility. Facet joints should be incorporated into a structural damage assessment method.
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- 2021
24. Spondyloarthropathies, Seronegative
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Lingg, G M, Schorn, C, and Baert, Albert L., editor
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- 2008
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25. Costovertebral joint involvement in patients with axial spondyloarthritis.
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Jung, Seung Min, Kim, Moon-Young, Hong, Yeon Sik, Park, Sung-Hwan, and Kang, Kwi Young
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SPONDYLOARTHROPATHIES , *INTRACLASS correlation , *ANKYLOSING spondylitis , *INTER-observer reliability , *COMPUTED tomography - Abstract
• Costovertebral joint is commonly involved in axial spondyloarthritis (axSpA). • Costovertebral joint involvement is associated with disease features of axSpA. • Low-dose CT is recommended for evaluating costovertebral joint abnormalities. To evaluate costovertebral joint involvement in patients with axial spondyloarthritis (axSpA) and to assess its association with disease features. We included 150 patients from the Incheon Saint Mary's axSpA observational cohort who underwent whole spine low-dose computed tomography (ldCT). Costovertebral joint abnormalities were scored by two readers on a scale of 0–48 based on the presence or absence of erosion, syndesmophyte, and ankylosis. The interobserver reliability of costovertebral joint abnormalities was assessed using intraclass correlation coefficients (ICCs). Associations between costovertebral joint abnormality scores and clinical variables were evaluated using a generalized linear model. Two independent readers found costovertebral joint abnormalities in 74 (49%) patients and 108 (72%) patients. The ICCs of scores for erosion, syndesmophyte, ankylosis, and total abnormality were 0.85, 0.77, 0.93, and 0.95, respectively. For both readers, total abnormality score was correlated with age, symptom duration, Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath AS functional index (BASFI), CT syndesmophyte score (CTSS), and number of bridging spines. Multivariate analyses showed age, ASDAS, CTSS to be independently associated with total abnormality scores in both readers. The frequency of ankylosed costovertebral joint was 10.2% (reader 1) and 17.0% (reader 2) in patients without radiographic syndesmophytes (n = 62), and 10.3% (reader 1) and 17.2% (reader 2) in patients without radiographic sacroiliitis (n = 29). Costovertebral joint involvement was common in patients with axSpA, even in the absence of radiographic damage. LdCT is recommended for evaluating structural damage in patients with clinically suspected costovertebral joint involvement. [ABSTRACT FROM AUTHOR]
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- 2023
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26. Anti-CD74 IgA autoantibodies in radiographic axial spondyloarthritis: a longitudinal Swedish study
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Mats Geijer, Torsten Witte, Urban Hellman, Kristina Lejon, Xenofon Baraliakos, Helena Forsblad-d'Elia, Lan Do, and Gabriel Granåsen
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Adult ,Male ,0301 basic medicine ,Immunoglobulin A ,medicine.medical_specialty ,Logistic regression ,Sensitivity and Specificity ,Gastroenterology ,outcomes research ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Interquartile range ,Internal medicine ,Spondylarthritis ,medicine ,Humans ,Pharmacology (medical) ,Longitudinal Studies ,BASDAI ,AcademicSubjects/MED00360 ,IgA anti-CD74 ,Rheumatology and Autoimmunity ,Aged ,Autoantibodies ,Sweden ,030203 arthritis & rheumatology ,Syndesmophyte ,Reumatologi och inflammation ,biology ,business.industry ,Histocompatibility Antigens Class II ,Odds ratio ,Clinical Science ,Middle Aged ,medicine.disease ,Spine ,Antigens, Differentiation, B-Lymphocyte ,Radiography ,030104 developmental biology ,radiographic axial spondyloarthritis ankylosing spondylitis ,Cohort ,biology.protein ,Female ,business ,BASFI - Abstract
Objectives Antibodies against anti-CD74 are related to axial spondyloarthritis (axSpA). The objectives were (i) to study IgA anti-CD74 in radiographic (r)-axSpA patients in the Backbone cohort and to calculate the sensitivity and specificity of anti-CD74, (ii) to study the fluctuation of IgA anti-CD74 levels in prospectively collected samples, and (iii) to explore the relation between IgA anti-CD74 and radiographic spinal changes. Methods IgA anti-CD74 was analysed by ELISA in 155 patients with r-axSpA and age- and sex-matched controls. BASDAI, ASDAS, BASFI and BASMI were assessed and spinal radiographs were scored for r-axSpA-related changes with mSASSS. Previously donated samples, before inclusion in the Backbone study, were identified in the Medical Biobank of Northern Sweden. Results A total of 155 patients comprising 69% men and 31% women, age [mean (s.d.)] 55.5 (11.4) years and 152 (98.1%) HLA-B27 positive, were included. The plasma level of IgA anti-CD74 was significantly higher in the patients [median (interquartile range), 12.9 (7.9–17.9) U/ml] compared with controls [10.9 (7.2–14.6) U/ml, P = 0.003]. IgA anti-CD74 was above the cut-off level of 20 U/ml in 36/155 (23.2%) patients and in 15/151 (9.9%) controls (P = 0.002). Multivariable logistic regression analyses revealed ≥1 syndesmophyte associated with IgA anti-CD74 (odds ratio 5.64; 95% CI: 1.02, 35.58; P = 0.048) adjusted for hsCRP, smoking, BMI, sex and age. No distinct pattern of IgA anti-CD74 over time was revealed. Conclusion Plasma levels of IgA anti-CD74 were increased in r-axSpA and independently associated with radiographic spinal changes, which suggests that IgA anti-CD74 could play a role in the pathogenies of r-axSpA.
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- 2020
27. Body mass index is related with the presence of syndesmophyte in axial spondyloarthritis: Data from the Korean College of Rheumatology BIOlogics (KOBIO) registry.
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Seong-Kyu Kim, Jung-Yoon Choe, Shin-Seok Lee, and Kichul Shin
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Objective: We investigated whether body mass index (BMI) is associated with parameters of disease activity and clinical manifestations in axial spondyloarthritis (axSpA). Methods: Demographic, clinical, and radiological features and disease activity indexes from 789 axSpA patients (619 males and 170 females) were obtained from the Korean College of Rheumatology BIOlogics (KOBIO) registry. BMI (kg/m2) was classified into normal (BMI <23.0), overweight (23.0-BMI <25.0), and obese (BMI -25.0). Disease activity indexes included Bath ankylosing spondylitis disease activity index (BASDAI), erythrocyte sediment rate (ESR), C-reactive protein (CRP), and ankylosing spondylitis disease activity score (ASDAS). Results: The mean BMI in patients with axSpA was 23.3 ± 3.5. 50.2% of all patients were overweight or obese. Overweight/obese patients had more syndesmophyte and less peripheral arthritis than those in normal BMI patients (p<0.001 and p<0.030, respectively). BMI was not associated with disease activity indexes in axSpA patients. Patients with syndesmophyte had higher BMI than those without syndesmophyte (24.2 ± 3.6 vs. 22.9 ± 3.3, p<0.001). Multivariate logistic regression analysis showed that increased BMI was closely related with the presence of syndesmophyte (OR=1.086, 95% CI 1.031-1.143, p=0.002). Conclusions: Our results imply that increased BMI is significantly associated with the presence of syndesmophyte, but not with disease activity in axSpA. [ABSTRACT FROM AUTHOR]
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- 2017
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28. Effects of targeted therapies on the bone in arthritides.
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Szentpétery, Ágnes, Horváth, Ágnes, Gulyás, Katalin, Pethö, Zsófia, Bhattoa, Harjit Pal, Szántó, Sándor, Szücs, Gabriella, FitzGerald, Oliver, Schett, Georg, and Szekanecz, Zoltán
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RHEUMATOID arthritis treatment , *OSTEOPOROSIS , *TRANCE protein , *RADIOGRAPHY , *DISEASE progression - Abstract
Inflammatory arthritides, such as rheumatoid arthritis (RA) and spondyloarthritides (SpA) have been associated with both localized bone resorption and/or formation, and generalized osteoporosis. Systemic inflammation may be the major driver for bone loss in arthritis. In RA and peripheral SpA the RANK-RANKL-OPG network is involved in bone resorption, while in axial SpA the Wnt-β-catenin axis and its inhibitors (DKK-1, sclerostin) are the most relevant. Targeted therapies including biologics and small molecule tyrosine kinase inhibitors may interfere with inflammatory bone metabolism. Most of these compounds are able to slow down radiographic progression and osteoporosis in arthritides. In very early cases of non-radiological SpA, there may be a window of opportunity allowing to prevent syndesmophyte formation. The inability of targeted therapies to increase the production of DKK-1 and sclerostin may explain the lack of efficacy of TNF inhibitors to halt syndesmophyte formation in SpA. Further clinical trials are needed to better understand the bone effects of targeted therapies. [ABSTRACT FROM AUTHOR]
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- 2017
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29. Radiographic involvement of cervical facet joints in ankylosing spondylitis: a longitudinal analysis in correlation with vertebral body lesions.
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Lee TH, Lee S, Koo BS, Joo KB, and Kim TH
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Background: The inability to assess structural changes in facet joints is a limitation of established radiographic scoring systems for ankylosing spondylitis (AS). We compared radiographic evidence of ankylosis in cervical facet joints and cervical vertebral bodies in patients with AS., Methods: We analysed longitudinal data collected from 1106 AS patients and assessed 4984 spinal radiographs obtained up to 16 years of follow-up. Comparisons between cervical facet joints and cervical vertebral bodies focused on the presence of ankylosis, which was defined by at least one facet joint exhibiting complete ankylosis (according to the method of de Vlam) or at least one vertebral body with a bridging syndesmophyte (according to the modified Stoke Ankylosing Spondylitis Spinal Score [mSASSS]). Ankylosis was assessed over time using spinal radiographs collected during follow-up periods stratified in 4-year increments., Results: Patients with cervical facet joint ankylosis had higher cervical mSASSS, sacroiliitis grades, and inflammatory markers, with more prevalent hip involvement and uveitis. Overall, the numbers of spinal radiographs indicating ankylosis were comparable between cervical facet joints (17.8%) and cervical vertebral bodies (16.8%), and they usually presented together (13.5%). We observed similar proportions of radiographs with ankylosis only in cervical facet joints (4.3%) and cervical vertebral bodies (3.3%). As damage progressed, configurations with both cervical facet joint ankylosis and bridging syndesmophytes became more predominant with longer follow-up times, while configurations with cervical facet joint ankylosis only or bridging syndesmophytes only were less frequently observed., Conclusions: Evidence of cervical facet joint ankylosis appears as often as bridging syndesmophytes on routine AS spinal radiographs. Presence of cervical facet joint ankylosis should be considered because it may have a higher disease burden., (© 2023. The Author(s).)
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- 2023
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30. Evaluation of the diagnostic performance of 18F-NaF positron emission tomography/computed tomography in patients with suspected ankylosing spondylitis according to the Assessment of SpondyloArthritis International Society criteria
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Seung Min Son, Keunyoung Kim, Seong-Jang Kim, Jung Sub Lee, Kyoungjune Pak, and Tae Sik Goh
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Sacroiliac joint ,Syndesmophyte ,030222 orthopedics ,Ankylosing spondylitis ,medicine.diagnostic_test ,business.industry ,Enthesopathy ,Sacroiliitis ,Context (language use) ,medicine.disease ,Low back pain ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Positron emission tomography ,medicine ,Surgery ,Orthopedics and Sports Medicine ,Neurology (clinical) ,medicine.symptom ,business ,Nuclear medicine ,030217 neurology & neurosurgery - Abstract
BACKGROUND CONTEXT Positron emission tomography (PET) is a potential imaging technique for the diagnosis of AS. The visualization of physiological change makes PET potentially suitable for early detection of inflammatory processes, even before anatomical changes occur. Thus, PET might provide specificity via the use of receptor targeting tracers and allows quantification of disease activity in order to accurately monitor therapeutic effects. PURPOSE To examine fluorine-18 sodium fluoride (18F-NaF) PET/computed tomography (PET/CT) findings in patients with inflammatory low back pain and evaluate the utility of this modality in the diagnosis of ankylosing spondylitis (AS) according to the Assessment of SpondyloArthritis International Society (ASAS) criteria. STUDY DESIGN Retrospective cohort study. PATIENTS SAMPLE Sixty-eight patients who underwent 18F-NaF PET/CT imaging between April 2015 and April 2017 for evaluation of inflammatory low back pain. OUTCOME MEASURES We defined AS-positive lesions on PET/CT as symmetric sacroiliac joint uptake that suggests sacroiliitis, syndesmophytes on the spine, and enthesopathy at any site. METHODS All patients were evaluated using the ASAS criteria and assigned to either the AS or the control group. The diagnostic criteria of AS on PET/CT images were defined as 18F-NaF PET/CT images with at least one of AS-positive findings. RESULTS The diagnostic rate of AS was 72.1% among the 68 patients according to the ASAS criteria. The baseline characteristics between the two groups differed significantly in terms of serum C-reactive protein levels and the presence of human leucocyte antigen-B27. Compared to the control group, in the AS group, 39 patients (79.5%) exhibited typical 18F-NaF PET/CT-positive findings, such as enthesopathy (65.3%, p=.003), syndesmophytes (61.2%, p=.006) and symmetric sacroiliitis (67.3%, p=.001). PET-positive findings had significantly higher area under the curve values than did single 18F-NaF PET/CT- positive findings, and they had the best performance for concordant diagnosis according to the ASAS criteria. CONCLUSIONS 18F-NaF PET/CT yielded significantly different findings between the two groups according to the ASAS criteria and is useful for diagnosing AS.
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- 2020
31. Is the trabecular bone score useful for assessing bone quality in patients with axial spondyloarthritis and syndesmophytes?
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M. Moreno Ramos, R. Reyes García, L.F. Linares Ferrando, A. Haro Martínez, and D. Palma-Sánchez
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Bone mineral ,Syndesmophyte ,Ankylosing spondylitis ,business.industry ,Osteoporosis ,Dentistry ,General Medicine ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Lumbar ,Trabecular bone score ,medicine ,030212 general & internal medicine ,Axial spondyloarthritis ,business ,Femoral neck - Abstract
Introduction and objectives Syndesmophytes appear to falsely raise lumbar bone mineral density values, thereby hindering the diagnosis of osteoporosis by dual-energy X-ray absorptiometry in patients with axial spondyloarthritis. The objective of the study was therefore to analyze the influence of syndesmophytes at the lumbar level on trabecular bone scores and lumbar and femoral neck bone mineral density values and to assess the clinical and analytical factors associated with trabecular bone scores in axial spondyloarthritis. Material and methods From January 2017 to June 2018, a cross-sectional study consecutively included patients with axial spondyloarthritis according to Assessment in Ankylosing Spondylitis criteria. We assessed the trabecular bone scores and bone mineral density values and recorded clinical, demographic, disease-related and laboratory variables. Results The study included 82 patients with axial spondyloarthritis (38 with syndesmophytes and 44 without syndesmophytes). The mean age of the patients with and without syndesmophytes was 55.7 ± 10.27 years and 44.36 ± 11.85 years, respectively (p Conclusion Trabecular bone scores do not appear to be masked by the presence of syndesmophytes.
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- 2020
32. Comparison of the Effects of Secukinumab and Adalimumab Biosimilar on Radiographic Progression in Patients with Ankylosing Spondylitis: Design of a Randomized, Phase IIIb Study (SURPASS)
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Denis Poddubnyy, Aimee Readie, Hiroshi Sawata, Xenofon Baraliakos, Mikkel Østergaard, Ruvie Martin, Uta Kiltz, Eun Young Lee, Brian Porter, and Lianne S. Gensler
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medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Antibodies, Monoclonal, Humanized ,030226 pharmacology & pharmacy ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Adalimumab ,Clinical endpoint ,Humans ,Spondylitis, Ankylosing ,Pharmacology (medical) ,Biosimilar Pharmaceuticals ,Spondylitis ,Sacroiliac joint ,Syndesmophyte ,Ankylosing spondylitis ,business.industry ,Interleukin-17 ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,TNF inhibitor ,Radiography ,medicine.anatomical_structure ,Antirheumatic Agents ,Disease Progression ,Secukinumab ,business ,medicine.drug - Abstract
Secukinumab, an anti-interleukin (IL)-17A monoclonal antibody, has demonstrated low radiographic progression over 4 years in patients with ankylosing spondylitis (AS). An adalimumab (tumor necrosis factor [TNF] inhibitor) biosimilar, GP2017 (SDZ-ADL; Sandoz), has been approved by the European Medicines Agency (July 2018) for use in all same indications as adalimumab, including AS. Adalimumab has also shown low long-term radiographic progression in patients with AS. Direct comparison of radiographic progression in AS between IL-17A and TNF inhibitors has not been studied. SURPASS is the first head-to-head, Phase IIIb, randomized, biologic-controlled study in AS to compare effects of secukinumab versus SDZ-ADL on spinal radiographic progression. Overall, 858 biologic-naive patients with AS with elevated high-sensitivity C-reactive protein (≥ 5 mg/L) and/or at least one syndesmophyte in the cervical/lumbar spine at baseline (without total ankylosis) were randomized (1:1:1) to subcutaneous (sc) secukinumab (300 or 150 mg) or SDZ-ADL (40 mg). Secukinumab will be administered at baseline, weeks 1, 2, 3, and 4, and then every 4 weeks until week 100. SDZ-ADL will be administered every 2 weeks from baseline until week 102. Patients and investigators will be unblinded to drug but blinded to secukinumab doses. Spinal X-rays will be obtained at baseline, and weeks 52 and 104, sacroiliac joint (SIJ) X-rays at baseline and week 104, and magnetic resonance imaging (MRI) of SIJs and spine at baseline, weeks 16, 52, and 104. The primary endpoint is to demonstrate superiority of secukinumab (300 or 150 mg) treatment versus SDZ-ADL regarding proportion of patients with no radiographic progression (change from baseline in modified Stoke Ankylosing Spondylitis Spinal Score [mSASSS] ≤ 0.5) at week 104. Secondary endpoints include change from baseline in mSASSS, proportion of patients with syndesmophyte at baseline who develop no new syndesmophytes, reduction of osteitis on MRI of SIJs and spine (Berlin method). Assessment of SpondyloArthritis International Society (ASAS) 20/40 responses, ASAS partial remission, and AS Disease Activity Score (ASDAS) inactive disease (ASDAS
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- 2020
33. Radiographic progression is associated with increased cardiovascular risk in patients with axial spondyloarthritis.
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Kwi Young Kang, Youn Hee Her, Ji Hyeon Ju, Yeon Sik Hong, and Sung-Hwan Park
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RADIOGRAPHY , *CARDIOVASCULAR diseases , *SPONDYLOARTHROPATHIES , *HIGH density lipoproteins , *X-ray detection - Abstract
Objectives: To compare the cardiovascular disease (CVD) risk between axial spondyloarthritis (axSpA) patients and matched controls, and to identify factors associated with increased CVD risk in axSpA patients. Methods: This cross-sectional study enrolled 185 axSpA patients who fulfilled the Assessment for Spondyloarthritis (ASAS) criteria and 925 age- and sex-matched controls. None of the subjects had a previous history of CVD or diabetes mellitus. Traditional CVD risk factors were assessed and the 10-year CVD risk was calculated using the Framingham risk score (FRS). Estimated 10-year CVD risk was compared between axSpA patients and matched controls. Disease activity and radiographic progression in the sacroiliac joint and spine of axSpA patients were evaluated at the time of CVD risk assessment. Results: High-density lipoprotein (HDL) cholesterol levels were lower in axSpA patients than in the matched controls (p=0.004); however, systolic blood pressure was higher (p50.001). The FRS was 5.0 ± 6.6% for controls and 6.3 ± 8.7% for axSpA patients (p=0.046). Both the grade of sacroiliitis on X-ray and the number of syndesmophytes correlated with the FRS (p=0.009 and p=0.001, respectively), but disease activity variables did not. The FRS was significantly higher in axSpA patients with a greater number of syndesmophytes (p=0.035). Multivariate analysis identified the number of syndesmophytes as being independently associated with the FRS (p50.001). Conclusions: The FRS was higher in axSpA patients than in a matched general population. Radiographic progression in the spine was associated with a high estimated 10-year CVD risk. [ABSTRACT FROM AUTHOR]
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- 2016
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34. Pain in Axial Spondyloarthritis: More to It Than Just Inflammation
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Marina Magrey and Philip J. Mease
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Syndesmophyte ,Inflammation ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Radiography ,Immunology ,Sacroiliitis ,Pain ,Magnetic resonance imaging ,medicine.disease ,Rheumatology ,Spondylarthritis ,medicine ,Immunology and Allergy ,Humans ,Spondylitis, Ankylosing ,Radiology ,Axial spondyloarthritis ,business - Abstract
The conceptual paradigm of axial spondyloarthritis (axSpA) has evolved and now comprises an expanded spectrum that includes more females and patients with little or no radiographic changes in sacroiliitis or syndesmophyte formation in the spine.1 This broadened paradigm is often, but not always, characterized by an inflammatory magnetic resonance imaging (MRI) signature.
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- 2021
35. Mediastinal hematoma secondary to syndesmophyte fracture in ankylosing spondylitis.
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Wasfie, Tarik, Kreitzberg, Scott, and Rydesky, Peter
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ANKYLOSING spondylitis , *BONE fractures , *MEDIASTINUM diseases , *SPINAL injuries , *DISEASE complications - Abstract
Ankylosing spondylitis is an inflammatory rheumatoid disease with severe osteoporosis affecting the spine with a tendency to fracture. Cervical spine fractures resulting in posterior mediastinal hematoma are rare. We present a patient with widened mediastinum secondary to fracture of a cervical ankylosing spondylitis and discuss its presentation and the current literature on the disease. [ABSTRACT FROM AUTHOR]
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- 2018
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36. Machine learning–based prediction of radiographic progression in patients with axial spondyloarthritis
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In-Woon Baek, Kyung-Su Park, Yune-Jung Park, Young Bin Joo, and Ki-Jo Kim
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Adult ,Male ,Radiography ,Detailed data ,Machine learning ,computer.software_genre ,Severity of Illness Index ,Machine Learning ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Republic of Korea ,Spondylarthritis ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Axial spondyloarthritis ,Retrospective Studies ,030203 arthritis & rheumatology ,Syndesmophyte ,Sacroiliac joint ,Ankylosing spondylitis ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Spine ,Support vector machine ,medicine.anatomical_structure ,Disease Progression ,Female ,Artificial intelligence ,business ,computer - Abstract
Machine learning is applied to characterize the risk and predict outcomes in multi-dimensional data. The prediction of radiographic progression in axial spondyloarthritis (axSpA) remains limited. Hence, we tested the feasibility of supervised machine learning algorithms to predict radiographic progression in axSpA.This is a retrospective and hospital-based study. Clinical and laboratory data obtained from two independent axSpA groups were used as training and testing datasets. Radiographic progression over 2 years was assessed using the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) and mSASSS worsening by ≥ two units was defined as progression. Seven machine learning models with different algorithms were fitted, and their performance for the testing dataset was assessed using receiver-operating characteristic (ROC) and precision-recall (PR) curve.The training and testing groups had equivalent characteristics, and radiographic progression was identified in 25.3% and 23.7%, respectively. The generalized linear model (GLM) and support vector machine (SVM) were the top two best-performing models with an average area-under-curve (AUC) of ROC of over 0.78. SVM had the higher AUC of PR compared with GLM (0.56 versus 0.51). Balanced accuracy was over 65% in all models. mSASSS was the most informative variable, followed by the presence of syndesmophyte(s) at the baseline and sacroiliac joint grades.Clinical and radiographic data-driven predictive models showed reasonable performance in the prediction of radiographic progression in axSpA. Further modelling with larger and more detailed data could provide an excellent opportunity for the clinical translation of the predictive models to the management of high-risk patients.Key Points• Clinical and radiographic data-driven predictive models showed reasonable performance in the prediction of radiographic progression in axSpA.• Further modelling with larger and more detailed data could provide an excellent opportunity for the clinical translation of the predictive models to the management of high-risk patients.
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- 2019
37. Features of trunk muscle weakness in patients with ankylosing spondylitis: A cross-sectional study
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Huei-Huang Ho, Ji-Yih Chen, Chin-Man Wang, Yu-Cheng Pei, Wei-Hsien Hong, and Yu-Lin Tsai
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0301 basic medicine ,Adult ,Male ,Cross-sectional study ,Isometric exercise ,03 medical and health sciences ,Ankylosing spondylitis (AS) ,0302 clinical medicine ,Lumbar ,medicine ,Humans ,In patient ,Spondylitis, Ankylosing ,Sacroiliitis ,Muscle, Skeletal ,lcsh:QH301-705.5 ,Syndesmophyte ,Inflammation ,Ankylosing spondylitis ,lcsh:R5-920 ,Muscle Weakness ,business.industry ,Muscle strength ,Trunk ,General Medicine ,Anatomy ,Middle Aged ,medicine.disease ,Spine ,Radiography ,030104 developmental biology ,Cross-Sectional Studies ,lcsh:Biology (General) ,030220 oncology & carcinogenesis ,Original Article ,Female ,business ,lcsh:Medicine (General) - Abstract
Background: Ankylosing spondylitis (AS) is an inflammatory autoimmune disorder that manifested with sacroiliitis at its early stage and developed extensive inflammation with syndesmophytes of the lumbar, thoracic and cervical spines at its later stage. In the present study, we characterized the trunk isometric strength in patients with AS with different disease severity, defined by the radiological images. Methods: In a cross-sectional study conducted in a university-affiliated hospital, thirty-eight male AS patients (23 in the early AS group whose radiological findings showed no syndesmophyte, Modified Stoke Ankylosing Spinal Score (m-SASSS
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- 2019
38. Association of Genetic Variants of RANK, RANKL, and OPG with Ankylosing Spondylitis Clinical Features in Taiwanese
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Jianming Wu, Ji Yih Chen, Chin Man Wang, Yeong Jian Jan Wu, Jing Chi Lin, and Shu Chun Tsai
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Adult ,Male ,musculoskeletal diseases ,0301 basic medicine ,medicine.medical_specialty ,Adolescent ,Genotype ,Article Subject ,Immunology ,Enzyme-Linked Immunosorbent Assay ,Single-nucleotide polymorphism ,Polymorphism, Single Nucleotide ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Osteoprotegerin ,Internal medicine ,lcsh:Pathology ,Humans ,Medicine ,SNP ,Genetic Predisposition to Disease ,Spondylitis, Ankylosing ,HLA-B27 Antigen ,030203 arthritis & rheumatology ,Syndesmophyte ,Ankylosing spondylitis ,Receptor Activator of Nuclear Factor-kappa B ,biology ,business.industry ,RANK Ligand ,Haplotype ,Cell Biology ,Middle Aged ,medicine.disease ,030104 developmental biology ,Endocrinology ,RANKL ,Mutagenesis, Site-Directed ,biology.protein ,Female ,business ,lcsh:RB1-214 ,Research Article - Abstract
Ankylosing spondylitis (AS) is a chronic inflammatory disease that leads to spinal ankylosis. The receptor activator of the nuclear factor-kappa (RANK), RANK ligand, and osteoprotegerin (OPG) (RANK/RANKL/OPG) pathway plays critical roles in bone metabolism and the immune system. The current study was aimed at investigating whether six single-nucleotide polymorphisms (SNPs) within the RANK, RANKL, and OPG genes essential for bone homeostasis are associated with AS. Genotype distributions, allele and haplotype frequencies, were compared between 1120 AS patients and 1435 healthy controls and among AS patients with stratification by syndesmophyte formation, onset age, and HLA-B27 positivity. We found that RANKL SNPs were associated with AS syndesmophyte formation. Notably, the RANKL SNP haplotype rs7984870C/rs9533155G/rs9525641C was negatively associated with AS susceptibility and appeared to protect against syndesmophyte formation in AS. Functionally, RANKL promoter SNPs (rs9525641 C/T and rs9533155 G/C) affected DNA-protein complex formation and promoter activity in promoter reporter analyses. The OPG SNP haplotype rs2073618G/rs3102735T was significantly associated with HLA-B27 negativity in AS patients. Furthermore, AS patients with syndesmophyte formation had significantly lower levels of soluble RANKL levels than those without syndesmophyte formation. Our data suggested a role for RANKL in AS susceptibility and severity.
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- 2019
39. Cross-correlation between spine and hip joint kinematics differs in healthy individuals and subgroups of ankylosing spondylitis patients during trunk lateral flexion
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Kuo-Lung Lai, Fang-Chuan Kuo, Shin-Tsu Chang, and Yu-San Kao
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Adult ,Male ,musculoskeletal diseases ,New York ,Physical Therapy, Sports Therapy and Rehabilitation ,Kinematics ,03 medical and health sciences ,0302 clinical medicine ,Lumbar ,Humans ,Medicine ,Spondylitis, Ankylosing ,Range of Motion, Articular ,Pelvis ,030203 arthritis & rheumatology ,Orthodontics ,Syndesmophyte ,030222 orthopedics ,Ankylosing spondylitis ,business.industry ,Sacroiliitis ,Middle Aged ,musculoskeletal system ,medicine.disease ,Trunk ,Healthy Volunteers ,Spine ,Biomechanical Phenomena ,body regions ,medicine.anatomical_structure ,Female ,Hip Joint ,business ,Range of motion ,Muscle Contraction - Abstract
Background The effects of sacroiliitis and syndesmophyte formation on the cross-correlation between spine and hip joint kinematics in ankylosing spondylitis (AS) are poorly understood. Objective To investigate the cross-correlation between spine and hip joint kinematics differs in healthy individuals and ankylosing spondylitis patients during trunk lateral flexion. Methods Fifty AS patients and thirty-nine healthy adults (controls) were recruited from a medical center. The patients were divided into two subgroups, namely the sacroiliitis (n = 28) and syndesmophyte (n = 22) subgroups. An inertial motion system was used to record kinematic data of spine, pelvic and hip joints during lateral trunk flexion. The maximal cross-correlation coefficient (CCF) and time lag of motion between the spine and hip joint were analyzed. Results The syndesmophyte group had the smallest range of motion in all recorded motion. The sacroiliitis group exhibited higher thoracic flexion, pelvic pitch, and pelvic rotation than the other two groups. In the syndesmophyte group, the CCF between lumbar lateral flexion (LLF) and hip abduction were weakly and LLF and hip rotation were strongly correlated. Considering in time sequence, LLF occurred earlier than hip abduction and hip rotation during trunk lateral flexion; however, both AS subgroups exhibited longer time lags than in the control group. Conclusion The cross-correlation between spine and hip joint kinematics differs in healthy individuals and AS patients during trunk lateral flexion. The motion pattern changes in patients with AS of differing severity may also alter the loads on the spine and hip joints.
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- 2018
40. Association between syndesmophyte and metabolic syndrome in patients with psoriatic arthritis or ankylosing spondylitis: a cross-sectional study
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Varalak Srinonprasert, Chonachan Petcharat, and Praveena Chiowchanwisawakit
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medicine.medical_specialty ,Cross-sectional study ,Diseases of the musculoskeletal system ,Factors ,03 medical and health sciences ,Psoriatic arthritis ,0302 clinical medicine ,Rheumatology ,Internal medicine ,Epidemiology ,Prevalence ,medicine ,Humans ,Spondylitis, Ankylosing ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Metabolic Syndrome ,030203 arthritis & rheumatology ,Syndesmophyte ,Ankylosing spondylitis ,business.industry ,Arthritis, Psoriatic ,Odds ratio ,Thailand ,medicine.disease ,Cross-Sectional Studies ,RC925-935 ,Female ,Metabolic syndrome ,business ,Research Article - Abstract
Objective To investigate the prevalence of and factors associated with metabolic syndrome (MetS) in patients with psoriatic arthritis (PsA) or ankylosing spondylitis (AS). Methods This cross-sectional study included PsA or AS patients who attended Siriraj Hospital (Bangkok, Thailand) during March 2014 to October 2017. The Harmonized MetS definition was used to diagnose MetS. Demographic, clinical, and spinal radiographic data were collected. Logistic regression was used to identify factors associated with MetS. Results Among 319 patients, 153 had AS and 166 had PsA. MetS was present in 43% of PsA and 19% of AS (p > 23 (odds ratio [OR]: 3.7), female gender (OR range: 3.8–3.9), and the number of syndesmophytes or ankylosis [SynAnk] (OR: 1.1) were associated with MetS among PsA patients. For AS patients, BMI > 23 (OR: 9.1) and age > 40 (OR: 4.3) were associated with MetS. Disease activity index was not associated with MetS. Conclusions MetS was significantly more prevalent in PsA than in AS. Structural change of the spine was associated with MetS in PsA. PsA patients with being female, BMI > 23 or evidence of spinal change should be informed to screen for MetS. AS patients with age > 40 or BMI > 23 should be informed to screen for MetS.
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- 2021
41. Dynamics of syndesmophyte growth in AS as measured by quantitative CT: heterogeneity within and among vertebral disc spaces.
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Tan, Sovira, Jianhua Yao, Flynn, John A., Lawrence Yao, and Ward, Michael M.
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ACADEMIC medical centers , *ALGORITHMS , *ANALYSIS of variance , *ANKYLOSING spondylitis , *CHI-squared test , *LONGITUDINAL method , *RESEARCH funding , *SPINAL fusion , *STATISTICS , *TOMOGRAPHY , *DATA analysis , *DATA analysis software - Abstract
Objective. Syndesmophytes in AS typically grow slowly, but it is not known whether growth is uniform among syndesmophytes in the same intervertebral disc space (IDS) or among different IDSs in the same patient or if growth is heterogeneous. We examined the dynamics of syndesmophyte growth over 24 months using CT, with the main aim of determining if syndesmophytes in the same IDS or the same patient grow at similar rates. Methods. We performed lumbar spine CT scans on 33 patients and measured syndesmophytes in four IDSs using a validated computer algorithm. Scans were done at baseline and 12 and 24 months. We compared absolute and percentage changes in volume from baseline to 12 months and to 24 months among syndesmophytes in the same IDS and among four IDSs of each patient. We also examined whether growth among all IDSs differed between study years. Results. Among 60 IDSs with at least two syndesmophytes at baseline (range 2–6), there was substantial heterogeneity in both absolute (P < 0.0001) and percentage (P = 0.0002) volume increases among syndesmophytes in the same IDS. Several IDSs had both syndesmophytes with no growth and syndesmophytes that increased by >100 mm3. Similarly there was significant heterogeneity in syndesmophyte growth among IDSs of individual patients. Increases in total syndesmophyte volume for each patient also tended to differ between study years (P = 0.07). Conclusion. Syndesmophytes in AS do not all grow continuously. Rates of growth over 24 months commonly differ between syndesmophytes in the same IDS and between different IDSs in the same patient, suggesting that local factors regulate syndesmophyte growth. [ABSTRACT FROM AUTHOR]
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- 2015
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42. S100A4 is elevated in axial spondyloarthritis:a potential link to disease severity
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Sumova, Barbora, Cerezo, Lucie Andres, Hulejova, Hana, Prajzlerova, Klara, Tomcik, Michal, Bubova, Kristyna, Stepan, Jan, Filkova, Maria, Kropackova, Tereza, Grigorian, Mariam, Pavelka, Karel, Vencovsky, Jiri, Senolt, Ladislav, Sumova, Barbora, Cerezo, Lucie Andres, Hulejova, Hana, Prajzlerova, Klara, Tomcik, Michal, Bubova, Kristyna, Stepan, Jan, Filkova, Maria, Kropackova, Tereza, Grigorian, Mariam, Pavelka, Karel, Vencovsky, Jiri, and Senolt, Ladislav
- Abstract
BackgroundS100A4 is a member of calcium binding S100 protein family well known for its role in cancer progression and metastasis. Nevertheless, S100A4 also serves as a negative regulator of bone formation. Dickkopf-1 (DKK-1), marker of bone remodelling, is also implicated in the process of syndesmophyte formation in ankylosing spondylitis. The aim of our study was to evaluate plasma levels of S100A4 in patients with axial spondyloarthritis and to determine the potential association of S100A4 with disease severity, clinical manifestations and with bone changes in a cross-sectional study.MethodsFifty-eight patients with axial spondyloarthritis and 40 healthy controls were studied. Biological samples were analysed for S100A4 and Dickkopf-1. Disease activity was assessed according to the Bath Ankylosing Spondylitis Disease Activity Index. C-reactive protein (CRP) was used as a marker of inflammation. Radiographic damage was assessed using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS).ResultsThe plasma levels of S100A4 were significantly higher in patients with axial spondyloarthritis compared to heathy controls (p
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- 2020
43. Elevated serum level of hepatocyte growth factor predicts development of new syndesmophytes in men with ankylosing spondylitis
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Hans Carlsten, Anna Deminger, Eva Klingberg, Merja Nurkkala, Lennart T H Jacobsson, Helena Forsblad-d'Elia, and Mats Geijer
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Adult ,Male ,medicine.medical_specialty ,Blood Sedimentation ,Logistic regression ,Gastroenterology ,Cohort Studies ,Elevated serum ,outcomes research ,Rheumatology ,Interquartile range ,Internal medicine ,medicine ,Humans ,Spondylitis, Ankylosing ,Pharmacology (medical) ,In patient ,Prospective cohort study ,AcademicSubjects/MED00360 ,Rheumatology and Autoimmunity ,Syndesmophyte ,Ankylosing spondylitis ,Reumatologi och inflammation ,Lumbar Vertebrae ,Hepatocyte Growth Factor ,business.industry ,Middle Aged ,Clinical Science ,medicine.disease ,Radiography ,C-Reactive Protein ,hepatocyte growth factor ,Cervical Vertebrae ,Disease Progression ,Female ,Hepatocyte growth factor ,business ,Biomarkers ,AS ,Follow-Up Studies ,medicine.drug - Abstract
Objectives To study baseline serum hepatocyte growth factor (s-HGF) as a predictor of spinal radiographic progression overall and by sex and to analyse factors correlated to changes in s-HGF in patients with AS. Methods At baseline and the 5-year follow-up, s-HGF was analysed with ELISA. Spinal radiographs were graded according to modified Stoke Ankylosing Spondylitis Spinal Score. Radiographic progression was defined as ≥2 modified Stoke Ankylosing Spondylitis Spinal Score units/5 years or development of ≥1 syndesmophyte. Logistic regression analyses were used. Results Of 204 baseline participants, 163 (80%) completed all examinations at the 5-year follow-up (54% men). Baseline s-HGF was significantly higher in men who developed ≥1 syndesmophyte compared with non-progressors, median (interquartile range) baseline s-HGF 1551 (1449–1898) vs 1436 (1200–1569) pg/ml, P = 0.003. The calculated optimal cut-off point for baseline s-HGF ≥1520 pg/ml showed a sensitivity of 70%, a specificity of 69% and univariate odds radio (95% CI) of 5.25 (1.69, 14.10) as predictor of development of ≥1 new syndesmophyte in men. Baseline s-HGF ≥1520 pg/ml remained significantly associated with development of ≥1 new syndesmophyte in men in an analysis adjusted for the baseline variables age, smoking, presence of syndesmophytes and CRP, odds radio 3.97 (1.36, 11.60). In women, no association with HGF and radiographic progression was found. Changes in s-HGF were positively correlated with changes in ESR and CRP. Conclusion In this prospective cohort study elevated s-HGF was shown to be associated with development of new syndesmophytes in men with AS.
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- 2021
44. Loss and gain of bone in spondyloarthritis:what drives these opposing clinical features?
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Gavin Clunie, Nicole J. Horwood, Clunie, Gavin [0000-0001-8411-0685], and Apollo - University of Cambridge Repository
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0301 basic medicine ,Osteolysis ,Osteoimmunology ,Osteoporosis ,Review ,Diseases of the musculoskeletal system ,spondyloarthritis (SpA) ,Bone remodeling ,03 medical and health sciences ,Osteosclerosis ,0302 clinical medicine ,Rheumatology ,ankylosing spondylitis (AS) ,medicine ,Orthopedics and Sports Medicine ,osteoproliferation ,030203 arthritis & rheumatology ,osteoimmunology ,osteomicrobiology ,business.industry ,bone pathophysiology ,syndesmophyte ,Extra-Articular Manifestations and Comorbidities in Spondyloarthritis ,medicine.disease ,Enthesis ,osteoporosis ,030104 developmental biology ,RC925-935 ,Osteitis ,business ,Dysbiosis ,Neuroscience ,enthesophyte ,axial spondyloarthritis (axSpA) - Abstract
The breadth of bone lesion types seen in spondyloarthritis is unprecedented in medicine and includes increased bone turnover, bone loss and fragility, osteitis, osteolysis and erosion, osteosclerosis, osteoproliferation of soft tissues adjacent to bone and spinal skeletal structure weakness. Remarkably, these effects can be present simultaneously in the same patient. The search for a potential unifying cause of effects on the skeleton necessarily focuses on inflammation arising from the dysregulation of immune response to microorganisms, particularly dysregulation of TH17 lymphocytes, and the dysbiosis of established gut and other microbiota. The compelling notion that a common antecedent pathological mechanism affects existing bone and tissues with bone-forming potential (entheses), simultaneously with variable effect in the former but bone-forming in the latter, drives basic research forward and focuses our awareness on the effects on these bone mechanisms of the increasing portfolio of targeted immunotherapies used in the clinic.
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- 2021
45. Autoantibodies against Protein Phosphatase Magnesium-Dependent 1A as a Biomarker for Predicting Radiographic Progression in Ankylosing Spondylitis Treated with Anti-Tumor Necrosis Factor Agents
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Bin Yoo, Jungsun Lee, Sang-Hoon Lee, Tae-Jong Kim, Yong-Gil Kim, Ye-Soo Park, Sungsin Jo, Eunju Lee, Seokchan Hong, Dae-Hyun Yoo, Jae-Hyun Lee, Tae-Hwan Kim, Chang-Keun Lee, Seunghun Lee, and Ji-Seon Oh
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medicine.medical_specialty ,Radiography ,Phosphatase ,lcsh:Medicine ,Gastroenterology ,Article ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,ankylosing spondylitis ,medicine ,Anti tumor necrosis factor ,030304 developmental biology ,030203 arthritis & rheumatology ,Syndesmophyte ,0303 health sciences ,Ankylosing spondylitis ,biology ,business.industry ,lcsh:R ,Autoantibody ,biomarkers ,General Medicine ,medicine.disease ,protein phosphatase magnesium-dependent 1 A ,radiographic progression ,biology.protein ,Biomarker (medicine) ,Antibody ,business ,autoantibody - Abstract
Background: Patients with ankylosing spondylitis (AS) have increased levels of protein phosphatase magnesium-dependent 1A (PPM1A) and autoantibodies. We evaluated the usefulness of serum anti-PPM1A antibodies as a biomarker for AS. Methods: Serum samples from 58 AS patients were obtained from a multicenter registry prior to the initiation of anti-TNF agents. The serum levels of anti-PPM1A antibodies were measured using ELISA. Spinal radiographic progression was defined as an increase in the modified stoke ankylosing spondylitis spinal score (mSASSS) by &ge, 2 units or a newly developed syndesmophyte. The role of exogenous PPM1A on bone mineralization was evaluated using primary osteoprogenitors acquired from patients with AS and non-inflammatory controls. Results: The baseline levels of anti-PPM1A antibodies and mSASSS were higher in the radiographic progression group than in the non-progression group. In logistic regression analysis, baseline mSASSS and serum anti-PPM1A antibodies were associated with a higher risk of progression. The level of anti-PPM1A antibodies for predicting progression had an AUC of 0.716 (cut-off value: 43.77 ng/mL). PPM1A stimulation increased matrix mineralization in AS-osteoprogenitors but not in controls. Conclusion: Along with mSASSS, the serum levels of anti-PPM1A antibodies might be useful as a predictor of radiographic progression after treatment with anti-TNF agents.
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- 2020
46. No relationship between bone mineral density and syndesmophyte formation at the same level in the lumbar spine of patients with radiographic axial Spondyloarthritis
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Désirée van der Heijde, Mary Lucy Marques, Pedro Machado, Sofia Ramiro, and Floris A. van Gaalen
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Adult ,Male ,musculoskeletal diseases ,Ankylosing ,medicine.medical_specialty ,Bone density ,Radiography ,Immunology ,lcsh:Medicine ,Absorptiometry, Photon ,Rheumatology ,Bone Density ,Internal medicine ,Spondylarthritis ,Spondyloarthritis ,Humans ,Immunology and Allergy ,Medicine ,Spondylitis, Ankylosing ,Spondylitis ,Bone mineral ,Syndesmophyte ,Inflammation ,Ankylosing spondylitis ,Lumbar Vertebrae ,business.industry ,lcsh:R ,medicine.disease ,musculoskeletal system ,Vertebra ,medicine.anatomical_structure ,Female ,business ,Nuclear medicine - Abstract
ObjectiveTo investigate if in radiographic axial Spondyloarthritis (r-axSpA) low vertebral bone mineral density (BMD) is associated with development of new syndesmophytes at the same vertebral level.MethodsIn a post-hoc analysis from the ASSERT trial (infliximab vs placebo), dual-energy X-ray absorptiometry was used to measure baseline BMD (g/cm2) of the lumbar spine L1 to L4. Syndesmophyte formation was assessed in the same vertebrae on conventional radiographs defined as an increase in modified Stoke Ankylosing Spondylitis Spine Score from 0 or 1 to 2 or 3 after 2 years. Radiographs were scored by two readers. Generalised estimating equations (GEE) adjusted for within-patient correlation across multiple vertebrae, taking potential confounders into account.ResultsWe analysed 599 vertebrae in 165 r-axSpA patients (78% male, mean (SD) age 38 (10) years, 67% with at least one syndesmophyte anywhere in the spine). In total, 24 to 74 new syndesmophytes developed in 9 (5%) to 30 (18%) patients and 13 (2%) to 39 (7%) vertebrae, if either a syndesmophyte was seen by both or only one of the readers (ie, specific and sensitive definitions) respectively. In multivariable analyses, no association was found between baseline local vertebral BMD and new syndesmophyte formation after 2 years: adjOR (95% CI): 0.56 (0.01, 44.45) (specific definition) and 0.26 (0.03, 2.63) (sensitive definition).ConclusionIn patients with active and established r-axSpA, with an observed low incidence of lumbar spine syndesmophyte formation over 2 years, no relationship was found between baseline BMD and new radiographic syndesmophyte formation at the same vertebra.
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- 2020
47. Facet joint ankylosis in r-axSpA: detection and 2-year progression on whole spine low-dose CT and comparison with syndesmophyte progression
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Alexandre Sepriano, Juergen Braun, Désirée van der Heijde, Rosaline van den Berg, Monique Reijnierse, Rosalinde Stal, Floris A. van Gaalen, and Xenofon Baraliakos
- Subjects
Adult ,Male ,musculoskeletal diseases ,medicine.medical_specialty ,Facet (geometry) ,Intraclass correlation ,Radiography ,Zygapophyseal Joint ,Facet joint ,Cohort Studies ,Spinal Osteophytosis ,outcomes research ,Rheumatology ,ankylosing spondylitis ,Ankylosis ,medicine ,Humans ,Pharmacology (medical) ,Spondylitis, Ankylosing ,AcademicSubjects/MED00360 ,Syndesmophyte ,Ankylosing spondylitis ,business.industry ,Osteophyte ,Middle Aged ,Clinical Science ,spondyloarthritis ,medicine.disease ,musculoskeletal system ,medicine.anatomical_structure ,Disease Progression ,Female ,Radiology ,business ,Tomography, X-Ray Computed ,low-dose computed tomography - Abstract
Objectives To evaluate the occurrence and progression of facet joint ankylosis in the whole spine using low-dose CT (ldCT) in radiographic axial spondyloarthritis (r-axSpA) and compare progression of facet joint ankylosis and syndesmophytes. Methods Patients with r-axSpA from the Sensitive Imaging in Ankylosing Spondylitis (SIAS) cohort underwent ldCT at baseline (n = 60) and 2 years (n = 53). Facet joints (right and left, levels C2-S1) were scored as ankylosed, not ankylosed or unable to assess. Joints that were frequently poorly visible (>15% missing), were excluded. Inter-reader reliability on the patient level was assessed with intraclass correlation coefficients (ICCs) and smallest detectable change (SDC). Ankylosis was assessed at joint level and patient level for both timepoints. Syndesmophytes were assessed with CT syndesmophyte score. Results Levels C5-T2 were difficult to assess and excluded from all further analyses. Facet joint ICCs were good to excellent for status scores (0.72–0.93) and poor to excellent for progression scores (0.10–0.91). Facet joint ankylosis was detected at every level but most frequently in the thoracic joints. In total, 48% of patients showed 2-year progression. Most progression occurred in the thoracic segment. Using SDCs as cutoff, 18% of patients had progression of facet joint ankylosis only, whereas 20% of patients had progression of syndesmophytes only. Conclusion This is the first study evaluating facet joints in the whole spine by ldCT in r-axSpA. Facet joint ankylosis was detected most often in the thoracic spine. Assessing facet joints in addition to syndesmophytes detected substantially more patients with damage progression over two years.
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- 2020
48. Morphometric Vertebral Assessments via the Use of Dual X-ray Absorptiometry for the Evaluation of Radiographic Damage in Ankylosing Spondylitis: A Pilot Study.
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Aubry-Rozier, Bérengère, Hans, Didier, Krieg, Marc-Antoine, Lamy, Olivier, and Dudler, Jean
- Abstract
Abstract: We performed a pilot study to compare vertebral fracture assessments (VFA) and lateral X-rays in terms of inter- and intraobserver reliability and degree of correlation for the detection of syndesmophytes in ankylosing spondylitis (AS). We recruited 19 patients with AS and recent lumbar or cervical lateral X-rays with at least one syndesmophyte. Each patient underwent dual-energy X-ray absorptiometry with measurement of bone mineral density and dorso-lumbar VFA. Intra- and interreader reliability for VFA and X-rays were measured using 2 independent, blinded observers and Cohen's kappa values. An adapted modified Stoke Ankylosing Spondylitis Spinal Score (amSASSS) was generated with each method, and these 2 values correlated. For X-rays, intraobserver and interobserver agreement were 94.3% (κ = 0.83) and 98.6% (κ = 0.96), respectively; for VFA, corresponding values were 92.8% (κ = 0.79) and 93.8% (κ = 0.82). Overall agreement between the 2 techniques was 88.6% (κ = 0.72). The Pearson correlation coefficient for the 2 methods was 0.95 for the modified Stoke Ankylosing Spondylitis Spinal Score . Per dual-energy X-ray absorptiometry−generated bone mineral density, >50% of patients were osteopenic and 10% osteoporotic. In terms of reproducibility and correlation with X-rays, performing a VFA appears to be a candidate for assessing radiographic damage in AS, thought further research is necessary to justify this indication. [Copyright &y& Elsevier]
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- 2014
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49. Visualization of Enthesitis by Ultrasound: a Key Diagnostic Tool in Spondyloarthropathy Diagnosis and Management
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Gurjit S. Kaeley
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Syndesmophyte ,medicine.medical_specialty ,Spondyloarthropathy ,business.industry ,Ultrasound ,Enthesitis ,Enthesopathy ,Enthesis ,medicine.disease ,Visualization ,Rheumatology ,medicine ,Humans ,Spondylarthropathies ,Radiology ,medicine.symptom ,business ,Ultrasonography - Abstract
The purpose of this review is to report on the current status of evaluation of enthesitis with sonography. Sonography can visualize peripheral entheses in great detail since most of them are superficial. Visualization of entheses has provided insights into the pathophysiology of enthesitis and highlighted the interconnectivity of stress dissipation mechanisms about the enthesis. The primary use of entheseal sonography presently revolves around diagnostic use. There is increasing awareness of biomechanical confounders that lead to entheseal changes, which are more prevalent in males, patients with higher body mass index, and those who are more active—though there are several approaches to mitigate biomechanical confounders in sonographic evaluation. Entheseal sonography may also provide prognostic information in predicting the severity of axial syndesmophyte formation. Although entheseal outcome scoring systems are available, there is sparse data on its use as an outcome tool, and hence, this is a fertile area for future research.
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- 2020
50. Consequences of spinal ankylosis on bone trabecular fragility assessed on CT scans in patients with ankylosing spondylitis. A retrospective study
- Author
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Edem Allado, Caroline Morizot, Frank Verhoeven, Damien Loeuille, Isabelle Chary-Valckenaere, Marine Fauny, Marie Semaan, Eliane Albuisson, Astrid Pinzano, Service de Rhumatologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), Université de Lorraine (UL), Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Institut Élie Cartan de Lorraine (IECL), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), InSciDens [Nancy], Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité. (DevAH), Pathologies et épithéliums : prévention, innovation, traitements, évaluation (EA 4267) (PEPITE), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université de Franche-Comté (UFC), Santé Publique, Information médicale et Enseignement multimédia Assisté par Ordinateur (SPI-EAO), Faculté de Médecine [Nancy], Université de Lorraine (UL)-Université de Lorraine (UL), Institut des Sciences du Mouvement Etienne Jules Marey (ISM), and Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)
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CT scan ,musculoskeletal diseases ,Male ,medicine.medical_specialty ,[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging ,[SDV]Life Sciences [q-bio] ,Osteoporosis ,Computed tomography ,Lumbar vertebrae ,03 medical and health sciences ,0302 clinical medicine ,Lumbar ,Rheumatology ,Bone Density ,medicine ,Ankylosis ,Humans ,Spondylitis, Ankylosing ,ComputingMilieux_MISCELLANEOUS ,vertebral fracture ,030304 developmental biology ,Retrospective Studies ,030203 arthritis & rheumatology ,Syndesmophyte ,0303 health sciences ,Ankylosing spondylitis ,Lumbar Vertebrae ,medicine.diagnostic_test ,business.industry ,mSASSS ,ankylosis ,Retrospective cohort study ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,bone attenuation coefficient ,Radiology ,bone mineral density ,business ,Tomography, X-Ray Computed - Abstract
International audience; Background: Ankylosing spondylitis (AS) patients seems to be at risk of osteoporosis but bone screening is not often performed. The objective was to evaluate the effect of vertebral ankylosis on scanographic bone attenuation coefficient (SBAC) on lumbar vertebrae in AS patients. Patients and methods: This study included AS patients fulfilling New York criteria who underwent both thoraco-abdomino-pelvic computed tomography and X-rays during routine follow-up. The modified stoke ankylosing spondylitis spinal score (mSASSS) was scored on X-rays, and the presence of at least one syndesmophyte (mSASSS≥2) defined mSASSS+ patients. Ankylosis of a lumbar vertebra was defined by the presence of bone bridges to its two adjacent vertebrae. The SBAC was measured from L1 to L5, and the fracture threshold was set at SBAC£145 HU. Results: A total of 73 AS patients were included (mean age: 60.3 (±10.7) years, 65 men (89%)). Sixty patients (82.2%) were mSASSS+; 13 patients (17.8%) presented ankylosis of at least one lumbar vertebra. The SBAC of each lumbar vertebra was not significantly different between mSASSS-and mSASSS+ patients. The SBAC was lower for patients with at least one bone bridge than for patients without (p
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- 2020
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