Do obesity and overweight influence disease activity measures in axial spondyloarthritis? A systematic review and meta‐analysis

2020 ◽  
Author(s):  
Augusta Ortolan ◽  
Mariagrazia Lorenzin ◽  
Mara Felicetti ◽  
Roberta Ramonda
Keyword(s):  
Systematic Review ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Meta Analysis ◽  
Obesity And Overweight ◽  
Activity Measures ◽  
Disease Activity Measures

Longitudinal Association Between Trabecular Bone Loss and Disease Activity in Axial Spondyloarthritis: A 4-year Prospective Study

2019 ◽  
Vol 47 (9) ◽  
pp. 1330-1337 ◽  
Author(s):  
Kwi Young Kang ◽  
Ji Hyeon Ju ◽  
Sung-Hwan Park ◽  
Yeon Sik Hong
Keyword(s):  
Ankylosing Spondylitis ◽  
Bone Loss ◽  
Disease Activity ◽  
Trabecular Bone ◽  
Inflammatory Markers ◽  
Axial Spondyloarthritis ◽  
Longitudinal Association ◽  
Trabecular Bone Loss ◽  
Activity Measures ◽  
Disease Activity Measures

Objective.To investigate whether trabecular bone loss is longitudinally associated with disease activity measures in patientswith axial spondyloarthritis (axSpA).Methods.Data from patients enrolled in the Incheon Saint Mary’s axSpA prospective observational cohort were evaluated. Trabecular bone loss was assessed using the trabecular bone score (TBS). The relationship between TBS and disease activity measures [Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP)] was investigated using generalized estimating equation (GEE) models.Results.Four-year followup data from 240 patients (80% males, mean age 37 ± 12 yrs) were evaluated. At baseline, higher disease activity according to ASDAS-ESR and ASDAS-CRP showed a trend toward lower TBS (p = 0.003 and p = 0.016, respectively). Univariate GEE analyses showed a significant association between TBS and disease activity measures over time, with the exception of BASDAI. Univariate analysis showed a longitudinal association between TBS and age, smoking, and spinal structural damage. In multivariate GEE analysis, ASDAS-ESR, ASDAS-CRP, ESR, and CRP were longitudinally associated with TBS after adjustment for confounding factors. ASDAS scores and inflammatory markers were longitudinally associated with TBS in patients with ankylosing spondylitis (AS; 79%), but not in patients with nonradiographic axSpA (nr-axSpA). BASDAI scores showed no relationship with TBS in either the AS or nr-axSpA groups.Conclusion.Trabecular bone loss in patients with axSpA, assessed using the TBS, showed a longitudinal association with ASDAS scores and inflammatory markers.

scholarly journals POS0188 DISEASE ACTIVITY OUTCOME MEASURES ARE ONLY AVAILABLE IN HALF OF THE ELECTRONIC MEDICAL FILES OF PATIENTS WITH AXIAL SPONDYLOARTHRITIS FOLLOWED IN AN OUTPATIENT CLINIC: THE RESULTS OF AN AUDIT OF A TERTIARY-CARE RHEUMATOLOGY DEPARTMENT.

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 308.2-308
Author(s):  
E. Portier ◽  
M. Dougados ◽  
C. Roux ◽  
A. Moltó
Keyword(s):  
Disease Activity ◽  
Outcome Measures ◽  
Outpatient Clinic ◽  
Axial Spondyloarthritis ◽  
Tertiary Care ◽  
Educational Programs ◽  
Self Assessment ◽  
Factors Associated ◽  
Activity Measures ◽  
Disease Activity Measures

Background:Current recommendations for management of patients with axial Spondylarthritis (axSpA) include regular collection of validated disease activity outcomes.Objectives:This study aimed at evaluating the proportion of patients for whom the elements allowing the calculation of the validated outcome measures were available on the visits reported on the electronic medical records (EMR) and the factors associated with the presence of such information on the EMR.Methods:This was a cross-sectional and monocentric observational study conducted in a tertiary-care rheumatology department, EULAR center of excellence and ASAS center. We performed a systematic electronic search among all patients with a SpA diagnosis code who attended an outpatient visit between February 1st, 2018 and February 28th, 2019. Thereafter, a manual search was performed in order to check whether disease activity outcome measures (or the elements allowing its calculation): BASDAI individual questions, Disease activity Global, CRP, BASDAI and ASDAS) were reported on EMR. Patient’s and physician’s demographics disease characteristics (including treatment) and whether the patient had participated in a systematic review were also collected. A descriptive analysis of the percentage of EMR with available outcomes was performed, and the characteristics of patients in whom these measures were available/were not available evaluated by univariable and multivariable analysis (including only variables with p < 0,10 on the univariate)Results:320 EMR of axSpA patients seen in the outpatient clinic were screened and selected. Among them, 178 (55.6%) had at least one disease activity outcome measure reported, while 144(45%) and 123 (38.4%) had a BASDAI and an ASDAS reported, respectively. The most frequently reported disease activity items were duration of morning stiffness (n=230, 72%) and CRP (n=224, 70%).Only previous participation on an educational program for self-assessment was found to be independently associated with a reported disease activity outcome: among the patients participating in such program, 93.1% (n=27/29) had a disease activity measure available, compared to 51.9% (n=151/291) in those who did not participate in such program (p<0.001) (Table 1)Conclusion:Implementation of recommendations with regard to regularly collecting disease activity outcome measures is not optimal. The participation in educational programs including self-assessment educational programs might be one of the keys to improve such implementation.References:[1]Smolen JS, Braun J, Dougados M, Emery P, Fitzgerald O, Helliwell P, et al. Treating spondyloarthritis, including ankylosing spondylitis and psoriatic arthritis, to target: recommendations of an international task force. Ann Rheum Dis 2014;73:6–16. https://doi.org/10.1136/annrheumdis-2013-203419.[2]van der Heijde D, Ramiro S, Landewé R, Baraliakos X, Van den Bosch F, Sepriano A, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis 2017;76:978–91. https://doi.org/10.1136/annrheumdis-2016-210770.Figure 1.Frequency of disease activity measures reporting in the Electronic Medical Record of patients with axial Spondyloarthritis, followed in a tertiary care rheumatology department outpatient clinicTable 1.Factors associated with the presence of a reported disease activity measures on the electronic medical file of patients with axial SpADisclosure of Interests:Elodie Portier: None declared, Maxime Dougados: None declared, Christian Roux: None declared, Anna Moltó Consultant of: Abbvie, BMS, MSD, Pfizer, Lilly, UCB Novartis, Grant/research support from: Pfizer

scholarly journals Association of body mass index on disease activity in axial spondyloarthritis: systematic review and meta-analysis

RMD Open ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e001225
Author(s):  
Jean W Liew ◽  
Irvin J Huang ◽  
Diana N Louden ◽  
Namrata Singh ◽  
Lianne S Gensler
Keyword(s):  
Systematic Review ◽  
Body Mass Index ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Body Mass ◽  
Axial Spondyloarthritis ◽  
Activity Index ◽  
Meta Analysis ◽  
Disease Activity Index ◽  
Random Effects Models

ObjectivesIn axial spondyloarthritis (axSpA), higher body mass index (BMI) is associated with worse outcomes including response to biologics. Further clarity is needed on whether BMI is associated with disease activity overall, independent of treatment response. We performed a systematic review and meta-analysis to assess the association between BMI and disease activity as reported by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) or Ankylosing Spondylitis Disease Activity Score (ASDAS) in axSpA.MethodsWe systematically searched for studies evaluating BMI and disease activity as the exposure and outcome of interest, respectively, in axSpA. Using random effects models, we estimated summary standardised mean differences (SMDs) and 95% CIs of BASDAI or ASDAS, comparing obese (BMI>30 kg/m2) or overweight/obese (BMI>25 kg/m2) individuals to those with normal BMI (18.5–24.9 kg/m2).ResultsTwelve studies were included in the meta-analysis. Among all studies reporting the BASDAI at baseline, the pooled SMD of the BASDAI for those with an obese or overweight/obese BMI compared to a normal BMI was 0.38 (95% CI 0.21 to 0.55, I2 =75.2%), indicating a significant association of higher BMI with higher BASDAI score. The pooled SMD of the ASDAS for those with an obese or overweight/obese BMI compared to a normal BMI was 0.40 (95% CI 0.27 to 0.54, I2=0%). Findings were robust across subgroup analyses.ConclusionThese results demonstrate an association between an overweight/obese BMI and higher disease activity in studies of axSpA. Future longitudinal studies of BMI and disease activity should assess how this association changes over time.

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