Sensitivity and Specificity of Autoantibodies Against CD 74 in Nonradiographic Axial Spondyloarthritis

2019 ◽  
Vol 71 (5) ◽  
pp. 729-735 ◽  
Author(s):  
Elke Riechers ◽  
Niklas Baerlecken ◽  
Xenofon Baraliakos ◽  
Katrin Achilles‐Mehr Bakhsh ◽  
Peer Aries ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Axial Spondyloarthritis ◽  
Nonradiographic Axial Spondyloarthritis

scholarly journals Tumor necrosis factor-α (TNFα) inhibitors in the treatment of nonradiographic axial spondyloarthritis: current evidence and place in therapy

2017 ◽  
Vol 9 (8) ◽  
pp. 197-210 ◽  
Author(s):  
Valeria Rios Rodriguez ◽  
Denis Poddubnyy
Keyword(s):  
Ankylosing Spondylitis ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Tumor Necrosis Factor Α ◽  
Axial Spondyloarthritis ◽  
Efficacy And Safety ◽  
Tnfα Inhibitors ◽  
Factor Α ◽  
Nonradiographic Axial Spondyloarthritis ◽  
Necrosis Factor

Nonradiographic axial spondyloarthritis (SpA) and radiographic SpA (also known as ankylosing spondylitis) are currently considered as two stages or forms of one disease (axial SpA). The treatment with tumor necrosis factor-α (TNFα) inhibitors has been authorized for years for ankylosing spondylitis. In recent years, most of the anti-TNFα agents have also been approved for the treatment of nonradiographic axial SpA by the European Medicines Agency (EMA) and similar authorities in many countries around the world (but not in the US), increasing the number of possible therapies for this indication. Data from several clinical trials have demonstrated the good efficacy and safety profiles from those anti-TNFα agents. Presently, a large number of patients achieve a satisfactory clinical control with the current therapies, however, there remains a percentage refractory to nonsteroidal anti-inflammatory drugs (NSAIDs) and TNFα inhibitors; therefore, several new drugs are currently under investigation. In 2015, the first representative of a new class of biologics [an interleukin (IL)-17 inhibitor] secukinumab, was approved for the treatment of ankylosing spondylitis; a clinical trial in nonradiographic axial SpA is currently underway. In this review, we discuss the recent data on efficacy and safety of TNFα-inhibitors focusing on the treatment of nonradiographic axial SpA.

Ankylosing Spondylitis versus Nonradiographic Axial Spondyloarthritis: Comparison of Tumor Necrosis Factor Inhibitor Effectiveness and Effect of HLA-B27 Status. An Observational Cohort Study from the Nationwide DANBIO Registry

2016 ◽  
Vol 44 (1) ◽  
pp. 59-69 ◽  
Author(s):  
Bente Glintborg ◽  
Inge J. Sørensen ◽  
Mikkel Østergaard ◽  
Lene Dreyer ◽  
Abdiweli A. Mohamoud ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Tumor Necrosis Factor Inhibitor ◽  
Observational Cohort Study ◽  
Hla B27 ◽  
Factor Inhibitor ◽  
Observational Cohort ◽  
Nonradiographic Axial Spondyloarthritis ◽  
Necrosis Factor

Objective.To compare baseline disease activity and treatment effectiveness in biologic-naive patients with nonradiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) who initiate tumor necrosis factor inhibitor (TNFi) treatment and to study the role of potential confounders (e.g., HLA-B27 status).Methods.Observational cohort study based on prospectively registered data in the nationwide DANBIO registry. We used Kaplan-Meier plots, Cox, and logistic regression analyses to study the effect of diagnosis (nr-axSpA vs AS) and potential confounders (sex/age/start yr/HLA-B27/disease duration/TNFi-type/smoking/baseline disease activity) on TNFi adherence and response [e.g., Bath Ankylosing Spondylitis Activity Index (BASDAI) 50%/20 mm].Results.The study included 1250 TNFi-naive patients with axSpA (29% nr-axSpA, 50% AS, 21% lacked radiographs of sacroiliac joints). Patients with nr-axSpA were more frequently women (50%/27%) and HLA-B27–negative (85/338 = 25%), compared to AS (81/476 = 17%; p < 0.01). At TNFi start patients with nr-axSpA had higher visual analog scale scores [median (quartiles)] for pain: 72 mm (55–84)/65 mm (48–77); global: 76 mm (62–88)/68 mm (50–80); fatigue: 74 mm (55–85)/67 mm (50–80); and BASDAI: 64 (54–77)/59 (46–71); all p < 0.01. However, patients with nr-axSpA had lower C-reactive protein: 7 mg/l (3–17)/11 mg/l (5–22); and BAS Metrology Index: 20 (10–40)/40 (20–50); all p < 0.01. Median (95% CI) treatment adherence was poorer in nr-axSpA than in AS: 1.59 years (1.15–2.02) versus 3.67 years (2.86–4.49), p < 0.0001; but only in univariate and not confounder-adjusted analyses (p > 0.05). Response rates were similar in AS and nr-axSpA (p > 0.05). HLA-B27 negativity was associated with poorer treatment adherence [HLA-B27 negative/positive, nr-axSpA: HR 1.74 (1.29–2.36), AS: HR 2.04 (1.53–2.71), both p < 0.0001]; and lower response rates (nr-axSpA: 18/61 = 30% vs 93/168 = 55%; AS: 17/59 = 29% vs 157/291 = 54%, both p < 0.05).Conclusion.In this nationwide cohort, patients with nr-axSpA had higher subjective disease activity at start of first TNFi treatment, but similar outcomes to patients with AS after confounder adjustment. HLA-B27 positivity was associated with better outcomes irrespective of axSpA subdiagnosis.

Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Part of a Common Spectrum or Distinct Diseases?

2013 ◽  
Vol 40 (12) ◽  
pp. 2038-2041 ◽  
Author(s):  
Dinny Wallis ◽  
Nigil Haroon ◽  
Renise Ayearst ◽  
Adele Carty ◽  
Robert D. Inman
Keyword(s):  
Ankylosing Spondylitis ◽  
Acute Phase ◽  
Axial Spondyloarthritis ◽  
Laboratory Data ◽  
Clinic Visit ◽  
Early Form ◽  
Acute Phase Reactants ◽  
Significant Burden ◽  
Distinct Disease ◽  
Nonradiographic Axial Spondyloarthritis

Objective.To investigate the features of ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (nr-axSpA) in a Canadian cohort of 639 patients with AS and 73 patients with nr-axSpA.Methods.Clinical and laboratory data were compared for patients with AS and nr-axSpA enrolled in a longitudinal SpA cohort.Results.The proportion of male patients was higher in AS than in nr-axSpA (76.2% vs 47.9%; p < 0.0001). There was no difference in the presence of HLA-B27 between AS (78.9%) and nr-axSpA (72.5%) patients, nor in age at the time of diagnosis, although AS patients were younger at the time of symptom onset (23.9 yrs vs 26.4 yrs; p = 0.03). Disease duration at the time of last clinic visit was longer for AS than for nr-axSpA patients (17.7 yrs vs 12.1 yrs; p = 0.0002). Acute-phase reactants were higher in AS than in nr-axSpA (C-reactive protein 11.4 vs 5.2, p < 0.0001; erythrocyte sedimentation rate 13.7 vs 9.9, p = 0.02). The Bath Ankylosing Spondylitis Metrology Index was higher in patients with AS (2.84 vs 1.35, p < 0.0001).Conclusion.Patients with nr-axSpA were more likely to be female and to have lower inflammatory markers than patients with AS. When restricted to female patients only, acute-phase reactants did not differ significantly between AS and nr-axSpA. The evidence provides indirect support for the concept that nr-axSpA may represent an early form of AS, but that also has features of a distinct disease entity with significant burden of symptoms.

Fat Infiltration on Magnetic Resonance Imaging of the Sacroiliac Joints Has Limited Diagnostic Utility in Nonradiographic Axial Spondyloarthritis

2013 ◽  
Vol 41 (1) ◽  
pp. 75-83 ◽  
Author(s):  
Ulrich Weber ◽  
Susanne J. Pedersen ◽  
Veronika Zubler ◽  
Kaspar Rufibach ◽  
Stanley M. Chan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Back Pain ◽  
Magnetic Resonance ◽  
Axial Spondyloarthritis ◽  
Morphological Features ◽  
Diagnostic Utility ◽  
Resonance Imaging ◽  
Fat Infiltration ◽  
Per Se ◽  
Nonradiographic Axial Spondyloarthritis

Objective.To explore whether morphological features of fat infiltration (FI) on sacroiliac joint (SIJ) magnetic resonance imaging (MRI) contribute to diagnostic utility in 2 inception cohorts of patients with nonradiographic axial spondyloarthritis (nr-axSpA).Methods.Four blinded readers assessed SIJ MRI in 2 cohorts (A/B) of 157 consecutive patients with back pain who were ≤ 50 years old, and in 20 healthy controls. Patients were classified according to clinical examination and pelvic radiography as having nr-axSpA (n = 51), ankylosing spondylitis (n = 34), or nonspecific back pain (n = 72). Readers recorded FI, bone marrow edema (BME), and erosion, predefined morphological features of FI (distinct border, homogeneity, subchondral location), and anatomical distribution of SIJ FI. The proportion of SIJ quadrants affected by FI and frequencies of various SIJ FI features were analyzed descriptively. We calculated positive/negative likelihood ratios (LR) to estimate the diagnostic utility of various features of FI, with and without associated BME, and erosion.Results.Of the patients with nr-axSpA in cohorts A/B, 45.0%/48.4% had FI in ≥ 2 SIJ quadrants. Of those, 25.0%/22.6% and 20.0%/25.8% showed FI with distinct border or homogeneous pattern, respectively, and 50% to 100% of those patients displayed concomitant BME or erosion. FI per se in ≥ 2 SIJ quadrants had no diagnostic utility (LR+ 1.62/1.91). FI with distinct border (LR+ 8.29/2.13) or homogeneity (LR+ 6.24/3.78) demonstrated small to moderate diagnostic utility.Conclusion.SIJ FI per se was not of clinical utility in recognition of nr-axSpA. Distinct border or homogeneity of FI on SIJ MRI showed small to moderate diagnostic utility in nr-axSpA, but were strongly associated with concomitant BME or erosion, highlighting the contextual interpretation of SIJ MRI.

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