scholarly journals Future Challenges and Critical Approach to Metrology in Patients with Axial Spondyloarthritis

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1533
Author(s):  
Juan L. Garrido-Castro ◽  
Eduardo Collantes-Estévez ◽  
Francisco Alburquerque-Sendín ◽  
Clementina López-Medina
Keyword(s):  
Chronic Disease ◽  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Critical Approach ◽  
Vertebral Level ◽  
Future Challenges

Axial spondyloarthritis (axSpA) is a rheumatic inflammatory chronic disease that mainly affects the spine, producing inflammation and structural damage at the vertebral level (erosions, syndesmophytes, and bony bridges) [...]

FRI0218 Structural Damage Distribution at Vertebral Level in Patients with Axial Spondyloarthritis

2015 ◽  
Vol 74 (Suppl 2) ◽  
pp. 503.2-504
Author(s):  
J.L. Garrido-Castro ◽  
J. Calvo-Gutierrez ◽  
C. Gonzalez-Navas ◽  
P. Font-Ugalde ◽  
M.D.C. Castro-Villegas ◽  
...  
Keyword(s):  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Vertebral Level ◽  
Damage Distribution

scholarly journals Assessment of the relationship between estimated cardiovascular risk and structural damage in patients with axial spondyloarthritis

2020 ◽  
Vol 12 ◽  
pp. 1759720X2098283
Author(s):  
María Lourdes Ladehesa-Pineda ◽  
Iván Arias de la Rosa ◽  
Clementina López Medina ◽  
María del Carmen Castro-Villegas ◽  
María del Carmen Ábalos-Aguilera ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cluster Analysis ◽  
Structural Damage ◽  
Disease Duration ◽  
Linear Models ◽  
Axial Spondyloarthritis ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Atherosclerotic Plaques ◽  
Cross Sectional

Aims: To evaluate the association of estimated cardiovascular (CV) risk and subclinical atherosclerosis with radiographic structural damage in patients with axial spondyloarthritis (axSpA). Methods: Cross-sectional study including 114 patients axSpA from the SpA registry of Córdoba (CASTRO) and 132 age- and sex-matched healthy controls (HCs). Disease activity and the presence of traditional CV risk factors were recorded. The presence of atherosclerotic plaques and carotid intima media thickness (cIMT) were evaluated through carotid ultrasound and the SCORE index was calculated. Radiographic damage was measured though modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). The association between mSASSS and SCORE was tested using generalized linear models (GLM), and an age-adjusted cluster analysis was performed to identify different phenotypes dependent on the subclinical CV risk. Results: Increased traditional CV risk factors, SCORE, and the presence of carotid plaques were found in axSpA patients compared with HCs. The presence of atherosclerotic plaques and SCORE were associated with radiographic structural damage. The GLM showed that the total mSASSS was associated independently with the SCORE [β coefficient 0.24; 95% confidence interval (CI) 0.10–0.38] adjusted for disease duration, age, tobacco, C-reactive protein, and non-steroidal anti-inflammatory drugs (NSAID) intake. Hard cluster analysis identified two phenotypes of patients. Patients from cluster 1, characterized by the presence of plaques and increased cIMT, had a higher prevalence of CV risk factors and SCORE, and more structural damage than cluster two patients. Conclusion: Radiographic structural damage is associated closely with increased estimated CV risk: higher SCORE levels in axSpA patients were found to be associated independently with mSASSS after adjusting for age, disease duration, CRP, tobacco and NSAID intake.

Is active sacroiliitis on MRI associated with radiographic damage in axial spondyloarthritis? Real-life data from the ASAS and DESIR cohorts

Rheumatology ◽  
2018 ◽  
Vol 58 (5) ◽  
pp. 798-802 ◽  
Author(s):  
Alexandre Sepriano ◽  
Sofia Ramiro ◽  
Robert Landewé ◽  
Maxime Dougados ◽  
Désirée van der Heijde ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Odds Ratio ◽  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Multivariable Analysis ◽  
Real Life ◽  
Daily Practice ◽  
Bone Marrow Oedema ◽  
Number Of Patients ◽  
Structural Progression

Abstract Objective To assess any association between bone marrow oedema on MRI of the sacroiliac joints (MRI-SIJ) according to local readings in daily practice and the development of structural damage on radiographs of the SIJ (X-SIJ) in axial spondyloarthritis (axSpA). Methods Patients with axSpA from the Assessment of the SpondyloArthritis international Society (ASAS) and DEvenir des Spondylarthopathies Indifférenciées Récentes (DESIR) multicentre cohorts were included. MRI-SIJ and X-SIJ were obtained at baseline, and X-SIJ at follow-up after a mean 4.6 years (ASAS) and 5.1 years (DESIR). All images were scored by local readers. Structural damage in the X-SIJ was defined according to the modified New York criteria. The percentage of structural net progression (number of ‘progressors’ minus the number of ‘regressors’ divided by the total number of patients) was assessed and the effect of bone marrow oedema on MRI-SIJ on X-SIJ damage evaluated by multivariable logistic regression. Results In total, 125 (ASAS-cohort) and 415 (DESIR-cohort) patients had baseline MRI-SIJ and complete X-SIJ data available. According to local readings, progression and ‘improvement’ in X-SIJ was seen in both the ASAS- and DESIR-cohort, yielding a net progression that was higher in the former than in the latter (19.2% and 6.3%). In multivariable analysis, baseline bone marrow oedema on MRI-SIJ was strongly associated with X-SIJ structural progression in both ASAS (odds ratio = 3.2 [95% CI: 1.3; 7.9]), and DESIR (odds ratio = 7.6 [95% CI: 4.3; 13.2]). Conclusion Inflammation on MRI-SIJ is associated with future radiographic progression according to local readings despite an expected increased imprecision invoked by local readings.

Axial Spondyloarthritis and New Bone Formation

2021 ◽  
Vol 30 (04) ◽  
pp. 311-318
Author(s):  
Uta Syrbe
Keyword(s):  
Bone Formation ◽  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Clinical Symptoms ◽  
Research Work ◽  
New Bone Formation ◽  
Sacroiliac Joints ◽  
Spine Mobility ◽  
Vertebral Bodies ◽  
Inflammatory Changes

AbstractAxial spondyloarthritis is an inflammatory disease of the axial skeleton. Its pathogenesis is only partly understood. At the beginning, there are inflammatory changes in the sacroiliac joints which are followed by inflammation in vertebral bodies and in facet joints. Low back pain occurring in the morning hours is the dominant clinical symptom. In the early phase, inflammatory changes are detectably by MRI. Inflammation promotes a process of joint remodelling in the sacroiliac joints which leads to erosions, sclerosis and bony bridging, i. e. ankylosis, which are detectable by X-ray. In the spine, vertical osteophytes developing at sites of previous inflammation connect vertebral bodies as syndesmophytes. Additional ossification of longitudinal ligaments contributes to the so-called bamboo spine. Ossification of the spine promotes fixation of a severe kyphosis of the thoracic spine which strongly impairs spine mobility and quality of life. High disease activity seems a prominent risk factor for development of structural damage. However, although NSAIDs improve clinical symptoms, they do not reduce new bone formation. In contrast, TNFα and IL-17 inhibitors seem to retard new bone formation apart from their clinical efficacy. Research work of the last years identified immunological pathways of inflammation. However, the trigger and cellular components of the immune reaction in the bone marrow are still poorly defined. Osteoclasts are involved in the destruction of the subchondral bone, while osteoblasts facilitate new bone formation and cartilage ossification. This review gives an overview about diagnostics and therapy of axSpA and about risk factors for the development of structural damage. Concepts about the immune pathogenesis and joint remodeling in AS are given under recognition of genetic and histopathological studies.

scholarly journals Comorbid pain in axial spondyloarthritis, including fibromyalgia

2020 ◽  
Vol 12 ◽  
pp. 1759720X2096612
Author(s):  
Clementina López-Medina ◽  
Anna Moltó
Keyword(s):  
Back Pain ◽  
Vertebral Fractures ◽  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Inflammatory Diseases ◽  
Correct Diagnosis ◽  
Degenerative Changes ◽  
Inflammatory Back Pain ◽  
Management Options ◽  
Biomechanical Stress

The main symptom in patients with axial spondyloarthritis (axSpA) is inflammatory back pain, caused principally by inflammation of the sacroiliac joints and the spine. However, not all back pain in patients with axSpA is related to active inflammation: other types of pain can occur in these patients, and may be related to structural damage (e.g. ankylosis), degenerative changes, vertebral fractures or comorbid fibromyalgia, which are not uncommon in these patients. Structural damage and ankylosis may lead to a biomechanical stress, which can lead to chronic mechanical pain; and degenerative changes of the spine may also exist in patients with axSpA also leading to mechanical pain. Osteoporosis is more prevalent in axSpA patients than in the general population, and vertebral fractures may result in acute bone pain, which can persist for several months. Fibromyalgia, which is also more prevalent in patients with chronic inflammatory diseases (including axSpA), presents with widespread pain which can mimic entheseal pain. A correct diagnosis of the origin of the pain is crucial, since treatments and management may differ considerably. Recognizing these causes of pain may be a challenge in clinical practice, especially for fibromyalgia, which can coexist with axSpA and may have a significant impact on biologic drug response. In this review, we provide an update of the most common causes of pain other than inflammatory back pain in axSpA patients, and we discuss the latest management options for such causes.

scholarly journals Predictors of Assessment of Spondyloarthritis International Society (ASAS) Health Index in Axial Spondyloarthritis and Comparison of ASAS Health Index between Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Data from the Catholic Axial Spondyloarthritis COhort (CASCO)

2019 ◽  
Vol 8 (4) ◽  
pp. 467 ◽  
Author(s):  
Hong Ki Min ◽  
Jennifer Lee ◽  
Ji Hyeon Ju ◽  
Sung-Hwan Park ◽  
Seung-Ki Kwok
Keyword(s):  
Regression Analysis ◽  
Health Status ◽  
Ankylosing Spondylitis ◽  
Alcohol Consumption ◽  
International Society ◽  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Economic Status ◽  
Linear Regression Analysis ◽  
Health Index

The Assessment of Spondyloarthritis International Society (ASAS) health index (HI) is a novel tool for approaching disability, health, and functioning in spondyloarthritis (SpA). In the present study we compared ASAS HI between patients with ankylosing spondylitis (AS) and those with nonradiographic axial SpA (nr-axSpA). In addition, we identified predictors of ASAS HI. We designed this cross-sectional study using data from the Catholic Axial Spondyloarthritis COhort (CASCO), a prospective cohort from a single tertiary hospital. We compared baseline characteristics, including ASAS HI, between AS and nr-axSpA, and determined the frequency of each item constituting the ASAS HI. We used linear regression analysis to identify factors associated with ASAS HI. Total of 357 patients with axSpA—261 with AS and 96 with nr-axSpA—were included in analysis. AS patients were older and had higher ASAS HI than nr-axSpA. Among ASAS HI items, pain (item No. 1) and energy/drive (item No. 5) were the most common areas for which axSpA patients experienced discomfort. ASAS HI correlated with other SpA-related parameters such as BASDAI, ASDAS, and BASFI. Multivariable regression analysis of the axSpA group showed that high NSAID intake and mSASSS were positively associated with ASAS HI, whereas higher economic status and alcohol consumption were negatively associated with ASAS HI. Results were consistent in the AS group on subgroup analysis, whereas alcohol consumption was the only factor significantly associated with ASAS HI in the nr-axSpA group. In the present cohort study, patients with AS had poorer health status (higher ASAS HI) than those with nr-axSpA. Items proposed by AS patients (items No. 1 and 5) were the most frequently checked areas as axSpA patients feel discomfort, and this support that ASAS HI could practically assess actual discomfort of axSpA patient. ASAS HI was well correlated with known disease parameters, including activity, function, and quality of life; therefore, ASAS HI could be used in the future to represent the health status of SpA in a systematic way. Spinal structural damage (higher mSASSS), high NSAID intake, alcohol consumption, and economic status were predictors of ASAS HI in patients with axSpA, especially those with AS.

scholarly journals THU0360 INCREASING IMPACT ON STRUCTURAL DAMAGE WITH INCREASING CUMULATIVE INFLAMMATION AT THE SI-JOINT QUADRANT LEVEL IN AXIAL SPONDYLOARTHRITIS – 5-YEAR DATA FROM THE DESIR COHORT

2019 ◽  
Author(s):  
Santiago Rodrigues-Manica ◽  
Alexandre Sepriano ◽  
Sofia Ramiro ◽  
Robert B.M. Landewé ◽  
Pascal Claudepierre ◽  
...  
Keyword(s):  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Si Joint
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