Effect of Therapy on Radiographic Progression in Axial Spondyloarthritis: A Systematic Review and Meta ‐Analysis

ConclusionAlthough no significant protective effect of TNFi treatment on spinal radiographic progression was seen over the course of 2 years or ≥4 years in patients with axial SpA, our analysis restricted to studies with a low risk of bias showed a protective effect of TNFi after ≥4 years. Therefore, long‐term TNFi exposure might confer beneficial effects on spinal radiographic progression in axial SpA. No difference in radiographic p rogression at 2 years was seen in either the NSAID or secukinumab treatment groups compared to their controls. Future studies should explore the effects of biologic treatment on radiographic progression, as well as the effects of long‐term biologics exposure, in patients with early axial SpA or th ose with nonradiographic axial SpA.
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: Review Source Type: research

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Purpose of review This review encompasses a detailed history of spondyloarthritis (SpA) evolution as early as the 17th century, continues on to the current concept of SpA, and ends with current gaps in our understandings of SpA. Recent findings Until the early 1960s, ankylosing spondylitis and other SpA family members were considered to be variants of rheumatoid arthritis (RA). The formal medical community separated them from RA at that time, and shortly thereafter they were recognized to be inter-connected based on shared clinical, laboratory, and imaging features. The last two decades have witnessed the formal disti...
Source: Current Opinion in Rheumatology - Category: Rheumatology Tags: SPONDYLOARTHROPATHIES: Edited by Joerg Ermann Source Type: research
Scientific breakthroughs have culminated in the development of the spondyloarthritis (SpA) concept as a family of rheumatic diseases, distinct from rheumatoid arthritis. The demonstration of inflammatory lesions in the sacroiliac joints and spine of patients with axial symptoms of SpA who lacked radiographic features of ankylosing spondylitis (AS) helped refine the SpA concept. Axial SpA includes patients with AS and patients with axial symptoms previously categorized as undifferentiated SpA. This review examines the sources of knowledge that inform axial SpA pathogenesis, highlighting current limitations, and a basic work...
Source: Rheumatic Disease Clinics of North America - Category: Rheumatology Authors: Source Type: research
Nonsteroidal antiinflammatory drugs (NSAIDs) are the first ‐line pharmacotherapy for patients with axial spondyloarthritis (SpA). In recent years, treatment options have expanded with the availability of biologic agents, including tumor necrosis factor inhibitors and interleukin‐17 inhibitors. However, a treatment strategy that clearly prevents syndesmo phyte formation has not been established. Observational studies of patients with ankylosing spondylitis indicated potential disease‐modifying effects of NSAIDs, but two randomized trials came to different conclusions. More broadly, whether any of the currently availab...
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: New Perspectives in Rheumatology Source Type: research
Publication date: Available online 17 February 2020Source: The Egyptian RheumatologistAuthor(s): Rehab A. Sallam, Amany S. ElbahnasawyAbstractAim of the workTo assess health-related quality of life (HRQoL) and associated variables in Egyptian ankylosing spondylitis (AS) patients.Patients and methods50 male patients with AS and 50 age-matched controls were enrolled. Clinical and laboratory data were examined including history for peripheral arthritis. Visual analog scale (VAS), Bath AS disease activity index (BASDAI), AS disease activity score (ASDAS)-C-reactive protein (CRP) and ASDAS-erythrocyte sedimentation rate (ESR), ...
Source: The Egyptian Rheumatologist - Category: Rheumatology Source Type: research
AbstractPsoriatic arthritis (PsA) is an inflammatory arthritis with distinct phenotypic subtypes. Enthesitis is assigned as a hallmark of the disease, given its significant relations to disease activity and quality of life. Our objective is to evaluate the prevalence of enthesitis and its association with some clinical parameters, particularly quality of life, using data from a national registry. Patients with PsA meeting ClASsification criteria for Psoriatic Arthritis (CASPAR) were enrolled by means of a multi-centre Turkish League Against Rheumatism (TLAR) Network Project. The following information was recorded in web-ba...
Source: Rheumatology International - Category: Rheumatology Source Type: research
Authors: Carli L, Calabresi E, Governato G, Braun J Abstract Spondyloarthritis (SpA) is the umbrella term for a broad spectrum of inflammatory rheumatic diseases with typical but also rather different clinical manifestations, limited laboratory abnormalities and characteristic imaging features. For classification purposes, a so-called non-radiographic form (nr-axSpA) is differentiated from a radiographic one (r-axSpA) which is almost identical to the classical ankylosing spondylitis (AS) that is genetically strongly associated with the major histocompatibility complex class 1 antigen HLA-B27. In axSpA, the axial sk...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
ConclusionThe safety profile of adalimumab was consistent with previous findings and no new safety signals were observed.
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
AbstractNon ‐steroidal anti‐inflammatory drugs (NSAIDs) are the first line pharmacotherapy for patients with axial spondyloarthritis (axSpA). In the recent years, treatment options have expanded with the availability of biologics, including tumor necrosis factor inhibitors (TNFi) and IL‐17 inhibitors. How ever, a treatment strategy that clearly prevents syndesmophyte formation has not been established. Observational studies of patients with ankylosing spondylitis indicated potential disease modifying effects of NSAIDs, but two randomized trials came to different conclusions. More broadly, whether any of the currently...
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: REVIEW ARTICLE Source Type: research
Abstract OBJECTIVE: The aim of this study was to compare patients with ankylosing spondylitis with psoriasis (ASP) and without psoriasis (AS), to axial PsA (axPsA) patients. METHODS: Two adult cohorts were recruited from the AS clinic: ASP and AS. These two cohorts were compared with two adult cohorts recruited from the PsA clinic: axPsA (radiographic sacroiliitis: ⩾bilateral grade 2 or unilateral grade 3 or 4); and Peripheral PsA. All patients were followed prospectively according to the same protocol. The demographic, clinical and radiographic variables were compared. Adjusted means were used to account f...
Source: Pain Physician - Category: Anesthesiology Authors: Tags: Rheumatology (Oxford) Source Type: research
Abstract Drug treatment in patients with axial spondylarthritis (axSpA) aims to modify symptoms and complaints and currently includes the substance groups of nonsteroidal anti-inflammatory drugs (NSAID) and biologicals (disease-modifying antirheumatic drugs, bDMARDS). Treatment with NSAIDs is the first line treatment according to international and national recommendations. Patients with persisting high disease activity despite continuous standard treatment with NSAIDs, should be treated with biologicals. In Germany treatment with tumor necosis factor (TNF) inhibitors or interleukin 17 inhibitor (secukinumab) ...
Source: Zeitschrift fur Rheumatologie - Category: Rheumatology Authors: Tags: Z Rheumatol Source Type: research
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