Spondyloarthropathies News

In patients with early, active non-radiographic axial spondyloarthritis and suboptimal response to at least two NSAIDs, a regimen of etanercept for 104 weeks appeared to yield lasting improvements in clinical and imaging outcomes, according to recently published findings.

Axial spondyloarthritis concepts can be feasibly and accurately identified in the free text of electronic medical record documents, according to findings.

Among patients with spondyloarthritis, smokers experience more severe disease vs. nonsmokers, according to recent findings.esearchers acquired clinical data on 946 patients with ankylosing spondylitis (73.5% were men; mean age, 52 years) who participated in the Scotland Registry for Ankylosing Spondylitis. Researchers extracted clinical data from medical records, including time since diagnosis, disease activity as measured by the bath ankylosing spondylitis disease activity index (BASDAI), function as measured by the bath ankylosing spondylitis functional index (BASFI) and metrology as assessed by the bath ankylosing spondylitis metrology (BASM). es as never smokers, ex-smokers or current smokers. The ankylosing spondylitis quality of life (ASQoL) questionnaire, the EuroQol, and the SF-36 physical and mental component summary scores were collected. Researchers used linear and logistic regression, adjusted for age, gender, socioeconomic deprivation, education level and alcohol use, to determine the effect of smoking and of smoking cessation, on various disease-specific and QoL outcomes.

PHILADELPHIA — According to a presenter at the Scoliosis Research Society Annual Meeting, spinal osteotomy may improve quality of life for patients with ankylosing spondylitis kyphosis.

Clinicians treating patients with spondyloarthropathies are required to walk many tightropes. One is the prevention of infections while treating patients with immunosuppressive drugs. Another is determining where clinical manifestations of spondyloarthritis end and the adverse event profile of the medication begins. Another is deciding when mainstay therapies, like tumor necrosis factor inhibitors, are working and when to move on to an agent with a novel or different target. The backdrop of all of this is little is known about the genetic factors that predispose patients to these diseases. In addition, the research community is beginning to compile metrics for patients to quantify and adequately express opinions on disease development, pain management and palliative care.

The history of the construct of spondyloarthritis as it evolved from ankylosing spondylitis from the late 19th century until now is remarkable to me. Why? Because it represents a culmination of careful observation by many who separated the disorder from the myriad of etiologies of structural and inflammatory back pain, combined these observations with careful epidemiology, took advantage of advances in musculoskeletal imaging and therapy and, ultimately, birthed the field of immunogenic investigation of disease with the discovery of the association of spondyloarthritis and B27.

In patients with anterior uveitis, the impact on physical quality of life has been underestimated, particularly in patients with pre-existing, previously undiagnosed spondyloarthritis, according to recently published findings. Researchers tested the Dublin Uveitis Evaluation Tool (DUET) algorithm, which was designed to improve and simplify referrals between ophthalmologists and rheumatologists, in patients with anterior uveitis (AU). They recruited 173 adults who presented to the eye casualty unit at Royal Victoria Eye and Ear Hospital in Dublin. Patients’ best-corrected visual acuity was assessed by the Snellen or LogMAR visual acuity (VA) charts and acquired from their eyeglass correction. Anterior chamber reaction according to the Standardization of Uveitis Nomenclature working group guidelines was assessed through slit lamp biomicroscopy of the anterior segment. HLA-B27 status was determined in all patients, and additional diagnostic testing was conducted if clinically warranted. Baseline examination was defined as the patient’s first exam in the research clinic, while the resolution assessment was the patient’s final assessment prior to discharge. All patients were independently examined for rheumatological factors, with radiographs taken as needed. SpA was diagnosed according to the assessment of Spondyloarthritis International Society classification criteria and the classification for psoriatic arthritis criteria. Patients completed two health-related quality of life (HRQoL) questionnaires: the SF-36 and the Vision Core Measure 1 (VCM1). Researchers found the mean baseline VCM1 score was 1.06 and the mean VCM1 score at resolution was 0.81. The VCM1 scores showed significant improvement from active AU to AU resolution with effect size of VCM1 being 0.26 in active AU to 0.32 upon resolution. Overall, patients with AU maintained good VA. The mean LogMAR VA of the affected eye at baseline was 0.18 and 0.06 at resolution, which showed significant improvement. Investigators found that at baseline 14.6% of patients had a VCM1 score of more than 2, which indicated “more than a little” concern about vision; while at resolution, 11% had a VCM1 score of more than 2. No association between VCM1 score and that affected eye VA was seen at baseline, while a weak correlation was observed between affected eye VA and VCM1 score at resolution. In 41% of patients, rheumatology assessment revealed a new diagnosis of SpA. A subgroup analysis compared SF-36 scores in those with a new SpA diagnosis vs. those with idiopathic uveitis. Among patients with SpA (n=71), questionnaires completed during active AU demonstrated decreased scores for physical function, role physical, social function and pain. In SF-36 scores completed on resolution of AU, all of these scores remained decreased except for the pain score, which improved between the active phase of AU and resolution. The early diagnosis and treatment of SpA has consistently been shown to improve short- and long-term outcomes,” the researchers wrote. “It is imperative that efforts are made to expedite its diagnosis. The results of our study are unique in identifying reduced quality of life scores in patients with underlying SpA prior to diagnosis.”

Among patients with recent-onset arthritis, roughly one-fourth develop chronic inflammatory rheumatic disease after 2 years, according to findings.

The FDA has approved the second biosimilar to Humira, Cyltezo, for several gastroenterological, rheumatological and dermatological indications.

Compared with controls, patients with ankylosing spondylitis had greater odds for complications after total hip arthroplasty, according to results of a recently published study.