Ankylosing Spondylitis Patients Research Articles

Comparison of oxidative stress, lipid peroxidation and inflammatory markers between rheumatoid arthritis and ankylosing spondylitis patients

Objective: To measure the levels of superoxide dismutase and malondialdehyde along with erythrocyte sedimentation rate and C-reactive protein in patients of rheumatoid arthritis and ankylosing spondylitis. Method: The comparative, cross-sectional study was conducted from February 2 to December 30, 2022, at the Centre for Research in Experimental and Applied Medicine laboratory of the Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi, Pakistan, in collaboration with the Department of Rheumatology, Pak Emirates Military Hospital, Rawalpindi. The sample comprised healthy controls in group 1, patients of rheumatoid arthritis in group 2 and patients of ankylosing spondylitis in group 3. Blood samples were assessed for levels of superoxide dismutase, malondialdehyde, erythrocyte sedimentation rate and C-reactive protein. Data was analysed using SPSS 25. Results: Of the 180 subjects, 60(33.3%) were in group 1; 32(53.3%) females and 28(46.7%) males with mean age 34.9±6.4 years. There were 60(33.3%) patients in group 2; 35(58.3%) females and 25(41.7%) males with mean age 46.0±11.1 years. There were 60(33.3%) patients in group 3, and all 60(100%) were males with mean age 35.9±6.9 years. Superoxide dismutase level was significantly low and malondialdehyde level was significantly high in groups 2 and 3 compared to group 1 (p<0.05). Erythrocyte sedimentation rate was the highest in group 2, followed by group 3 (p<0.05). C-reactive protein levels were the highest in group 2 and the lowest in group 3 (p<0.05). A significantly negative correlation (p<0.001) was found between superoxide dismutase and malondialdehyde. Conclusion: Oxidative stress played a pivotal role in chronic inflammatory rheumatic diseases, like rheumatoid arthritis and ankylosing spondylitis. Key Words: Rheumatoid arthritis, Ankylosing spondylitis, Superoxide dismutase, Malondialdehyde.

Comparative surgical outcomes of navigated vs non-navigated posterior spinal fusions in ankylosing spondylitis patients

IntroductionAnkylosing Spondylitis (AS) patients with acute spinal fractures represent a challenge for practicing spine surgeons due to difficult operative anatomy and susceptibility to complications. Research questionDoes intraoperative CT-navigation improve outcomes in patients with ankylosing spondylitis undergoing surgery? MethodsA retrospective review was carried out at our centre from 05/2016–06/2021 to identify AS patients presenting with a traumatic spinal fracture, managed surgically with posterior spinal fusion (PSF). Cohorts were categorised and compared for outcomes based on those who underwent PSF with intraoperative CT-navigation versus those surgically managed with traditional intraoperative fluoroscopy. Results37 AS patients were identified. 29/37 (78.4%) underwent PSF. Intraoperative navigation was used in 14 (48.3%) cases. Mean age of the entire cohort was 67.6 years. No difference existed between the navigated and non-navigated groups for mean levels fused (5.35 vs 5.07; p ​= ​0.31), length of operation (217.9mins vs 175.3mins; p ​= ​0.07), overall length-of-stay (12 days vs 21.9 days; p ​= ​0.16), patients requiring HDU (3/14 vs 5/15; p ​= ​0.09) or ICU (5/14 vs 9/15; p ​= ​0.10), postoperative neurological improvement (1/14 vs 1/15; p ​= ​0.48) or deterioration (1/14 vs 0/15; p ​= ​0.15), intraoperative complications (2/14 vs 3/15; p ​= ​0.34), postoperative complications 4/14 vs 4/15; p ​= ​0.46), revision surgeries (3/14 vs 1/15; p ​= ​0.16) and 30-day mortality (0/14 vs 0/15). ConclusionThis is the first study that compares surgical outcomes of navigated vs non-navigated PSFs for AS patients with an acute spinal fracture. Although limited by its retrospective design and sample size, this study highlights the non-inferiority of intraoperative navigation as a surgical aid in a challenging cohort.

Combined use of QRISK3 and SCORE2 increases identification of ankylosing spondylitis patients at high cardiovascular risk: Results from the CARMA Project cohort after 7.5 years of follow-up

ObjectiveTo establish the predictive value of the QRESEARCH risk estimator version 3 (QRISK3) algorithm in identifying Spanish patients with ankylosing spondylitis (AS) at high risk of cardiovascular (CV) events and CV mortality. We also sought to determine whether to combine QRISK3 with another CV risk algorithm: the traditional SCORE, the modified SCORE (mSCORE) EULAR 2015/2016 or the SCORE2 may increase the identification of AS patients with high-risk CV disease. MethodsInformation of 684 patients with AS from the Spanish prospective CARdiovascular in ReuMAtology (CARMA) project who at the time of the initial visit had no history of CV events and were followed in rheumatology outpatient clinics of tertiary centers for 7.5 years was reviewed. The risk chart algorithms were retrospectively tested using baseline data. ResultsAfter 4,907 years of follow-up, 33 AS patients had experienced CV events. Linearized rate=6.73 per 1000 person-years (95 % CI: 4.63, 9.44). The four CV risk scales were strongly correlated. QRISK3 correctly discriminated between people with lower and higher CV risk, although the percentage of accumulated events over 7.5 years was clearly lower than expected according to the risk established by QRISK3. Also, mSCORE EULAR 2015/2016 showed the same discrimination ability as SCORE, although the percentage of predicted events was clearly higher than the percentage of actual events. SCORE2 also had a strong discrimination capacity according to CV risk. Combining QRISK3 with any other scale improved the model. This was especially true for the combination of QRISK3 and SCORE2 which achieved the lowest AIC (406.70) and BIC (415.66), so this combination would be the best predictive model. ConclusionsIn patients from the Spanish CARMA project, the four algorithms tested accurately discriminated those AS patients with higher CV risk and those with lower CV risk. Moreover, a model that includes QRISK3 and SCORE2 combined the best discrimination ability of QRISK3 with the best calibration of SCORE2.

Natural Autoantibodies in Biologic-Treated Rheumatoid Arthritis and Ankylosing Spondylitis Patients: Associations with Vascular Pathophysiology.

Cardiovascular (CV) morbidity and mortality have been associated with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Natural autoantibodies (nAAb) are involved in innate immunity, as well as autoimmunity, inflammation, and atherosclerosis. There have not been any studies assessing the effects of biologics on nAAbs in RA and AS, also in relation to vascular pathophysiology. Fifty-three anti-TNF-treated RA and AS patients were included in a 12-month follow-up study. Anti-citrate synthase (CS) and anti-topoisomerase I fragment 4 (TOPO-F4) IgM and IgG levels were determined by ELISA. Ultrasonography was performed to assess brachial artery flow-mediated vasodilation (FMD), common carotid intima-media thickness (ccIMT), and arterial pulse-wave velocity (PWV). Other variables were also evaluated at baseline and 6 and 12 months after treatment initiation. Anti-TNF therapy improved FMD in RA and PWV in AS and stabilized ccIMT. TNF inhibition increased anti-CS IgM and IgG, and possibly also anti-TOPO-F4 IgG levels. Various correlation analyses revealed that nAAbs might be independently involved in autoimmunity as well as changes in inflammation and vascular pathology over time in biologic-treated patients (p < 0.05). We also found associations between anti-TOPO-F4 IgG and anti-Hsp60 IgG (p < 0.05). Baseline nAAb levels or nAAb level changes might determine changes in CRP, disease activity, FMD, PWV, and ccIMT over time (p < 0.05). The interplay between arthritis and inflammatory atherosclerosis, as well as the effects of anti-TNF biologics on these pathologies, might independently involve nAAbs.

IL-17-producing cells in ankylosing spondylitis patients show gender-based differences in gene expression.

Gender has been shown to impact disease expression in ankylosing spondylitis (AS) and Th17 cells play a key role in AS pathogenesis. To better understand what Th17-associated immune pathways are different between men and women, we compared the transcriptome of IL-17-enriched peripheral blood mononuclear cells (PBMCs) in male and female AS patients, with a particular focus on inflammatory cytokine genes. PBMCs were collected from 10 female and 11 male AS patients at the Clinical Research Unit of MetroHealth Medical Center. IL-17-enriched PBMCs were isolated and stimulated with CytoStim. RNA-sequencing (RNA-seq) was performed on the samples, and the data were analysed using iPathwayGuide. Inflammatory markers and genes related to Th17 differentiation and function were identified based on previous studies. female AS patients. TGF-β, PGE2, and S100 proteins were significantly upregulated in males. Levels of IL-12B, a Th17 inducer, were lower in males compared to females. Additionally, receptors of IL-6, 12, 23, TGF-β, and PGE2 were downregulated in males, except for IL-17RC, which was upregulated. Genes involved in Th17 differentiation showed differential expression between genders, with elevated expression of BATF, SOCS1, NKD2, and ARID5A in men and decreased expression of FOXO1. Transcriptomic analysis revealed that male AS patients exhibit distinct expression patterns of IL-17 pro-inflammatory genes, which may contribute to the phenotypic differences observed between genders in AS.

Reliability and validity of the PROMIS-29 health profile in Ankylosing Spondylitis patients: A cross-sectional study.

The Patient-Reported Outcomes Measurement Information System 29-Item Health Profile (PROMIS-29) is a generic measure of health-related quality of life that is not well-studied in Ankylosing Spondylitis (AS) patients. Our objective was to investigate the reliability and validity of the PROMIS-29 in AS. About 169 consecutive AS patients were enrolled from 2017 to 2022 with 167/169 patients fully completing the PROMIS-29 in this cross-sectional study. Test-retest reliability and internal consistency was assessed using intraclass correlation coefficients (ICC) and Cronbach alpha, respectively. We studied structural validity with confirmatory factor analysis (CFA) of our hypothesized and general population models. We evaluated model fit by Chi-squared goodness-of-fit-test (χ2), comparative fit index, and root mean square error of approximation. A χ2 test was used to compare nested models. PROMIS-29 convergent validity was studied by Spearman correlation coefficients with AS-legacy measures. PROMIS-29 domains showed good test-retest reliability (intraclass correlation coefficients (ICC) > 0.7) and excellent internal consistency with Cronbach alpha > 0.9 in all subscales. CFA of only the general population model met our model fit cutoffs (χ2 goodness-of-fit P-value of 0.21, comparative fit index of 0.99, and root mean square error of approximation of 0.05). Furthermore, a nested χ2 test was not significantly different between our hypothesized (full) and general (reduced) model [χ2 (1) = 0.754, P > .38]. AS legacy measures showed a strong correlation (rho > |0.7|) with the extracted physical health factor. The PROMIS-29 demonstrated good reliability and construct validity in AS patients with the general population model. Further study is required to determine its clinical and research utility in AS patients.

Evaluation of the relationship between serum irisin levels and disease activity in ankylosing spondylitis patients

Evaluation of the relationship between serum irisin levels and disease activity in ankylosing spondylitis patients

"Long-term MRI findings in Ankylosing spondylitis patients treated with TNF inhibitors for a decade".

This study aims to evaluate the active and chronic lesions in sacroiliac joints and lumbar spine over a decade of TNFi therapy in patients with AS. The study enrolled patients with AS under treatment with a TNFi for over a decade. The patients underwent a new MRI scan of their lumbar spine and sacroiliac joint (SIJ). Two readers evaluated all images. Inflammation of SIJ(SIS), SIJ structural damage (SSS) including Fat Metaplasia, Erosions, Backfill and Ankylosis, and Spondyloarthritis Research Consortium of Canada Bone marrow edema (SPARCC) spine score were recorded. In the study, 15 patients were included, with 80% being male. The mean age during their first MRI was 38.1 (± 11.9) years old, and the majority (86.7%) tested positive for HLA-B27. While TNFi improved both BASDAI and BASFI scores, there was a noticeable increase in MRI acute lesions in the SIJ over time, where the median score increased from 0 (0-4) to 3 (0-10) after ten years (p = 0.028). After a decade of treatment, the median SPARCC spine score also increased from 0 (0-9) to 5 (0-16), p = 0.093. Finally, it was observed that there was a significant positive correlation between ESR and SIS erosions in cases of chronic lesions (r = 0.819, p < 0.001). While TNFi have significantly improved the treatment of AS, this study shows that acute lesions can still develop despite treatment. A personalized approach that adapts MRI assessment to each patient's specific requirements may help detect changes early and enable doctors to intervene promptly to prevent further damage.

The efficacy of tofacitinib combined with bDMARDs in the treatment of ankylosing spondylitis patients with inadequate response to bDMARDs: a retrospective study

IntroductionAnkylosing spondylitis(AS) is a chronic inflammatory rheumatic disease primarily affecting the spine and sacroiliac joints. While biologic disease-modifying antirheumatic drugs(bDMARDs) and targeted synthetic DMARDs(tsDMARDs) are popular treatments for AS, there is limited research on their combined use. This study examined a cohort of AS patients who demonstrated inadequate response to bDMARDs and subsequently initiated combination therapy with tofacitinib in conjunction with bDMARDs, assessing both the efficacy and safety profile of this therapeutic approach.MethodsIn this study, we retrospectively collected the electronic medical records (EMR) of 15 adult patients with AS who were admitted to the Fourth Affiliated Hospital Zhejiang University School of Medicine between January 2018 and June 2022. All patients had received at least one bDMARD treatment for more than three months and still exhibited moderate to high disease activity. Tofacitinib 5 mg bid was added to their original biological treatment. Treatment was continued for a minimum of 12 weeks following the initiation of combination therapy. Changes in ASDAS-CRP and BASDAI scores at week 12 were collected and analyzed from baseline, while changes in C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) at weeks 4, 8, and 12 were also collected and analyzed.ResultsAfter 12 weeks of treatment, the overall ASDAS-CRP score decreased significantly from a baseline of 3.82 ± 1.47 (2.83 ~ 4.99) to 1.47 ± 0.48 (0.75 ~ 2.44), with remission achieved by 7 patients (46.7%) and low disease activity achieved by 5 patients (33.3%). The overall BASDAI score also showed significant improvement, decreasing from a baseline of 5.11 ± 1.42 (3.25 ~ 7 0.75) to 1.28 ± 0.70(0.20 ~ 2.55). Additionally, both ESR and CRP levels decreased significantly during the course of treatment without any reported adverse events leading to discontinuation.ConclusionTo a certain extent, our findings provide some evidence supporting the efficacy and safety of the combination of bDMARD and JAK inhibitor tofacitinib in AS patients with inadequate response to bDMARD monotherapy. It effectively controls disease activity while maintaining a relatively low and manageable incidence of adverse events. Further prospective randomized controlled trials with large sample sizes are anticipated to provide evidence-based medical support.

Pan-immune inflammation value as a biomarker in ankylosing spondilitis and associated with disease activity

Aims: Ankylosing spondylitis(AS) is the most common and characteristic form of Spondyloarthritis. The pan-immune inflammation value(PIV) is a marker obtained from complete blood count parameters, which has been used as an inflammatory and immune marker. In this study, we aimed to investigate the relationship between inflammation and disease activity in patients with AS and PIV. Methods: In this prospective controlled study a total of 208 participants were included, consisting of 104 AS patients and 104 healthy controls. Complete blood count values, including neutrophils, monocytes, lymphocytes, platelets, and also C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), were measured in all participants. In AS group disease activity was assessed with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The AS group was divided into two subgroups based on BASDAI score: low disease activity(BASDAI score &amp;lt;4) and high disease activity(BASDAI score ≥4).The pan-immune inflammation value of patients and the control group was calculated as neutrophil count × monocyte count × platelet count/lymphocyte count. Comparative analysis was performed between the two groups, and these values were also compared based on the BASDAI. Results: The AS group exhibited statistically higher values of CRP, monocytes, and PIV compared to the control group (p&amp;lt;0.001 for all). Patients with BASDAI≥4 had a statistically lower disease duration (p&amp;lt;0.001) and lymphocyte count (p:0.012) compared to those with BASDAI&amp;lt;4. Patients with BASDAI ≥ 4 had statistically higher values of CRP, ESR, neutrophils, platelets, and PIV compared to those with BASDAI&amp;lt;4 (p&amp;lt;0.001, p&amp;lt;0.001, p&amp;lt;0.001, p:0.008, p&amp;lt;0.001 respectively). Strong positive correlation was found between PIV and BASDAI (rho=0.790; p&amp;lt;0.001), moderate positive correlation with PIV and CRP (rho=0.467; p&amp;lt;0.001) and also positive correlation was found between PIV and ESR (rho=0.326; p&amp;lt;0.001). The specificity and sensitivity of PIV using a cutoff value of &amp;gt;309,2 were 80.0% and 86.0% respectively, for the active group. Conclusion: Since the parameters comprising PIV are obtained from a complete blood count, it provides an advantage for its use as a simple and cost-effective marker in ankylosing spondylitis patients. In our study, we demonstrated that PIV is sensitive and specific in differentiating disease activity in patients with ankylosing spondylitis from healthy individuals and associated with disease activity.

A case report on new-onset peritoneal tuberculosis in ankylosing spondylitis patient on adalimumab

Adalimumab, a widely employed tumor necrosis factor-alpha inhibitor for autoimmune diseases, raises concern about reactivating latent tuberculosis (TB) and new-onset TB. Despite its established efficacy in managing inflammation, clinicians must recognize and manage adalimumab-induced TB promptly to minimize associated morbidity. This case report explores guidelines for TB screening in adalimumab-treated patients, utilizing interferon-gamma release assays and tuberculin skin tests, and discusses treatment considerations. Increased TB incidence in adalimumab-treated patients necessitates vigilant screening for latent TB before therapy initiation. Therapeutic decisions must balance the need for continuing immunosuppressive therapy against the potential risks of uncontrolled TB. Diagnostic challenges arise from atypical presentations and the intricate interplay between adalimumab therapy and TB manifestations. Given adalimumab’s expanding use, clinicians should be mindful of potential TB reactivation, emphasizing thorough screening, diagnosis, and management for improved patient care and safety amidst immunosuppressive therapies. Here, we are presenting the case of adalimumab-induced peritoneal TB.

Independent Relationship Between Uveitis and Increased Left Atrial Volume Index in Ankylosing Spondylitis Patients

Objective The aim of this study was to evaluate the relationship between uveitis and left atrial volume index (LAVI) in patients with ankylosing spondylitis (AS). Methods Demographic, clinical, echocardiographic and brachial artery flow-mediated dilation measurement data of patients diagnosed with AS were recorded prospectively between January 2019 and June 2023. The patients were categorized into two groups: increased (group 2) and normal (group 1) based on a cut-off value of 34 ml/m2 for increased LAVI and the data were compared. Results Of the 89 patients with AS, 54 were male and 35 were female, with a mean age of 42.8±11.8 years. There were N=67 patients in the group with normal LAVI levels, and N=22 patients in the group with high LAVI levels. Mean age, uveitis and comorbid conditions were higher in Group 2. Among the basic echocardiographic parameters that may affect LAVI, only the left ventricular mass index was different in group 2. In Group 2, flow-dependent dilatation in the vessel decreased. When we evaluated all parameters by multivariate logistic regression analysis, we found that age (odds ratio:1.097; 95% confidence interval:1.017-1.183; P=0.016) and the presence of uveitis (odds ratio:21.3; 95% confidence interval:2.476-182.1; P=0.005) independently predicted group 2. Conclusion Evaluation of LAVI in AS patients with uveitis may be a guide in predicting the risk of cardiovascular events and early treatment.

Assessment of quality of life and clinical status in active ankylosing spondylitis patients treated with biologics and physical therapy

Assessment of quality of life and clinical status in active ankylosing spondylitis patients treated with biologics and physical therapy

Predictive values of circulating miR-146a and miR-155 for disease activity and clinical response to TNF-α blocking therapy in patients with ankylosing spondylitis.

Ankylosing spondylitis is an insidiously progressive and debilitating form of arthritis involving the axial skeleton. MicroRNAs have been reported to act as candidate biomarkers for ankylosing spondylitis diagnosis and progression. The study aimed to assess the roles of circulating miR-146a and miR-155 in ankylosing spondylitis and their prediction to clinical response to TNF-α blocking therapy. The study included 62 ankylosing spondylitis patients who were given originator TNFi with a 6-month period. Responders to anti-TNF treatment were defined as those reaching the Assessment of SpondyloArthritis international Society 40 (ASAS40) response at the 6-month interval, and nonresponders were defined those not (n = 24). The ankylosing spondylitis patients at M0 (before beginning TNFi treatment) had higher serum levels of miR-146a and miR-155 than the healthy controls (p < .0001). Lower serum levels of miR-146a and miR-155 were noted in the responders (n = 38) compared with the nonresponders (n = 24) at different time points after anti-TNF treatment (p < .0001). The serum levels of miR-146a and miR-155 alone or in combination used to predict treatment outcomes produced AUCs of 0.884, 0.902, and 0.936, respectively. We submitted the following variables: miR-146a and miR-155 levels, BASDAI, ASDASCRP, ESR (mm/h), and CRP (mg/L) into multivariate logistic regression analysis, and results showed that higher levels of miR-146a (OR: 13.75, 95%CI: 1.32 to 143.57, p = .029), miR-155 (OR: 5.74, 95% CI: 1.63 to 20.20, p = .006), and ESR (OR: 1.08, 95% CI: 1.01 to 1.15, p = .022) were independent baseline predictors of ASAS40 response at 6-month anti-TNF-a treatment. These findings obtained from the study suggest that high serum levels of miR-146a and miR-155 could aid in prediction of poor treatment outcomes after TNF-α blocking therapy.

A rare T-cell lymphoma in an ankylosing spondylitis patient under immunosuppression with tumor necrosis factor inhibitor

A rare T-cell lymphoma in an ankylosing spondylitis patient under immunosuppression with tumor necrosis factor inhibitor

Increased serum visfatin level is associated with fat deposition of the lumbar spine in ankylosing spondylitis patients

ObjectivesTo assess the serum visfatin levels in patients with ankylosing spondylitis (AS), as well as its correlation with fat deposition of the lumbar spine. MethodsSerum visfatin levels were detected by enzyme-linked immunosorbent assay (ELISA) in 50 AS patients and 75 sex-and age-matched healthy controls. The clinical and laboratory indexes of AS patients were recorded, and the lumbar spine magnetic resonance scan was performed to evaluate the lumbar spine fat deposition in AS patients. The level of serum visfatin and its correlation with lumbar fat deposition were analyzed, and the risk factors of AS lumbar MRI fat deposition were evaluated by Logistic regression. ResultsSerum visfatin levels in AS patients were elevated compared with that in healthy controls (p < 0.001), and were more significant in patients with fat deposition and syndesmophyte formation (p = 0.017 and p = 0.014, respectively). Serum visfatin levels were positively correlated with CRP, BASDAI, mSASSS and fat deposition (all p < 0.05). Age (OR = 1.085, 95% CI: 1.005–1.173, p = 0.038), disease duration (OR = 1.267, 95% CI: 1.017–1.578, p = 0.035), and visfatin (OR = 1.846, 95% CI: 1.004–3.393, p = 0.048) were risk factors for fat deposition in AS patients. ConclusionsThe level of serum visfatin in AS patients is significantly increased, which is associated with fat deposition on lumbar MRI. Elevated visfatin level is an independent risk factor for AS lumbar fat deposition.

Effectiveness of bDMARDs in ankylosing spondylitis patients by biologic use: experience from the CorEvitas PsA/SpA Registry

Objective To describe bDMARD initiators by biologic experience among ankylosing spondylitis (AS) patients and change in disease activity and patient-reported outcomes (PROs) in real-world US patients. Methods We included patients ≥18 years with AS based on physician diagnosis enrolled between 3/2013 and 11/2019 in the CorEvitas Psoriatic Arthritis (PSA)/Spondyloarthritis Registry (NCT02530268). Patients concurrently diagnosed with PSA were excluded. Baseline (bDMARD initiation) demographics, comorbidities, disease characteristics, treatment, and PROs were collected. Response rates and changes in disease activity and PROs between baseline and 6- and 12- month follow-up visits were calculated. Results Of the 489 AS patients in the PsA/SpA Registry, 254 AS (52.0%) patients initiated a bDMARD at enrollment or during follow-up (total initiations: AS = 313). Of the 313 AS initiations, 179 (57.2%) had a 6-month follow-up, 122 (39.0%) had a 12-month follow-up, and 94 (30.0%) had a 6- and 12-month follow-up visit. For those AS initiators with a 6-month follow-up, the mean age was 49.1 years, 44.4% were female, and 70.4%, 47.5%, 96.1%, and 46.9% had never used cDMARDs, TNFis, non-TNFis, and bDMARDs, respectively. Of these 179 AS initiators, 20.1% and 14.0% achieved ASAS20/40, respectively. Further, only 34% achieved low disease activity (ASDAS <2.1). When stratified by biologic-naivete and biologic-experience, the ASAS 20/40 achievement rates were 26.2% and 14.7%, and 21.4% and 7.4%, respectively, for this cohort. Conclusion Although AS patients initiate bDMARDs, many do not achieve optimal treatment responses. Future research is needed to investigate the aspects associated with inadequate improvement and treatment response to bDMARDs.

Evaluation of QTc and Tp-e changes in rheumatoid arthritis and ankylosing spondylitis patients treated with biological drugs

Evaluation of QTc and Tp-e changes in rheumatoid arthritis and ankylosing spondylitis patients treated with biological drugs

Evaluation of the Systemic Immune-Inflammation Index and Systemic Inflammatory Response Index in Ankylosing Spondylitis Patients

Evaluation of the Systemic Immune-Inflammation Index and Systemic Inflammatory Response Index in Ankylosing Spondylitis Patients

Serial mediation of illness perception and beliefs about medicines in the relationship between patient satisfaction and medication adherence: An evaluation of self-regulatory model in rheumatoid arthritis and ankylosing spondylitis patients.

This study examined the effect of patient satisfaction on medication adherence through serial mediation of Self Regulatory Model (SRM) components which are illness perception and beliefs about medicines in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The 222 outpatients (nRA = 112; nAS = 110) were administered a sociodemographic form, the Medication Adherence Report Scale, the Brief Illness Perception Questionnaire, the Short Assessment of Patient Satisfaction, and the Beliefs about Medicines Questionnaire. The results showed that SRM components fully mediated the relationship between patient satisfaction and medication adherence. This proposed model had acceptable and better fit indices than the alternative model where patient satisfaction was introduced as a direct predictor. Furthermore, patient satisfaction, illness perception, and beliefs about medicines had an extremely good relationship, so these may be interpreted as variables of a latent construct of the illness experience which deserves further research in these group of patients.