Concept Of Axial Spondyloarthritis Research Articles

Understanding the paradigm of non-radiographic axial spondyloarthritis.

The concept of axial spondyloarthritis (axSpA) encompasses both non-radiographic (nr-axSpA) and traditional radiographic axSpA (r-axSpA) forms. The former was conceived following the establishment of the ASAS classification criteria for axSpA, which for the first time included the use of magnetic resonance imaging of the sacroiliac joints. This facilitated the classification of patients with axSpA who did not present substantial structural damage. This conception of nr-axSpA revolutionized the classical understanding of axSpA opening new doors for research and broadening the scope of treatment to the entire spectrum of axSpA. In this sense, epidemiologic patterns of the disease were viewed anew, and early diagnosis became a primary objective in the management of the disease. However, despite these advances, this new axSpA subtype led to some concerns within the scientific community. These issues have been addressed by several studies that set out to clarify the concept of nr-axSpA. In this review, we summarize the findings of the most relevant studies including nr-axSpA and then discuss recent advances in understanding disease clinical patterns, burden of disease, and treatment effects. Current scientific research has shown subtle differences between nr-axSpA and r-axSpA. In the near future, these advances will allow for better management of individual patients across the axSpA spectrum.

Prevalence of Spondyloarthritis Among Patients Who Underwent Lumbar Disc Herniation Surgery.

This study aims to estimate the prevalence of spondyloarthritis (SpA) among patients who had been surgically treated for lumbar disc herniation (LDH), according to the modified New York (mNY) criteria for the diagnosis of ankylosing spondylitis and Amor, the European Spondyloarthropathy Study Group (ESSG), the Assessment of Spondyloarthritis International Society (ASAS) classification criteria for SpA. The study included 321 patients (142 males, 179 females; mean age 49±10.8 years; range, 18 to 79 years) who underwent LDH surgery between April 2008 and May 2012 in the neurosurgery clinic of our hospital. Patients were contacted by phone on at least two attempts. Totally, 123 patients accepted to come to the outpatient clinic, while the remaining 198 agreed to be interviewed on the phone. Patients who agreed to come to the outpatient rheumatology clinic underwent clinical examination, and pelvic X-ray and magnetic resonance imaging (MRI) scan of the sacroiliac joints when indicated. Inflammatory back pain was diagnosed in 108 patients (34%) and 40 patients (13%) according to Calin criteria and the ASAS criteria, respectively. Prevalence of SpA among all patients was estimated as 17.7% according to the ESSG criteria, and 8.7% according to Amor criteria. Five of the 308 pelvic radiographs had definite radiographic sacroiliitis as required by the mNY criteria. Four patients had a characteristic pattern of bone marrow edema on MRI examination in accordance with the ASAS definitions. The overall prevalence of sacroiliitis (MRI sacroiliitis+X-ray sacroiliitis) among the patients who came to the clinic was 7.3% ([4+5]/123). The relatively increased prevalence of SpA among patients who underwent LDH surgery indicates the necessity of increasing awareness on the new concept of axial SpA for specialists treating patients with low back pain.

Axial spondyloarthritis: a current look at the concept and evolution of the disease

The article provides data on the terminology and classification of spondyloarthritis (SpA) and highlights the current concept of axial SpA (axSpA). It gives the comparative characteristics of international cohorts of patients with axSpA. The review describes the role of magnetic resonance imaging and radiography in the diagnosis and study of the evolution of axSpA.

Clinical and Radiological Assessment in Axial Spondyloarthritis

Abstract The Assessment of SpondyloArthritis International Society (ASAS) has developed the concept of axial spondyloarthritis (SpA) in 2009. The symptoms and burden of disease of nonradiographic axial SpA and Ankylosing Spondylitis (AS) are similar and both can affect multiple organs and systems. Assessment and monitoring in SpA are, therefore, crucial. Different instruments have been developed for assessing and monitoring the wide variety of presentations in SpA. Generally, disease monitoring of patients can include patient reported outcome, clinical findings, laboratory tests, imaging, and disease activity composite scores.

Axial Spondyloarthritis: An Evolving Concept

Axial spondyloarthritis (AxSpA) is the prototype of a family of inter-related yet heterogeneous diseases sharing common clinical and genetic manifestations: the spondyloarthritides (SpAs). The condition mainly affects the sacroiliac joints and axial skeleton, and has a clear classification scheme, wider epidemiological data, and distinct therapeutic guidelines when compared with other SpAs. However, the concept of AxSpA has not been immutable over time and has evolved tremendously on many levels over the past decades. This review identifies the evolution of the AxSpA concept at two levels. First, at the level of classification, the old classifications and rationales leading to the current Assessment of SpondyloArthritis international Society (ASAS) classification are reviewed, and the advantages and drawbacks are discussed. Second, at the therapeutic level, current and future treatments are described and treatment strategies are discussed.

The concept of axial spondyloarthritis: joint statement of the spondyloarthritis research and treatment network and the Assessment of SpondyloArthritis international Society in response to the US Food and Drug Administration's comments and concerns.

The concept of axial spondyloarthritis: joint statement of the spondyloarthritis research and treatment network and the Assessment of SpondyloArthritis international Society in response to the US Food and Drug Administration's comments and concerns.

The classification and diagnostic criteria of ankylosing spondylitis

Ankylosing spondylitis is the prototype of immune-mediated inflammatory rheumatic diseases grouped under the term spondyloarthritis (SpA). An early diagnosis has now become increasingly important because effective therapies are available and anti-TNF drugs are even more effective if used in early stages of the disease. In ankylosing spondylitis, the 1984 modified New York criteria have been used widely in clinical studies and daily practice but are not applicable in early disease when the characteristic radiographic signs of sacroiliitis are not visible but active sacroiliitis is readily detectable by magnetic resonance imaging (MRI). Thus there has been a need for new classification or diagnostic criteria to identify inflammatory spondyloarthritis at early stage of the disease. This led to the concept of axial SpA to include the entire spectrum of patients with axial disease both, with and without radiographic damage. New classification criteria for the wider group of SpA have been proposed by ASAS (Assessment of Spondylo Arthritis International Society); and the patients are sub-grouped into (1) a predominantly axial disease, termed axial SpA including AS and non-radiographic axial SpA; (2) peripheral SpA. The clinical course and disease process of non-radiographic axial spondyloarthritis remains unclear. However the development of the SpA criteria by ASAS particularly for axial SpA, is an important step for early diagnosis and better management of these patients.

SAT0277 The prevalence of inflammatory back pain, sacroiliitis and spondyloarthropathy in patients who underwent lumbar disc herniation surgery

ObjectivesThere is considerable delay in the diagnosis of ankylosing spondylitis (AS) mostly due to the slow development of radiographic sacroiliitis. In a previous multi-center study we showed that approximately 1/3...

Quel est l’intérêt du bilan de thrombophilie au cours du SAPL obstétrical ?

Ankylosing spondylitis is the prototype of immune-mediated inflammatory rheumatic diseases grouped under the term spondyloarthritis (SpA). An early diagnosis has now become increasingly important because effective therapies are available and anti-TNF drugs are even more effective if used in early stages of the disease. In ankylosing spondylitis, the 1984 modified New York criteria have been used widely in clinical studies and daily practice but are not applicable in early disease when the characteristic radiographic signs of sacroiliitis are not visible but active sacroiliitis is readily detectable by magnetic resonance imaging (MRI). Thus there has been a need for new classification or diagnostic criteria to identify inflammatory spondyloarthritis at early stage of the disease. This led to the concept of axial SpA to include the entire spectrum of patients with axial disease both, with and without radiographic damage. New classification criteria for the wider group of SpA have been proposed by ASAS (Assessment of Spondylo Arthritis International Society); and the patients are sub-grouped into (1) a predominantly axial disease, termed axial SpA including AS and non-radiographic axial SpA; (2) peripheral SpA. The clinical course and disease process of non-radiographic axial spondyloarthritis remains unclear. However the development of the SpA criteria by ASAS particularly for axial SpA, is an important step for early diagnosis and better management of these patients.

Aspectos comunes entre la espondilitis psoriásica y la espondilitis anquilosante

In this article we review the common aspects between ankylosing spondylitis and psoriatic arthritis. These aspects are discussed at 3 fundamental levels: concept and diagnostic focus, clinical expression and impact the main domains of disease and therapeutic approach. It is concluded that there are enough arguments to consider both entities within the same concept of axial spondyloarthritis.

Undifferentiated spondyloarthritis: A global perspective

This paper reviews the concept and outcome of undifferentiated spondyloarthritis (SpA) as reported in retrospective and prospective studies from different parts of the world. Although the designs and definitions vary across different studies, clearly a significant proportion of patients with undifferentiated SpA will fulfill ankylosing spondylitis within 10 years in association with certain prognostic factors. The paper also examines the concept of axial SpA and its importance as an early indicator of ankylosing spondylitis. Ultimately, the recognition of undifferentiated SpA and axial SpA may lead to early treatment with highly efficacious drugs.