Higher Bath Ankylosing Spondylitis Disease Activity Index Scores Research Articles

Combined moxibustion/adalimumabin treatment of ankylosing spondylitis, and its influence on related functional indicators

Purpose: To study the clinical efficacy of the combination of du-moxibustion and adalimumab in the treatment of ankylosing spondylitis, as well as its influence on related functional indicators.Methods: From 2019 to 2020, 90 ankylosing spondylitis patients treated in Shandong Traditional Chinese Medicine University Hospital were assessed for eligibility and recruited. They were assigned, based on the order of admission, to receive either conventional treatment (control group) or dumoxibustion plus adalimumab (study group). Clinical treatment efficacy, levels of inflammatory indices, and spinal mobility in the two groups were determined and compared. Numerical Rating Scale (NRS) was employed for pain assessment, while Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used for disease status evaluation. Bath Ankylosing Spondylitis Functional Index (BASFI) was used for assessing functional limitation.Results: Du-moxibustion plus adalimumab was associated with significantly higher treatment efficacy and lower levels of inflammatory factors when compared to conventional treatment (p < 0.05). Comparable NRS scores before treatment and 2 weeks after treatment were observed in the two groups (p > 0.05). The eligible patients given du-moxibustion plus adalimumab showed lower NRS scores, higher BASDAI scores, and lower BASFI scores versus those receiving conventional treatment (p < 0.001).Conclusion: Treatment of ankylosing spondylitis patients with the combination of du-moxibustion and adalimumab mitigates symptoms and clinical indicators of the disease and relieves pain in the patients. Therefore, the combined treatment should be subjected to further clinical trials prior to its use in clinical practice.

Sleep quality and depression in patients with ankylosing spondylitis and their associations with clinical parameters: A cross-sectional, case-control study.

This study aimed to explore sleep quality in patients with ankylosing spondylitis (AS) and to reveal the clinical parameters that predict sleep quality and depression in AS. This study included 100 AS patients and 100 age/sex-matched healthy individuals. The AS activity was assessed by Bath AS Disease Activity Index (BASDAI), AS Disease Activity Score (ASDAS-ESR, ASDAS-CRP), and Visual Analog Scale (VAS). The functional status was assessed by the Bath AS Functional Index (BASFI). AS Quality of Life Questionnaire was administered for the assessment of the disease-related quality of life. Pittsburgh Sleep Quality Index for sleep assessment and Beck Depression Inventory for psychological assessment were administered to all participants. Sleep problems and depressive symptoms were significantly higher in AS patients compared to healthy individuals. All of the AS clinical parameters were significantly higher in AS patients with poor sleep quality than in AS patients with good sleep quality. In the correlation analysis, it was determined that poor sleep quality, depressive symptoms and low quality of life were strongly correlated with each other and AS clinical parameters. The most effective predictor for sleep problems was higher BASDAI scores, followed by higher BASFI, VAS, ASDAS-ESH scores, and younger age. Higher BASFI and VAS scores were predictors for depressive symptoms. The findings indicate that poor sleep, depressive symptoms and low quality of life may negatively affect the AS clinic, and therefore sleep quality and depression should not be ignored in the examinations of AS patients.

Association of body mass index on disease activity in axial spondyloarthritis: systematic review and meta-analysis

ObjectivesIn axial spondyloarthritis (axSpA), higher body mass index (BMI) is associated with worse outcomes including response to biologics. Further clarity is needed on whether BMI is associated with disease activity...

Associated factors with adherence to standard exercise therapy and health-related quality of life in Chinese patients with ankylosing spondylitis

Objectives: The aim of this study is to assess the current situations of standard exercise treatment and predictors of non-standard exercise in Chinese patients with ankylosing spondylitis (AS). An analysis of the effect of standard exercise on health-related quality of life (HR-QoL) was also conducted.Methods: In the cross-sectional study, a total of 259 AS patients were constantly invited to participate in this study and complete the questionnaire under the researchers’ supervision in a clinical setting including sociodemographic variables, clinical variables, psychological variables, and HR-QoL. Data were analyzed by Mann–Whitney U test, Chi-square test as well as multivariable analysis of Binary Stepwise Logistic Regression.Results: The data showed that just 20.5% of them could complete the standard exercise. Exercise adherence was associated with employment, educational level, marital status, place of residence, treatment of Tumor Necrosis Factor-α inhibitor, knowledge about exercise, disease duration, clinical variables, and anxiety. The HR-QoL in the group of standard exercise was better than that in the non-standard exercise group. Logistic Regression Analysis showed that lower educational level, less knowledge about benefits of exercise treatment and higher score of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were the independent risk factors of exercise treatment non-adherence.Conclusion: AS patients educated less than 9 years or with higher BASDAI score were more likely not to adhere to standard exercise treatment. Non-adherence to exercise treatment among AS patients is exceedingly common, particularly in patients without knowledge about benefits of exercise treatment. Standard exercise treatment can also improve HR-QoL of AS patients.

Metabolic Syndrome in Rheumatoid Arthritis and Ankylosing Spondylitis

Objectives: To evaluate and compare the prevalence of insulin resistance and metabolic syndrome (MetS) in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) and to determine the relationship of MetS with disease-activities and the factors associated with MetS. Materials and Methods: The cross-sectional study included a total of 174 patients with RA and AS. MetS was defined according to the International Diabetes Federation (IDF) criteria. Insulin resistance was assessed with the Homeostasis Model Assessment (HOMA) Index. The Disease Activity Score including 28 joints (DAS28) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were used to measure disease activity. Functional status was evaluated using the Health Assessment Questionnaire (HAQ) and the Bath Ankylosing Spondylitis Functional Index (BASFI). Logistic regression analysis was applied to identify predictors of metabolic syndrome. Results: The prevalence of MetS was significantly higher in patients with RA (47%) than in patients with AS (24.56%) (p=0.005). The prevalence of insulin resistance was significantly higher in patients with RA (34.18%) than in patients with AS (17.54%)(p=0.031). No significance difference was found in the disease activity score between RA and AS patients with metabolic syndrome and without metabolic syndrome (p=0.580 and p=0.158, respectively). The number of patients with a higher BASDAI score was greater in AS patients with MetS. Age and body mass index were determined to be predictors for MetS (p=0.015 and p<0.001, respectively). Conclusion : Higher rates of MetS and insulin resistance were seen in RA patients compared to the patients with AS. Better control of the MetS components and disease activity may help to decrease the prevalence of MetS in rheumatic disease.

Male smokers with HLA-B27 positivity, SI joints inflammation have more radiological damages and higher prevalence of AS while females have higher BASDAI scores: observations from cluster analyses of a group of SpA patients

Abstract Objectives To describe the clinical characteristics and the relations with disease activity, functional status, and syndesmophytes formation in patients with axial spondyloarthritis (AxSpA) by categorizing them into different groups. Methods One hundred and sixty three patients with AxSpA were recruited. Clinical and blood parameters were collected. Patients were asked to complete the self-assessment questionnaires, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Functional Index (BASFI). Spinal mobility was measured according to Bath Ankylosing Spondylitis Metrology Index (BASMI). Radiographs of cervical and lumbosacral spine were performed for modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Radiological sacroiliitis was scored for ankylosing spondylitis (AS). Magnetic resonance imaging (MRI) of the sacroiliac (SI) joints was performed for spondyloarthritis research consortium of Canada (SPARCC) MRI inflammation score. Two-way cluster analyses were performed to determine the relationships between the parameters. Results Two cluster models were built using SPARCC scores of different scorers. Results were similar. The group of patients with highest mSASSS (20.33 vs 20.33) and prevalence radiological AS (85% vs 86%) were male patients (75% vs 75%), positive for HLA-B27 (70.0% vs 66.7%), smokers (87.5% vs 97.2%), and higher SPARCC SI joints score (5.32 vs 3.17). Higher BASDAI was observed among female sex. BASMI varies little but the group with highest BASMI (3.60 vs 3.62) also had highest mSASSS (20.33 vs 20.33). Conclusion Our data showed that male smokers with HLA-B27 positivity and SI joints inflammation have more radiological damage and higher prevalence of AS, consistent with known poor prognosis factors.

The effect of smoking on clinical and radiographic variables, and acute phase reactants in patients with ankylosing spondylitis

To investigate the association between smoking and clinical, inflammatory and radiographic parameters in patients with ankylosing spondylitis (AS). One hundred and six tumour necrosis factor inhibitor naïve patients with AS were included in the study. The erythrocyte sedimentation rate, C-reactive protein, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI) and modified Stroke AS Spine Score (mSASSS) were assessed cross-sectionally for each patient. Smoking history was obtained, and smoking pack years were calculated. Current smokers had significantly higher BASDAI (p<0.001) and a trend for higher BASFI (p=0.059). Ever smokers had significantly higher BASFI (p=0.035) and a trend for higher mSASSS (p=0.063) compared to never smokers. Pack years (smoking intensity) were positively correlated with duration of inflammatory back pain (r=0.628, p<0.001), BASFI (r=0.443, p<0.001) and mSASSS (r=0.683, p<0.001). Multivariate regression analyses showed that current smoking was independently associated with a higher BASDAI score [regression coefficient (B)=14.75, p<0.001] and increasing pack years were independently associated with higher mSASSS (B=0.26, p=0.005). In patients with AS, current smoking was strongly and independently associated with higher disease activity, and cumulative smoking exposure with more radiographic spinal damage. In AS smokers, smoking cessation should be strongly recommended.