Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01889 (ankylosing spondylitis)
 5,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Alclofenac is a non-steroidal anti-inflammatory agent advocated for use in rheumatoid arthritis, degenerative joint disease and ankylosing spondylitis. Published data to date, suggest that alclofenac 3g daily is comparable in efficacy with aspirin 4.8g daily, phenylbutazone 300 to 600mg daily and indomethacin 150mg daily. In Welsh patients, gastro-intestinal side-effects have generally been less frequent and milder than with the standard comparison drugs, but in other populations differences in the overall incidence of these side-effects have been less marked. Results of a long-term trial, as evidenced by alterations in certain biochemical indications of disease activity, suggest that alclofenac may possibly reduce the severity of the disease itself, but further studies will be needed to confirm this. However, at present alclofenac should be considered along with the other drugs of its type in the initial treatment of the arthritic patient. Skin rash is the most frequent side-effect, which in a small proportion of affected patients may be associated with systemic effects. A cutaneous reaction appears to be more likely in patients with a history of previous allergy to penicillin and other drugs.
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PMID:Alclofenac: a review of its pharmacological properties and therapeutic efficacy in rheumatoid arthritis and allied rheumatic disorders. 2 Oct 68

A double-blind crossover trial of fenclofenac was untertaken to compare the short-term effects of phenylbutazone (Butacote) therapy with fenclofenac therapy (1200 mg daily) in 23 patients suffering from ankylosing spondylitis. The patients were randomly allocated to each of the test drugs for a period of two weeks, following wash-out periods of paracetamol for four days. The results favoured Butacote therapy in a dosage of 300 mg daily in the expressed preferences of both the patients and the physicians conducting the trial. Butacote was also better tolerated, as no severe side-effects occurred during treatment, whereas five patients developed a widespread rash during the period of fenclofenac therapy. No significant differences were seen between the two drugs in terms of clinical measurements of pain, morning stiffness, spinal movements, chest expansion, and abduction of the hips. Butacote was shown to cause some significant depletion of haemoglobin level, probably due to water retention, and Butacote also reduced the serum urate level to a significant degree.
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PMID:A controlled comparative trial of Butacote and fenclofenac in the treatment of ankylosing spondylitis. 33 11

Epidemiologic, clinical, radiologic and serologic evidence suggests that psoriatic arthritis is a specific entity and not the coincidental occurrence of 2 common diseases, psoriasis and rheumatoid arthritis. Psoriatic arthritis may be defined as psoriasis associated with inflammatory arthritis (peripheral arthritis or spondylitis or both) and usually a negative serologic test for rheumatoid factor. Clinical characteristics of the disease include: almost equal distribution between males and females; peripheral arthritis involving only a few small joints in asymmetical fashion; involvement of distal interphalangeal joints; sausage digits; arthritis mutilans; ankylosing spondylitis; goutlike onset; and higher frequency of nail involvement than occurs in uncomplicated psoriasis. The rash may present with arthritis, or, equally, may precede or succeed joint involvement. With regard to pain and disability, the prognosis in psoriatic arthritis is better than in rheumatoid arthritis.
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PMID:The clinical spectrum of psoriatic arthritis. 50 38

The immuno-modulatory effect of Levamisole in the treatment of rheumatic diseases was studied in an open trial. Nine patients with theumatoid arthritis (RA), 13 with ankylosing spondylitis (AS) and one with Reiter's syndrome (RS) were treated initially with 150 mg Levmisole daily for 4 weeks, then intermittently 3 days a week. Significant clinical improvement was observed in 7 out of 9 patients with RA, in 4 out of 13 patients with AS, and in the one patient with RS. An increased skin sensitivity to a panel of antigens was noted in 3 out of 9 RA patients and in 6 out of 13 AS patients. A fall in rheumatoid factor titre was observed in 2 out of 5 patients with seropositive RA. No development of other auto-antibodies was observed. No significant changes in the absolute lymphocyte counts either of the total counts or of the T, B, and null cell counts, were noted. Drug-related adverse reactions were seen in 13 patients, mostly allergic skin rash which required a short interruption in therapy. Severe leucopenia was observed in 2 patients, whereupon therapy was definitely withdrawn. Levamisole seems to have a definite beneficial effect on RA and a possible effect on AS and RS. Severe adverse reactions, mostly on the haemopoietic system, demonstrated some potential hazardous complications of the drug and required physical and laboratory examinations at short intervals.
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PMID:Immunotherapy with levamisole in rheumatic diseases. 79 21

The spondyloarthropathies of childhood present a diagnostic and therapeutic challenge. It is important to differentiate this group of arthritides from JRA because the nature and frequency of extra-articular complications are quite different, as is the prognosis and the therapeutic approach. JAS is the prototype of the spondyloarthropathies and probably accounts for greater than 75 per cent of all children with diseases included in this category. Unlike adult-onset ankylosing spondylitis, axial skeleton disease (sacroiliac, lumbar spine) is infrequent at onset of JAS and may not develop for months or years after the onset of arthritis in peripheral joints (particularly those of the lower extremity). Enthesitis, the inflammation of the insertion of tendon, capsule, ligament, or fascia to bone, is an important clinical diagnostic feature of this group of diseases. Extra-articular disease, such as rash in psoriatic arthritis, erythema nodosum, weight loss of abdominal pain (in the arthropathies of inflammatory bowel disease), urethritis, conjunctivitis, or Reiter's syndrome help to differentiate these spondyloarthropathies from JAS. Laboratory studies are of little assistance in differentiating JRA from the spondyloarthropathies except that in the latter group, RF is absent and HLA-B27 is frequently present. The high frequency of ANA in JRA contrasts with its corresponding low frequency in JAS. The long-term follow-up of chronic arthritis in childhood has demonstrated the variable and evolving nature of these conditions, and stresses the importance of continually questioning the accuracy of the diagnosis.
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PMID:Spondyloarthropathies of childhood. 376 52

In two monitored-release studies of feprazone (Methrazone), one in hospital and the other in general practice and involving a total of about 4,000 patients, there were 343 patients with a variety of sero-negative rheumatological conditions or soft tissue lesions. The diagnoses included spondylosis, ankylosing spondylitis, psoriatic arthritis, capsulitis, frozen shoulder, polymyalgia rheumatica and gout. Most of the patients were classified as moderately or severely affected. Feprazone in a dose of 200 mg thrice daily appeared to benefit about 60% of patients during a course of 8 weeks of therapy. No serious adverse reactions directly attributable to the drug were recorded. About 20% of patients stopped treatment because of side-effects, usually gastro-intestinal disturbance or rash. Two patients experienced a marked fall in platelet count which might have been due to the drug, but neither developed any signs of thrombocytopenic purpura.
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PMID:Miscellaneous rheumatological conditions treated in monitored-release studies with feprazone. 697 94

Reports of histologically proven low-dose methotrexate (MTX)-induced vasculitis are uncommon and mostly found for patients with rheumatoid arthritis. Herein we present a patient with ankylosing spondylitis who developed large atypical erythematopurpuric cutaneous lesions after the second oral dose of 7.5 mg MTX therapy. The histological findings of a cutaneous lesion were consistent with vasculitis. The skin lesions regressed significantly after the discontinuation of MTX therapy. As the clinical picture of the patient's rheumatological condition became progressively severe, prednisolone therapy was initiated 8 days later and the skin rash resolved completely in a couple of weeks.
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PMID:Atypical methotrexate dermatitis and vasculitis in a patient with ankylosing spondylitis. 1098 37

A clinical evaluation of phenylbutazone and Butapyrin(R) (a mixture of phenylbutazone and aminopyrine) was made in 409 patients who had a variety of rheumatic diseases. Preliminary European claims were substantiated.In gout a specific favorable effect was brought about by phenylbutazone alone. Effects equivalent to the previously reported favorable response to Butapyrin (Irgapyrin) were observed when its constituent phenylbutazone was used alone. The drug had a suppressive effect in a high percentage of patients with rheumatoid arthritis, ankylosing spondylitis, arthritis with psoriasis and mixed arthritis (rheumatoid arthritis plus osteoarthritis). Favorable effect in peritendinitis of the shoulders, osteoporosis of the spine and acute lumbosacral strain also was noted. Toxicity resulted in discontinuance of medication in 10 per cent of patients with each drug. Manifestations of toxicity generally included fluid retention, nausea and rash, but there were several instances of transitory leukopenia and anemia. There was one instance of agranulocytosis with Butapyrin but none with phenylbutazone.dagger Aggravation of peptic ulcer occurred in ten patients with hemorrhage in two. Generally the toxicity was of a low order as compared with that of other drugs having an antirheumatic effect.
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PMID:Phenylbutazone (butazolidin) and butapyrin; a study of clinical effects in arthritis and gout. 1300 82

The spondyloarthropathies include ankylosing spondylitis, reactive arthritis (including Reiter's syndrome), psoriatic arthritis, inflammatory bowel disease-associated spondyloarthropathy, and undifferentiated spondyloarthropathy. These diseases are linked by their association with the HLA-B27 gene and by the presence of enthesitis as the basic pathologic lesion. Additional clinical features include inflammatory back pain, dactylitis, and extra-articular manifestations such as uveitis and skin rash. The history and physical examination are the major diagnostic tools, although radiographic evidence of sacroiliitis is helpful. Therapeutic options include nonsteroidal anti-inflammatory drugs, sulfasalazine, methotrexate, and tumor necrosis factor-alpha inhibitors. Early recognition and appropriate treatment can help to limit disability.
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PMID:Spondyloarthropathies. 1522 50

Primary care physicians should have a working knowledge of rheumatic diseases of childhood that manifest primarily as musculoskeletal pain. Children with juvenile rheumatoid arthritis can present with painless joint inflammation and may have normal results on rheumatologic tests. Significant morbidity may result from associated painless uveitis, and children with juvenile rheumatoid arthritis should be screened by an ophthalmologist. The spondyloarthropathies (including juvenile ankylosing spondylitis and reactive arthritis) often cause enthesitis, and patients typically have positive results on a human leukocyte antigen B27 test and negative results on an antinuclear antibody test. Patients with acute rheumatic fever present with migratory arthritis two to three weeks after having untreated group A beta-hemolytic streptococcal pharyngitis. Henoch-Schbnlein purpura may manifest as arthritis before the classic purpuric rash appears. Systemic lupus erythematosus is rare in childhood but may cause significant morbidity and mortality if not treated early. Nonsteroidal anti-inflammatory drugs and physical therapy may be useful early interventions if a rheumatic illness is suspected. Family physicians should refer children when the diagnosis is in question or subspecialty treatment is required. Part I of this series discusses an approach to diagnosis with judicious use of laboratory and radiologic testing.
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PMID:Chronic musculoskeletal pain in children: part II. Rheumatic causes. 1688 27


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