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)

Spondylo-arthropathies are a broad group of inflammatory diseases that primarily involve the axial skeleton and the sacro-iliac joints. The pattern of peripheral joint involvement in spondylo-arthropathies differs from rheumatoid arthritis. Spondylo-arthropathies are known to include several conditions like ankylosing spondylitis, reactive arthritis (including Reiter's syndrome), arthritis associated with psoriasis and inflammatory bowel disease, juvenile and also undifferentiated spondylo-arthropathies. The characteristic features of spondylo-arthropathies are absence of rheumatoid factor, inflammatory low backache, sacro-iliitis, peripheral arthritis, enthesopathy, tendency to familial aggregation and association with HLA-B27. ESR may be elevated and patients may exhibit anaemia of chronic inflammation. HLA-B27 is a useful adjunctive test. The radiologic interpretation is very important. Non-steroidal anti-inflammatory drugs and spinal exercises are the cornerstone of therapy. Intra-articular corticosteroids are helpful. Patients may be benefited from, sulfasalazine, methotrexate or azathioprine.
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PMID:Spondylo-arthropathies. 1516 85

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

The spondyloarthritides (SpA) comprise ankylosing spondylitis (AS), psoriatic SpA (PsSpA), reactive SpA (ReSpA), arthritis associated with chronic inflammatory bowel disease (SpAIBD) and undifferentiated SpA (uSpA). There are characteristic clinical features of SpA: inflammatory back pain (IBP), asymmetric peripheral arthritis, enthesitis, anterior uveitis, positive family history and others. The SpA, mainly AS, are strongly associated with HLA B27. AS is the most frequent and potentially most severe subtype, next to PsSpA. The prevalence of all SpA is rather high and not much different from rheumatoid arthritis (RA) and AS patients carry a burden of disease similar to RA patients. The prognosis of AS has not been extensively studied but some factors have been identified. There is a clear role for imaging modalities in the diagnosis of AS. Changes in the sacroiliac joint as detected by radiography still constitute the basis for the diagnosis of AS (New York criteria 1984). A diagnosis of sacroiliitis as made by magnetic resonance imaging (MRI) provides more objective evidence to a diagnosis of IBP arguing in favour of SpA which is defined on the basis of the ESSG criteria 1991 mainly on a clinical basis. Radiographic spinal changes such as syndesmophytes are important for the staging and outcome of AS. MR based assessment of spinal changes in are now being increasingly used to assess disease activity of AS patients. The presence of spinal radiographic changes at time of presentation was found to be the best predictor of further deterioration using the score modified SASSS' in a recent study. Other clinical features such as hip arthritis, early onset of disease, dactylitis, oligoarthritis, limitation of spinal mobility and poor efficacy of nonsteroidal antiinflammatory drugs were found to also have negative prognostic value.
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PMID:[Epidemiology and prognostic aspects of ankylosing spondylitis]. 1528 56

Inflammatory bowel diseases (IBD), as Crohn's disease (CD) or ulcerative colitis (UC), are frequently complicated by joint complaints with prevalence that varies between 10 and 28%. The IBD related arthropathy may be expressed as peripheral arthritis or axial one frequently indistinguishable from the classical ankylosing spondylitis (AS). According to ESSG criteria for spondyloarthropathy, the presence of synovitis or the inflammatory back pain (IBP) in IBD patients is diagnostic for spondyloarthropathy, but for diagnosis of ankylosing spondylitis also radiological criteria must be fulfilled. There are few studies regarding the radiological prevalence of sacroiliitis in patients with IBD. We examined, by plain film radiograms of pelvis, 100 sacroiliac joints (SJ) of 50 IBD patients with IBP. The New York (1984) SJ radiological score with gradation from 0 to 4 was applied. Total sacroiliac score (SJS) was summarized between left and right side (from 0 to 8). Fourteen patients fulfilled New York modified criteria for AS and 8 patients had unilateral 2nd grade sacroiliitis. Only 4 of 14 AS patients (28%) were HLA B27 positive. Thirty patients had localized IBP, 10 extended to buttock and 4 extended to sacrum. Sixteen patients had sciatica-like extension of back pain. A difference in SJS between left and right side was observed only in CD patients (1.3 +/- 0.8 and 0.8 +/- 0.9 respectively; p < 0.05), but not in UC (1.5 +/- 1.2 vs 1.5 +/- 1.3; p = ns) nor in total IBD patients (1.4 +/- 1.0 vs 1.2 +/- 1.2; p = ns). Total SJS was higher in UC respect CD, but not significantly (2.9 +/- 2.3 vs 2.1 +/- 1.5; p = ns). Our data confirm the importance of these symptoms in patients with IBD, who need to be carefully investigated also for these aspects.
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PMID:[The prevalence of radiographic sacroiliitis in patients affected by inflammatory bowel disease with inflammatory low back pain]. 1530 19

Recent success in the treatment of patients with the more severe forms of spondyloarthritides (SpA) has dramatically changed old paradigms. There is evidence that anti-tumor necrosis factor (TNF)-alpha therapy is highly effective in SpA, especially in ankylosing spondylitis (AS) and psoriatic arthritis. Based on recent data on more than 1000 patients with AS and psoriatic arthritis, this treatment seems to be even more effective than in rheumatoid arthritis (RA). The currently available anti-TNFalpha agents, infliximab, etanercept, and adalimumab, are approved for the treatment of RA in the US and in Europe. TNFalpha blockers may even be considered as a first-line treatment in patients with active AS whose condition is not sufficiently controlled with NSAIDs, as in the case of axial disease. There is preliminary evidence that both agents also work in other SpA, such as undifferentiated SpA. There is hope that ankylosis may be preventable, but it remains to be shown whether patients benefit from long-term anti-TNFalpha therapy and whether radiologic progression and ankylosis can be stopped. Furthermore, it seems that anti-TNFalpha therapy can also improve clinical manifestations of other inflammatory spinal disorders, such as sciatica and back pain caused by disc herniation, or possibly even intermittent inflammatory states of degenerative disc disease. Severe adverse events from treatment with anti-TNFalpha continue to be rare. Tuberculosis can be largely prevented by appropriate screening. As it stands now, the benefits of anti-TNFalpha therapy in AS seem to outweigh the shortcomings.
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PMID:Current concepts in the therapy of the spondyloarthritides. 1537 73

An earlier diagnosis of ankylosing spondylitis (AS) is required because there is still a 5-7 year delay between first symptoms and diagnosis, and new effective treatments are available for active disease. Primary care physicians need easy to apply parameters to help them identify patients with suspected AS for onward referral. The best measures found were inflammatory back pain and HLA-B27 positivity.
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PMID:Early referral recommendations for ankylosing spondylitis (including pre-radiographic and radiographic forms) in primary care. 1552 81

Infection of the spine is a rare but serious cause of back pain. Conventional radiographs remain the initial screening procedure. Typically two adjacent vertebral bodies and the intervening disk space are affected. Early in the course of the disease, radiographs may be normal or nondiagnostic. Magnetic resonance imaging or radionuclide bone scan will establish pathology centered in the vertebral body. Because of the ability to image soft tissues, magnetic resonance imaging is particularly helpful in detecting paravertebral and extradural abscesses. Four other conditions may mimic infectious spondylitis: degenerative disk disease associated with Modic type 1 changes, pseudoarthrosis in ankylosing spondylitis, dialysis spondyloarthropathy, and neuropathic spondyloarthropathy. Advanced imaging studies in combination with radiographs and clinical information are essential in determining the correct diagnosis.
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PMID:Infectious spondylitis. 1566 17

The objective of this study was to obtain post-marketing information about the use of infliximab in an ambulatory setting. We studied--retrospectively and prospectively--the case records of patients with rheumatoid arthritis (n=37), psoriatic arthritis (n=5), mixed connective tissue disease (n=1), and ankylosing spondylitis (n=2) who received infliximab (3 mg/kg) from August 2000 to January 2003. Descriptive values were given as percentage, mean or median, and standard deviation or interquartile range. Wilcoxon test was used for paired analysis of pre/post doses of corticosteroids, non-steroidal anti-inflammatory drugs, and methotrexate therapy. A p value < or = 0.05 was considered significant. Forty-five patients were included. A total of 207 infusions were administered. In 4 patients the treatment was permanently discontinued due to severe back pain during the infusion (2 cases) and serious anaphylactic reactions (2 cases). Other adverse reactions occurring during infusions were mild and successfully managed with standard treatment. A case of staphylococcal septic arthritis resolved with standard antibiotic treatment. No patient had evidence of active tuberculosis. One patient with rheumatoid arthritis and chronic renal insufficiency, received treatment with infliximab 1.9 mg/kg, every 30 days, with no changes in renal function. Due to improvement of symptoms, 14/39 (35.9%) patients could decrease the doses of corticosteroids, 15/43 (34.8%) decreased the doses of antiinflammatory drugs and 12/34 (35.3%) decreased methotrexate dosage. Although some questions remain to be elucidated, this case series shows the drug safety profile, the possibility to reduce concomitant drug doses, as well as individual approaches for situations where there are not yet guidelines available, so that rheumatologists have to make decisions based on clinical needs.
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PMID:[Use of infliximab in patients of a rheumatologic center]. 1583 Jul 89

The concept and definition of disease duration in patients with ankylosing spondylitis is ambiguous, and often many years pass between the onset of symptoms and diagnosis. Members of the Assessment in Ankylosing Spondylitis (ASAS) International Working Group by consensus recently recommended identifying specific components of the medical history to better define and document the concept of disease duration. These include (1) the time of onset of the first symptoms of axial manifestations (including inflammatory back pain); (2) the time of onset of the first symptoms of each individual manifestation, which may be an extra-axial sign or symptom of ankylosing spondylitis, such as peripheral arthritis and enthesitis; (3) the time of onset of associated diseases belonging to the spondyloarthritides, in particular acute anterior uveitis, inflammatory bowel disease and psoriasis; and (4) the time since actual diagnosis by a healthcare provider. Such uniformity in data collection will ensure comparability across studies and facilitate future research.
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PMID:Definition of disease duration in ankylosing spondylitis: reassessing the concept. 1646 87

In spondyloarthritis, in particular ankylosing spondylitis (AS), a need exists for clinically meaningful biomarkers, both for diagnosis and prognosis. Earlier diagnosis has become an imperative since the advent of biologic therapy, which has proved effective in controlling axial inflammation. Presently, however, there are no biomarkers that reliably distinguish inflammatory back pain from the far more prevalent mechanical back pain. The target sites in AS--sacroiliac joints and the spine--are relatively inaccessible to the investigator and clinician, so defining markers associated with or predictive of axial inflammation remains an important goal. Cytokines, metalloproteinases, and cartilage catabolic products are all candidates for the important role of biomarker in spondyloarthritis.
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PMID:Biomarkers in spondyloarthritis. 1683 7


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