Do patients with non‐radiographic axial spondylarthritis differ from patients with ankylosing spondylitis?

Arthritis Care and Research - Tập 64 Số 9 - Trang 1415-1422 - 2012
Uta Kiltz1, Xenofon Baraliakos, Pantelis Karakostas, M. Igelmann, Ludwig Kalthoff, Claudia Klink, D. Krause, Elmar Schmitz-Bortz, Martina Flörecke, Matthias Bollow, Jürgen Braun
1Rheumazentrum Ruhrgebiet, Herne, Germany. [email protected]

Tóm tắt

AbstractObjectivePatients with axial spondylarthritis (SpA) who have structural changes in the sacroiliac joints and/or the spine have been classified as having ankylosing spondylitis (AS), while those without such changes are now classified as having nonradiographic axial SpA (nr‐axSpA). The differentiating features are incompletely understood.MethodsData from 100 consecutive patients with axial SpA not treated with tumor necrosis factor antagonists were compared clinically and with laboratory parameters, spinal radiographs, and magnetic resonance imaging (MRI) of the spine. Standardized clinical assessment tools were used to assess health status.ResultsAS was diagnosed in 56 patients and nr‐axSpA in 44 patients. Signs of inflammation were significantly higher in patients with AS than in patients with nr‐axSpA, with a median C‐reactive protein level of 8.0 versus 3.8 mg/liter, a median Ankylosing Spondylitis Disease Activity Score of 2.2 versus 2.8, respectively, and a median amount of spinal inflammatory lesions on MRI of 2.0 versus 0.0, respectively. Significant differences between these 2 groups were seen in sex (76.8% male AS patients versus 31.8% male nr‐axSpA patients). Clinical variables did not differ between patients with AS and nr‐axSpA (Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life questionnaire, Short Form 36 health survey).ConclusionPatients with nr‐axSpA were characterized by the low proportion of male patients and the low burden of inflammation compared to patients with AS. While both groups did not differ regarding health status, disease activity, and physical function, they did differ in signs of inflammation; all were higher in patients with AS. Since many patients with nr‐axSpA had not developed structural changes after years of symptoms, we propose that those patients should not be regarded as having preradiographic AS but rather as having nr‐axSpA.

Từ khóa


Tài liệu tham khảo

10.1016/S0140-6736(07)60635-7

10.1002/art.1780270401

10.1002/art.1780341003

Doran M, 2003, Predictors of longterm outcome in ankylosing spondylitis, J Rheumatol, 30, 316

10.3899/jrheum.100094

10.1136/ard.2009.108233

10.1136/ard.2010.133645

10.1002/art.20990

10.1136/ard.2003.011247

10.3899/jrheum.090625

10.1002/art.24483

10.1136/ard.2008.094870

10.1136/ard.2010.138594

Garrett S, 1994, A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index, J Rheumatol, 21, 2286

Calin A, 1994, A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index, J Rheumatol, 21, 2281

10.1097/00005650-199206000-00002

10.1136/ard.62.1.20

Ellert U, 1999, The SF‐36 in the Federal Health Survey: description of a current normal sample, Gesundheitswesen, 61, S184

10.1136/ard.2004.020503

Lukas C, 2007, Scoring inflammatory activity of the spine by magnetic resonance imaging in ankylosing spondylitis: a multireader experiment, J Rheumatol, 34, 862

10.1136/ard.2008.091793

10.1136/ard.2010.145995

10.1093/rheumatology/ken506

10.1002/art.24408

10.1136/ard.2006.060293

10.1007/s00296-002-0237-4

10.1136/ard.2006.053918

10.1136/ard.2005.043471

10.1136/ard.2011.151563

Thông tin
Thông tin xuất bản

Arthritis Care and Research

Tập 64 Số 9

1415-1422

Thông tin tác giả