Ankylosing Spondylitis Research Today is a free monthly online journal that collates and summarizes the latest research about Ankylosing Spondylitis, including details on diagnosis, treatment, symptoms, causes.

Inflammatory biomarkers, disease activity and spinal disease measures in patients with ankylosing spondylitis after treatment with infliximab.

Visvanathan S, Wagner C, Marini JC, Baker D, Gathany T, Han J, van der Heijde D, Braun J

Centocor Research and Development, Inc., Malvern, PA, USA. svisvana@cntus.jnj.com

OBJECTIVE: To evaluate the relationship between biomarker levels and disease activity and the spinal inflammation detected by magnetic resonance imaging (MRI) in patients with ankylosing spondylitis (AS). METHODS: Patients with AS were randomly assigned in a 3:8 ratio to receive infusions of placebo or 5 mg/kg infliximab at weeks 0, 2, 6, 12 and 18. Sera were collected for biomarker analysis at weeks 0, 2 and 24 and were analysed for levels of interleukin-6 (IL-6), vascular endothelial growth factor (VEGF) and C-reactive protein (CRP). Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores and pre- and post-gadolinium T1 and short tau inversion recovery MRIs were collected at baseline and week 24. RESULTS: Significantly greater reductions in IL-6, VEGF and CRP were observed at weeks 2 and 24 in the infliximab group compared with the placebo group (all p<0.001). Baseline IL-6 levels >7.38 pg/ml and CRP levels >1.5 mg/dl were associated with increased rates of clinical response after 24 weeks. Multiple regression analyses showed that reductions from baseline to week 2 in IL-6, but not CRP or VEGF, were significantly associated with reductions in MRI activity and BASDAI scores from baseline to week 24 in the infliximab group (p<0.001). CONCLUSIONS: Significant reductions in IL-6, VEGF and CRP were observed with infliximab compared with placebo. High levels of baseline IL-6 and CRP were associated with clinical response after infliximab treatment. Early reductions in IL-6 were significantly associated with improvements in disease activity and the spinal inflammation detected by MRI.

Published 19 March 2008 in Ann Rheum Dis, 67(4): 511-7.
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Articles on Ankylosing Spondylitis published 19 March 2008:

Proposal of a linear definition of the Bath Ankylosing Spondylitis Metrology Index (BASMI) and comparison with the 2-step and 10-step definitions.   Ann Rheum Dis, 67(4): 489-93.

BACKGROUND: The Bath Ankylosing Spondylitis Metrology Index (BASMI) characterises the spinal mobility of patients with ankylosing spondylitis. Two versions have been published using categorical scores with either scores 0-2 for each of the five assessments, or scores 0-10. For metric purposes, we recently defined a BASMI version with linear score definitions. Aim: to evaluate agreement between three BASMI definitions and to test sensitivity to change. PATIENTS AND METHODS: The performance of ... [Abstract] [Full-text]

Articles on Ankylosing Spondylitis published 17 March 2008:

Vertebral artery decompression in a patient with rotational occlusion.   Acta Neurochir (Wien), 150(4): 391-4; discussion 394.

We report a patient who suffered drop attacks during head reclination. Computer tomography of the cervical spine demonstrated a stenotic right vertebral artery at C4/5. However, Doppler ultrasonography of the vertebral artery showed no abnormality. Angiography confirmed complete occlusion of the left vertebral and a stenosis of the right vertebral artery. Dynamic angiography indicated occlusion of the stenotic region on the right side during reclination of the head. Surgery using a posterior ... [Abstract] [Full-text]

Articles on Ankylosing Spondylitis published 3 March 2008:

Predictive value of intraoperative neurophysiological monitoring during cervical spine surgery: a prospective analysis of 1055 consecutive patients.   J Neurosurg Spine, 8(3): 215-21.

OBJECT: Despite the growing use of multimodal intraoperative monitoring (IOM) in cervical spinal surgery, limited data exist regarding the sensitivity, specificity, and predictive values of such a technique in detecting new neurological deficits in this setting. The authors sought to define the incidence of significant intraoperative electrophysiological changes and new postoperative neurological deficits in a cohort of patients undergoing cervical surgery. METHODS: The authors conducted a ... [Abstract] [Full-text]

Articles on Ankylosing Spondylitis published 22 February 2008:

Efficacy and safety of up to 192 weeks of etanercept therapy in patients with ankylosing spondylitis.   Ann Rheum Dis, 67(3): 346-52.

OBJECTIVE: Evaluate long-term safety and efficacy of etanercept treatment in patients with ankylosing spondylitis (AS). METHODS: Patients with AS who previously participated in a randomised controlled trial (RCT) of etanercept were eligible to enroll in a 168-week open-label extension (OLE). Safety end points included rates of adverse events (AE), serious adverse events (SAE), infections, serious infections and death. Efficacy end points included Assessment in Ankylosing Spondylitis (ASAS20) ... [Abstract] [Full-text]

Persistent clinical efficacy and safety of anti-tumour necrosis factor alpha therapy with infliximab in patients with ankylosing spondylitis over 5 years: evidence for different types of response.   Ann Rheum Dis, 67(3): 340-5.

BACKGROUND: There is insufficient evidence for the long-term efficacy and safety of anti-tumour necrosis factor therapy in patients with ankylosing spondylitis (AS). This is the first report on the treatment with infliximab over 5 years. METHODS: As part of a multicentre randomised trial, 69 patients with active AS at baseline (BL) have been continuously treated with infliximab (5 mg/kg i.v. every 6 weeks)--except for a short discontinuation after 3 years (FU1). The primary outcome of this ... [Abstract] [Full-text]

Comparison of two different dosages of celecoxib with diclofenac for the treatment of active ankylosing spondylitis: results of a 12-week randomised, double-blind, controlled study.   Ann Rheum Dis, 67(3): 323-9.

OBJECTIVES: To demonstrate the non-inferiority of celecoxib compared with diclofenac in subjects with ankylosing spondylitis (AS). METHODS: The basis of the present work was a 12-week randomised, double-blind, controlled study in active AS subjects with three treatment arms: celecoxib 200 mg once a day, celecoxib 200 mg twice a day, and diclofenac SR 75 mg twice a day. The primary efficacy endpoint was the change from baseline in global pain intensity on a visual analogue scale (VAS) at week ... [Abstract] [Full-text]

Articles on Ankylosing Spondylitis published 15 February 2008:

Evidence-based recommendations for the management of ankylosing spondylitis: systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising rheumatologists.   Rheumatology (Oxford), 47(3): 355-61.

OBJECTIVE: Recommendations and/or guidelines represent a popular way of integrating evidence-based medicine into clinical practice. The 3E Initiatives is a multi-national effort to develop recommendations for the management of rheumatic diseases, which involves a large number of experts combined with practising rheumatologists addressing specific questions relevant to clinical practice. METHODS: Ten countries participated in three rounds of discussions and votes concerning the management of AS. ... [Abstract] [Full-text]

Articles on Ankylosing Spondylitis published 5 February 2008:

HLA-B27 subtypes differentially associated with disease exhibit conformational differences in solution.   J Mol Biol, 376(3): 798-810.

Human leukocyte antigen (HLA) class I molecules consist of a heavy chain, beta(2)-microglobulin, and a peptide that are noncovalently bound. Certain HLA-B27 subtypes are associated with ankylosing spondylitis (such as HLA-B*2705), whereas others (such as HLA-B*2709) are not. Both differ in only one residue (Asp116 and His116, respectively) in the F pocket that accommodates the peptide C-terminus. An isotope-edited IR spectroscopy study of these HLA-B27 subtypes complexed with the self-peptide ... [Abstract] [Full-text]

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