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Axial Spondyloarthritis
Published in Jason Liebowitz, Philip Seo, David Hellmann, Michael Zeide, Clinical Innovation in Rheumatology, 2023
Whole-body MRI (wbMRI), in contrast, allows imaging of the full body in a single examination, currently lasting less than one hour.83–86 This technique has particular appeal in the context of spondyloarthritis. Currently, data regarding the utility of this technique is limited, and it is not routinely available in clinical practice. Given the heterogeneous presentation of AxSpA, a single sequence capable of a screen for findings of enthesitis, or typical findings of spondylitis, holds appeal.
Reactive arthritis
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
The classic syndrome is a triad of symptoms, involving the urethra, conjunctiva, and synovium; however, the majority of patients do not present with this classic triad [1]. It is considered as a form of spondyloarthritis, a group of diseases with inflammatory arthritis, negative rheumatoid factor, and genetic association with HLA-B27 [2].
Rheumatology
Published in Shahed Yousaf, Medical Examination Made Memorable (MEMM), 2018
Ankylosing spondylitis derives its name from the Greek ankylos (bent) spondylos (vertebrae). A seronegative spondyloarthritis, a chronic, progressive inflammatory arthritis affecting joints in the spine and the sacroilium causing fusion of the spine.
Tofacitinib for the treatment of active ankylosing spondylitis in adults
Published in Expert Review of Clinical Immunology, 2022
Raagav Mohanakrishnan, Secia Beier, Atul Deodhar
Spondyloarthritis (SpA) is a group of chronic immune-mediated inflammatory disorders that encompasses many diseases involving joints, entheses, skin, nails, as well as extra-musculoskeletal organs such as eyes and gastrointestinal tract. Axial spondyloarthritis (axSpA), a member of the SpA family of diseases, is an inflammatory arthritis that involves the spine including sacroiliac joints, and often manifests as chronic back pain [1,2]. AxSpA can further be differentiated into ankylosing spondylitis (AS), also known as radiographic axial spondyloarthritis, and non-radiographic axial spondyloarthritis (nr-axSpA) based on the presence or lack of definitive sacroiliitis on imaging, respectively [2]. There have been many treatment options developed for axial spondyloarthritis, focusing primarily on symptom management and the inflammatory cascade. These treatments include physical therapy, non-steroid anti-inflammatory drugs (NSAIDs), and biologics such as anti-tumor necrosis factor alpha (anti-TNF-alpha) inhibitors, and Interleukin 17 (IL-17) inhibitors [3]. Janus kinase inhibitors (JAKi) are the latest class of agents to have undergone successful clinical trials in the treatment of axSpA [4]. While this article specifically focuses on the use of tofacitinib in adults with active AS, we have included a brief review on the pathogenesis of AS, since it is germane to the discussion on why JAK inhibitors would be useful in the management of AS.
Antibodies to malondialdehyde-acetaldehyde modified low-density lipoprotein in patients with newly diagnosed inflammatory joint disease
Published in Scandinavian Journal of Rheumatology, 2021
A Kononoff, S Hörkkö, P Pussinen, H Kautiainen, P Elfving, E Savolainen, L Arstila, H Niinisalo, J Rutanen, O Marjoniemi, O Kaipiainen-Seppänen
Data on all newly diagnosed patients with an inflammatory joint disease in the age group ≥ 16 years were collected by the rheumatologists practising in the Northern Savo rheumatological outpatient departments in an epidemiological prospective survey from 1 January to 31 December 2010, as described earlier (11). In this study, RA was defined according to the American College of Rheumatology (ACR)/European League against Rheumatism (EULAR) 2010 classification criteria (12). Spondyloarthritis definitions have been described previously (11). Patients with AS, PsA, reactive arthritis, arthritis with inflammatory bowel disease, or unspecified spondyloarthritis (SpA) were included in the SpA group. Cases with other rheumatoid factor (RF)- and/or anti-citrullinated protein antibody (ACPA)-positive mono- or oligoarthritis, or RF- and ACPA-negative mono-, oligo-, or polyarthritis, were classified as undifferentiated arthritis (UA). MetS was defined according to the National Cholesterol Education Program (NCEP) panel ATPIII definition (2). MetS analysis was carried out for patients > 18 years of age.
Treatment patterns and health care resource utilization among Japanese patients with ankylosing spondylitis: A hospital claims database analysis
Published in Modern Rheumatology, 2021
Tetsuya Tomita, Masayo Sato, Elizabeth Esterberg, Rohan C. Parikh, Kohei Hagimori, Ko Nakajo
Spondyloarthritis encompasses a group of inflammatory autoimmune conditions that can lead to severely impaired quality of life among those affected. In Japan, spondyloarthritis is relatively uncommon, with an estimated prevalence of 9.5 per 100,000 person-years [1]. However, the current diagnosis rate for spondyloarthritis has been increasing and suggests spondyloarthritis has historically been both underdiagnosed and misdiagnosed in Japan [2]. The difficulty in accurately diagnosing this condition could be due to a lack of information on clinical characteristics of spondyloarthritis in Japanese patients [2]. Ankylosing spondylitis (AS) is the most common type of spondyloarthritis, comprising 68.3% of spondyloarthritis cases in Japan [1]. Although the presence of human leukocyte antigen B27 (HLA-B27) is common among patients with AS, the prevalence and incidence of AS varies across populations because of ethnic differences in the presence of HLA-B27 [3]. In Japan, HLA-B27 is uncommon, which could plausibly explain a low prevalence and incidence of AS [1,3].