Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Spondylarthropathies”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMedDate not supplied

Validation of the European Spondylarthropathy Study Group and B. Amor criteria for spondylarthropathies in Lebanon.

OBJECTIVES: 1) To validate European Spondylarthropathy Study Group (ESSG) and B. Amor's criteria for spondylarthropathies in Lebanon. 2) To evaluate the frequency of spondylarthropathies in rheumatological practice in Lebanon. PATIENTS AND METHODS: Cases of definite and probable spondylarthropathy were diagnosed based on the clinical judgement of participating rheumatologists, without reference to the two criteria sets under study. The first two patients without spondylarthropathy seen after each spondylarthropathy case were included into the control group. Criteria in the ESSG and B. Amor sets were looked for in the patient and control groups. The frequency of spondylarthropathy meeting each criteria set was determined. RESULTS: Of the 841 patients evaluated during the study period, 68 met B. Amor's criteria and 72 met ESSG criteria. There were 29 cases of ankylosing spondylitis (40.3%), ten of peripheral psoriatic arthritis (13.8%), two of reactive arthritis (2.8%), two of enteropathic arthropathy (2.8%), and 29 of undifferentiated spondylarthropathy (40.3%). In the definite spondylarthropathy group, sensitivity and specificity were 77.19% and 97.55% for B. Amor's criteria versus 91.23% and 100% for ESSG criteria. The frequency of spondylarthropathy was 8.1% (95% confidence interval [CI], 6.3-9.9) or 8.56% (CI 6.6-10.5) according to B. Amor and ESSG criteria, respectively. CONCLUSION: Our data validate both criteria sets in the Lebanese population, demonstrating that they are useful in populations that are genetically different from the European populations used to develop them. Spondyloarthropathy is the most common in our rheumatology practice.

Adult↗
PubMed1991

The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy.

Classification criteria for most of the disorders belonging to the spondylarthropathy group already exist. However, the spectrum of spondylarthropathy is wider than the sum of these disorders suggests. Seronegative oligoarthritis, dactylitis or polyarthritis of the lower extremities, heel pain due to enthesitis, and other undifferentiated cases of spondylarthropathy have been ignored in epidemiologic studies because of the inadequacy of existing criteria. In order to define classification criteria that also encompass patients with undifferentiated spondylarthropathy, we studied 403 patients with all forms of spondylarthropathy and 674 control patients with other rheumatic diseases. The diagnoses were based on the local clinical expert's opinion. The 403 patients included 168 with ankylosing spondylitis, 68 with psoriatic arthritis, 41 with reactive arthritis, 17 with inflammatory bowel disease and arthritis, and 109 with unclassified spondylarthropathy. Based on statistical analysis and clinical reasoning, we propose the following classification criteria for spondylarthropathy: inflammatory spinal pain or synovitis (asymmetric or predominantly in the lower limbs), together with at least 1 of the following: positive family history, psoriasis, inflammatory bowel disease, urethritis, or acute diarrhea, alternating buttock pain, enthesopathy, or sacroiliitis as determined from radiography of the pelvic region. These criteria resulted in a sensitivity of 87% and a specificity of 87%. The proposed classification criteria are easy to apply in clinical practice and performed well in all 7 participating centers. However, we regard them as preliminary until they have been further evaluated in other settings.

Europe↗
PubMed1998

Genetic studies of spondylarthropathies. French Spondylarthropathy Genetic Study Group.

Influence of genetic factors in the spondylarthropathies has been clearly established. The goal of familial studies is to determine the respective weight of genetic factors and to discover new genes involved in the pathogenesis of spondylarthropathies. Among these factors, the HLA region appears to be of most importance. We are currently conducting a prospective multicenter French study aimed at collecting multiplex families of spondylarthropathies. We present preliminary results obtained from nearly 300 individuals corresponding to the first 20 collected families. Through the screening procedure, we have identified 57 patients of an average age of 42 and a mean age at onset of 23. The relative risk of spondylarthropathy in males as compared with females is 1.03. HLA typing revealed the presence of HLA-B27 in all affected patients from 19 of the 20 families, whereas in the last family, the two affected individuals shared the HLA-B14 allele. Study of HLA class I allelic transmission confirmed a strong association of spondylarthropathy with HLA-B27 (p < 10(-9)). A weaker association was found with HLA-A28, HLA-C1 and HLA-C2, probably secondary to linkage disequilibrium between these alleles and HLA-B27. Study of HLA class II region indicated a possible protective effect of HLA-DR2 and an influence due to the presence of HLA-DR14. The risk to develop spondylarthropathy in HLA-B27+ relatives of patients decreased very rapidly in respect to the genetic distance, suggesting the genetic contribution of at least one other important gene distinct from the HLA region. These data encourage us to carry on a systematic screening of the whole human genome to discover implicated genes.

Adult↗
PubMed2000

The familial form of spondylarthropathy: a clinical study of 115 multiplex families. Groupe Français d'Etude Génétique des Spondylarthropathies.

OBJECTIVE: To investigate the interrelationships among different phenotypes, and their relationship to the HLA-Blocus, in multiplex families with spondylarthropathy (SpA). METHODS: We recruited 115 white French families, each of which had at least 2 members with SpA. Pedigrees were established. Clinical data and pelvic radiographs were collected. The HLA-B27 status of all patients was determined. Analysis was performed to determine the prevalence of SpA manifestations according to sex, disease duration, and HLA-B status, and to examine clustering of specific manifestations in subsets of families. RESULTS: We identified 329 SpA patients. Mean +/-SD age at onset was 24+/-9.4 years. The male:female ratio was 186:143, or 1.3, with few sex differences in disease expression. Axial manifestations and HLA-B27 were each present in 97% of the patients. Inflammatory bowel disease and HLA-B35 were overrepresented in the 7 families containing HLA-B27-negative patients. The frequency of radiographic sacroiliitis increased in parallel with disease duration. Peripheral enthesitis, radiographic sacroiliitis, and psoriasis were evenly distributed in the families. Clustering independent of age was only observed for peripheral arthritis, suggesting that specific factors may predispose individuals to this manifestation. CONCLUSION: Familial SpA appears to be homogeneous, based on the high frequencies of axial skeletal involvement and HLA-B27. The lack of clustering of most manifestations in families suggests that a predominant shared component, including HLA-B27, predisposes individuals to all forms of familial SpA, and that ubiquitous genetic or environmental factors contribute to phenotype diversity.

Adult↗
PubMed1991

[Evaluation of the Amor criteria for spondylarthropathies and European Spondylarthropathy Study Group (ESSG). A cross-sectional analysis of 2,228 patients].

Two sets of criteria have been proposed to discriminate spondylarthropathies (SA) from other rheumatic diseases. To evaluate their performance, we conducted a cross-sectional study in the patients observed during one week in 28 French Departments of Rheumatology by 91 staff-teaching physicians. The physicians had to apply these criteria to all their patients and had to classify them as definite SA, definite other rheumatic disease or possible SA. The analysis performed on the 2,088 patients with a definite diagnosis (124 SA and 1,964 controls) showed the following results: (table; see text) Of the 140 patients with possible SA, 37 fulfilled both sets of criteria, 22 the ESSG criteria alone and 12 the Amor criteria alone. These data suggest that a) the overall performance of these two sets of criteria is similar; b) this performance is better in the group of patients with a definite diagnosis; c) the patients without a definite diagnosis require a longer follow-up to assess the clinical relevance of these two sets of criteria.

Cross-Sectional Studies↗
PubMed1994

[The epidemiology of spondylarthropathies among the native inhabitants of Chukotka (Eskimos and Chukchi). 1. The prevalence of spondylarthropathies among the Eskimos and the coast Chukchi].

To establish the prevalence of spondyloarthropathies among the indigenous population of Chukot Peninsula, a one-stage cross-sectional study was made with a direct medical examination of the natives of the two settlements of Eastern Chukot Peninsula: Sireniki and Novo-Chaplino where the main part of Eskimos live. During expedition, 640 natives aged over 6 years lived in both settlements (382 and 258 respectively). 464 persons (72.5%) were examined. Of these, 7 persons (1.5%) were diagnosed to suffer from diseases belonging to the group of spondyloarthropathies: 2 persons (0.4%) had ankylosing spondyloarthritis, 2 (0.4%) Reiter's syndrome, 2 undifferentiated spondyloarthropathies, and 1 juvenile chronic arthritis. Of the 7 patients, 4 were Eskimos, 2 half-breeds and 1 was a Chukchi man. The incidence of ankylosing spondyloarthritis among Eskimos amounted to 0.9%, Reiter's syndrome to 0.5%, and undifferentiated spondyloarthropathies to 0.5%. Thus the one-stage expedition examination of the indigenous population of Chukotka Peninsula (Eskimos and Chukchi) has shown that diseases belonging to the group of spondyloarthropathies are widely prevalent among Eskimos.

Adolescent↗
PubMed2005

Late-onset ankylosing spondylitis and related spondylarthropathies: clinical and radiological characteristics and pharmacological treatment options.

Ankylosing spondylitis is the prototype of related diseases commonly called spondylarthropathies which include reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel diseases (enteropathic arthritis) and undifferentiated spondylarthropathies. Ankylosing spondylitis and spondylarthropathies are generally observed in young patients but can be observed later in life or in persons >50 years of age. All the spondylarthropathy subgroups are represented in the elderly with some features particular to this age group. Indeed, radiological aspects of ankylosing spondylitis may be difficult to interpret because of the radiological changes induced by aging. Late-onset peripheral spondylarthropathies are characterised by severe disease, marked elevation of laboratory parameters of inflammation, oligoarthritis involving the lower limbs and oedema of the extremities. Psoriatic arthritis is more severe in the elderly and is associated with worse outcomes than in young patients. The clinical presentation of undifferentiated spondylarthropathy is as varied in the elderly as in young and middle-aged adults. Reactive arthritis and enteropathic arthritis are observed in the elderly more rarely. The effects of aging on drug metabolism and pharmacokinetics, together with the existence of co-morbidities and polypharmacy, are responsible for difficulties in the therapeutic management of late-onset ankylosing spondylitis or spondylarthropathies. Indeed, NSAIDs should be used with caution in older patients because of the high risk of serious gastrointestinal complications. Sulfasalazine and methotrexate have been used as disease-controlling drugs but did not prove very effective. Pamidronate and tumour necrosis factor (TNF)-alpha antagonists offer a therapeutic alternative but have not been specifically tested in the elderly. Pamidronate has been tested in young-onset ankylosing spondylitis and spondylarthropathies with conflicting results but can be used in older patients without risk of major adverse effects. TNFalpha antagonists have been adequately evaluated in ankylosing spondylitis and spondylarthropathies and are associated with dramatic improvement in clinical and biological parameters of disease activity. However, the safety profile of these agents in the elderly is not currently known and careful surveillance, in particular for the risk of infection such as tuberculosis, and/or exacerbation of chronic heart failure, is thus required when using these drugs in this age group.

Aged↗
PubMed2006

Synovial biomarkers in the spondylarthropathies.

PURPOSE OF THE REVIEW: To explore the concept of a biomarker, or surrogate endpoint, to enhance early diagnosis or predict the response to therapeutic intervention in patients with spondylarthropathy. RECENT FINDINGS: Immunopathologic studies have suggested that the features of spondylarthropathy are distinctive, supporting a prominent role for innate immune cells, and can be consistently differentiated from rheumatoid arthritis. Successful treatment of spondylarthropathy synovitis resulted in rapid and sustained decrease in infiltration by macrophage populations and neutrophils, and decreased expression of many proinflammatory mediators. Consistent with studies in rheumatoid arthritis, significant correlations between the effects of both methotrexate and infliximab on disease activity and sublining macrophage populations were reported. These observations highlight the possibility that macrophage populations may be a synovial tissue biomarker of therapeutic intervention in spondylarthropathy. Preliminary studies have evaluated advanced genomic and proteomic methodologies in spondylarthropathy. SUMMARY: Defining the immunopathology of spondylarthropathy has been associated with identifying potential biomarkers of the clinical response to therapeutic intervention. A surrogate marker of arthritis activity in spondylarthropathy could profoundly enhance screening for efficacy and optimization of dose ranges in early-phase randomized clinical trials.

Biomarkers↗
PubMedDate not supplied

[Enthesiopathy and bone disease during the course of inflammatory spondylarthropathies. Diagnostic and physiopathologic importance].

Our studies concerning enthesopathies during the course of spondylarthropathies show that enthesopathies are very frequent: 58% among 48 spondylarthropathies in a preliminary study. The comparison of the frequency of enthesopathies in spondylarthropathies (58%) and in Rheumatoid Arthritis (6.6%) show a highly significant difference. In our latest study enthesopathies were found in 67% among 115 spondylarthropathies. We have also described the mean locations and clinical features. They are observed early in the course of the disease. Histological studies of enthesopatic and normal enthesis were also performed. They were unable to find a specific image. Nevertheless inflammatory changes in some of our cases and in cases retrieved in the medical literature confirm the involvement of enthesis in the pathological process of spondylarthropathies. Enthesopathies represent a very good diagnostic symptom. They are the hallmark of spondylarthropathies for adults and even more for children. Furthermore, if one admits the assertion that peripheral and spinal involvement is the result of bone remodeling enthesitic lesions, then enthesopathies and osteitis, ending in ankylosis, may be considered as the fundamental pathophysiological mechanism of spondylarthropathies in contrast with erosive lesions of rheumatoid arthritis.

Adult↗
PubMed1998

[Comparative study of epidemiology of spondylarthropathies in indigenous population of the Chukot peninsula and Alaska].

UNLABELLED: The paper sums up the many-year cooperative Russian-American studies of the epidemiology of spondylarthropathies in the arctic populations of the Chukot Peninsula and Alaska. AIM: Comparison of the epidemiology of spondylarthropathies in the indigenous population of the Chukot Peninsula and Alaska. MATERIALS AND METHODS: A universal design of investigation with the same diagnostic criteria was used in both countries. A total of 974 indigenous residents of the Chukot Peninsula were examined simultaneously, on the Alaska the sampling was formed as the residents applied for care. RESULTS: In both regions the study revealed 1) a high incidence of HLA-B27, reaching 40% in the Chukot Eskimos; 2) a similarly high incidence of spondylarthropathies varying from 2 to 3.4%; 3) a similar spectrum of diseases, including, primarily, ankylosing spondylarthritis and Reiter's syndrome and undifferentiated spondylarthropathies and (rarely) psoriatic arthritis. Among HLA-B27 positive adults, the incidence of spondylarthropathies in all groups is 4.2% and of ankylosing spondylarthritis 1.5%. CONCLUSION: A high incidence of spondylarthropathies, varying from 2 to 3.4%, was revealed in the Arctic populations of the Chukot Peninsula and Alaska with a high incidence of HLA-B27 antigen. Although the spectrum of detected diseases was similar in the two groups, ankylosing sponditis was more incident on the Chukot Peninsula, whereas on the Alaska reactive arthritis and nondifferentiated spondylarthropathies predominated, which can be explained by difference in the methods of examination.

Adolescent↗
PubMed2005

[Spondylarthropathies and anti-TNFalpha drugs].

PURPOSE: Spondylarthropathies are a heterogeneous group of disorders including ankylosing spondylitis, psoriatic arthritis, reactive arthritis, arthritis associated with inflammatory bowel disease, and undifferentiated spondylarthropathies. These diseases are characterised by inflammation in the spine, sacroiliac joints, entheses, peripheral joints, and a strong association with HLA-B27; they may cause severe destruction and/or ankylosis in a minority of patients. Conventional treatment includes non steroidal anti-inflammatory drugs, corticosteroid injections, and DMARDs such as sulfasalazine in patients with peripheral arthritis. TNFalpha appears as an important actor in the pathogenesis of spondylarthropathies. METHOD AND RESULTS: Among the anti-TNFalpha drugs, etanercept and infliximab have proved to be effective in the symptomatic treatment of ankylosing spondylitis and psoriatic arthritis. A clinical relapse was observed within a few weeks after treatment discontinuation in a majority of patients. Potential beneficial effects on the destructive and/or ankylosing evolution remains to be confirmed. CONCLUSIONS: Patients with active, severe and refractory spondylarthropathies are potential candidates for treatment with anti-TNFalpha drugs. Taking into account not only the efficacy but also the side effects, with rare but potentially severe complications such as tuberculosis or other opportunistic infections, and the relatively high cost of these drugs, preliminary criteria for the initiation, monitoring and discontinuation of these drugs in the treatment of spondylarthropathies were proposed. Long-term follow-up in large populations of patients with spondylarthropathies is necessary to better define the benefit/risk/cost ratio of anti-TNFalpha drugs.

Adrenal Cortex Hormones↗
PubMed1994

High frequency of silent inflammatory bowel disease in spondylarthropathy.

OBJECTIVE: To search for an association between gut infection, gut inflammation, and spondylarthropathies. METHODS: Ileocolonoscopy was performed in 118 patients with various inflammatory and noninflammatory joint diseases and in 24 patients with uncomplicated acute bacterial gastroenteritis. RESULTS: Endoscopic lesions were more frequent in patients with spondylarthropathy (44%) compared with those with other inflammatory arthritides (6%; P = 0.001). Ileal changes were observed only in patients with spondylarthropathy (20% versus 0%; P = 0.01). Inflammatory bowel disease was the endoscopic diagnosis in 19% of the arthritis patients. Possible or definite Crohn's disease was diagnosed in 26% of patients with chronic spondylarthropathy, and ulcerative colitis in 1 patient with rheumatoid arthritis and in 1 with chronic uroarthritis. Histologic evidence of inflammation differed less distinctly than endoscopy findings between patients groups. There was no association of gut lesions with the use of nonsteroidal antiinflammatory drugs or with the presence of HLA-B27. CONCLUSION: Gut inflammation is frequent in patients with spondylarthropathy, and one-fourth of the patients who have chronic disease have early features of Crohn's disease.

Adolescent↗
PubMed1995

Pathogenesis of spondylarthropathies. Persistent bacterial antigen, autoimmunity, or both?

We have discussed partially mutually exclusive, partially overlapping models for the pathogenesis of the spondylarthropathies. Not all possibilities have been presented here; others are discussed elsewhere (77, 78). Furthermore, we have not addressed the issue of B27-negative spondylarthropathy. However, in our opinion, the key to understanding the pathogenesis of the spondylarthropathies lies in the interaction between the class I MHC molecule HLA-B27 and the T cell response. Although a T cell response driven by persisting bacterial antigen is still an attractive hypothesis, it does not explain all the known aspects of spondylarthropathy pathogenesis. The possibility of autoimmunity triggered by bacterial infection needs also to be considered, especially the new idea of HLA-B27-derived peptides presented by class II MHC molecules. The predominant involvement of joints is not easily explained in the case of autoimmunity. Cross-reactivity to joint-specific structures such as type II collagen (79) and/or bacteria inside the joint at the beginning of the immune response, with induction of local autoimmunity, might be involved. Most of the issues raised here could be tested by experiment, and we can expect to learn soon whether any of these models will explain the pathogenesis, or if we have to look further. The PCR technique will facilitate the search for bacteria not only in peripheral joints, but also now in sacroiliac biopsy samples from patients with AS and other spondylarthropathies. A prospective study on ReA in an endemic area should teach us more about predisposing factors (for example for Shigella-induced enteritis, which occurs in many parts of the world outside Europe and the US) (80).(ABSTRACT TRUNCATED AT 250 WORDS)

Antigen Presentation↗
PubMed1996

Spondylarthropathy with distal joint involvement.

To study whether the presence of distal joint involvement in spondylarthropathy corresponds to a particular set of the disease, one hundred and twenty six patients with spondylarthropathy were included in a retrospective study. Two groups of patients were defined according to the presence or the absence of distal joint involvement and their clinical, radiological, and biological features were compared. The patients with distal joint involvement had a later onset of spondylarthropathy and showed higher levels of biological markers of inflammation in their peripheral blood. However, no great difference appeared between the two groups of patients. Spondylarthropathy with distal joint involvement cannot be separated from spondylarthropathy without distal joint involvement and appears to be the same disease.

Adult↗
PubMed2000

Clinical, radiological, and laboratory findings in Lebanese spondylarthropathy patients according to HLA-B27 status.

UNLABELLED: To evaluate clinical, radiologic, and laboratory features in Lebanese spondylarthropathy patients according to HLA-B27 status. METHODS: We retrospectively compared demographic, clinical, radiologic, and severity data in 40 HLA-B27-positive and 58 HLA-B27-negative patients. All 98 patients met Amor's or European Spondylarthropathy Study Group criteria for spondylarthropathy, and 51.7% met New York modified criteria for ankylosing spondylitis. RESULTS: Onset before 16 years of age, hip involvement, and an elevated mean erythrocyte sedimentation rate were significantly associated with the presence of the HLA-B27 (32.5 vs 13.8%, P=0.02; 45 vs 7.5%, P=0.001; and 47.7 vs 25.4, P=0.02; respectively). The two groups were comparable for age, sex ratio, prevalence and distribution of spondylarthropathy types, family history, sacroiliitis, bamboo spine, syndesmophytes, peripheral joint involvement, enthesopathies, extra-articular involvement, response to nonsteroidal anti-inflammatory drugs, and need for other medications. CONCLUSION: In Lebanon, spondylarthropathy patients positive for HLA-B27 experience disease onset at an earlier age, are more likely to develop hip involvement, and have laboratory evidence of more severe inflammation than their HLA-B27-negative counterparts. None of the other clinical and radiologic parameters are modified by HLA-B27 status.

Adult↗
PubMedDate not supplied

[Rheumatic spondylodiscitis in spondylarthropathies].

The involvement of enthesis like disc space is the typical lesion of spondylarthropathies. Out of 240 patients with spondylarthropathies, 10 (7 M, 3 W; mean age: 37 years) have spondylodiscitis, affecting a total of 13 disc spaces: 1 cervical, 2 thoracic, 10 lumbar. The mean duration of spondylarthropathy at the time of diagnosis of spondylodiscitis is 10 years. Spondylodiscitis has a variable clinical presentation: painful (6 cases), asymptomatic (4 cases). Its coexistence with typical radiographic signs of spondylarthropathy added to the exclusion of bacterial origin, permit to link it to spondylarthropathy. Its evolution is generally favourable.

Adult↗
PubMedDate not supplied

Subclinical involvement of the gut in undifferentiated spondylarthropathies.

In order to evaluate the frequency of subclinical gut involvement in the seronegative spondylarthropathies, ileocolonoscopy with biopsies of the colon, ileocecal valve and ileum were performed on 211 patients with ankylosing spondylitis (AS), reactive arthritis (ReA) and undifferentiated spondylarthropathies. Inflammatory gut lesions were detected in a large number of these patients. It was concluded that the group of undifferentiated spondylarthropathies could be split into fairly equal subgroups: one subgroup suffering from subclinical inflammatory bowel disease associated with peripheral joint symptoms, a second subgroup presenting a form of enterogenic ReA, and a third subgroup in which no relation with the gut could be demonstrated. Ankylosing spondylitis, which has to be considered as a form of undifferentiated seronegative spondylarthropathy, could be subdivided into the same subgroups. These findings confirm the existence of subclinical gut involvement in patients with seronegative spondylarthropathies.

Arthritis↗