Obesity can be a factor that affects the course of chronic systemic inflammatory arthritis. The objective of this study was to characterise patients with ankylosing spondylitis (AS) according to an evaluation of their body mass index (BMI BMI £ 24.9,
J. Zepa et al. 2 CD40 gene rs4810485 polymorphism was tested by a TaqMan Pre-Designed SNP Genotyping Assay. In the case of CD40 gene rs4810485 polymorphism, the minor allele is T. Compared to the control subjects, the case group had a higher frequency of the minor allele T (28.6% vs. 17.5%; p=0.00345).The T allele was the risk allele for disease onset (OR 1.88 (95% CI 1.23-2.88)). The relationship between the disease and genotypes was of moderate significance (V=0.20). As for genotypes, GT and TT were the susceptibility genotypes for AS (respectively OR 2.42 (95% CI 1.38 -4.25) and 1.94 (95% CI 0.71-5.32)). The GG genotype had a protective feature (OR 0.43 (95% CI 0.25 -0.73)). A significant difference was not found in the analysis of the SNP alleles and genotype distribution in the peripheral arthritis (p=0.85 and p=0.86, respectively) and uveitis (p=0.47 and p=0.3, respectively) subgroups of AS patients. The study data showed that CD40 gene rs4810485 polymorphism is associated with risk of AS.
The aim of this study was to analyse the rheumatic disease profile and treatment aspects of the patients consulted in the outpatient department of Pauls Stradiņš Clinical University Hospital during the first month of the COVID-19 pandemic from 2020 March 13 till April 14. A total of 457 (76.04%) remote and 144 (23.96%) face-to-face consultations were analysed, totalling 601 patients: 434 (72.21%) females and 167 (27.79%) males with mean age 51.40 ± 14.73 years. Rheumatoid arthritis (223 (37.10%)), psoriatic arthritis (93 (15.47%)) and ankylosing spondylitis (80 (13.31%)) were the most frequently consulted conditions. Disease modifying antirheumatic drugs (DMARDs) or immunosuppressants (IS) were taken by 515 (85.69%) patients. These included synthetic DMARD (242 (46.99%)), mainly methotrexate; and biologic DMARD (156 (30.29%)), mainly tumour necrosis factor inhibitor. More than one-half of the cohort (427 (71.05%)) was not taking a glucocorticoid (GC). NSAIDs were used in 391 (65.08%) patients, mainly on demand (354 (90.54%)). Most patients (401 (66.72%)) had no comorbidities (hypertension, diabetes, malignancy and/or chronic respiratory disease). The profile of patients consulted in the outpatient department consisted mainly of middle-age females with autoimmune inflammatory arthritis treated by DMARD. Most of the patients did not use GCs, they did not regularly use NSAIDs and did not have comorbidities. Telemedicine is an acceptable way of care delivery for chronic rheumatic patients with previously known disease and treatment, especially during a pandemic.
Background and objectives One of the most frequently reported symptoms by patients with axial spondyloarthritis (AxSpA) is disease-related fatigue. The role of fatigue and its degree during the course of AxSpA still remains a challenge. The objective of this study was to characterise the patients with AxSpA accordingly to the evaluation of disease-related fatigue. Materials and methods 120 patients were included in the cross-sectional study fulfilling the Assessment of Spondyloarthritis international Society (ASAS) classification criteria for AxSpA. Fatigue was evaluated using the first item of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) questionnaire. Patients were divided into two groups: with the evaluation of fatigue ≤5 and >5. The following variables were chosen for characteristics of the groups: age, duration of the disease, the age of AxSpA onset, duration of morning stiffness, Ankylosing Spondylitis Disease Activity Score (ASDAS) (using c-reactive protein (CRP)), functional (BASFI) and metrological (BASMI) indices, the evaluation of enthesitis using the fourth item of the BASDAI questionnaire. Results The mean BASDAI fatigue score was 5.0 (SD 2.59). In our data, 44.2% of patients experienced severe fatigue (score >5). The mean value of age, duration of morning stiffness, ASDAS, BASFI, BASMI and evaluation of enthesitis in the group with lower fatigue level was respectively 37.4 years (SD 9.63), 41 min (SD 37.97), 2.3 (SD 1.32), 2.2 (SD 2.09), 2.8 (SD 2.39) and 2.7 (SD 2.89). In the group with severe fatigue expression the mean age was 41.5 years (SD 10.09), duration of morning stiffness – 66.2 min (SD 43.06), ASDAS – 3.7 (SD 0.94), BASFI – 5.0 (SD 2.34), BASMI - 4.4 (SD 2.54), evaluation of enthesitis – 5.2 (SD 2.99). These variables were statistically different between groups. There was no difference between groups on duration of the disease and age of AxSpA onset. Conclusions Patients with severe fatigue had a higher level of the disease activity, functional disability and spinal mobility impairment. These results suggest that the level of fatigue can be used as one of the clinical signs which show the expression of systemic inflammation and induced impairment of mobility in the course of the disease independent of the disease duration.
Background and Objectives Ankylosing spondylitis (AS) is a chronic, autoimmune, systemic, inflammatory disease. Recently, a link has been established between autoimmune inflammatory diseases, incl. AS, and the risk of developing cardiovascular disease (CVD). Uveitis is the most frequent extraarticular location of AS - it occurs in about 25 - 40% of patients. The impact of evidence of uveitis during the course of AS still remains a challenge. Does AS with uveitis differ from AS without uveitis? The objective of this study was to detect the link between uveitis during the course of AS and the CVD risk factors in patients with AS. Materials and Methods 77 AS patients classified using the modified New York criteria were assessed clinically and 6 ml of serum was collected from each patient. Patients were divided into two groups: with and without uveitis. The following parameters were chosen as the CVD risk factors: body mass index (BMI), waist circumference (WC) and high density lipoprotein cholesterol (HDLc). Statistical analyses included a between-group comparison of age, duration of the disease, the disease activity (measured using Ankylosing Spondylitis Disease Activity Score (ASDAS) with C-reactive protein (CRP)) and values of the CVD risk factors. Results The mean age was 39.7 years (SD 10.15), disease duration 13.5 years (SD 8.44) and ASDAScrp 3.0 (SD 1.38). These parameters were not statistically significantly different between the groups. The mean value of BMI, WC and HDLc in AS group with uveitis (n = 26) were respectively 24.8 kg/cm2 (SD 4.22), 91.3 cm (SD 14.23) and 1.51 mmol/l (SD 0.5). The mean value of BMI, WC and HDLc in AS group without uveitis (n = 51) were respectively 25.4 kg/cm2 (SD 4.2), 93.1 cm (SD 11.67) and 1.39 mmol/l (SD 0.39). The values of the CVD risk factors were not statistically significantly different between the groups. Conclusions These results suggest that uveitis does not impact the CVD risk factors in patients with AS. Thus it can be proposed that aspects of the pathogenesis, genetics of uveitis in patients with AS do not interfere with pathways of CVD. Further investigations are needed.
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