ASDAS, BASDAI and different treatment responses and their relation to biomarkers of inflammation, cartilage and bone turnover in patients with axial spondyloarthritis treated with TNF  inhibitors

Pedersen, Susanne Juhl; Sørensen, Inge Juul; Garnero, Patrick; Johansen, Julia S.; Madsen, Ole Rintek; Tvede, N.; Hansen, Michael Sejer; Thamsborg, Gorm; Andersen, Lis Smedegaard; Majgaard, Ole; Loft, Anne Gitte; Erlendsson, Jon; Asmussen, Karsten; Jurik, Anne Grethe; Møller, Jakob M.; Hasselquist, Maria; Mikkelsen, Dorrit; Skjødt, Thomas; Lambert, Robert G.; Hansen, Annette; Østergaard, Mikkel

doi:10.1136/ard.2010.138883

Cited by 103 publications

(102 citation statements)

References 27 publications

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“…The present authors' evaluation has demonstrated significantly lower serum VEGF levels in patients treated with TNFα inhibitors versus the untreated patients. These data are in accordance with the data of other authors in whose studies the administration of TNFα inhibitors resulted in a decrease in the VEGF level (16,18,19,20,21). For the time being it is not clear whether TNFα inhibitors influence radiographic progression in patients with AS.…”

Section: Discussionsupporting

confidence: 80%

The Vegf and BMP-2 Levels in Patients With Ankylosing Spondylitis and the Relationship to Treatment With Tumour Necrosis Factor Alpha Inhibitors

Tošovský

Bradna

Andrýs

et al. 2014

Acta Med. (Hradec Kralove, Czech Repub.)

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Summary:Introduction: Ankylosing spondylitis (AS) is an inflammatory rheumatic disease characterized by the development of osteoproductive changes in the spine which could possibly result in ankylosis. Treatment with tumour necrosis factor alpha (TNFα) inhibitors has proved to be an important step forward in the treatment of this disease, but for the time being it is not clear whether it favourably influences radiographic progression of the disease. Vascular endothelial growth factor most probably plays a role in the development of osteoproductive changes and recently its predictive influence on radiographic progression has been demonstrated. Bone morphogenic protein 2 (BMP-2) participates in the regulation of bone proliferation and its increased serum level has been demonstrated in patients with advanced AS and correlated with the degree of radiographic changes. Aim: The study aims to evaluate the VEGF and BMP-2 levels in patients with ankylosing spondylitis and how these levels relate to the concurrent treatment with TNFα inhibitors. Methods: Sera were evaluated from patients at the Rheumatologic Clinic of the Hradec Králové Faculty Hospital who fulfilled the modified New York Criteria for AS (n = 55). In these patients, the parameters of the activity of the disease (BASDAI = Bath Ankylosing Spondylitis Disease Activity Index, CRP = C-reactive protein) and the concurrent therapy (TNFα inhibitors, n = 21, vs. non-anti TNFα, n = 34) were recorded. The levels of VEGF and BMP-2 were analyzed using the ELISA method. Results: In patients treated with TNFα inhibitors, a significantly lower VEGF level was found when compared to untreated patients (140.3 (109.4; 262.2) vs. 261 (172.4; 396.6) pg/ml; p = 0.02). No difference was found between BMP-2 levels in both groups (treated vs. untreated patients) (254.8 (2301; 267.3) vs. 261.1 (248.6; 273.5) pg/ml; p = 0.24). A correlation analysis did not reveal any relationship between VEG F and BMP-2 (r = 0.057; p = 0.68). Serum levels of VEGF correlated with serum levels of CRP (r = 0.56; p = 0.00001) and the BASDAI value (r = 0.33; p = 0.015). Conclusion: Significantly lower VEGF levels were found in patients treated with TNFα inhibitors versus the untreated patients. These findings are in harmony with some hitherto published analyses and may give evidence of a favourable effect of TNFα inhibitors on radiographic progression. Neither influence on the BMP-2 level by treatment with TNFα inhibitors nor correlation with VEGF levels was demonstrated.

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Section: Discussionsupporting

confidence: 80%

The Vegf and BMP-2 Levels in Patients With Ankylosing Spondylitis and the Relationship to Treatment With Tumour Necrosis Factor Alpha Inhibitors

Tošovský

Bradna

Andrýs

et al. 2014

Acta Med. (Hradec Kralove, Czech Repub.)

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“…One other limitation of this study was that we did not use the more sensitive index Ankylosing Spondylitis Disease Activity Score. 21 BASDAI is an established, reliable and valid disease activity measure in axSpA, but has been shown to be less sensitive to change in disease activity than Ankylosing Spondylitis Disease Activity Score in some studies. However, the fact that we were still able to detect significant associations between 25(OH)D and the Bath indices is a strength of the study.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Deficiency in Axial Spondyloarthritis is Associated With Higher Disease Activity

et al. 2017

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Objectives: This study aims to assess whether vitamin D deficiency is associated with increased disease activity and functional impairment in axial spondyloarthritis (axSpA), with control for its seasonal variation. Patients and methods: Serum 25-hydroxyvitamin D [25(OH)D] levels were measured in 235 consecutive axSpA patients (176 males, 59 females; mean age 46.3 years; range 18 to 85 years) attending a specialist spondyloarthritis service in the United Kingdom. Disease activity and functional status were assessed using Bath Ankylosing Spondylitis indices, C-reactive protein, and erythrocyte sedimentation rates. Vitamin D deficiency was defined as 25(OH)D <30 nmol/L. Associations between vitamin D deficiency and: (i) disease activity (Bath Ankylosing Spondylitis Disease Activity Index), (ii) spinal pain, (iii) functional impairment (Bath Ankylosing Spondylitis Functional Index), and (iv) inflammatory markers were explored using multivariable logistic regression models (adjusted for age, sex, vitamin D supplementation, and seasonal variation). Results: Median symptom duration was 17 years (inter-quartile range 8.5 to 28.6 years). Median 25(OH)D was 54.5 nmol/L (inter-quartile range 34 to 77 nmol/L) and 52 patients (22%) were deficient for vitamin D. Increasing Bath Ankylosing Spondylitis Disease Activity Index (adjusted odds ratio 1.23; 95% confidence interval 1.06-1.41), spinal pain visual analog scale (adjusted odds ratio 1.21; 95% confidence interval 1.07-1.38), and C-reactive protein (adjusted odds ratio 1.02; 95% confidence interval 1.01-1.04) were each significantly associated with 25(OH)D deficiency. Conclusion:This cross-sectional study demonstrated associations between vitamin D deficiency and both higher disease activity and functional impairment in axSpA. Whilst this may reflect reduced ultra-violet exposure in functionally impaired patients, it supports the hypothesis that vitamin D may have an immunomodulatory role. Interventional studies are needed to evaluate a potential causal relationship, as optimizing vitamin D may be a cost-effective adjunctive intervention to modify disease activity in axSpA.

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“…While the ASDAS includes the categories of spinal pain, peripheral joint pain, morning stiffness, the patient's global assessment of disease activity, and laboratory parameters, [21][22][23] it does not include fatigue and local tenderness. The ASDAS-ESR levels of the female patients in this study were significantly higher than those of the male patients, but the ASDAS-CRP levels for both genders were similar.…”

Section: Discussionmentioning

confidence: 99%

A Possible Correlation Among Different Disease Activity Parameters and Functional Status in Patients with Ankylosing Spondylitis

Demir

Aytekin

Özgönenel³

et al. 2013

Turk J Rheumatol

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ASDAS, BASDAI and different treatment responses and their relation to biomarkers of inflammation, cartilage and bone turnover in patients with axial spondyloarthritis treated with TNF inhibitors

Cited by 103 publications

References 27 publications

The Vegf and BMP-2 Levels in Patients With Ankylosing Spondylitis and the Relationship to Treatment With Tumour Necrosis Factor Alpha Inhibitors

The Vegf and BMP-2 Levels in Patients With Ankylosing Spondylitis and the Relationship to Treatment With Tumour Necrosis Factor Alpha Inhibitors

Vitamin D Deficiency in Axial Spondyloarthritis is Associated With Higher Disease Activity

A Possible Correlation Among Different Disease Activity Parameters and Functional Status in Patients with Ankylosing Spondylitis

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