Prevalence of ankylosing spondylitis in males and females in a young middle-aged population of Tromso, northern Norway.

Gran, Jan Tore; Husby, Gunnar; Hordvik, M

doi:10.1136/ard.44.6.359

Cited by 212 publications

(89 citation statements)

References 22 publications

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“…to be 0.5-1.9% (2), similar to that of rheumatoid arthritis (RA). The interaction between a strong genetic component, mainly represented by certain HLA-B27 subtypes (3), and bacteria seems to be crucial for the pathogenesis of AS (4).…”

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confidence: 82%

Six‐month results of a double‐blind, placebo‐controlled trial of etanercept treatment in patients with active ankylosing spondylitis

Brandt

Khariouzov

Listing

et al. 2003

Arthritis & Rheumatism

419

268

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Objective. There is increasing evidence that tumor necrosis factor ␣ (TNF␣) is centrally involved in the pathogenesis of ankylosing spondylitis (AS) and other spondylarthritides. This study was designed to investigate the efficacy of anti-TNF␣ therapy with etanercept, a 75-kd receptor fusion protein, in active AS.Methods. This multicenter trial had 2 phases: an initial placebo-controlled period of 6 weeks' duration and an observational phase lasting 24 weeks. Thirty patients with active AS were included. They were randomized into 2 groups, which received either etanercept (25 mg twice weekly) (n ‫؍‬ 14) or placebo (n ‫؍‬ 16) for 6 weeks. Then both groups were treated with etanercept. Nonsteroidal antiinflammatory drug (NSAID) treatment could be continued, but disease-modifying antirheumatic drugs (DMARDs) and steroids had to be withdrawn prior to the study. All patients received etanercept for a total of 12 weeks and were followed up for at least 24 weeks. The Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index, Bath AS Metrology Index, pain level on a numeric rating scale, quality of life by the Short Form 36, and C-reactive protein (CRP) level were assessed. The primary outcome parameter was a >50% improvement in the BAS-DAI.Results. Treatment with etanercept resulted in at least a 50% regression of disease activity in 57% of these patients at week 6, versus 6% of the placebo-treated patients (P ‫؍‬ 0.004). After the placebo-treated patients switched to etanercept, 56% improved. The mean ؎ SD BASDAI improved from 6.5 ؎ 1.2 at baseline to 3.5 ؎ 1.9 at week 6 in the etanercept group, with no improvement in the placebo group (P ‫؍‬ 0.003 between groups). Similarly, pain, function, mobility, and quality of life improved with etanercept but not with placebo at week 6 (P < 0.05). Mean CRP levels decreased significantly with etanercept but not with placebo (P ‫؍‬ 0.001). There was ongoing improvement in all parameters in both groups until week 12 and week 18, respectively (i.e., throughout the period of etanercept treatment). Disease relapses occurred a mean ؎ SD of 6.2 ؎ 3.0 weeks after cessation of etanercept. No severe adverse events, including major infections, were observed during the trial.Conclusion. This study shows that on a shortterm basis (3 months), treatment with etanercept is clearly efficacious in patients with active AS who are receiving NSAID therapy but not DMARDs or steroids. After cessation of therapy, almost all patients experienced a relapse within a few weeks. Thus, it seems probable that etanercept must be administered continuously in most AS patients to achieve permanent inhibition of the inflammatory process.Ankylosing spondylitis (AS), the prototype of the spondylarthritides (SpA), is a chronic inflammatory rheumatic disease. In the past, the prevalence of SpA has been underestimated (1); more recently, the prevalence of the group of SpA as a whole has been calculated

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confidence: 82%

Six‐month results of a double‐blind, placebo‐controlled trial of etanercept treatment in patients with active ankylosing spondylitis

Brandt

Khariouzov

Listing

et al. 2003

Arthritis & Rheumatism

419

268

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“…4 Furthermore, although 95% of Caucasian AS patients are B27-positive, only a small proportion of the 8% of B27-positive individuals in the population go on to develop disease. [5][6][7] This indicates that although B27 is almost essential for the inheritance of AS within families, there are other genetic risk factors involved. Recurrence risk ratio modelling in different degrees of relatives suggests that 2-6 genes are likely to interact multiplicatively in determining susceptibility to AS.…”

Section: Introductionmentioning

confidence: 99%

Non-B27 MHC associations of ankylosing spondylitis

et al. 2006

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Ankylosing spondylitis (AS) has been associated with human leukocyte antigen (HLA)-B27 for over 30 years; however, the mechanism of action has remained elusive. Although many studies have reported associations between AS and other genes in the major histocompatibility complex (MHC) in AS, no conclusive results have emerged. To investigate the contribution of non-B27 MHC genes to AS, a large cohort of AS families and controls were B27 typed and genotyped across the region. Interrogation of the data identified a region of 270 kb, lying from 31 952 649 to 32 221 738 base pairs from the p-telomere of chromosome 6 and containing 23 genes, which is likely to include genes involved with susceptibility to AS.

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“…Hvis man aksepterer antakelsen om at det ikke er store genetiske forskjeller i befolkningen i disse områdene, indikerer dette at tilstanden er betydelig underdiagnostisert (9). I en tidligere publisert populasjonsbasert studie fra Tromsø fant man en betydelig høyere prevalens på 1,1-1,4% (29), og det må derfor antas at vårt estimat på 0,41% er et konservativt anslag. I tråd med den høyere forekomsten av HLA B27 i de indre områder av Finnmark, har man her også funnet en høyere prevalens av AS på 1,8% (28).…”

Section: Prevalensunclassified

Epidemiologiske forhold ved ankyloserende spondylitt

Bakland

2009

Nor J Epidemiol

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SAMMENDRAGAnkyloserende spondylitt er en inflammatorisk revmatisk sykdom som hovedsakelig affiserer ileosakralledd og kolumna, og den er assosiert til perifere artritter, inflammatorisk tarmsykdom, psoriasis og Reiters syndrom. Forekomsten er korrelert til utbredelsen av HLA B27, og viser derved en viss geografisk variasjon. I europeiske studier finner man en generell prevalens av AS på 0,15-0,5%, men dette kan vaere høyere i enkelte subpopulasjoner med 1,8% rapportert i en norsk samisk populasjon. En norsk studie har indikert en insidens på ca. 1 per 10.000 personår i voksen befolkning, mens data fra Finland og USA viser noe lavere anslag. Det foreligger data som indikerer en økning av mortalitet på 50%, mens man i andre populasjoner ikke har funnet noen mortalitetsøkning. Nye og effektive behandlingsmuligheter stiller høye krav til tidlig diagnostikk, og utvikling samt validering av nye diagnostiske kriterier er en viktig utfordring. ENGLISH SUMMARYAnkylosing spondylitis (AS) is an inflammatory rheumatic disease affecting the sacroiliac joints and spine. The prevalence of AS is correlated to that of HLA B27, which demonstrate a geographical gradient with higher occurrence in the northern circumpolar areas. European populations studies indicate a prevalence of 0.15-0.5%, although it could be as high as 1.8% in some subpopulations. There are few studies concerning the incidence rate of AS, but a Norwegian study indicates an annual incidence of 1 per 10.000 in the adult population. There are contradicting studies regarding mortality. Some indicate that it may be increased by 50%, whereas others show no increased mortality. INNLEDNINGAnkyloserende spondylitt (synonym: Behkterevs sykdom, Marie-Strümpells sykdom) er en inflammatorisk revmatisk sykdom karakterisert ved inflammasjon i ileosakralledd (IS-ledd) og ofte også i ryggsøylen som medfører smerte, stivhet og redusert bevegelighet. Sykdommen kan lede til sammenvoksing av knokler (ankylose) i IS-ledd og, til en varierende grad, i ryggsøylen, i noen tilfeller med en påfølgende fullstendig avstivning av kolumna. Tilstanden er sterkt assosiert til vevstypeantigenet HLA B27, og forekomst av perifere artritter, akutte uveitter, psoriasis og inflammatorisk tarmsykdom (1).Sykdommen klassifiseres innen gruppen "Spondyloartritter", som også inkluderer psoriasis artritt, artritt assosiert til inflammatorisk tarmsykdom og reaktiv artritt/Reiters syndrom. Disse tilstandene er alle karakterisert ved en assosiasjon til HLA B27, asymmetrisk oligoartritt, uveitt, sakroileitt og entesitt (2). HISTORISK BAKGRUNNI de nordiske land samt en del øvrige europeiske land har AS vaert omtalt som Morbus Behkterev, etter den russiske legen Vladimir Behkterev som beskrev tilstanden på slutten av det nittende århundre. I samme periode ble tilstanden også beskrevet av den kjente franske nevrologen Pierre Marie og den tyske legen Ernst Adolf von Strümpell, og på kontinentet har derfor betegnelsen Morbus Marie-Strümpell blitt brukt. I internasjonal sammenheng er likevel "ankyloserende spondyli...

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Prevalence of ankylosing spondylitis in males and females in a young middle-aged population of Tromso, northern Norway.

Cited by 212 publications

References 22 publications

Six‐month results of a double‐blind, placebo‐controlled trial of etanercept treatment in patients with active ankylosing spondylitis

Six‐month results of a double‐blind, placebo‐controlled trial of etanercept treatment in patients with active ankylosing spondylitis

Non-B27 MHC associations of ankylosing spondylitis

Epidemiologiske forhold ved ankyloserende spondylitt

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