Trends in amyloidosis in spondyloarthritis: results from the Spanish National Inpatient Registry over a 17-year period (1999–2015)—TREND-EspA study

Mazzucchelli, Ramón; Almodóvar-González, Raquel; Dieguez-Costa, Elisa; Crespí-Villarías, Natalia; Pérez‐Fernández, Elia; García‐Zamora, Elena; Vadillo, A. Garcia

doi:10.1136/rmdopen-2021-001782

Cited by 4 publications

(5 citation statements)

References 30 publications

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“… 21 , 22 , 23 , 24 Interestingly, IBD shares part of similar pathogenesis of AS meanwhile it is known that around 40% of AS patients have subclinical bowel inflammation. 25 , 26 , 27 Whereas, no evidence reveals the blood CDC42 expression in AS patients. The present study exhibited that blood CDC42 expression was lower in AS patients compared with HCs.…”

Section: Discussionmentioning

confidence: 99%

PBMC CDC42 reveals the disease activity and treatment efficacy of TNF inhibitor in patients with ankylosing spondylitis

Zhang¹,

Du²,

Mou³

et al. 2022

Clinical Laboratory Analysis

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Objective Cell division cycle 42 (CDC42) regulates the polarization of M2 macrophage and maintains the T cell homeostasis, to participate in multiple autoimmune diseases, while its clinical involvement in ankylosing spondylitis (AS) remains unclear. Hence, the current study aimed to investigate the correlation of CDC42 with clinical characteristics and treatment outcome in AS patients receiving tumor necrosis factor (TNF) inhibitor therapy. Methods Peripheral blood mononuclear cell (PBMC) CDC42 expression was detected at baseline, week (W) 4, W8, and W12 after TNF inhibitor treatment in 91 AS patients and in 50 HCs after enrollment. Furthermore, serum TNF‐α, interferon‐γ (IFN‐γ), interleukin‐10 (IL‐10), and interleukin‐17A (IL‐17A) from AS patients were detected at baseline. Results Blood CDC42 was lower in AS patients compared with HCs (p < 0.001). Additionally, blood CDC42 was negatively linked with CRP (r = −0.349, p = 0.001), BASDAI score (r = −0.243, p = 0.020), and ASDASCRP score (r = −0.238, p = 0.023) in AS patients; however, blood CDC42 was not correlated with other clinical characteristics. Besides, CDC42 was negatively correlated with TNF‐α (r = −0.237, p = 0.024) and IL‐17A (r = −0.339, p = 0.001) but not with IFN‐γ (p = 0.083) or IL‐10 (p = 0.280). Moreover, blood CDC42 was elevated after TNF inhibitor treatment (p < 0.001). Meanwhile, blood CDC42 was not varied at baseline and W4 between response patients and non‐response patients, while it was higher at W8 (p = 0.019) and W12 (p = 0.002) in response patients than in non‐response patients after treatment. Conclusion Blood CDC42 deficiency links with elevated pro‐inflammatory cytokines, disease activity and unsatisfying response to TNF inhibitor in AS patients.

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Section: Discussionmentioning

confidence: 99%

PBMC CDC42 reveals the disease activity and treatment efficacy of TNF inhibitor in patients with ankylosing spondylitis

Zhang¹,

Du²,

Mou³

et al. 2022

Clinical Laboratory Analysis

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“…We conducted an observational, retrospective, population-based, serial cross-sectional study. This study has a similar methodology to other studies carried out by our group 18…”

Section: Methodsmentioning

confidence: 85%

“…Given that it is an observational retrospective study, a causal relationship cannot be established with the results found. Even if the MBDS provides information from a network of hospitals that covers more than 98% of the population living in Spain,18 some OS may have not been properly recorded by the public hospital discharge registry, and there may be coding errors. In addition, cases of OS in patients with SpA may not have been coded as SpA, thus implying an underestimation in our results.…”

Section: Discussionmentioning

confidence: 99%

Trends in orthopaedic surgery for spondyloarthritis: outcomes from a National Hospitalised Patient Registry (MBDS) over a 17-year period (1999–2015).TREND-EspA study

et al. 2022

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ObjectiveTo assess the incidence of orthopaedic surgery (OS) (including total hip arthroplasty (THA), total knee arthroplasty, upper limb arthroplasty, arthrodesis and spinal surgery) and associated trends in patients with spondyloarthritis (SpA) over a long period (17 years).MethodsAn observational, retrospective, population-based, serial cross-sectional study was conducted. All hospital admissions of patients with SpA reported between 1999 and 2015 were analysed, and a control group was selected and matched by age, sex and year of admission. Incidence rates for OS (and subtypes) were calculated. Generalised linear models were used to analyse trends; unconditional logistic regression models were used to calculate crude and adjusted ORs (aORs) with the aim of evaluating the association between OS and SpA.ResultsThe study database contained data on 214 280 hospital admissions (SpA/non-SpA 1:1 ratio). In the SpA cohort, 5 382 admissions (5.02%) had undergone OS compared with 3 533 in the non-SpA cohort (3.29%) (AOR 1.64; 95% CI 1.57 to 1.72). OS rates increased for both cohorts (+4.92% per year vs +8.41%). The trend in OS, THA, arthrodesis and spinal surgery decreased or stabilised in patients under age 60 in the SpA cohort, while the non-SpA cohort remained stable. In the SpA cohort, the mean age was 53.68 years (SD 13.65) in 1999, increasing to 62.76 years (SD 12.74) in 2015. In the non-SpA cohort, the mean age remained stable at around 63 years.ConclusionsA 9-year difference in the age of patients undergoing OS was observed in patients with SpA. The incidence of OS, THA and arthrodesis decreased in patients under age 60, and the incidence of spinal surgery decreased in patients under age 40. Our findings suggest that these patients are increasingly able to defer surgical interventions.

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“…Die Amyloidose ist gemäß einer landesweit zwischen 1999 und 2015 in Spanien durchgeführten Hospitalisierungsstudie mit einer Prävalenz von im Mittel 0,7 % eine seltene Komplikation der axSpA, die zudem häufiger bei gleichzeitig vorliegender chronisch entzündlicher Darmerkrankung bzw. "inflammatory bowel disease" (IBD) gefunden wurde, v. a. aber in der Gesamtgruppe von Jahr zu Jahr im Mittel um 4,6 % abgenommen hat [16]. Insgesamt aber hatte die Amyloidose in dieser Studie als Komplikation anderer Entitäten zugenommen, sodass es keinen offensichtlicheren Grund für den rückläufigen Trend der Amyloidose bei der axSpA als den Einsatz der Biologika gibt.…”

Section: Extraspinale Manifestationenunclassified

Chronische Rückenschmerzen bei axialer Spondyloarthritis

Möller

2022

Z Rheumatol

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Zusammenfassung Hintergrund Die axiale Spondyloarthritis (axSpA) ist unter den chronischen Rückenerkrankungen wohl die Entität mit dem größten Spektrum spezifischer antientzündlicher Behandlungsoptionen. Sie wird aber erst nach Rückenmark- oder Cauda-equina-Kompression, Knochenmetastasen, epiduralem Abszess oder Osteomyelitis der Wirbelkörper, Radikulopathie oder engem Spinalkanal nur als eine ferner zu berücksichtigende Ätiologie von Rückenschmerzen in den allgemeinmedizinisch orientierten Praxishilfen erwähnt. Es besteht wegen einer vergleichsweise niedrigen Prävalenz und erst später zu erwartender Folgen die tendenzielle Gefahr, dass die axSpA als eine Entität für Spezialisten vernachlässigt wird. Ergebnisse Diese Arbeit rekapituliert die Empfehlungen der internationalen Gesellschaft für das Assessment der ankylosierenden Spondylitis (ASAS). Dieser Review weist auf die praktischen Aspekte der detaillierten Evaluation bisheriger Therapieversuche mit nichtsteroidalen Antirheumatika (NSAR) bei Rückenschmerzen hin. Von besonderem Interesse können dabei unerwünschte Effekte auf eine Symptomatik des unteren Intestinaltraktes sein. Die geschlechtsspezifischen Unterschiede im Ansprechen auf eine TNF(Tumor-Nekrose-Faktor)-Inhibitor-Therapie bei axSpA finden Erwähnung, ebenso wie weitere Aspekte der biologischen Therapieoptionen bei axSpA anhand eines Falles von anhaltender Remission einer HLA-B27 und Magnetresonanztomographie(MRT)-positiven axSpA nach Anti-IL(Interleukin)-17-Behandlung und dem mehrjährigen guten Ansprechen auf eine IL-12/23-Inhibitor-Therapie bei axialer Psoriasisarthritis besprochen werden. Ferner wird die Literatur im Hinblick auf Uveitis, Karditis und Amyloidose im Kontext der axSpA diskutiert. Schlussfolgerung Die rechtzeitige Erkennung im allgemeinmedizinischen Kontext und die spezifische Berücksichtigung zahlreicher prädiktiver Faktoren spielen bei der personalisierten Behandlung der axSpA eine weiter zunehmende Rolle.

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Trends in amyloidosis in spondyloarthritis: results from the Spanish National Inpatient Registry over a 17-year period (1999–2015)—TREND-EspA study

Cited by 4 publications

References 30 publications

PBMC CDC42 reveals the disease activity and treatment efficacy of TNF inhibitor in patients with ankylosing spondylitis

PBMC CDC42 reveals the disease activity and treatment efficacy of TNF inhibitor in patients with ankylosing spondylitis

Trends in orthopaedic surgery for spondyloarthritis: outcomes from a National Hospitalised Patient Registry (MBDS) over a 17-year period (1999–2015).TREND-EspA study

Chronische Rückenschmerzen bei axialer Spondyloarthritis

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