Rudwaleit, M., Khan, M. A. & Sieper, J. The challenge of diagnosis and classification in early ankylosing spondylitis: do we need new criteria? Arthritis Rheum. 52, 1000-1008

Case Western Reserve University, Cleveland, Ohio, United States
Arthritis & Rheumatology (Impact Factor: 7.76). 04/2005; 52(4):1000-8. DOI: 10.1002/art.20990
Source: PubMed

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    • "Laconicorama, and The diagnosis of AS was made on the basis of modified New York criteria[31]scale by rheumatologists of the Hospitals Kalamata, Panarkadikon, and Korinthos or by rheumatologists in private practice in the mentioned Peloponnese prefecture cities. Eligible patients were given a detailed description of the intended treatment procedure and were informed about the possibility of receiving placebo therapy, and their right to withdraw from the study at any time. After receiving this information in a participant information sheet, the patients gave their informed consent. "
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    ABSTRACT: This study aimed to compare the effectiveness of the combined low-level laser therapy (LLLT) and passive stretching with combined placebo LLLT laser and the same passive stretching exercises in patients suffering from Αnkylosing spondylitis. Forty-eight patients suffering from Αnkylosing spondylitis participated in the study and were randomized into two groups. Group A (n = 24) was treated with a λ = 820 Ga-Al-As laser CW, with power intensity = 60 mW/cm2, energy per point in each session = 4.5 J, total energy per session = 27.0 J, in contact with specific points technique, plus passive stretching exercises. Group B (n = 24), received placebo laser plus the same passive stretching exercises. Both groups received 12 sessions of laser or placebo within 8 weeks; two sessions per week (weeks 1–4) and one session per week (weeks 5–8). Pain and function scales were completed before the treatment, at the end of the fourth and eighth week of treatment, and 8 weeks after the end of treatment (follow-up). Group A revealed a significant improvement after 8 weeks of treatment in all pain and function scales. At 8-week follow-up, the improvement remained only for the pain, while for all other function outcomes the differences were not statistically significant. The results suggested that after an 8-week treatment and after a follow-up, the combination of LLLT and passive stretching exercises decreased pain more effectively than placebo LLLT along with the same passive stretching exercises in patients with Αnkylosing spondylitis. Future studies are needed to establish the relative and absolute effectiveness of the above protocol.
    Full-text · Article · Jan 2016 · Lasers in Medical Science
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    • "diagnosis, especially in patients with isolated axial involvement (Rudwaleit et al. 2005). This was particularly true until 5–10 years ago, when diagnosis could only be confirmed based on radiological damage (van der Linden et al. 1984). "
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    ABSTRACT: Spondyloarthritis (SpA) is a family of inflammatory diseases sharing clinical, genetic, and radiological features. While crucial for tailoring early interventions, validated prognostic biomarkers are scarce in SpA. We analyze the correlation between serum levels of vasoactive intestinal peptide (VIP) and disease activity/severity in patients with early chronic inflammatory back pain. The study population comprised 54 patients enrolled in our early chronic inflammatory back pain register. We collected demographic information, clinical data, laboratory data, and imaging findings. VIP levels were measured by enzyme immunoassay in serum samples from 162 visits. The association between independent variables and VIP levels was analyzed using longitudinal multivariate analysis nested by patient and visit. No significant differences were observed in VIP levels between these two groups. Lower levels of VIP were significantly associated with a higher Bath Ankylosing Spondylitis Disease Activity Index (BASFI) score, presence of bone edema in magnetic resonance imaging (MRI) scan, and lower hemoglobin levels. Coexistence of cutaneous psoriasis was independently associated with lower VIP levels, and similar trend was observed for enthesitis. We conclude that SpA patients with low serum VIP levels had worse 2-year disease outcome, suggesting that serum VIP levels could be a valid prognostic biomarker.
    Full-text · Article · Feb 2015 · Journal of Molecular Neuroscience
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    • "The following independent variables were considered: (a) sociodemographic variables: age, sex, marital status, education level, place of residence, and distance to the hospital from the place of residence; (b) clinical data: age at onset of SpA, date of disease onset, date of first visit to a rheumatologist, date of diagnosis, duration of disease, subtype of clinical involvement, compliance with the modified New York [24], Amor et al. [25], European Spondyloarthropathy Study Group [26], Rudwaleit et al. [27] and Berlin criteria [28], HLA-B27, family history, extraarticular manifestations and disease activity, and severity data [erythrocyte sedimentation rate ( "
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    ABSTRACT: To describe the variability in the prescription of non-biologic disease-modifying antirheumatic drugs (nbDMARDs) for the treatment of spondyloarthritis (SpA) in Spain and to explore which factors relating to the disease, patient, physician, and/or center contribute to these variations. A retrospective medical record review was performed using a probabilistic sample of 1168 patients with SpA from 45 centers distributed in 15/19 regions in Spain. The sociodemographic and clinical features and the use of drugs were recorded following a standardized protocol. Logistic regression, with nbDMARDs prescriptions as the dependent variable, was used for bivariable analysis. A multilevel logistic regression model was used to study variability. The probability of receiving an nbDMARD was higher in female patients [OR = 1.548; 95% confidence interval (CI): 1.208-1.984], in those with elevated C-reactive protein (OR = 1.039; 95% CI: 1.012-1.066) and erythrocyte sedimentation rate (OR = 1.012; 95% CI: 1.003-1.021), in those with a higher number of affected peripheral joints (OR = 12.921; 95% CI: 2.911-57.347), and in patients with extra-articular manifestations like dactylitis (OR = 2.997; 95% CI: 1.868-4.809), psoriasis (OR = 2.601; 95% CI: 1.870-3.617), and enthesitis (OR = 1.717; 95% CI: 1.224-2.410). There was a marked variability in the prescription of nbDMARDs for SpA patients, depending on the center (14.3%; variance 0.549; standard error 0.161; median odds ratio 2.366; p < 0.001). After adjusting for patient and center variables, this variability fell to 3.8%. A number of factors affecting variability in clinical practice, and which are independent of disease characteristics, are associated with the probability of SpA patients receiving nbDMARDs in Spain. Copyright © 2014 Elsevier Inc. All rights reserved.
    Full-text · Article · Nov 2014 · Seminars in Arthritis and Rheumatism
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