SIGNIFICANCE OF PERIPHERAL ARTHRITIS IN ANKYLOSING SPONDYLITIS
https://doi.org/10.14412/1995-4484-2014-295-299
Abstract
Objective: to elucidate the role of peripheral arthritis in ankylosing spondylitis (AS) and its impact on therapy choice in daily practice of rheumatologists.
Subjects and methods. The investigation enrolled 330 consecutive patients with AS referred to rheumatologists during 4 months in 24 cities and towns of the Russian Federation. A specially designed clinical schedule was filled out for all the patients.
Results. Peripheral arthritis was present in 47% of patients, including in 17 and 46% who had upper and lower limb joint involvement, respectively. Patients with peripheral arthritis had higher ESR, BASDAI and ASDAS-ESR levels. They were also found to have more marked functional disorders than the patients with its isolated axial variant. The clinical signs of hip joint involvement were detected in 56% of the patients and they were bilateral in 43%. In the rheumatologists' opinion, 24 (8%) needed total hip joint replacement.
Conclusion. Peripheral arthritis aggravates AS.
About the Authors
Sh. F. ErdesRussian Federation
E. V. Volnukhin
Russian Federation
References
1. Baek HJ, Shin KC, Lee YJ, et al. Clinical features of adult-onset ankylosing spondylitis in Korean patients: patients with peripheral joint disease (PJD) have less severe spinal disease course than those without PJD. Rheumatology (Oxford). 2004;43(12):1526–31. DOI: http://dx.doi.org/10.1093/rheumatology/keh373.
2. Rojas-Vargas M, Munoz-Gomariz E, Escudero A, et al. First signs and symptoms of spondyloarthritis – data from an inception cohort with a disease course of two years or less (REGISPONSER-Early). Rheumatology (Oxford). 2009;48(4):404–9. DOI: http://dx.doi.org/10.1093/rheumatology/ken506.
3. Singh G, Lawrence A, Agarwal V, et al. Higher prevalence of extraarticular manifestations in ankylosing spondylitis with periph- eral arthritis. J Clin Rheumatol. 2008 Oct;14(5):264–6. DOI: http://dx.doi.org/10.1097/RHU.0b013e31817b8789.
4. Aggarwal R, Malaviya AN. Clinical characteristics of patients with ankylosing spondylitis in India. Clin Rheumatol. 2009;28(10):1199–205. DOI: 10.1007/s10067-009-1227-7. Epub 2009 Jul 18.
5. Boonen A, Cruyssen BV, de Vlam K, et al. Spinal radiographic changes in ankylosing spondylitis: association with clinical charac- teristics and functional outcome. J Rheumatol. 2009;36(6):1249–55. DOI: 10.3899/jrheum.080831. Epub 2009 May 15.
6. Vander Cruyssen B, Munoz-Gomariz E, Font P, et al. Hip involvement in ankylosing spondylitis: epidemiology and risk factors associated with hip replacement surgery. Rheumatology (Oxford). 2010;49(1):73–81. DOI: http://dx.doi.org/10.1093/rheumatology/kep174.
7. Amor B, Santos RS, Nahal R, et al. Predictive factors for the longterm outcome of spondyloarthropathies. J Rheumatol. 1994;21(10):1883–7.
8. Strobel ES, Fritschka E. Renal diseases in ankylosing spondylitis: review of the literature illustrated by case reports. Clin Rheumatol. 1998;17(6):524–30. DOI: http://dx.doi.org/10.1007/BF01451293.
9. Braun J, Pincus T. Mortality, course of disease and prognosis of patients with ankylosing spondylitis. Clin Exp Rheumatol. 2002;20(6 Suppl 28):S16–22.
10. Claudepierre P, Sibilia J, Goupille P, et al. Evaluation of a French ver- sion of the Bath Ankylosing Spondylitis Disease Activity Index in patients with spondyloarthropathy. J Rheumatol. 1997;24(10):1954–8.
11. Heuft-Dorenbosch L, van Tubergen A, Spoorenberg A, et al. The influence of peripheral arthritis on disease activity in ankylosing spondylitis patients as measured with the Bath Ankylosing Spondylitis Disease Activity Index. Arthritis Rheum. 2004;51(2):154–9. DOI: http://dx.doi.org/10.1002/art.20233.
12. Song IH, Rudwaleit M, Listing J, Sieper J. Comparison of the Bath Ankylosing Spondylitis Disease Activity Index and a modified version of the index in assessing disease activity in patients with ankylosing spondylitis without peripheral manifestations. Ann Rheum Dis. 2009;68(11):1701–7. DOI: http://dx.doi.org/10.1136/ard.2008.099226.
13. Hakkou J, Rostom S, Aissaoui N, et al. Comparison of the BASDAI and the mini-BASDAI in assessing disease activity in patients with ankylosing spondylitis. Clin Rheumatol. 2012;31(3):441–5. DOI: http://dx.doi.org/10.1007/s10067-011-1872-5.
14. Braun J, van den Berg R, Baraliakos X, et al. 2010 update of the ASAS/EULAR recommendations for the management of ankylos- ing spondylitis. Ann Rheum Dis. 2011;70(6):896–904. DOI: http://dx.doi.org/10.1136/ard.2011.151027.
15. Chen J, Liu C. Methotrexate for ankylosing spondylitis. Cochrane Database Syst Rev. 2004;(3):CD004524.
16. Haibel H, Brandt HC, Song IH, et al. No efficacy of subcutaneous
17. methotrexate in active ankylosing spondylitis: a 16-week open- label trial. Ann Rheum Dis. 2007;66(3):419–21. DOI: http://dx.doi.org/10.1136/ard.2006.054098.
18. Ревматология. Национальное руководство. Под ред. Е.Л. Насонова, В.А. Насоновой. Москва: ГЭОТАР-Медиа; 2008. 336 с. [Nasonov EL, Nasonova VA, editors. Revmatologiya. Natsional'noe rukovodstvo [Rheumatology. National Guide]. Moscow: GEOTAR-media; 2008. 336 p.]
19. Волнухин ЕВ, Галушко ЕА, Бочкова АГ и др. Клиническое многообразие анкилозирующего спондилита в реальной практике врача-ревматолога в России (Часть 1). Научно- практическая ревматология. 2012;51(2):44–9. [Volnukhin EV, Galushko EA, Bochkova AG, et al. Clinical diversity of ankylosing spondylitis in the real practice of a rheumatologist in Russia (Part 1). Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2012;51(2):44–9. (In Russ.)]. DOI: http://dx.doi.org/10.14412/1995-4484-2012-1272.
20. Vander Cruyssen B, Ribbens C, Boonen A, et al. The epidemiology of an-kylosing spondylitis and the commencement of anti-TNF therapy in daily rheumatology practice. Ann Rheum Dis. 2007;66(8):1072–7. DOI: http://dx.doi.org/10.1136/ard.2006.064543.
21. Deesomchok U, Tumrasvin T. Clinical study of Thai patients with ankylosing spondylitis. Clin Rheumatol. 1985 Mar;4(1):76–82. DOI: http://dx.doi.org/10.1007/BF02032322.
22. Wanders A, Heijde D, Landewe R, et al. Nonsteroidal antiinflam- matory drugs reduce radiographic progression in patients with ankylosing spondylitis: a randomized clinical trial. Arthritis Rheum. 2005;52(6):1756–65. DOI: http://dx.doi.org/10.1002/art.21054.
23. Collantes E, Zarco P, Munoz E, et al. Disease pattern of spondy- loarthropathies in Spain: description of the first national registry (REGISPONSER) extended report. Rheumatology (Oxford). 2007;46(8):1309–15. DOI: http://dx.doi.org/10.1093/rheumatol- ogy/kem084.
24. Clegg DO, Reda DJ, Weisman MH, et al. Comparison of sulfasalazine and placebo in the treatment of ankylosing spondylitis. A department of veterans affairs cooperative study. Arthritis Rheum. 1996;39(12):2004–12. DOI: http://dx.doi.org/10.1002/art.1780391209.
25. Schmidt WA, Wierth S, Milleck D, et al. Sulfasalazine in ankylos- ing spondylitis: a prospective, randomized, double-blind placebo- controlled study and comparison with other controlled studies. J Rheumatol. 2002 Apr;61(2):159–67. DOI: http://dx.doi.org/10.1007/s003930200024.
26. Chen J, Liu C. Sulfasalazine for ankylosing spondylitis. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD004800.
27. Braun J, Zochling J, Baraliakos X, et al. Efficacy of sulfasalazine in patients with inflammatory back pain due to undifferentiated spondyloarthritis and early ankylosing spondylitis: a multicenter ran- domised controlled trial. Ann Rheum Dis. 2006;65(9):1147–53. DOI: http://dx.doi.org/10.1136/ard.2006.052878. Epub 2006 Apr 10.
28. Gonzalez-Lopez L, Garcia-Gonzalez A, Vazquez-Del-Mercado M, et al. Efficacy of methotrexate in ankylosing spondylitis: a ran- domized, double blind, placebo controlled trial. J Rheumatol. 2004;31(8):1568–74.
29. Оригинальные исследования
Review
For citations:
Erdes Sh.F., Volnukhin E.V. SIGNIFICANCE OF PERIPHERAL ARTHRITIS IN ANKYLOSING SPONDYLITIS. Rheumatology Science and Practice. 2014;52(3):295-299. (In Russ.) https://doi.org/10.14412/1995-4484-2014-295-299