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Patients with non-radiographic axial spondyloarthritis differ from patients with ankylosing spondylitis in several aspects.
MedLine Citation:
PMID:  22505331     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Patients with axial spondyloarthritis (SpA) who have structural changes in the sacroiliac joints and/or the spine have been classified as ankylosing spondylitis (AS) while those without such changes are now named non-radiographic axial SpA (nr-axSpA). The differentiating features are incompletely understood. METHODS: Data of 100 consecutive patients with axial SpA not treated with TNF antagonists were compared clinically and with laboratory parameters, spinal x-rays and MRI of the spine. Standardized clinical assessment tools were used to assess health status. RESULTS: AS was diagnosed in 56 and nr-axSpA in 44 patients. Signs of inflammation were significantly higher in patients with AS than in patients with nr-axSpA, with a median CRP of 8.0 in AS patients compared with 3.8 in nr-axSpA, median ASDAS (2.2 vs. 2.8), median amount of spinal inflammatory lesions on MRI (2.0 vs. 0.0). Significant differences between these two groups were seen in gender (76.8% vs. 31.8% male). Clinical variables did not differ between patients with AS and nr-axSpA (BASDAI, BASFI, ASQoL, SF-36). CONCLUSION: Patients with nr-axSpA are characterized by the low proportion of males and the low burden of inflammation compared to AS patients. While both groups do not differ regarding health status, disease activity and physical function, they do differ in signs of inflammation - all were higher in patients with AS. Since many patients with nr-axSpA had not developed structural changes after years of symptoms, we propose that those patients should not be regarded as pre-radiographic AS but rather as nr-axSpA. © 2012 by the American College of Rheumatology.
Authors:
Uta Kiltz; Xenofon Baraliakos; Pantelis Karakostas; Manfred Igelmann; Ludwig Kalthoff; Claudia Klink; Dietmar Krause; Elmar Schmitz-Bortz; Martina Flörecke; Matthias Bollow; Jürgen Braun
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-13
Journal Detail:
Title:  Arthritis care & research     Volume:  -     ISSN:  2151-4658     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 by the American College of Rheumatology.
Affiliation:
Rheumazentrum Ruhrgebiet, Landgrafenstr. 15, 44652 Herne, Germany. kiltz@rheumazentrum-ruhrgbiet.de.
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