The Journal of Musculoskeletal Medicine.
ACR2012 Highlights: Ankylosing Spondylitis
December 10, 2012In reports to the American College of Rheumatology meeting in Washington last month, there werereports on a phase III trial of a new treatment, studies showing failed and useful measures for severityanalysis and diagnosis, and a new study on risk of fractures. (Click on the abstract numbers to read theabstract of the presentation online.)•
Certolizumab pegol, a monoclonal antibody to TNF, reduced signs and symptoms of axial
The RAPID-axSpA phase III trial is following 325
spondyloarthritis, including spinal mobility.
patients for 158 weeks, and was placebo-controlled for 24 weeks. By week 12, 63.6% of higher-dosecertolizumab patients, vs. 38.3% placebo, had a response of ASAS20 (the primary endpoint). By week 24, the response was 70.1% vs. 29.0%, respectively. ASAS40 and partial remission rates were alsohigher with certolizumab. Improvements were confirmed by MRI at baseline and week 12. Responsewas similar in ankylosing spondylitis and non-radiographic axial spondyloarthritis. Serious infectionsoccurred in 1.1% of certolizumab patients, but no deaths, TB or cancers. (Abstracts and )#777#1705•
After axial spondyloarthritis has been diagnosed with MRI of the sacroiliac joints, an additional
After 130 consecutive patients with back pain were assigned by
MRI of the spine has little value.
clinical examination and pelvic radiology as either non-radiographic axial spondyloarthritis, ankylosingspondylitis,, or mechanical back pain, they and 20 healthy controls were given sacroiliac joint and spinalMRIs. Three blinded readers assessed the sacroiliac joint MRI alone, the spinal MRI alone, and bothtogether. Only two (4%) of the patients who were negative on sacroiliac joint MRI were reclassified asnon-radiographic axial spondyloarthritis with the addition of spinal MRI, but three (15%) of healthycontrols were rated as having spondyloarthritis based on spinal MRI scan alone. (Abstract #)778•
Patients with ankylosing spondylitis are at 18% higher risk of osteoporotic fracture related to
The Spanish SIDIAP
oral corticosteroids, and at almost twice the risk of clinical spine fractures.
database contains anonymized medical and pharmacy records of more than 4.9 million people (80% of the population). A European group identified 6,474 patients 15 years or older who had a diagnosis of ankylosing spondylitis, as well as 32,346 controls, and followed them for a median of six years.Osteoporotic and clinical spine fracture rates per 1,000 person-years were 9.64 and 2.12, respectively,among ankylosing spondylitis patients, compared to 8.05 and 1.05 among controls. (Abstract #)781•
Elevated vascular endothelial growth factor (VEGF) is highly predictive of new syndesmophyte
Fifty-four patients from the German Spondyloarthritis Inception
formation in ankylosing spondylitis.
The Journal of Musculoskeletal Medicine. Vol. No. December 10, 2012