Increase In Il-31 Serum Levels Is Associated With Reduced Structural Damage In Early Axial Spondyloarthritis

Un nouvel article scientifique intitulé «Increase In Il-31 Serum Levels Is Associated With Reduced Structural Damage In Early Axial Spondyloarthritis.» a été publié dans le journal Sci Rep.

Rosine N, Etcheto A, Hendel-Chavez H, Seror R, Briot K, Molto A, Chanson P, Taoufik Y, Wendling D, Lories R, Berenbaum F, van den Berg R, Claudepierre P, Feydy A, Dougados M, Roux C, Miceli-Richard C.

ABSTRACT:

In spondyloarthritis, little is known about the relation between circulating cytokines and patient phenotype. We have quantified serum levels of T helper type 1 cell (Th1), Th2 and Th17 cytokines in patients with recent-onset axial spondyloarthritis (AxSpA) from the DESIR cohort, a prospective, multicenter French cohort consisting of 708 patients with recent-onset inflammatory back pain (duration >3 months but <3 years) suggestive of AxSpA. Serum levels of Th1, Th2, and Th17 cytokines were assessed at baseline in patients from the DESIR cohort fulfilling the ASAS criteria (ASAS+) and were compared with age- and sex-matched healthy controls. At baseline, ASAS+ patients (n = 443) and healthy controls (n = 79) did not differ in levels of most of the Th1, Th2 and Th17 cytokines except for IL-31, and sCD40L, which were significantly higher for ASAS+ patients than controls (p < 0.001 and p = 0.012, respectively). On multivariable analysis of ASAS+ patients, IL-31 level was associated with sCD40L level (p < 0.0001), modified Stoke AS Spine Score (mSASSS) < 1 (p = 0.035). The multivariable analyses showed that IL-31 was an independent factor associated with mSASSS < 1 (p = 0.001) and low bone mineral density (p = 0.01). Increased level of IL-31 might protect against structural damage but is also related to low BMD.

Adherence to recommendations for the use of anti-tumour necrosis factor and its impact over 5 years of follow-up in axial spondyloarthritis.

Un nouvel article scientifique intitulé «Adherence to recommendations for the use of anti-tumour necrosis factor and its impact over 5 years of follow-up in axial spondyloarthritis.» a été publié dans le journal Rheumatology (Oxford).

López-Medina C, Dougados M, Collantes-Estévez, Moltó A.

Abstract

OBJECTIVES:
To describe adherence to recommendations for TNFα blocker (TNFb) initiation and continuation in early axial Spondyloarthropathy (axSpA); and to evaluate the impact of adherence to these recommendations over 5 years of follow-up in the DEvenir des Spondyloarthrites Indifférenciées Récentes (DESIR) cohort.

METHODS:
The first 5 years of follow-up of the DESIR early axSpA cohort were analysed. We evaluated adherence to Assessment of SpondyloArthritis International Society (ASAS) 2003/2006, 2016 and European Medicines Agency recommendations in axSpA patients for: TNFb initiation (patients were adherent if they either commenced TNFb therapy when they met the conditions for initiation or if they did not commence TNFb therapy when conditions were not met) and; TNFb continuation (either when they continued TNFb therapy when conditions to continue were met or when they discontinued when conditions were not met). The impact of adherence to these recommendations on functional disability, quality of life and sick-leave days over 5 years was explored.

RESULTS:
A total of 708 patients were analysed: 440 (62.15%), 389 (54.94%) and 335 (47.32%) were considered adherent to ASAS 2003/2006, 2016 and European Medicines Agency recommendations for TNFb initiation, respectively. Adherence to 2003/2006 and 2016 recommendations for TNFb continuation was observed in 47.37 and 49.39% of patients, respectively. According to over 5 years of follow-up, better outcomes (lower BASFI, higher SF-36 and fewer days of sick leave) were found in patients adhering to recommendations for TNFb commencement and continuation.

CONCLUSION:
Less than 50% of patients were treated in agreement with recommendations for TNFb initiation and continuation. Nevertheless, adherence to such recommendations leads to better functional outcomes and fewer days of sick leave, according to long-term follow-up.

In patients with axial spondyloarthritis, inflammation on MRI of the spine is longitudinally related to disease activity only in men: 2 years of the axial spondyloarthritis DESIR cohort

Un nouvel article scientifique intitulé  » In patients with axial spondyloarthritis, inflammation on MRI of the spine is longitudinally related to disease activity only in men: 2 years of the axial spondyloarthritis DESIR cohort  » a été publié dans le journal Ann Rheum Dis.

Navarro-Compán V, Ramiro S, Landewé R3, Dougados M, Miceli-Richard C, Richette P, van der Heijde D.

Ann Rheum Dis. 2017 Mar 3. pii: annrheumdis-2016-210697. doi: 10.1136/annrheumdis-2016-210697. [Epub ahead of print]

KEYWORDS:

Disease Activity; Magnetic Resonance Imaging; Spondyloarthritis

Newsletter Radiologues N°6

Bonjour,
Nous mettons en ligne aujourd’hui la nouvelle Newsletter rhumatologues rédigée par le Dr A. Feydy, rhumatologue à Cochin .
Pour y avoir accès, merci de consulter le lien suivant: cliquer ici.

Newsletter Rhumatologues N°27

Bonjour,
Nous mettons en ligne aujourd’hui la nouvelle Newsletter rhumatologues rédigée par le Pr F Berenbaum, rhumatologue à Saint Antoine .
Pour y avoir accès, merci de consulter le lien suivant: cliquer ici.

Newsletter Patient N°18

Bonjour,
Nous mettons en ligne aujourd’hui la nouvelle Newsletter patients rédigée par le Pr C Miceli, rhumatologue au CHU de Cochin.
Pour y avoir accès, merci de cliquer ici.

Newsletter Patient N°17

Nous mettons en ligne aujourd’hui la nouvelle Newsletter patients rédigée par le Pr L. Gossec, rhumatologue au CHU La pitié Salpêtrière.
Pour y avoir accès, merci de cliquer ici.

Newsletter Patient N°16

Bonjour,
Nous mettons en ligne aujourd’hui la nouvelle Newsletter patients rédigée par le Pr P Claudepierre , rhumatologue au CHU Henri Mendor.
Pour y avoir accès, merci de cliquer ici.

Evaluation of the change in structural radiographic sacroiliac joint damage after 2 years of etanercept therapy (EMBARK trial) in comparison to a contemporary control cohort (DESIR cohort) in recent onset axial spondyloarthritis

Un nouvel article scientifique intitulé «Evaluation of the change in structural radiographic sacroiliac joint damage after 2 years of etanercept therapy (EMBARK trial) in comparison to a contemporary control cohort (DESIR cohort) in recent onset axial spondyloarthritis.» a été publié dans le journal Ann Rheum Dis .

Dougados M, Maksymowych W, Landewé RB, Moltó A, Claudepierre P, de Hooge M, Lambert RG, Bonin R, Bukowski JF, Jones HE, Logeart I, Pedersen R, Szumski A, Vlahos B, van der Heijde D.

Abstract

OBJECTIVE:

To compare 2 years of radiographic sacroiliac joint (SIJ) changes in patients with recent onset axial spondyloarthritis (axSpA) receiving etanercept in a clinical trial (EMBARK) to similar patients not receiving biologics in a cohort study (DESIR).

METHODS:

Endpoints were changes at week 104 per the modified New York (mNY) grading system in total SIJ score (primary endpoint) and net percentage of patients with progression defined three ways. Treatment effect was analysed with and without adjustment for baseline covariates.

RESULTS:

At 104 weeks, total SIJ score improved in the etanercept group (n=154, adjusted least-squares mean change: -0.14) and worsened in the control group (n=182, change: 0.08). The adjusted difference between groups (etanercept minus control) was -0.22 (95% CI -0.38 to -0.06), p=0.008. The net percentage of patients with progression was significantly lower in the etanercept versus the control group for two of three binary endpoints: -1.9% versus 1.6% (adjusted difference for etanercept minus control: -4.7%,95% CI -9.9 to 0.5, p=0.07) for change in mNY criteria; -1.9% versus 7.8% (adjusted difference: -18.2%,95% CI -30.9 to -5.6, p=0.005) for change ≥1 grade in ≥1 SIJ; and -0.6% versus 6.7% (adjusted difference: -16.4%,95% CI -27.9 to -5.0, p=0.005) for change ≥1 grade in ≥1 SIJ, with shift from 0 to 1 or 1 to 0 considered no change.

CONCLUSION:

Despite the slow radiographic SIJ progression rate over 2 years in axSpA, this study suggests a lower rate of progression in the SIJ with etanercept than without anti-tumour necrosis factor therapy.
TRIAL REGISTRATION NUMBERS:

NCT01258738,NCT01648907; Post-results.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

KEYWORDS:

anti-tnf; spondyloarthritis; treatment

Classification criteria versus physician’s opinion for considering a patient with inflammatory back pain as suffering from spondyloarthritis

Un nouvel article scientifique intitulé «Classification criteria versus physician’s opinion for considering a patient with inflammatory back pain as suffering from spondyloarthritis.» a été publié dans le journal Joint Bone Spine.

Gazeau P, Cornec D, Timsit MA, Dougados M, Saraux A.

Abstract

OBJECTIVE:

To assess agreement among methods for classifying patients with inflammatory back pain (IBP) after a 2-year follow-up.

METHODS:

Patients with IBP in the French nationwide, longitudinal, prospective cohort DESIR were classified after 2years based on imaging findings, rheumatologist’s confidence in a diagnosis of spondyloarthritis, three classification criteria sets (axial Assessment of Spondyloarthritis international Society [ASAS], European Spondylarthropathy Study Group [ESSG], and Amor) and treatment (TNFα antagonists). Agreement among these methods was assessed by computing the percentage of concordant classifications and Cohen’s kappa coefficient. Using logistic regression, we identified the items most strongly associated with rheumatologist’s confidence.

RESULTS:

Agreement among criteria sets was poor (kappa<0.6), even in the group with inflammation by magnetic resonance imaging. Of 708 patients, 541 had all available data including rheumatologist’s confidence after 2years, which was 0/10 for 31 (5.7%) patients, 1/10 to 7/10 for 158 (29.2%) patients, 8/10 or 9/10 for 167 (30.9%) patients, and 10/10 for 185 (34.2%) patients. TNFα antagonists were used in 156/356 (43.8%) patients in the two highest confidence groups versus 53/188 (28.2%) patients in the two lowest confidence groups. Factors independently associated with confidence ≥8/10 were fulfilment of ASAS, ESSG, and Amor criteria.

CONCLUSION:

Confidence of rheumatologists in the diagnosis of spondyloarthritis in patients with recent-onset IBP shows limited agreement with classification criteria. The best way to currently classify spondyloarthritis should be the association of both at least one classification criteria and a diagnosis of spondyloarthritis according to the rheumatologist.

KEYWORDS:

Ankylosing spondylitis; Axial spondyloarthritis; Sacro-iliitis