Due to the fact that the clinical manifestations of AS and nrAxSpA are comparable, it can be assumed that the latter is an early stage of AS.

Aim:The hip joint is the most commonly affected non-axial joint in ankylosing spondylitis (AS). Data on the effects of tumor necrosis factorα inhibitors (TNFi) in AS patients with coxitis are limited. The aim of this study was evaluation of coxitis treated with the TNFi golimumab in real-world settings.Methods: This study was a prospective non-interventional cohort study. A total of 39 patients newly prescribed with golimumab were enrolled and followed for up to 24 months. The data collected included BASFI, BASMI, ASDAS-CRP, BASDAI indices. BASRI-hip X-ray score was assessed at baseline, and at 12 and 24 months. Magnetic resonance imaging (MRI) and ultrasound examination data were obtained at baseline, and at 6 and 12 months.Results: Significant improvements in BASFI, BASMI, ASDAS-CRP, BASDAI scores were observed (P ≤ 0.0001), but the BASRI-hip score remained stable. After 6 months of treatment, MRI signs of joint effusion were found in a smaller percentage of patients compared with baseline (P = 0.005 for the right and P = 0.015 for the left hip joints). After 12 months, this percentage was significantly lower than at baseline for the right hip joint (P = 0.005) and numerically lower for the left hip joint (P = 0.098).Ultrasound showed a significant increase in the percentage of patients without inflammatory changes after 6 and 12 months compared with baseline (right hip joint: P = 0.026 and P = 0.045, respectively; left hip joint: P = 0.026 for both time points). Conclusion:Golimumab therapy in AS patients with coxitis was accompanied by improvement in clinical scores, and in MRI and ultrasound findings without obvious radiographic progress.

The article presents information on the current state of the problem of autoinflammatory diseases (AID) in rheumatology, reflects the clinical and demographic, laboratory and molecular genetic characteristics of the main monogenic AID (mAID), the most common in real clinical practice. Approaches to the diagnosis and differential diagnosis of these conditions are presented. The variants of classification and diagnostic criteria of the most studied mAID are discussed. The principles of treatment with an emphasis on the use of targeted therapy with interleukin 1 (IL1) inhibitors are shown. The clinical examples demonstrate the variants of late diagnosis of the mAID in adult patients with the disease onset in childhood. Different variants of multi-organ damage are considered. Effectiveness of therapy with IL1β inhibitor kanakinumab is demonstrated. Even in such cases it provided the possibility of significant symptoms regression and restoration of a satisfactory quality of life.

The review analyzes the foreign and Russian literature published in the past 30 years and devoted to the diagnosis and treatment of coxitis in ankylosing spondylitis (AS). The results of previous works have revealed the high rate of hip joint injury (HJI) in AS, but it is still unclear which diagnostic technique is the most sensitive for the early detection of coxitis. The latter has been shown to serve as one of the predictors of early disability in patients. The most studied treatment for coxitis is now HJI endoprosthesis, for which indications and contraindications have been clearly developed, while the question of drug therapy remains open.

In Russia, coxitis is one of the most common extra-axial manifestations of ankylosing spondylitis (AS). However, many issues regarding its early diagnosis remain unresolved.Objective: to compare the clinical manifestations of coxitis with the data from an instrumental examination of CoRSAR cohort (Cohort of Early Axial Spondyloarthritis) patients.Patients and methods. Examinations were made in 175 patients (mean age, 28.2±5.7 years) diagnosed as having axial spondyloarthritis (axSpA) with inflammatory back pain lasting up to 5 years, which occurred at the age of ≤45 years. There was non-radiographic axSpA (nraxSpA) in 69 patients and AS in 106 patients. 87% of patients were HLA-B27-positive. The median disease duration was 23.8 [1–60] months; BASDAI was 3.3±1.94. Regardless of complaints, all the patients underwent hip X-ray and ultrasound studies and 54 more patients had magnetic resonance imaging (MRI).Results and discussion. The clinical signs of coxitis were present in 95 (54%) patients, of them 60% were diagnosed with AS and 40% had nraxSpA. According to the numerical pain rating scale (NPRS), the median hip joint pain was 4 [3; 7]. Limited joint movement was observed in 6 (3.4%) patients. The level of hip joint pain correlated with BASDAI (r=0.53) and ASDAS (r=0.30). The ultrasound signs of coxitis were detected in 42 (24%) patients; of them 26 (62%) had the clinical manifestations of hip joint injury, and such changes were absent in 16 patients. The patients with ultrasound signs of coxitis were noted to have a higher disease activity; peripheral arthritis and enthesitis were more common. According to MRI, coxitis was diagnosed in 39 (72%) of the 54 examinees, while the disease was asymptomatic in 10%.Conclusion. Different diagnostic methods used in patients with early axSpA could reveal coxitis in 33% of cases. The patients with coxitis show higher laboratory disease activity than those without hip joint injury. It is necessary to include MRI and ultrasound in the mandatory examination of patients with axSpA.