Impairment in cognitive function in patients with axial spondyloarthritis and psoriatic arthritis

Kleinert, Stefan; Schuch, Florian; Rapp, Praxedis; Ronneberger, Monika; Wendler, J.; Sternad, Patrizia; Popp, Florian; Bartz‐Bazzanella, Peter; Decken, Cay von der; Karberg, Kirsten; Gauler, Georg; Wurth, Patrick; Späthling-Mestekemper, Susanna; Kuhn, Christoph; Englbrecht, Matthias; Vorbrüggen, Wolfgang; Adler, Georg; Welcker, Martin

doi:10.1007/s00296-022-05248-4

Cited by 5 publications

(2 citation statements)

References 38 publications

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“…Those suffering from dementia with Lewy bodies may present with core diagnostic features of fluctuating cognition with pronounced variations in attention and alertness, visual hallucinations or parkinsonism onset subsequent to cognitive decline, and/or display significant antipsychotic sensitivity or REM sleep behaviours that have onset years before the cognitive impairment 8. There is also literature to suggest that patients with ankylosing spondylitis experience deficits in selective attention 9. Although this may be contributory, her deficits extend beyond expectations in terms of scope and severity.…”

Section: Differential Diagnosismentioning

confidence: 99%

Chronic high-dose dimenhydrinate use contributing to early multifactorial cognitive impairment

Fabiano,

Dholakia,

Walker

et al. 2024

BMJ Case Rep

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Dimenhydrinate is an over-the-counter antihistaminergic medication with anticholinergic properties used to treat nausea or motion sickness worldwide. There is a well-established correlation between the use of anticholinergic medications and dementia, however, it is unclear if a causal role exists. We report a case of minor neurocognitive disorder in a woman in her 40s with several years of high-dose daily dimenhydrinate abuse who subsequently developed significant delusional beliefs. Her clinical presentation was confounded by numerous other factors that could have impacted her cognition, such as a longstanding presumed learning disability, ankylosing spondylitis with adalimumab treatment, extensive cannabis use or potential development of a primary psychotic disorder. Her workup was within normal limits, and she has not responded to first-line antipsychotic medications to date. This case report adds to the growing evidence supporting concerns about potentially irreversible cognitive deficits in chronic misuse of anticholinergic agents, an association previously observed only in the elderly population.

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Section: Differential Diagnosismentioning

confidence: 99%

Chronic high-dose dimenhydrinate use contributing to early multifactorial cognitive impairment

Fabiano,

Dholakia,

Walker

et al. 2024

BMJ Case Rep

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“…Было показано, что пациенты с р-аксСпА и нр-аксСпА сходны по клиническим проявлениям, но первые, как правило, имеют больше структурных повреждений. Примерно в 10-40% случаев нр-аксСпА прогрессирует до р-аксСпА в течение 2-10 лет [4].…”

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Results of a non-interventional multicenter study of management of patients with non-radiological axial spondyloarthritis in real-life clinical practice in the Russian Federation (NiSpAR)

Dubinina,

Lila,

Kvasova

et al. 2024

Sovremennaâ revmatologiâ

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NiSpAR is a non-interventional, multicenter study whose aim was to describe a cohort of patients with non-radiological axial spondyloarthritis (nr-axSpA) and approaches to its diagnosis in the Russian Federation.Material and methods. The study involved 20 research centers in different regions of the Russian Federation. The work consisted of two phases: retrospective data collection 12 months before enrolment in the study and prospective observation of patients in whom the diagnosis of nr-axSpA was confirmed (104 weeks).The study included 272 patients who met the inclusion and exclusion criteria (Full Analysis Set, FAS). The mean age of the FAS-population was 38.7±11.0 years. The diagnosis of nr-axSpA was confirmed in 159 (58.5 %) of the 272 patients. Of the remaining 113 (41.5%) participants, 57 (50.4%) did not have the information required to confirm the diagnosis, 34 (30.1%) did not have pelvic radiographs, and 22 (19.5%) did not fulfil the ASAS criteria for nr-axSpA.Results and discussion. The mean age of patients with nr-axSpA was 37.6±10.4 years, more than half of them (52.8%) were women. The median disease duration was 36 [12; 80] months. In half of the patients the disease duration was more than 2 years, in more than one third – less than 2 years. The median CRP and ESR values were 5.0 [2.0; 12.0] mg/l and 11.0 [5.0; 18.0] mm/h, respectively. The BASDAI averaged 3.5±2.0 and was >4 in more than half of the cases (64.2%). The mean ASDAS-CRP value reached 2.6±1.1. Only 1 in 5 participants (20.8%) had low axSpA activity, while in 61.1% it was high (44.7%) or very high (16.4%). An inactive state was found in a small number of patients (9.4%). Twenty two (13.8%) patients had treatment with biologic disease-modifying antirheumatic drugs (bDMARDs) in anamnesis, and 21 (13.2%) patients were still taking them.Conclusion. The results of the retrospective phase of the study show that in real-life clinical practice in the Russian Federation there is a continued positive trend towards improving the diagnosis of nr-axSpA. The median duration of the disease at the time of enrolment in the study was 3 years. The frequency of use of magnetic resonance imaging has increased by more than 1.8 times. At the same time, practitioners still have difficulties in establishing the diagnosis of nr-axSpA and a shortage of bDMARDs for treatment of these patients.

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Radiographic and non-radiographic axial spondyloarthritis are not routinely distinguished in everyday clinical care: an analysis of real-world data from rheumatology practices

Kleinert,

Schuch,

Rapp

et al. 2023

Rheumatol Int

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Impairment in cognitive function in patients with axial spondyloarthritis and psoriatic arthritis

Cited by 5 publications

References 38 publications

Chronic high-dose dimenhydrinate use contributing to early multifactorial cognitive impairment

Chronic high-dose dimenhydrinate use contributing to early multifactorial cognitive impairment

Results of a non-interventional multicenter study of management of patients with non-radiological axial spondyloarthritis in real-life clinical practice in the Russian Federation (NiSpAR)

Radiographic and non-radiographic axial spondyloarthritis are not routinely distinguished in everyday clinical care: an analysis of real-world data from rheumatology practices

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