Managing seronegative spondarthritides

Koehler, L.; Kuipers, Jens G.; Zeidler, Henning

doi:10.1093/rheumatology/39.4.360

Cited by 32 publications

(21 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In late 1970s and early 1980s, our group and the Bath group developed the idea of`indeterminate',`undierentiated', or`unclassi®able' seronegative spondarthritides [2,3,4]. Since then, this entity has been extensively discussed and described, being summarised recently [5,6]. In a European population study, undifferentiated spondylarthropathy (uSpA) was found to be the second most common clinical entity in this group of conditions [7].…”

Section: Introductionmentioning

confidence: 99%

Long-term outcome of undifferentiated spondylarthropathy

Kumar

Bansal

et al. 2001

Rheumatol Int

View full text Add to dashboard Cite

Undifferentiated spondylarthropathy is one of the common disease subsets in the group of so-called seronegative spondarthritides. It is not exactly known how often it differentiates into ankylosing spondylitis or other well-defined disease subsets over time. The present study was designed to find out the long-term outcome in this subset. Thirty-five patients diagnosed with undifferentiated spondylarthropathy between January 1987 and December 1988 were recruited. Twenty-two (63%) of them were available for detailed assessment 11 years after the original diagnosis. Their baseline characteristics did not differ from those of the original cohort of 35 patients and were as follows: male:female ratio 19:3, median age of onset 17 years (range 8-39), and median duration of disease 8 months (range 4-24). Clinical features were enthesitis (45%) and inflammatory pain in the back (100%), buttock (77%), hip (64%), shoulder (18%), knee (82%), ankle (77%), and hand and wrists (50%). There was no restriction in spinal movement. Family history was positive in two cases. Radiologically, the only finding was grade I sacroiliitis in 17 patients (77%). Human leukocyte antigen (HLA)-B27 was positive in all. Functionally, all were in class I. During follow-up, one patient developed psoriatic skin lesions after 9 years. Uveitis developed in four patients (18%). After a median follow-up of 11 years, 15 (68%) had ankylosing spondylitis, one developed psoriatic arthritis, four remained undifferentiated, and two had natural remission. Functionally, 19 patients (86%) were in class I and three (14%) were in class III. No patient had bamboo spine, but three underwent total hip replacement. Thus, a majority of patients (68%) with undifferentiated spondylarthropathy gradually developed ankylosing spondylitis of mild severity.

show abstract

Section: Introductionmentioning

confidence: 99%

Long-term outcome of undifferentiated spondylarthropathy

Kumar

Bansal

et al. 2001

Rheumatol Int

View full text Add to dashboard Cite

show abstract

“…Managing spondyloarthropathies initially involves patient education, physical therapy, and exercise. Pharmacologically, NSAIDs such as diclofenac, naproxen, and meloxicam are first‐line treatments . When NSAIDs are ineffective, pulse therapy with intravenous methylprednisolone 15 mg/kg over a 3‐day period can control acute flare‐ups .…”

Section: Discussionmentioning

confidence: 99%

“…Pharmacologically, NSAIDs such as diclofenac, naproxen, and meloxicam are first-line treatments. 11 When NSAIDs are ineffective, pulse therapy with intravenous methylprednisolone 15 mg/kg over a 3-day period can control acute flare-ups. 12 With chronic disease activity (>3 months), sulphasalazine can be utilized, with effectiveness starting between 4 and 8 weeks of treatment and maximal benefit achieved after 16 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…12 With chronic disease activity (>3 months), sulphasalazine can be utilized, with effectiveness starting between 4 and 8 weeks of treatment and maximal benefit achieved after 16 weeks. 11 After the discovery of tumor necrosis factor-a (TNFa), agents that inhibit TNF-a became a newer, alternate treatment for patients with spondyloarthropathies. Medications such as infliximab and etanercept have been proven to provide symptomatic relief.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cervical Epidural Injection in the Management of Refractory Pain and Stiffness in Spondyloarthropathy: A Case Report Series

2017

View full text Add to dashboard Cite

show abstract

“…Die symptomatische Therapie orientiert sich am Konzept der Spondyloarthritiden und ist ausführlich publiziert [28,29,30].…”

Section: Symptomatische Therapieunclassified

Reaktive Arthritis

Rihl

Kuipers

2010

Z. Rheumatol.

View full text Add to dashboard Cite

Reactive arthritis (ReA) was first described 100 years ago. It is defined as a sterile joint inflammation following a primary, extra-articular infection often in the form of urethritis or enteritis and less frequently respiratory infection and is characterized by the presence of bacterial antigens or non-culturable bacteria in the joint,. The prevalence is estimated to be 40/100,000 adults, while the incidence is 4-5/100,000. The classic HLA-B27-associated form with asymmetric involvement of the lower extremities and/or the spine is part of the spondyloarthritis concept. The phenomenon of persistence, which will be discussed in detail herein, plays an important role in the pathogenesis of ReA. Up to 30% of patients develop chronic symptoms posing a therapeutic challenge. Combination antibiotic treatment showing a response in up to 63% of patients has recently been proposed. Biologics could represent an alternative therapeutic option for patients showing a severe and highly active disease course.

show abstract

Managing seronegative spondarthritides

Cited by 32 publications

References 30 publications

Long-term outcome of undifferentiated spondylarthropathy

Long-term outcome of undifferentiated spondylarthropathy

Cervical Epidural Injection in the Management of Refractory Pain and Stiffness in Spondyloarthropathy: A Case Report Series

Reaktive Arthritis

Contact Info

Product

Resources

About