Pos1008 the Role of Serum Calprotectin in the Diagnosis of Inflammatory Bowel Disease in Patients With Ankylosing Spondylitis

Kulakova, P.; Lukina, G.; Alexandrova, E.; Новиков, А. А.; Klimets, A.; Savenkova, N.; Kovshik, A.; Volnukhin, E.

doi:10.1136/annrheumdis-2021-eular.3584

Cited by 2 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…SC is exposed to proteolytic enzymes, but its level also increases with inflammation in the intestine and is associated with a higher disease activity [2]. SC levels positively correlate with CRP, ESR, disease activity in AS, but not as obvious as with FC [3,4]. Objectives: The aim of this study was to evaluate the possibility of using SC in the diagnosis of IBD in patients with AS.…”

Section: Discussionmentioning

confidence: 99%

Pos1007 optimizing a Referral Strategy for Patients With a High Probability of Axial Spondyloarthritis: The Role of Age and Symptom Duration

Proft

Spiller

Muche

et al. 2021

Annals of the Rheumatic Diseases

View full text Add to dashboard Cite

Background:One of the most important prerequisites for a timely diagnosis of axial spondyloarthritis (axSpA) is the early referral of a patient with back pain to a rheumatologist. In the past years a number of referral strategies has been proposed, most of them in line with the ASAS referral recommendations [1] and with a similar performance – about 30-40% of the referred patients can be diagnosed with axSpA after examination by a rheumatologist. In addition to physician-based strategies, an online self-referral (OSR) strategy has been recently proposed and evaluated about 20% of the patients being diagnosed with axSpA after rheumatologic evaluation [2].Objectives:The objective of the current analysis was to investigate the role of age and symptom duration for the optimization of a physician-based and an OSR strategy for axSpA.Methods:In the OptiRef study, patients with chronic back pain and suspicion of axSpA either referred by primary care physicians /orthopedists using the Berlin referral tool (=physician based) or based on a referral recommendation of an OSR were evaluated by rheumatologists in a specialized center [2]. All patients underwent a structured examination including imaging that resulted into the final diagnosis of axSpA or no axSpA. The relationship between age, symptom duration and the likelihood of axSpA diagnosis was evaluated in this analysis.Results:A total of 360 patients (180 presented via the OSR and 180 referred by the physician based referral strategy) were included in this analysis. Patient’s characteristics are shown in Table 1. A total of 71 patients (39.4%) in the physician-based group and 35 patients (19.4%) in the OSR group were finally diagnosed with axSpA. The heatmaps depicting the relationship between the proportions of patients diagnosed with axSpA and age plus symptom duration (Figure 1) showed a clear decline of the axSpA probability with increasing age. In the physician-referred group, however, axSpA was diagnosed even in patients who were above 50 years at the time-point of the examination, while there were only few patients with axSpA in the self-referred group aged 40-49 years, and none in the age group ≥50 years. Interestingly, there was no clear relationship between symptom duration and probability of the diagnosis: axSpA was diagnosed in a substantial proportion of patients even with a long history of back pain (>12 years) in both subgroups.Conclusion:The probability of axSpA is high in patients suffering from back pain and aged <40 years with a substantial decline thereafter. Therefore, a referral strategy based on self-evaluation of symptoms should be more focused on a younger patient population, while physician-based strategies do not require such a restriction.References:[1]Poddubnyy D, et al. Ann Rheum Dis 2015 Aug; 74(8):1483-1487.[2]Proft F, et al. Semin Arthritis Rheum. 2020; 50(5):1015-1021.Table 1.Patient characteristicsTotalN=360Berlin toolN=180Self-referralN=180p-valueDiagnosis of axial SpA, n (%)106 (29.4%)71 (39.4%)35 (19.4%)<0.0001Age, years, mean (SD)36.9 (10.4)37.2 (11.5)36.6 (9.2)>0.99Male sex, n (%)177 (49.2%)100 (55.6%)77 (42.8%)0.02Back pain duration, years, mean (SD)7.9 (7.6)6.5 (6.9)9.2 (8.1)<0.0001HLA-B27 positive, n (%)141 (40.9%)104 (59.8%)37 (21.6%)<0.0001CRP elevation, n (%)52 (14.8%)34 (19.4%)18 (10.2%)0.02Inflammatory back pain, n (%)204 (56.7%)103 (57.2%)101 (56.1%)0.92Figure 1.Heatmaps depicting the proportions of patients diagnosed with axSpA in relation to age and symptom duration in the physician-based (A) and OSR (B) groups.Acknowledgements:We would like to thank all orthopaedists and primary care physicians who referred their patients. Further, we thank Dr. Anne-Katrin Weber and Dr. Susanne Lüders for the data collection support, Annegret Langdon for the data management support and Torsten Karge for set-up and support of the online screening tool.Funding statementThe OptiRef study was supported by an unrestricted research grant from Novartis.Disclosure of Interests:None declared.

show abstract

Section: Discussionmentioning

confidence: 99%

Pos1007 optimizing a Referral Strategy for Patients With a High Probability of Axial Spondyloarthritis: The Role of Age and Symptom Duration

Proft

Spiller

Muche

et al. 2021

Annals of the Rheumatic Diseases

View full text Add to dashboard Cite

show abstract

“…Указанные белки определяются в биологических средах в повышенной концентрации, отражая тяжесть заболевания. Что касается фекального кальпротектина, то он выступает как предиктор рецидива ВЗК, а у лиц со СпА как предиктор развития поражения кишечника [41,42]. Вероятность возникновения суставных поражений при ВЗК отражает такой маркер как хрящевой гликопротеин 39: повышение его уровня наблюдалось у пациентов с клинически манифестным артритом [43].…”

Section: патогенетические аспекты ассоциации взк и спаunclassified

Immuno-mediated comorbidity: clinical and pathogenetic aspects of the inﬂ ammatory bowel diseases and spondyloarthritis association

Бабаева

Осадчук

Солоденкова

et al. 2022

jour

View full text Add to dashboard Cite

Background. The problem of comorbidity is becoming increasingly important in modern medicine and healthcare. A combination of inﬂ ammatory bowel diseases (IBD) and spondyloarthritis (SpA), the genesis of which is closely related to immune inﬂ ammation, can be attributed to the number of comorbid mutually aggravating pathology. In real clinical practice, there is often a late diagnosis of these comorbid processes, which aﬀ ects the quality and eﬀ ectiveness of treatment and worsens the outcomes of diseases.Aim. In order to attract the attention of specialists of various proﬁ les to immuno-i nﬂ ammatory comorbidity, the article presents current data on the association between IBD and SpA with an analysis of the frequency of joint and spine lesions in ulcerative colitis (UC) and Crohn’s disease (CD), as well as the frequency of detection of intestinal lesions in various SpA phenotypes.Basic provisions. It has been shown that joint lesions in IBD and intestinal lesions in SpA, as a rule, occur in severe and moderate forms of these diseases, occurring with high or moderate activity. The HLA B27 genotype is more typical for individuals with manifest SpA, including developed against the background of IBD. The combination of IBD and SpA is caused by similar disorders of immunoregulation, the functional state of cells of native and adaptive immunity, and an imbalance of cytokines. These mechanisms have become the basis for the use of biological and targeted therapy in IBD and SpA, as well as in their combination. It has been shown that approximately half of patients resistant to standard drugs can achieve clinical remission on biological therapy.Conclusions. Thus, in order to objectify the severity of the immuno- inﬂ ammatory process and improve outcomes, it is advisable to diagnose the most likely comorbid pathology in a timely manner and take this factor into account to optimize treatment.

show abstract

Pos1008 the Role of Serum Calprotectin in the Diagnosis of Inflammatory Bowel Disease in Patients With Ankylosing Spondylitis

Cited by 2 publications

References 0 publications

Pos1007 optimizing a Referral Strategy for Patients With a High Probability of Axial Spondyloarthritis: The Role of Age and Symptom Duration

Pos1007 optimizing a Referral Strategy for Patients With a High Probability of Axial Spondyloarthritis: The Role of Age and Symptom Duration

Immuno-mediated comorbidity: clinical and pathogenetic aspects of the inﬂ ammatory bowel diseases and spondyloarthritis association

Contact Info

Product

Resources

About