Relationships between ultrasound enthesitis, disease activity and axial radiographic structural changes in patients with early spondyloarthritis: data from DESIR cohort

Ruyssen‐Witrand, Adeline; Jamard, B.; Cantagrel, A.; Nigon, Delphine; Lœuille, Damien; Degboé, Yannick; Constantin, Arnaud

doi:10.1136/rmdopen-2017-000482

Cited by 23 publications

(23 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…All three of these biomarkers tightly correlated with CRP and were higher in AS patients than in nr-axSpA patients, which may reflect the different degrees of inflammation of these two entities. An increased number of inflammatory spinal lesions in AS patients than in nr-axSpA patients was found previously 26,30 and a recent study demonstrated increased entheseal abnormalities in axSpA patients with worse structural damage 31 . We did not find correlations between the severity of MRI lesions in the SIJ and biomarkers levels, but the mSASSS tended to correlate with C1M and C4M2 in AS.…”

Section: Discussionsupporting

confidence: 57%

Metabolites of type I, II, III, and IV collagen may serve as markers of disease activity in axial spondyloarthritis

Hušáková

Bay‐Jensen

Forejtová

et al. 2019

Sci Rep

View full text Add to dashboard Cite

Local inflammation in axial spondyloarthritis (axSpA) leads to the release of collagen metabolites from the disease-affected tissue. We investigated whether collagen metabolites were associated with disease activity and could distinguish non-radiographic(nr)-axSpA from ankylosing spondylitis (AS). A total of 193 axSpA patients (nr-axSpA, n = 121 and AS, n = 72) and asymptomatic controls (n = 100) were included. Serum levels of metalloproteinase (MMP)-degraded collagen type I (C1M), type II (C2M), type III (C3M) and type IV (C4M2) were quantified by enzyme-linked immunosorbent assay (ELISA). All metabolites were higher in axSpA than in controls (all p < 0.001). Serum levels of C1M, C3M, and C4M2 were increased in AS compared to nr-axSpA (43.4 ng/mL vs. 34.6; p < 0.001, 15.4 vs. 12.8; p = 0.001, and 27.8 vs. 22.4; p < 0.001). The best metabolite to differentiate between axSpA and controls was C3M (AUC 0.95; specificity 92.0, sensitivity 83.4). C1M correlated with ASDAS-CRP in nr-axSpA (ρ = 0.37; p < 0.001) and AS (ρ = 0.57; p < 0.001). C1M, C3M, and C4M2 were associated with ASDAS-CRP in AS and nr-axSpA after adjustment for age, gender, and disease duration. Serum levels of collagen metabolites were significantly higher in AS and nr-axSpA than in controls. Moreover, the present study indicates that collagen metabolites reflect disease activity and are useful biomarkers of axSpA.

show abstract

Section: Discussionsupporting

confidence: 57%

Metabolites of type I, II, III, and IV collagen may serve as markers of disease activity in axial spondyloarthritis

Hušáková

Bay‐Jensen

Forejtová

et al. 2019

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Our results indicate that PDUS-defined enthesitis is not frequent in patients with recent IBP, even though structural abnormalities, such as calcifications, erosions, increased thickness of tendon and enthesiophytes, were more frequent (about one out of four patients). 15 Thus, adding PDUS-defined enthesitis to the ASAS criteria set would result in only very few additional patients being classified as axSpA (18 in our study). However, the likelihood of axSpA in these few patients would be very high: in our study, about two-thirds of these patients met Amor’s criteria and 16 (89%) ESSG criteria, and they all had at least one strong objective feature of SpA (in addition to IBP).…”

Section: Discussionmentioning

confidence: 87%

“… 14 The prevalence of the various PDUS entheseal abnormalities in a cohort of patients with recent IBP suggestive of axSpA (DESIR (DEvenir des Spondylarthropathies Indifférenciées Récentes) cohort) has been recently reported. 15 …”

Section: Introductionmentioning

confidence: 99%

Can power Doppler ultrasound of the entheses help in classifying recent axial spondyloarthritis? Data from the DESIR cohort

Poulain¹,

D'Agostino

Thibault

et al. 2018

RMD Open

Self Cite

View full text Add to dashboard Cite

Early diagnosis of axial spondyloarthritis (axSpA) remains a challenge due to the lack of specificity of clinical symptoms and variable prevalence of axial imaging findings permitting a definite diagnosis. Power Doppler ultrasonography (PDUS) of the entheses has demonstrated to be a potential useful tool for the classification and diagnostic management of early SpA independently of the phenotype.ObjectivesTo assess the classification value (sensitivity and specificity) of PDUS-defined enthesitis for identifying patients fulfilling Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axSpA (ASAS+) in patients with recent inflammatory back pain (IBP) (the DESIR (DEvenir des Spondylarthropathies Indifférenciées Récentes) cohort).MethodsBaseline PDUS was performed at eight entheseal sites, and PDUS enthesitis was defined by the presence of vascularisation at entheseal insertion.Results402 patients from the DESIR cohort underwent a PDUS evaluation. PDUS enthesitis was detected in 58 (14.4%) patients of whom 40 (14.2%) belonged to the ASAS+ patients and 18 (17%) to the ASAS- patients. The sensitivity of PDUS enthesitis was 13.9% and the specificity was 83.5%, with a positive predictive value of 69% and 26.8% of negative predictive value for meeting ASAS criteria for axSpA. Of the 18 ASAS- patients with positive PDUS, 59% fulfilled Amor’s criteria, 88% European Spondyloarthropathy Study Group criteria and 59% both.ConclusionsIn a cohort of patients with recent IBP, the prevalence of PDUS enthesitis was low (14.4%); however, its specificity for classifying patients as axSpA according to ASAS criteria was high (83.5%). PDUS enthesitis might be of additional value for classifying as patients with axSpA IBP who do not fulfil ASAS criteria.

show abstract

“…US has been proven to be a valuable tool for monitoring disease activity and therapeutic effect evaluation [12,20,28]. However, one study from the DESIR cohort found that US could not be helpful for monitoring disease activity in 402 patients with spondyloarthritis [21]. Therefore, further studies still need to be conducted to demonstrate the association between US lesions and disease activity.…”

Section: Discussionmentioning

confidence: 99%

“…The ACW has been demonstrated as the second most commonly involved site in spondyloarthritis just behind the sacroiliac joint [18]. Furthermore, there are different opinions on whether US can monitor disease activity [19][20][21]. More studies are needed to assess whether disease activity is correlated with US elemental lesions.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Assessment of Entheses and Correlations Between Disease Activity and Ultrasound Scores in Ankylosing Spondylitis: A Cross Sectional Study

Xie¹,

Zhou²,

Luo³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: An increasing number of studies have applied ultrasound (US) to evaluate enthesitis in spondyloarthritis. However, there is no clear agreement on which sites should be evaluated for enthesitis. Furthermore, there are different opinions on whether US can monitor disease activity. The objectives of this study were to evaluate the common involvement of entheses and correlations between disease activity and US scores in ankylosing spondylitis (AS).Methods: A cross-sectional, monocentric, and controlled study was performed. US was used to scan 34 entheses per person and the Madrid sonography enthesitis index (MASEI) score was used. US scores were used to evaluate the elemental lesions of hypoechogenicity, thickness, erosion, calcification, bursitis, and Doppler signal. Disease activity was assessed by Disease Activity Score–C reactive protein (ASDAS-CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).Results: 104 patients with AS and 50 control subjects were included. A total of 5236 entheses were assessed. Compared with the control subjects, only three entheses – the Achilles tendon (AT), sternoclavicular joint (SCJ), and costochondral joint (CCJ) – showed significant differences in the AS group (p < 0.05). Patients with high disease activity (ASDAS-CRP ≥ 2.1) had higher scores than patients with low activity (ASDAS-CRP < 2.1) in erosion (p = 0.02). Patients who were categorized in very high disease activity (ASDAS-CRP ≥ 3.5) had a higher score in erosion (p = 0.02). The erosion score was moderately associated with ASDAS-CRP and BASDAI (r = 0.44, r = 0.21).Conclusions: The commonly involved entheses were the AT, SCJ, and CCJ in AS. Erosion occurred more often in patients with disease activity or high activity. Erosion would be more useful for monitoring disease activity in AS.

show abstract

Relationships between ultrasound enthesitis, disease activity and axial radiographic structural changes in patients with early spondyloarthritis: data from DESIR cohort

Cited by 23 publications

References 29 publications

Metabolites of type I, II, III, and IV collagen may serve as markers of disease activity in axial spondyloarthritis

Metabolites of type I, II, III, and IV collagen may serve as markers of disease activity in axial spondyloarthritis

Can power Doppler ultrasound of the entheses help in classifying recent axial spondyloarthritis? Data from the DESIR cohort

Ultrasound Assessment of Entheses and Correlations Between Disease Activity and Ultrasound Scores in Ankylosing Spondylitis: A Cross Sectional Study

Contact Info

Product

Resources

About