THE COURSE OF ESTABLISHED ANKYLOSING SPONDYLITIS AND THE EFFECTS OF SULPHASALAZTh OVER 3 YEARS

Kirwan, John R.; Edwards, Alison; Huitfeldt, Bernhard; Thompson, Paul; Currey, H. L. F.

doi:10.1093/rheumatology/32.8.729

Cited by 63 publications

(19 citation statements)

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“…Although sulfasalazine appears to play little role in suppressing axial symptoms in AS, there is some evidence of improvement in peripheral arthritis (Kirwan et al 1993). In an extended 3-year study, AS patients had significantly fewer episodes of peripheral arthritis during therapy with sulfasalazine compared with placebo.…”

Section: Current Therapy Optionsmentioning

confidence: 99%

Adalimumab in ankylosing spondylitis: an evidence-based review of its place in therapy

Hennigan¹,

Ackermann²,

Kavanaugh

2007

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Introduction: Ankylosing spondylitis (AS) is an idiopathic chronic inflammatory disease that has prominent effects on the spine and peripheral joints. In addition, extraarticular manifestations such as enthesitis and acute anterior uveitis may be clinically important. In recent years, the therapy of AS has changed, largely due to the introduction of inhibitors of the proinflammatory cytokine tumor necrosis factor (TNF). Adalimumab, a human monoclonal antibody specifically for TNF, is the most recent of the TNF blocking agents that have been approved for the treatment of active, nonsteroidal antiinflammatory drug (NSAID)-refractory patients with AS.

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Section: Current Therapy Optionsmentioning

confidence: 99%

Adalimumab in ankylosing spondylitis: an evidence-based review of its place in therapy

Hennigan¹,

Ackermann²,

Kavanaugh

2007

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“…A 26-week, placebo-controlled trial showed that enteric-coated SZN seemed to be effective and well tolerated in AS patients [113]. In a 3-year placebo-controlled trial of SZN, a reduced frequency of peripheral arthritis was observed in the treated but not in the control group of AS patients [114]. A 6-month randomised, multi-centre, double-blind, placebo-controlled trial of SZN in spondyloarthritic patients resistant to treatment with NSAIDs showed that SZN had greater efficiency than placebo [115].…”

Section: ) Antibiotic Treatmentmentioning

confidence: 99%

Ankylosing Spondylitis, HLA-B27 and Klebsiella - An Overview: Proposal for Early Diagnosis and Treatment

Ebringer¹,

Rashid²,

Wilson³

et al. 2006

CRR

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Ankylosing spondylitis (AS) is a potentially disabling rheumatic disease for which no curative treatment has yet been discovered.An extensive computer-based and manual search was undertaken to evaluate the role of microbes in the pathogenesis of AS. All together 147 papers were scrutinised. A total of 24 studies carried out on 1330 AS patients and 1191 healthy controls involving 15 different countries showed significantly elevated Klebsiella antibodies in AS patients when compared to controls. Molecular analysis has shown that Klebsiella microbes possess antigens, which cross-react with self-antigens, such as HLA-B27 and spinal collagens.Diagnostic criteria have been developed in which a person who is HLA-B27 positive and has clinical and laboratory evidence of an inflammatory backache for at least three months is proposed to have pre-AS. A specific elevation of antiKlebsiella antibodies would confirm the diagnosis. A proposal for an early treatment using anti-Klebsiella measures is suggested.So far, apart from Klebsiella no other microbes have been shown to have a link with the development of AS. It is suggested that identifying and treating patients with Klebsiella reactive arthritis/pre-AS could involve the use of antiKlebsiella measures, such as antibiotics and low starch diet together with immunosuppressive drugs in an endeavour to prevent the irreversible sequelae of established AS.

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“…ASAS/EULAR recommendations also confirm the lack of evidence for the efficacy of DMARDs, including sulfasalazine and methotrexate, for the treatment of axial disease, and suggest considering a therapeutic trial of SSZ in patients with peripheral arthritis (80).…”

Section: Disease-modifying Antirheumatic Drugsmentioning

confidence: 97%

Treatment of ankylosing spondylitis

Sarı¹,

Öztürk²,

Akkoç³

2015

Turk J Med Sci

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IntroductionAnkylosing spondylitis (AS) is a chronic, inflammatory, rheumatic disease involving primarily the spine and sacroiliac joints. It is a prototype of spondyloarthritis (SpA) group diseases and its prevalence in Turkey has been reported as 0.49% (1). It is encountered in mostly young adults and in 80% of the cases symptoms appear before 30 years of age (2). Studies have revealed that the quality of life is reduced and the risk of disability and mortality is increased in patients with AS (3,4). It has been reported that the direct (due to health expenses) and indirect (as a result of workforce loss) economic losses associated with the disease are similar to those of rheumatoid arthritis (RA) in the long term (5).Management of AS consists of pharmacological and nonpharmacological treatment modalities (6-11). The pharmacological treatment options are limited; however, with the recent introduction of biological drugs, remarkable improvements have been reported in this field. In general, the treatment targets include control of symptoms and inflammation (pain, stiffness, and joint swelling), preservation/normalization of physical function, prevention of progressive structural damage and disabilities, and eventually maximizing the longterm health-related quality of life (6,11). The aim of this review article is to present an updated overview of the pharmacologic treatment of AS, as defined by the modified New York criteria (Table 1) (12). Nonpharmacological treatment modalities including physiotherapy and exercise are only briefly mentioned and surgical treatment is not discussed. Nonpharmacological treatment approaches: physiotherapy and exerciseThe nonpharmacological treatment for AS comprises patient training and regular exercise. Pharmacological treatment and nonpharmacological treatment approaches complement each other. Physiotherapy and exercise for the treatment of AS are also cost-effective (13). A recent Cochrane article summarized the available scientific evidence on the effectiveness of physiotherapy interventions in the management of AS ( 14). Personal home exercising and training, when compared to AS patients without such interventions, lead to significant improvement in some spinal mobility parameters (finger tips-to-floor distance); however, they have no effect on disease activity, pain, stiffness, and global patient evaluation (14). Studies comparing group physiotherapy programs applied with a supervisor with personal home exercise programs showed that there were no differences among groups in regard to pain, stiffness, and function; however, some spinal mobility parameters (Schober's distance) and patient global

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THE COURSE OF ESTABLISHED ANKYLOSING SPONDYLITIS AND THE EFFECTS OF SULPHASALAZTh OVER 3 YEARS

Cited by 63 publications

References 0 publications

Adalimumab in ankylosing spondylitis: an evidence-based review of its place in therapy

Adalimumab in ankylosing spondylitis: an evidence-based review of its place in therapy

Ankylosing Spondylitis, HLA-B27 and Klebsiella - An Overview: Proposal for Early Diagnosis and Treatment

Treatment of ankylosing spondylitis

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