65 research outputs found
Spine and sacroiliac joints on nuclear magnetic resonance imaging and research of serological biomarkers predictive of severity and disease activity in early axial spondyloarthritis
Recently several studies have focused on the use of magnetic resonance imaging (MRI) and new biomarkers that might facilitate early diagnosis of axial spondyloarthritis (axSpA) and identify individuals at higher risk of developing the disease. Objectives:The study aimed to identify:1)potentially useful biomarkers for early diagnosis of axSpA and their correlations with disease activity and imaging indices;2)the prevalence of spine and pelvis MRI lesions in patients (pts) with low back pain (LBP);3)the correlation between the site of axial pain and of MRI-lesions.Material and Methods:Seventy-two pts with LBP (≥3 months, ≤2 years, onset ≤45 years) underwent a physical examination, questionnaires, laboratory tests, X-rays and MRI of the spine and sacroiliac joints (SIJ) at baseline and during a follow-up period of 24 months.Two expert rheumatologists formulated axSpA diagnosis and assessed fulfilment of Assessment of SpondyloArthritis International Society ASAS criteria.Disease activity and physical functioning were assessed using imaging,clinical and serological indices: Bath Ankylosing Spondylitis Metrology Index (BASMI);Maastricht Ankylosing enthesitis Spondilities Score (MASES);Bath Ankylosing Spondylitis Disease Activity Index (BASDAI);Bath Ankylosing Spondylitis Functional Index (BASFI);Ankylosing Spondylitis disease activity score (ASDAS);Visual Analogue Scale (VAS pain);VAS night pain;VAS disease activity;Bath Ankylosing Spondylitis Patient Global Score (BASG1);BASG2;Health Assessment Questionnaire (HAQ);ESR;serum ultrasensitive CRP (hs-CRP);matrix metalloproteinase (MMP3);interleukin (IL) IL-22, IL-17, IL-23.Spine and SIJ MRI and X-rays were scored independently by 2 readers following the SPARCC, mSASSS and NY-criteria.The axial pain and localization of MRI-lesions were classified into 4 sites:cervical/thoracic/lumbar spine and buttocks.The association between the site of pain and MRI-lesions was evaluated through Odds Ratio (OR).The Spearman test and Kruskal Wallis test were used to compare all indices in these cohorts. Results: Patients were diagnosed with axSpA and classified in accordance ASAS criteria as: 1)21 pts classified according to axSpA imaging arm+;2)29 pts classified according to axSpA clinical arm+;3)25 pts not fulfilling ASAS criteria. The median LBP onset was 28.51±8.05 years, 45.3% were male, HLA-B27 was positive in 38.7% pts;56% pts showed bone marrow edema (BME) in spine-MRI and 61.3% pts in SIJ-MRI. Eigtheen (24%) pts presented a negative BME SIJ-MRI with a positive BME spine-MRI. OR between site of pain and site of BME lesions was 20.78 (p=NS),163.93 (p=0.0006);0.34 (p=NS) for cervical/thoracic/lumbar spine and 304.88 (p=0.0203) for buttocks.A significant correlation between thoracic pain/enthesitis on thoracic district (OR=32.69;p= 0.0336) was also found. There was a significant difference between the three cohorts with regard to the prevalence of radiographic sacroiliitis,active sacroiliitis on MRI and the SPARCC SIJ score.There were no differences in these groups regarding ILs, MMP-3 and hsCRP.There was found a correlation between IL-22 and some clinical indices.The correlation between mSASSS, MMP3 and hsCRP was an interesting finding. Conclusions:The site of pain correlated in a statistically significant manner with BME lesions in thoracic and buttock districts.Since positive spine-MRI images were observed in absence of sacroiliitis, we can be therefore hyphothezise that this finding could have a diagnostic significance in suspected axSpA.Although not significantly higher in any of the three groups, IL-22, MMP3 and hsCRP values correlated with some disease activity indices and with mSASSS.Larger observational studies are warranted to confirm these preliminary findings
Validation of the Italian version of the educational needs assessment tool in rheumatoid arthritis patients and factors associated with educational needs
The educational needs assessment tool (ENAT) is a seven-domain questionnaire assessing the educational needs (EN) of patients with rheumatoid arthritis (RA). The aim of this study was to validate the Italian version of the ENAT and to identify factors associated with EN in people with RA. The original English ENAT version was translated into Italian according to Beaton's method and subjected to Rasch analysis for validity testing. Socio-demographic and clinical variables were tested for associations with the ENAT domain scores using a multivariable linear regression model. The ENAT translated well into Italian and retained its construct validity. Some adjustments were needed when pooling the Italian and English datasets. The overall score of the ENAT had a high median: 82.8 (interquartile range (IQR): 57.5 to 100) i.e., 72.4% of the maximum score. The highest score was observed in the domain "Arthritis process" and the lowest was in "Support systems". Only gender was independently associated with EN (females having higher EN than males). The Italian ENAT is feasible for the use in the clinical setting and may help the health care practitioners to tailor educational interventions for RA patients. The characteristics of the patients, particularly female gender, may be associated with higher EN
SARS-CoV-2 Infection in Spondyloarthritis Patients Treated With Biotechnological Drugs: A Study on Serology
ObjectiveSerology could help to define the real extent of SARS-CoV-2 diffusion, especially in individuals considered at higher risk of COVID-19, such as spondyloarthritis (SpA) patients undergoing immunosuppressant. Our aim was to detect, by serology, previous SARS-CoV-2 contact in SpA, compared to health care workers (HCW), and healthy controls.MethodsSera from consecutive patients affected by SpA undergoing cytokine-targeted therapy, HCW and healthy controls from 2015 were analysed through chemiluminescent analytical system for the presence of IgG and IgM anti-SARS-CoV-2. Positive patients (IgM or IgG, or both) additionally underwent real-time Polymerase-Chain-Reaction (RT-PCR) to test for active infection. Serology was repeated at 3-months in SpA. Data across 3 groups were compared by Kruskal Wallis/Chi-square, and between 2 groups by Wilcoxon rank test/Chi-Square. P ≤ 0.05 were considered significant.Results200 SpA, 95 HCW and 101 controls were recruited. Positive serology was found in 25(12.5%) SpA, 8(8.4%) HCW, 0(0%) controls (p=0.001). SpA patients with positive serology more frequently reported COVID-19-like symptoms than those with negative serology (20% vs. 4%, p=0.009) and 2 had COVID-19 as confirmed by RT-PCR, non severe. No HCW reported symptoms or had positive RT-PCR. In SpA patients, at 3 months, mean IgM titres decreased from 2.76 ± 2.93 to 2.38 ± 2.95 (p=0.001), while IgG titres from 0.89 ± 3.25 to 0.31 ± 0.87 (p=ns).ConclusionsSerology revealed that exposure to SARS-CoV-2 in SpA patients and HCW was higher than expected based on reported symptoms. In SpA, anti-cytokine therapy could act as a protective factor for a severe disease course. However, a seroconversion was not observed at 3-months
Patient-reported impact of spondyloarthritis on work disability and working life: The ATLANTIS survey
44noopenopenRamonda, Roberta; Marchesoni, Antonio; Carletto, Antonio; Bianchi, Gerolamo; Cutolo, Maurizio; Ferraccioli, Gianfranco; Fusaro, Enrico; De Vita, Salvatore; Galeazzi, Mauro; Gerli, Roberto; Matucci-Cerinic, Marco; Minisola, Giovanni; Montecucco, Carlomaurizio; Pellerito, Raffaele; Salaffi, Fausto; Paolazzi, Giuseppe; Sarzi-Puttini, Piercarlo; Scarpa, Raffaele; Bagnato, Gianfilippo; Triolo, Giovanni; Valesini, Guido; Punzi, Leonardo; Olivieri, Ignazio; Ortolan, Augusta; Lorenzin, Mariagrazia; Frallonardo, Paola; Giollo, Alessandro; Locaputo, Antonella; Paolino, Sabrina; Simone, Davide; Quartuccio, Luca; Bartoloni, Elena; Luca, Rossella De; Bartoli, Francesca; Sensi, Felice; Caporali, Roberto; Carlo, Marco Di; Roberto, Bortolotti; Atzeni, Fabiola; Costa, Luisa; Ciccia, Francesco; Perrotta, Fabio; Gilio, Michele; ATLANTIS study groupRamonda, Roberta; Marchesoni, Antonio; Carletto, Antonio; Bianchi, Gerolamo; Cutolo, Maurizio; Ferraccioli, Gianfranco; Fusaro, Enrico; De Vita, Salvatore; Galeazzi, Mauro; Gerli, Roberto; Matucci-Cerinic, Marco; Minisola, Giovanni; Montecucco, Carlomaurizio; Pellerito, Raffaele; Salaffi, Fausto; Paolazzi, Giuseppe; Sarzi-Puttini, Piercarlo; Scarpa, Raffaele; Bagnato, Gianfilippo; Triolo, Giovanni; Valesini, Guido; Punzi, Leonardo; Olivieri, Ignazio; Ortolan, Augusta; Lorenzin, Mariagrazia; Frallonardo, Paola; Giollo, Alessandro; Locaputo, Antonella; Paolino, Sabrina; Simone, Davide; Quartuccio, Luca; Bartoloni, Elena; Luca, Rossella De; Bartoli, Francesca; Sensi, Felice; Caporali, Roberto; Carlo, Marco Di; Roberto, Bortolotti; Atzeni, Fabiola; Costa, Luisa; Ciccia, Francesco; Perrotta, Fabio; Gilio, Michele; ATLANTIS study, Grou
Work productivity is associated with disease activity and functional ability in Italian patients with early axial spondyloarthritis: an observational study from the SPACE cohort
Spine and sacroiliac joints on nuclear magnetic resonance imaging and research of serological biomarkers predictive of severity and disease activity in early axial spondyloarthritis
Recently several studies have focused on the use of magnetic resonance imaging (MRI) and new biomarkers that might facilitate early diagnosis of axial spondyloarthritis (axSpA) and identify individuals at higher risk of developing the disease. Objectives:The study aimed to identify:1)potentially useful biomarkers for early diagnosis of axSpA and their correlations with disease activity and imaging indices;2)the prevalence of spine and pelvis MRI lesions in patients (pts) with low back pain (LBP);3)the correlation between the site of axial pain and of MRI-lesions.Material and Methods:Seventy-two pts with LBP (≥3 months, ≤2 years, onset ≤45 years) underwent a physical examination, questionnaires, laboratory tests, X-rays and MRI of the spine and sacroiliac joints (SIJ) at baseline and during a follow-up period of 24 months.Two expert rheumatologists formulated axSpA diagnosis and assessed fulfilment of Assessment of SpondyloArthritis International Society ASAS criteria.Disease activity and physical functioning were assessed using imaging,clinical and serological indices: Bath Ankylosing Spondylitis Metrology Index (BASMI);Maastricht Ankylosing enthesitis Spondilities Score (MASES);Bath Ankylosing Spondylitis Disease Activity Index (BASDAI);Bath Ankylosing Spondylitis Functional Index (BASFI);Ankylosing Spondylitis disease activity score (ASDAS);Visual Analogue Scale (VAS pain);VAS night pain;VAS disease activity;Bath Ankylosing Spondylitis Patient Global Score (BASG1);BASG2;Health Assessment Questionnaire (HAQ);ESR;serum ultrasensitive CRP (hs-CRP);matrix metalloproteinase (MMP3);interleukin (IL) IL-22, IL-17, IL-23.Spine and SIJ MRI and X-rays were scored independently by 2 readers following the SPARCC, mSASSS and NY-criteria.The axial pain and localization of MRI-lesions were classified into 4 sites:cervical/thoracic/lumbar spine and buttocks.The association between the site of pain and MRI-lesions was evaluated through Odds Ratio (OR).The Spearman test and Kruskal Wallis test were used to compare all indices in these cohorts. Results: Patients were diagnosed with axSpA and classified in accordance ASAS criteria as: 1)21 pts classified according to axSpA imaging arm+;2)29 pts classified according to axSpA clinical arm+;3)25 pts not fulfilling ASAS criteria. The median LBP onset was 28.51±8.05 years, 45.3% were male, HLA-B27 was positive in 38.7% pts;56% pts showed bone marrow edema (BME) in spine-MRI and 61.3% pts in SIJ-MRI. Eigtheen (24%) pts presented a negative BME SIJ-MRI with a positive BME spine-MRI. OR between site of pain and site of BME lesions was 20.78 (p=NS),163.93 (p=0.0006);0.34 (p=NS) for cervical/thoracic/lumbar spine and 304.88 (p=0.0203) for buttocks.A significant correlation between thoracic pain/enthesitis on thoracic district (OR=32.69;p= 0.0336) was also found. There was a significant difference between the three cohorts with regard to the prevalence of radiographic sacroiliitis,active sacroiliitis on MRI and the SPARCC SIJ score.There were no differences in these groups regarding ILs, MMP-3 and hsCRP.There was found a correlation between IL-22 and some clinical indices.The correlation between mSASSS, MMP3 and hsCRP was an interesting finding. Conclusions:The site of pain correlated in a statistically significant manner with BME lesions in thoracic and buttock districts.Since positive spine-MRI images were observed in absence of sacroiliitis, we can be therefore hyphothezise that this finding could have a diagnostic significance in suspected axSpA.Although not significantly higher in any of the three groups, IL-22, MMP3 and hsCRP values correlated with some disease activity indices and with mSASSS.Larger observational studies are warranted to confirm these preliminary findings.Recenti studi si sono concentrati sull’impiego della risonanza magnetica (RMN) e di nuovi biomarcatori che potrebbe facilitare la diagnosi precoce della spondiloartrite assiale (axSpA) e identificare gli individui a più alto rischio di sviluppare la malattia. Scopo del lavoro:Valutare:1)biomarcatori potenzialmente utili per la diagnosi precoce di axSpA e le loro correlazioni con gli indici di attività di malattia e di imaging;2)la prevalenza delle lesioni alla RMN del rachide e del bacino in pazienti (pts) con lombalgia (LBP);3)la correlazione tra la sede del dolore assiale e la localizzazione delle lesioni alla RMN.Materiali e Metodi:Settantadue pts con LBP (≥3 mesi,≤2 anni, insorgenza≤45 anni) sono stati valutati con:esame obiettivo, questionari, indagini sierologiche, radiografie e risonanza magnetica del rachide e delle articolazioni sacro-iliache (SI) al basale e durante un periodo di follow-up di 24 mesi.Due reumatologi esperti hanno formulato la diagnosi axSpA secondo i criteri ASAS “SpondyloArthritis International Society” per axSpA.Sono stati valutati i seguenti indici:Bath Ankylosing Spondylitis Metrology Index (BASMI);Maastricht Ankylosing enthesitis Spondilities Score (MASES);Bath Ankylosing Spondylitis Disease Activity Index (BASDAI);Bath Ankylosing Spondylitis Functional Index (BASFI);Ankylosing Spondylitis disease activity score (ASDAS);Visual Analogue Scale (VAS pain);VAS night pain;VAS disease activity;Bath Ankylosing Spondylitis Patient Global Score (BASG1);BASG2;Health Assessment Questionnaire (HAQ);VES;PCR ultrasensibile (hs-PCR);la metallo-proteinasi 3 (MMP3);interleuchine (IL) IL-22, IL-17, IL-23.Le immagini alla radiografia e alla RMN sono state valutate in modo indipendente da 2 radiologi secondo i criteri SPARCC, mSASSS e mNY.La sede del dolore assiale e delle lesioni alla RMN sono state classificate in 4 siti: colonna cervicale/toracica/lombare e regione glutea.L'associazione tra la sede del dolore e delle lesioni alla RMN è stata valutata tramite Odds Ratio (OR).I test Spearman e Kruskal Wallis sono stati usati per confrontare tutti gli indici di queste coorti.Risultati: I pts sono stati diagnosticati come axSpA e classificati secondo i criteri ASAS come: 1)21 pts classificati axSpA secondo il braccio dell’imaging; 2)29 pts classificati axSpA secondo il braccio clinico; 3)25 pts che non soddisfacevano i criteri ASAS.L'età media di insorgenza della LBP era 28,51 anni, il 45,3% era di sesso maschile,l'HLA-B27 era positivo nel 38,7%.Il 56% dei pts mostrava segni di edema midollare osseo (BME) a carico della RMN del rachide e il 61,3% a carico della RMN delle SI.Diciotto pts (24%) presentavano una RMN delle SI negativa per BME con una RMN del rachide positiva.L’OR tra la sede del dolore e delle lesioni BME era rispettivamente:20.78(p=NS); 163.93(p=0.0006); 0,34(p=NS)per la colonna cervicale/toracica/lombare e 304,88 (p=0,0203) per la regione glutea.È stata anche trovata una correlazione significativa tra dolore toracico/entesite del distretto toracico (OR=32.69; p=0.0336). C'era una differenza significativa tra le tre coorti per quanto riguarda la prevalenza di sacroileite radiografica, sacroileite attiva alla RMN e punteggio SPARCC-SI. È stata trovata una correlazione tra IL-22 e alcuni indici clinici.La correlazione tra mSASSS, MMP3 e hsPCR è stata una scoperta interessante.Conclusioni:Il sito del dolore si correla significativamente con le lesioni BME nei distretti toracico e gluteo. Dato che sono state osservate immagini positive alla RMN del rachide in assenza di sacroileite, riteniamo che lo studio del rachide possa avere un valore aggiunto nella diagnosi di early axSpA.I valori di IL-22, MMP3 e hsPCR correlano con alcuni indici di attività della malattia e con mSASSS.Sono necessari studi osservazionali più ampi per confermare questi risultati preliminari
Do obesity and overweight influence disease activity measures in axial spondyloarthritis? A systematic review and meta‐analysis
the aim of our systematic review and meta-analysis was to investigate whether overweight/obesity are associated with higher disease activity measures in axial spondyloarthritis (axSpA) patients
Do obesity and overweight influence disease activity measures in axial spondyloarthritis? A systematic review and meta-analysis
the aim of our systematic review and meta-analysis was to investigate whether overweight/obesity are associated with higher disease activity measures in axial spondyloarthritis (axSpA) patients
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