Spondyloarthritis
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Format: | Buch |
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Sprache: | English |
Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2012
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Schriftenreihe: | Rheumatic disease clinics of North America
38,3 |
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Online-Zugang: | Inhaltsverzeichnis |
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245 | 1 | 0 | |a Spondyloarthritis |c guest ed.: Jürgen Braun ... |
264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 2012 | |
300 | |a XXI S., S. 442 - 652 |b Ill., graph. Darst. | ||
336 | |b txt |2 rdacontent | ||
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338 | |b nc |2 rdacarrier | ||
490 | 1 | |a Rheumatic disease clinics of North America |v 38,3 | |
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689 | 0 | 0 | |a Bechterew-Krankheit |0 (DE-588)4069213-9 |D s |
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Datensatz im Suchindex
DE-BY-UBR_call_number | 01/21.X1078 |
---|---|
DE-BY-UBR_katkey | 5042340 |
DE-BY-UBR_location | 00 |
DE-BY-UBR_media_number | 069033939060 |
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adam_text | Spondyloarthrìtis
Contents
Foreword
xiii
Michael
H.
Weisman
Preface
xvii
Jürgen Braun and Joachim Sieper
Epidemiology of Spondyloarthritis
441
Carmen Stolwijk, Annelies Boonen, Astrid van Tubergen, and John D.
Reveille
Spondyloarthritis (SpA)
represents a group of interrelated diseases with
common clinical features and a close association with HLA-B27. Reports
of incidence and prevalence of diseases vary depending on methodolog¬
ical differences between studies, the case definition used to classify
disease, and the prevalence of HLA-B27 in the population studied. Newly
proposed criteria for axial SpA and peripheral SpA present a new
approach to facilitate classification of the SpA into
2
main subtypes and
the criteria allow earlier detection of patents with inflammatory back
pain. These criteria were developed for use in a (specialized) clinical setting
and not for large
epidemiologie
studies.
Classification, Diagnosis, and Referral of Patients with Axial Spondyloarthritis
477
Jürgen Braun
and Joachim Sieper
The concepts for classification, diagnosis and referral of patients with axial
spondyloarthitis differ, although they of course basically relate to the same
disease. While classification criteria and referral strategies concentrate
largely on patients with chronic back pain with an age at onset before
45
years, the rheumatologist can make a diagnosis of axial SpA in patients
with late onset or in patients with back pain for only some weeks if other
items are fulfilled. Early recognition of patients with axial SpA is important
to establish the diagnosis, potentially start therapeutic interventions and
avoid unnecessary health care procedures.
Inflammatory Back Pain
487
Rubén Burgos-Vargas
and
Jürgen Braun
Inflammatory back pain (IBP) is a concept, which elements characterize
the spinal involvement of patients with ankylosing spondylitis (AS) and
axial spondyloarthritis (axSpA). The identification of patients with IBP
depends on the clinical setting and the diagnostic value of several IBP
criteria. IBP differentiation from non-inflammatory, mechanical chronic
back might be sometimes difficult, but the role of IBP diagnosis in the early
stage of axSpA and AS leads to a better treatment.
Inflammatory Back Pain: The United States Perspective
501
Michael H. Weisman
Inflammatory back pain (IBP) is a relatively recent and well-accepted con¬
cept whose precise definition remains elusive. The definition of IBP varies
Contents
by criteria set, as does its sensitivity and specificity regarding screening
and case ascertainment in various clinical and
epidemiologie
settings.
This article reviews the history of efforts to define IBP, particularly the cri¬
teria sets that have been built around its measurement, describes assess¬
ment of IBP in the clinical setting, and illustrates how IBP has been used in
epidemiologie
and clinical research.
Imaging in Axial Spondyloarthritis: Diagnostic Problems and Pitfalls
513
Xenofon Baraliakos, Kay-Geert A. Hermann, and
Jürgen Braun
Structural changes in axial Spondyloarthritis (axSpA) are best identified by
conventional radiographs, while magnetic resonance imaging
(MRI)
is
considered the gold standard for assessment of inflammatory changes.
Imaging of the axial skeleton is crucial for the diagnosis but also for
classification to non-radiographic axSpA according to the
2009
ASAS
classification criteria. Despite the existing definitions for a positive
MRI
for the sacroiliac joints and the spine, these predefined lesions can also
be seen in other conditions, representing pitfalls and false-positive conclu¬
sions in patients with similar clinical symptoms who do not have SpA.
Diagnosis of SpA should result from the combination of clinical, laboratory
and imaging findings.
Comorbidities in Patients with Spondyloarthritis
523
Irene E. van
der
Horst-Bruinsma, Michael T. Nurmohamed, and
Robert B.M.
Landewé
Chronic inflammatory spondyloarthritis involves axial symptoms of the
spine and sacroiliac joints, or peripheral arthritis. Many patients suffer
from extra-articular manifestations. With acute anterior uveitis, rapid
treatment prevents synechiae. Other organs can be involved. Treatment
includes exercise, nonsteroidal antiinflammatory drugs (if insufficient
response, tumor necrosis factor
blockers),
and (with peripheral arthritis)
sulfasalazine. Patients with ankylosing spondylitis have comorbidities
and increased cardiovascular risk. For uveitis or inflammatory bowel
disease, patients should be referred to an ophthalmologist or gastroen-
terologist. Cardiovascular risk may originate from atherosclerotic dis¬
ease and cardiac manifestations.
Epidemiológica!
studies should be
conducted before echocardiogram screening and cardiovascular risk
management.
The Genetics of Ankylosing Spondylitis and Axial Spondyloarthritis
539
Philip C. Robinson and Matthew A. Brown
Ankylosing spondylitis (AS) and spondyloarthritis are strongly genetically
determined. The long-standing association with HLA-B27 is well de¬
scribed, although the mechanism by which that association induces AS
remains uncertain. Recent developments include the description of HLA-
B27 tag single nucleotide polymorphisms in European and Asian popula¬
tions. An increasing number of non-MHC genetic associations have been
reported, which provided amongst other things the first evidence of the in¬
volvement of the IL-23 pathway in AS. The association with ERAP1 is now
known to be restricted to HLA-B27 positive disease. Preliminary studies on
Contents
the genetics of axial spondyloarthritis demonstrate a lower HLA-B27 car¬
riage rate compared with AS. Studies with larger samples and including
non-European ethnic groups are likely to further advance the understand¬
ing of the genetics of AS and spondyloarthritis.
Pathophysiology of New Bone Formation and Ankylosis in Spondyloarthritis
555
Rik J.U.
Lories and
Georg Schett
The outcome of patients suffering from spondyloarthritis is determined
by chronic inflammation and new bone formation leading to ankylosis.
The latter process manifests by new cartilage and bone formation leading
to joint or spine fusion. This article discusses the main mechanisms of new
bone formation in spondyloarthritis. It reviews the key molecules and con¬
cepts of new bone formation and ankyiosis in animal models of disease
and translates these findings to human disease. In addition, proposed
biomarkers
of new bone formation are evaluated and the translational
current and future challenges are discussed with regards to new bone
formation in spondyloarthritis.
Pathophysiology and Role of the Gastrointestinal System in Spondyloarthritides
569
Peggy Jacques, Liesbet Van Praet, Philippe
Carrón,
Filip
Van den Bosch,
and Dirk Elewaut
Inflammatory bowel disease (IBD) is a well-known extra-articular manifes¬
tation in spondyloarthritis (SpA); about
6.5%
of patients with ankylosing
spondylitis develop IBD during the course of the disease. The pathogene-
sis of both SpA and IBD is considered to be the result of a complex
interplay between the host (genetic predisposition), the immune system
and environmental factors, notably microorganisms, leading to a disturbed
immune system and chronic inflammation. Over the past decade, the role
of tumor necrosis factor inhibition (infliximab, etanercept, adalimumab, go-
limumab) in improving signs and symptoms and overall quality of life has
been well documented in various forms of SpA. Future research will clarify
the role of other potential targets.
Therapy for Spondyloarthritis: The Role of Extra-articular Manifestations
(Eye. Skin)
583
Philippe
Carrón,
Liesbet Van Praet Peggy Jacques, Dirk Elewaut,
and
Filip
Van den Bosch
Spondyloarthritis can be considered one of the prototypes (besides rheu¬
matoid arthritis) of an inflammatory rheumatic disease. The
locomotor
sys¬
tem is prominently involved with arthritis, enthesitis, dactylitis, sacroiliitis,
and/or axial disease; but besides the rheumatologic component, other
body systems are frequently affected. Extra-articular manifestations are
all the medical conditions and symptoms that are not directly related to
the
locomotor
system. Besides inflammatory bowel diseases, the major
concept-related extra-articular manifestations are located in the eye
(acute anterior uveitis) and the skin (psoriasis). This review focuses on
the possible implications of these nonrheumatologic manifestations re¬
garding the treatment of spondytoarthritis.
Contents
Therapeutic Controversies in Spondyloarthritis: Nonsteroidal Anti-Inflammatory
Drugs
601
Denis Poddubnyy and
Désirée
van
der Heijde
Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered a first-line
therapy in patients with axial spondyloarthritis (axSpA), including ankylos-
ing spondylitis. NSAIDs reduce pain and stiffness effectively in most pa¬
tients, are able to reduce systemic and local inflammation, and can
inhibit progression of structural damage in the spine. However, effective
control of symptoms and retardation of
radiographie
progression often re¬
quire continuous and long-term treatment, which raises safety concerns.
This article discusses controversies related to the current role of NSAIDs
in axSpA treatment, risks and benefits of this treatment, and current trends
for individualized treatment.
Therapeutic Controversies: Tumor Necrosis Factor
α
Inhibitors in Ankylosing
Spondylitis
613
I.H. Song and W.P. Maksymowych
Tumor necrosis factor
α
inhibitors (TNF
blockers)
have revolutionized the
treatment of patients with ankylosing spondylitis. Despite clinical efficacy,
there are questions and controversies treating rheumatologists face,
which this review discusses: whether there are specific indications for spe¬
cific TNF
blockers;
whether the dose of TNF
blockers
can be decreased;
whether immunogenicity plays a role; what the role of residual active in¬
flammation on
MRI
might be; and whether there is a window of opportunity
to treat patients with ankyiosing spondylitis and prevent
radiographie
pro¬
gression. This article also summarizes evidence for switching between
TNF
blockers
and addresses the question of malignancies.
How Important is Early Therapy in Axial Spondyloarthritis?
635
Joachim Sieper and
Jürgen Braun
There are
2
groups of drugs that have been shown effective in the treatment
of patients with axial spondyloarthritis: nonsteroidal anti-inflammatory
drugs and tumor necrosis factor a,
blockers.
Conventional disease-modify¬
ing drugs and some other biologies have not been shown clinically effica¬
cious in this disease. This overview discusses the available data on
whether early treatment strategies in patients with axial spondyloarthritis
have an effect on
(1)
the percentage of patients reaching clinical remission,
(2)
achieving drug-free remission, and
(3)
the progress of
radiographie
pro¬
gression in the spine as a parameter for structural damage.
Index
643
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illustrated | Illustrated |
indexdate | 2024-12-24T02:54:30Z |
institution | BVB |
isbn | 9781455750665 |
language | English |
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oclc_num | 820425653 |
open_access_boolean | |
owner | DE-355 DE-BY-UBR |
owner_facet | DE-355 DE-BY-UBR |
physical | XXI S., S. 442 - 652 Ill., graph. Darst. |
publishDate | 2012 |
publishDateSearch | 2012 |
publishDateSort | 2012 |
publisher | Saunders |
record_format | marc |
series | Rheumatic disease clinics of North America |
series2 | Rheumatic disease clinics of North America |
spellingShingle | Spondyloarthritis Rheumatic disease clinics of North America Bechterew-Krankheit (DE-588)4069213-9 gnd |
subject_GND | (DE-588)4069213-9 |
title | Spondyloarthritis |
title_auth | Spondyloarthritis |
title_exact_search | Spondyloarthritis |
title_full | Spondyloarthritis guest ed.: Jürgen Braun ... |
title_fullStr | Spondyloarthritis guest ed.: Jürgen Braun ... |
title_full_unstemmed | Spondyloarthritis guest ed.: Jürgen Braun ... |
title_short | Spondyloarthritis |
title_sort | spondyloarthritis |
topic | Bechterew-Krankheit (DE-588)4069213-9 gnd |
topic_facet | Bechterew-Krankheit |
url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=025420175&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
volume_link | (DE-604)BV000625464 |
work_keys_str_mv | AT braunjurgen spondyloarthritis |