ABSTRACT
Objective To investigate the clinical effect of azithromycin on ankylosing spondylitis (AS). Methods Sixty-four AS patients with active disease were enrolled in this study. Among them, thirty-two AS patients (treatment group)received Azithromycin treatment at a dose of 0.5 g once a day for a period of 5~7 days , and another thirty-two patients receiving conventional treatment served as control (control group). BASDAI, CRP and ESR served as the disease activity evaluation index. Results Activity indexes in two groups of in the first 4~ 20 weeks of the treatment were decreased compared with those before the treatment (P < 0.05), while a rise was found in the 20 ~ 24 week and activity indexes gradually returned to pretreatment levels. At 0 ~ 16 weeks , the disease activity index of treatment group was below normal levels but that of control group was higher than the normal level with significant difference (P < 0.05). Conclusion The treatment of Azithromycin can control the disease activity of AS in the long term, which would be a new proposal in AS treatment.
ABSTRACT
Objective To investigate the relationship between recent chlamydia pneumoniae (Cp)infection and active ankylosing spondylitis (AS). Methods Seventy nine AS outpatients and 73 normal controls (NC) were enrolled into this study. Serum anti-Cp antibodies (CpIg) were tested using the enzymelinked immunosorbent assay (ELISA). Clinical and experimental data were collected. Patients with positive CpIgM or CpIgA were considered as having a recent Cp infection. Wilcoxon test, Student's t test, χ2 test and multivariate logistic regression were used for statistical analysis. Results Both AS patients and normal controls had a high prevalence for sero-positive CpIgG, which was 89％(70/79) vs 92％(67/73) respectively,while AS patients had a higher frequency of CpIgA and CpIgM when compared with NC [52％(41/79) vs 32％(23/73), χ2=6.61, P=0.010 for CpIgA; 80％(63/79) vs 21％(15/73), χ2=44.031, P＜0.01 for CpIgM]. The presence of CpIgM or CpIgA favored AS, the OR was 17.1 (95％CI 7.4～39.5), or 3.1 (95％CI 1.3～7.2),respectively. In addition, CpIgM was associated with disease activity parameters including ESR (χ2=2.56, P=0.021), CRP (χ2=7.28, P=0.007) and BASDAI (χ2=6.79, P=0.009). Furthermore, consecutive positive CpIgM favored the persistent active or relapsed disease, while negative CpIgM favored a reduced disease activity.There was no correlation between CpIgM/CpIgA and peripheral joint disease and enthesitis. Conclusion Recent Cp infection is highly associated with AS and CpIgM antibody relates with active AS, which indicates that Cp infections may be a critical triggering factor for active AS.