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Abstract Background Secukinumab has shown high efficacy in randomized controlled trials in both ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Here, we investigated its real-life effectiveness and tolerability in a cohort of AS and PsA patients. Methods We retrospectively analyzed medical records of outpatients with AS or PsA treated with secukinumab between December 2017 and December 2019. ASDAS-CRP and DAS28-CRP scores were used to measure axial and peripheral disease activity in AS and PsA, respectively. Data were collected at baseline and after 8, 24, and 52 weeks of treatment. Results Eighty-five adult patients with active disease (29 with AS and 56 with PsA; 23 males and 62 females) were treated. Overall, mean disease duration was 6.7 years and biologic-naïve patients were 85%. Significant reductions in ASDAS-CRP and DAS28-CRP were observed at all time-points. Body weight (in AS) and disease activity status at baseline (particularly in PsA) significantly affected disease activity changes. ASDAS-defined inactive disease and DAS28-defined remission were achieved in comparable proportions between AS and PsA patients, at both 24 weeks (45% and 46%) and 52 weeks (65.5% and 68%, respectively); male sex was found an independent predictor of positive response (OR 5.16, P = 0.027). After 52 weeks, achievement of at least low disease activity and drug retention were observed in 75% of patients. Secukinumab was well-tolerated and only mild injection-site reactions were recorded in 4 patients. Conclusion In a real-world setting, secukinumab confirmed great effectiveness and safety in both AS and PsA patients. The influence of gender on treatment response deserves further attention.
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AIM: To study the spectrum of imaging appearances on CTand MRI in ankylosing spondylitis with HLAB27 positive patients in kumaon region. Materials and Methods: This was a prospective study conducted in the department of Radiodiagnosis Government Medical College and Dr Susheela Tiwari Memorial Hospital,Haldwani. This study was carried out on 51 cases of ankylosing spondylitis HLAB27 positive cases. C.T. and MRI features were observed on T1weighted, T2weighted and short tau inversion recovery (STIR) sequences. The Spectrum of imaging was studied on the basis of history, clinical evaluation and characteristic radiological features on C.T. and M.R.I. Results: The disease was most commonly seen in adults with a male predominance in 37 (72.5%) cases. Backache (82.4%) was most common clinical feature followed by inflammation in (80%) cases. Lumbar spine was the most common site in 45 (88%) cases with bilaterally symmetrical involvement in 45 (88%) cases. Subchondral sclerosis was better appreciated in C.T. in 34 (66.6%) cases followed by joint erosion in 23 (45%) cases and joint space alteration in 15(29.4%) cases. Whereas, bone marrow oedema 37 (72.5%) cases was better appreciated in M.R.I followed by articular margin irregularity in 34(66.6%) cases and presence of erosion in 32 (62.7%) cases. Conclusion: Imaging is an integral part in the early detection of disease and optimizing management of affected patients for their better prognosis. CTand MRI plays a decisive role in the diagnosis and these modalities are also helpful in monitoring the disease
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OBJECTIVE@#To compare the clinical efficacy between herb-separated moxibustion and conventional moxibustion on ankylosing spondylitis (AS) based on oral administration of sulfasalazine enteric-coated tablets.@*METHODS@#A total of 64 patients with AS of cold-dampness obstruction type were randomly divided into an herb-separated moxibustion group and a conventional moxibustion group, 32 cases in each one. Based on oral administration of sulfasalazine enteric-coated tablets, the patients in the conventional moxibustion group were treated with moxibustion at the area with Dazhui (GV 14) to Changqiang (GV 1) as center and about 10 cm in width; the moxibustion was given for 1 hour. In the herb-separated moxibustion group, the gauze was soaked in the medicinal liquor and ginger juice, and placed on the same moxibustion area as the conventional moxibustion group, followed by moxibustion for 1 hour. The treatment in the two groups was given once a week, three treatments constituted a course and totally three courses were given. The symptom quantification score, occipital-wall distance, Schober test, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were observed before and after treatment in the two groups, and the clinical efficacy was evaluated.@*RESULTS@#Compared before treatment, the symptom quantification score, occipital-wall distance, CRP and ESR levels were lower but the Schober test was higher after treatment in the two groups (all 0.05). The total effective rate was 90.0% (27/30) in the herb-separated moxibustion group, which was higher than 73.3% (22/30) in the conventional moxibustion group (<0.05).@*CONCLUSION@#The herb-separated moxibustion combined with sulfasalazine enteric-coated tablets has significant efficacy for AS with cold-dampness obstruction type, which could obviously relieve pain symptoms, improve occipital-wall distance, Schober test and other physical signs, and improve the quality of life.
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Humans , Acupuncture Points , Moxibustion , Quality of Life , Spondylitis, Ankylosing , Therapeutics , Sulfasalazine , Tablets, Enteric-Coated , Treatment OutcomeABSTRACT
Objective:To investigate the clinical significance of bone metabolism indexes and human leukocyte antigen B27 (HLA-B27)in ankylosing spondylitis(AS)and analyze their diagnostic value. Methods:The subjects were 94 cases of AS patients,239 cases with other diseases and 80 healthy controls, and the results were retrospectively surveyed. Results:In the AS group, the concentration of the β-collagen specific sequence (β-CTX ) was higher ( P<0. 05 ) while the concentrations of osteocalcin ( OC ) , 25-hydroxyvitamin D[25-(OH)D] and parathyroid hormone(PTH)were lower than those in the control group. In the AS group,there was a positive correlation between the concentration of C-reactive protein(CRP)and β-CTX(P<0. 01),and the concentration of CRP was negatively correlated with the concentration of 25-(OH)D(P<0. 05). However,the concentrations of other bone metabolic indexes had no correlation with the concentration of CRP(P<0. 05). The positive rate of HLA-B27 in the AS group was significantly higher than that in other groups(P<0. 05),and HLA-B27 had highly sensitive and specific in the diagnosis of AS. In the AS group,the sensitivity of the concentration of 25-( OH) D was higher than β-CTX,while its specificity was lower than β-CTX. Conclusion:Bone metabolic indexes have great value in early screening and clinical diagnosis of AS,especially β-CTX and 25-( OH) D were more obvious.
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Objective:To investigate the clinical significance of bone metabolism indexes and human leukocyte antigen B27 (HLA-B27)in ankylosing spondylitis(AS)and analyze their diagnostic value. Methods:The subjects were 94 cases of AS patients,239 cases with other diseases and 80 healthy controls, and the results were retrospectively surveyed. Results:In the AS group, the concentration of the β-collagen specific sequence (β-CTX ) was higher ( P<0. 05 ) while the concentrations of osteocalcin ( OC ) , 25-hydroxyvitamin D[25-(OH)D] and parathyroid hormone(PTH)were lower than those in the control group. In the AS group,there was a positive correlation between the concentration of C-reactive protein(CRP)and β-CTX(P<0. 01),and the concentration of CRP was negatively correlated with the concentration of 25-(OH)D(P<0. 05). However,the concentrations of other bone metabolic indexes had no correlation with the concentration of CRP(P<0. 05). The positive rate of HLA-B27 in the AS group was significantly higher than that in other groups(P<0. 05),and HLA-B27 had highly sensitive and specific in the diagnosis of AS. In the AS group,the sensitivity of the concentration of 25-( OH) D was higher than β-CTX,while its specificity was lower than β-CTX. Conclusion:Bone metabolic indexes have great value in early screening and clinical diagnosis of AS,especially β-CTX and 25-( OH) D were more obvious.
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<p><b>OBJECTIVE</b>To observe the clinical efficacy differences between acupuncture combined with dynamic moxibustion and acupuncture alone for adult ankylosing spondylitis (AS) at early-to-mid stage based on medication.</p><p><b>METHODS</b>Fifty-five cases of adult AS were randomly divided into an acupuncture-moxibustion group (28 cases) and an acupuncture group (27 cases). The two groups were treated with oral administration of sulfasalazine tablets. In addition, the acupuncture-moxibustion group was treated with acupuncture at Jiaji (EX-B 2), Shenshu (BL 23), Dachangshu (BL 25), Weizhong (BL 40) as well as dynamic moxibustion at the first line of bladder meridian of foot-and governor vessel from Dazhui (GV 14) to Yaoshu (GV 2). The acupuncture group was treated with acupuncture, the acupoints and manipulation of which were identical to acupuncture-moxibustion group. The treatment was given once a day, five days per week; one session was consisted of one-month treatment, and totally three sessions were given. The bath ankylosing spondylitis functional index (BAFI) and bath ankylosing spondylitis disease activity index (BASDAI) were compared before and after treatment in the two groups; also the clinical effective rates were compared between the two groups.</p><p><b>RESULTS</b>The total effective rate was 96.4% (27/28) in the acupuncture-moxibustion group, which was superior to 88.9% (24/27) in the acupuncture group (<0.05). Compared before treatment, the BASFI and BASDAI were reduced after treatment in the two groups (all<0.05), which were more significant in the acupuncture-moxibustion group (both<0.05).</p><p><b>CONCLUSIONS</b>Based on medication, acupuncture combined with dynamic moxibustion could improve the clinical symptoms of AS, which is superior to simple acupuncture.</p>
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<p><b>OBJECTIVE</b>To compare the clinical efficacy differences betweenmethod and twirling-reinforcing needling method for ankylosing spondylitis (AS) at early stage.</p><p><b>METHODS</b>Sixty-eight patients were randomly assigned to an observation group and a control group, 34 cases in each one. The acupoint selection in the two groups was identical, taking Dazhui (GV 14) and Mingmen (GV 4) as the main acupoints. Patients in the observation group were treated withmethod, while patients in the control group were treated with twirling-reinforcing needling method. The treatment was given once a day, and seven treatments were considered as one course of treatment. The TCM symptom grading quantitative standard score, Barthel ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis ankylosing spondylitis function index (BASFI) were compared in the two groups before and after 3 treatment courses; also the efficacy was evaluated.</p><p><b>RESULTS</b>The total efficacy rate was 91.2% (31/34) in the observation group, which was superior to 79.4% (27/34) in the control group (<0.05); after treatment, the TCM symptom grading quantitative standard score, BASDAI and BASFI were significantly improved in the two groups (all<0.05), which were more significant in the observation group (all<0.05).</p><p><b>CONCLUSIONS</b>Themethod at Dazhui (GV 14) and Mingmen (GV 4) could effectively improve the symptoms of AS patients at early stage, which was superior to twirling-reinforcing needling method.</p>
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Objective To compare PCR-SBT to IMS-ELISA in the HLA-B27 detection in the ankylosing spondylitis (AS)pa-tients.Methods Simultaneously,PCR-SBT and IMS-ELISA were used to detect the HLA-B27 expression in peripheral blood samples which were suspected patients with AS from 120 cases.Chisquare test of paired design and the area under curve of receiver operating characteristics of SPSS17.0 software were used to evaluate the value of PCR-SBT and IMS-ELISA in HLA-B27 detection of AS patients.Results Among 120 cases of suspected patients with AS,the positive rates of HLA-B27 detected by PCR-SBT and IMS-ELISA were 45.83%(55/120)and 37.50% (45/120),respectively.There was statistical difference between the two methods in the HLA-B27 detection (χ2 =59.455,P =0.000).The sensibility and spe-cificity of PCR-SBT were 96.36% and 96.92%,respectively.While the sensibility and the specificity of IMS-ELISA were 69.09% and 89.23%,respectively.Area under the curve of two methods were 0.966 and 0.792,respectively.Conclusion In comparison with IMS-ELISA,the sensibility and the specificity of PCR-SBT in HLA-B27 detection were higher in AS diag-nosis,that is to say,PCR-SBT is better in HLA-B27 detection and AS diagnosis.