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Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease of the axial spine that can manifest with various clinical signs and symptoms. Chronic back pain and progressive spinal stiffness are the most common features of this disease. It is an autoimmune disease which also leads to the involvement of skeletal, cardiac, nervous tissues, and other systemic organs. Aim and Objectives: This study was conducted to assess the correlation between the Bath AS Disease Activity Index (BASDAI) score/visual analog scale (VAS) and various age groups in the patients suffering with AS using standard questionnaire. Materials and Methods: Forty-eight AS patients having BASDAI scores of ?4 were included in this study. The height and weight were taken and responses to the standard questionnaire were recorded. BASDAI Score, body mass index (BMI), and VAS were computed. The patients with history of chronic diseases such as hyper/hypothyroidism, diabetes mellitus, and hypertension or the use of any medication such as ?/? blockers, calcium channel blockers, and antiepileptics were excluded from the study. Results: The patients were divided into six different age groups, i.e., 15–20 years, 21–25 years, 26–30 years, 31–35 years, 36–40 years, and 41–45 years. The mean ± SEM values of the BASDAI score in various age groups were 6.8 ± 0.34, 6.3 ± 0.33, 6.2 ± 0.26, 7.1 ± 0.41, 6.5 ± 0.30, and 5.8 ± 0.48, respectively. The mean ± SEM values of VAS are shown in relation to the various age groups, i.e., 15–20 years, 21–25 years, 26–30 years, 31–35 years, 36–40 years, and 41–45 years and the values were 6.88 ± 0.312, 6.58 ± 0.22, 6.55 ± 0.66, 6.00 ± 0.23, 6.72 ± 0.25, and 6.0 ± 0.50, respectively. Conclusion: This study indicates that in the young age group, patients BASDAI score is higher and BMI is lower, and in the older age group, patients BASDAI score is lower and BMI is higher than each other indicating higher disease activity in the younger patients than older patients. An inverse correlation between VAS and age further substantiates our previous finding.
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Objective To investigate whether expression quantity of HLA-B27 and its subtypes associated with incidence of AS,the gene expression of HLA-B27 and its subtypes were detected in patients with AS.Methods 120 cases patients sus-pected with AS and 50 healthy subjects were enrolled in the study.Main demographic and clinical characteristics of the sub-jects were collected.Meanwhile total RNA was isolated from peripheral blood and real time RT-PCR was used to measure the quantitative expression of HLA-B27 gene.Besides RT-PCR,sequence-based typing (SBT)method was used to confirm the HLA-B27 subtype.All experimental data were analyzed by SPSS17.0 software and P values <0.05 were considered to be significant.Results Firstly,there were 55 subjects were finally diagnosed as AS patients among the 120 patients suspec-ted with AS.There were 53 subjects whose HLA-B27 was positive (96.36%)in 55 patients with AS.It showed that there was a correlation between BASDAI and expression quantity of HLA-B27 gene (r=0.845,P =0.000).Five subtypes were found and which were HLA-B27∶04 subtype (29/53,54.72%),HLA-B27:05 subtype (20/53,37.74%),HLA-B27 ∶02 subtype (2/53,3.77%),HLA-B27∶03 subtype (1/53,1.89%)and HLA-B27∶07 subtype (1/53,1.89%),respectively. Among the 50 healthy subjects,there were only one kind of subtype (2/50,4%),which was HLA-B27∶04.There were no statistical difference in the age (t=0.711,P =0.480),sex (χ2 =0.880,P =0.348),family history (χ2 =0.011,P =0.916) and treatment (χ2 =0.113,P =0.736)between the HLA-B27∶04 and HLA-B27∶05 subtypes.Conclusion HLA-B27∶04 and HLA-B27∶05 were primary subtypes in AS patients which HLA-B27 positive.There was a correlation between gene expression quantity of HLA-B27 and AS disease activity index.
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Objective To investigate the value of ankylosing spondylitis(AS)disease activity score (ASDAS)and the Bath AS disease activity index(BASDAI)in evaluating disease activity in AS.Methods ASDAS and BASDAI were used to evaluate disease activity in patients with AS,taking the patients' global scores,physician global scores and treatment decision as the “gold standard” for disease activity.According to the “gold standard”,the patients were divided into low and high disease activity groups.Statistical analysis included descriptive statistics,linear correlation and regression and ROC curve.Results A total of 227 patients with AS were included.ASDAS and BASDAI showed good correlation with disease activity as reflected by the patients' global score[r for BASDAI,ASDAS based on ESR(ASDAS-ESR)and ASDAS based on C-reactive protein(ASDAS-CRP)were 0.713,0.698 and 0.725,respectively,P =0.000]and the physician global score(r for BASDAI,ASDAS-ESR and ASDAS-CRP were 0.771,0.782,0.847,respectively,P =0.000).Both scores showed good discriminative ability for high and low disease activity states.ASDAS-CRP had the highest sensitivity.Conclusion ASDAS is a promising tool for evaluating disease activity in AS patients.
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PURPOSE: To investigate whether serum amyloid A (SAA) levels are increased in patients with ankylosing spondylitis (AS) and whether its levels correlate well with AS disease activity. MATERIALS AND METHODS: Thirty-eight patients with AS and 38 age- and sex-matched control subjects were enrolled in this cross-sectional study. Their SAA levels were quantitatively measured by immunonephelometry. An established, self-administered instrument for evaluating disease activity (Bath Ankylosing Spondylitis Disease Activity Index, BASDAI) was used to measure and acute phase reactants, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), in patients with AS. RESULTS: Patients with AS had a significantly higher mean SAA level than controls (9.52 +/- 7.49mg/L versus 2.73 +/- 1.57mg/L, p < 0.05), and the mean BASDAI score of patients with elevated SAA levels was significantly higher than that of patients with normal SAA levels (5.6 +/- 1.3 versus 4.4 +/- 1.5, p < 0.05). SAA levels showed significant correlations with BASDAI scores (r=0.431, p=0.007), ESR (r=0.521, p=0.001) and CRP levels (r=0.648, p < 0.001). Additionally, the correlation between ESR and CRP levels also appeared significant (r=0.703, p < 0.001). In those with normal ESR or CRP levels, SAA levels and BASDAI scores were elevated (p < 0.05) and showed a trend of positive correlation with one another. CONCLUSION: Our data showed that SAA levels were increased in patients with AS and correlated well with disease activity. These findings suggest that SAA can be used as a valuable indicator of disease activity in AS.
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Objective To assess the efficacy and safety of leflunomide in active ankylosing spondylitis.Methods Totally 62 cases of active ankylosing spondylitis were included,and divided randomly into leflunomide group(n=26)and methotrexate group(n=36).The patients in leflunomide group received an oral leflunomide loading dose of 50 mg or 40 mg once daily for the first 3 days followed by a maintenance dose of 50 mg or 40 mg once weekly,according to whether the bodyweight was more than 50 kg or less than 50 kg,respectively.The patients in methotrexate group were prescribed oral methotrexate 5 mg once in the first week,10 mg once in the second week,15 mg once in the third week and thereafter weekly.Sulfasalazine was prescribed 0.75 three times daily in both groups.The Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)and The Bath Ankylosing Spondylitis Metrology Index(BASIM)scoring instruments were used to assess the responsiveness to leflunomide and methotrexate at entry,three months,six months,twelve months and eighteen months after treatment,respectively.Laboratory data including peripheral blood counts(WBC,HGB,RBC),erythrocyte sedimentation rates(ESR),liver enzymes,serum creatinine,urinary sediments were detected at the same time.Sacroiliac joints CT scan and other involved joints x-ray radiograph examinations were taken at entry,six months,twelve months and eighteen months after treatment,respectively.Results Twenty-two cases in leflunomide group and 29 cases in methotrexate group were followed up to eighteen months.BASDAI in leflunomide group was significantly lower(P