Real-world experience of secukinumab treatment for ankylosing spondylitis at the Royal National Hospital for Rheumatic Diseases, Bath.

We reviewed our experience of treating ankylosing spondylitis patients with the IL-17 inhibitor secukinumab at the Royal National Hospital for Rheumatic Diseases, Bath. A total of 76 patients were included, of whom secukinumab was the first-line biologic drug used in 24, second line in 23, and third line in 29 patients, respectively. Only 5 patients discontinued the drug due to side effects before their first outpatient review, including 1 new case of inflammatory bowel disease. Significant improvements were seen in all disease outcome measures in patients receiving secukinumab as their first-line biologic agent, with a trend to improved mean BASDAI and BASFI even in patients receiving it as a second- or third-line biologic agent. This real-world analysis adds to the evidence recommending secukinumab as a largely safe and effective treatment for ankylosing spondylitis.Key Points• Secukinumab was efficacious for improving short-term mean disease activity and function in our cohort of ankylosing spondylitis patients, regardless of whether used as the first-, second-, or third-line biologic disease-modifying drug.• There were very low rates of discontinuation due to side effects in our cohort of secukinumab-treated ankylosing spondylitis patients.

Ankylosing spondylitis: diagnosis and management.

This article provides an overview of ankylosing spondylitis, including signs and symptoms, diagnosis and management. The article focuses on the difficulties and delays associated with diagnosing this chronic inflammatory disease and developments in diagnostic criteria. Changes in the management of patients with the disease are also discussed, particularly in light of anti-tumour necrosis factor therapy.

A literature review regarding the management of varicella-zoster virus.

Chickenpox and shingles (varicella-zoster virus [VZV]) pose a threat to individuals who are immunosuppressed and/or have rheumatoid arthritis or another inflammatory musculoskeletal condition. In this paper we present a literature review of the condition, management and prevention.

Kinetics and structural constraints of chromate reduction by green rusts.

Green rusts, ferrous-ferric iron oxides, occur in many anaerobic soils and sediments and are highly reactive, making them important phases impacting the fate and transport of environmental contaminants. Despite their potential importance in environmental settings, reactions involving green rusts remain rather poorly described. Chromate is a widespread contaminant having deleterious impacts on plant and animal health; its fate may in part be controlled by green rust. Here we examine chromate reduction by a series of green rust phases and resolve the reaction kinetics at pH 7. The overall kinetics of the reactions are well described by the expression d[Cr(VI)]/dt = -k[Cr(VI)][GR], and this model was successfully used to predict rates of reaction at varying chromium concentrations. The rates of reduction are controlled by the concentration of ferrous iron, surface area, and chemical structure of the green rust including layer spacing. On a mass basis, green rust (GR) chloride is the most rapid reductant of Cr(VI) followed by GRCO3 and GRSO4, with pseudo-first-order rate coefficients (k(obs)) (with respect to Cr(VI) concentration) ranging from 1.22 x 10(-3) to 3.7 x 10(-2) s(-1). Chromium(III)-substituted magnetite and lepidocrocite were identified as the major oxidation products. The nature of the oxidation products appears to be independent of the anionic class of green rust, but their respective concentrations display a dependence on the initial GR. The mole fraction of Fe(III) in the Cr(x),Fe(1-x)(OH)3 x nH2O reaction product ranged from 17% to 68%, leading to a highly stabilized (low solubility) phase.