Studies From Around The Web: May 30, 2006
5/30/2006
Sometimes, the progress of diagnosis of a spondyloarthropathy can be a long and frustrating road. At times a diagnosis of "undifferentiated spondyloarthropathy" (USpA) is initially made when the symptoms of a specific disease - ankylosing spondylitis for example - are not present. In a recent study published in the journal, Annals of the Rheumatic Diseases, researchers have found that even "low grade" sacroiliac joint involvement is a sign of AS in those people initially diagnosed with USpA:
Low grade radiographic sacroiliitis as prognostic factor in patients with undifferentiated spondyloarthritis fulfilling diagnostic criteria for ankylosing spondylitis throughout follow up
Conclusions: Low grade radiographic sacroiliitis is a prognostic factor for ankylosing spondylitis in patients originally classified as having undifferentiated SpA. Low grade radiographic sacroiliitis should be regarded as indicative of early ankylosing spondylitis in patients with undifferentiated SpA.
More information
Link to study abstract: http://ard.bmjjournals.com/cgi/content/abstract/65/5/642
Go here for more information on USpA: http://www.spondylitis.org/about/undif.aspx
Researchers are constantly evaluating and re-evaluating medicinal treatments for their safety and effectiveness. The biologic medications or TNF-a Inhibitors (Enbrel, Remicade & Humira) are no exception. In the following study published in June 2006 issue of Arthritis & Rheumatism, Dr. Dominique Baeten led a team who was trying to determine if using synovial tissue biopsies (biopsies of the thin, loose, vascular connective tissue that makes up the membranes surrounding joints and the sheaths protecting tendons where they pass over bony prominences) could help show the effectiveness of treating people with Enbrel or Remicade.
Identification of synovial biomarkers of response to experimental treatment in early-phase clinical trials in spondylarthritis
Conclusion: Changes in synovial macrophage subsets, PMN levels, and MMP-3 expression reflect response to treatment in SpA. The ability of these parameters to correctly identify effective therapy makes them interesting biomarkers for use in early-phase clinical trials in SpA.
According to Dr. Baeten, "Their ability to correctly
discriminate between effective and ineffective treatment in
small patient cohorts makes them interesting biomarkers to
facilitate conclusive early phase clinical trials in SpA.
Further studies are needed to confirm their
value as biomarkers at early time points across different
therapeutic regimens and to combine synovial assessment
with predictors of axial response to treatment in SpA."
More information
What is a biomarker? (from: http://www.alz.org/Resources/Glossary.asp): "Used to indicate or measure a biological process (for instance, levels of a specific protein in blood or spinal fluid, genetic mutations, or brain abnormalities observed in a PET scan or other imaging test). Detecting biomarkers specific to a disease can aid in the identification, diagnosis, and treatment of affected individuals and people who may be at risk but do not yet exhibit symptoms."
Link to abstract: http://www3.interscience.wiley.com/cgi-bin/abstract/112636777/ABSTRACT
Go here for more information on the TNF-a Treatments: http://www.spondylitis.org/press/tnf.aspx