Jonathan Crowe

My Correct Views on Everything

Spondylitis News: November 2011

A lot of news related to spondylitis research to report on this time, thanks in part to papers presented earlier this month at the American College of Rheumatology’s Annual Scientific Meeting in Chicago.

A new study suggests that CT scans are better at detecting sacroilitis — inflammation of the sacroiliac joint, the main symptom of AS patients — than X-rays, Doctors Lounge reports. My last X-rays showed very little evidence of sacroilitis after 14 years; my rheumatologist really had to look for it. I’m going in for an MRI at some point in the future, but that takes some time to schedule.

Of course, it might be because I’ve been taking NSAIDs all this time. Another study reports that NSAIDs actually slow the progression of AS, rather then just treat it symptomatically: “the researchers noted that patients with ankylosing spondylitis who had a high NSAID intake (which was about 27 percent of the participants), in comparison to those with low intake (73 percent), had significantly lower rate of disease progression in the spine.” The article also introduces me to a new concept: non-radiographic axial spondyloarthritis, where there are symptoms but no apparent damage. Maybe that’s what I have.

Another study presented at the ACR’s annual meeting explores the predictors of spinal damage in spondyloarthritis.

The safety of TNFα antagonistsetanercept (Enbrel), infliximab (Remicade), adalimumab (Humira) and golimumab (Simponi) — is a hot topic of discussion lately. While Abbott presented the results of a five-year study into Humira’s effectiveness in reducing AS’s symptoms at the ACR meeting (hint: improvement), and also announced results of a study looking at its use in that non-radiographic axial spondlyoarthritis I was talking about earlier (hint: helpful), the U.S. Food and Drug Administration has issued another warning asking for increased cancer surveillance among young patients receiving TNFα blockers.

On the other hand, TNFα antagonists do not appear to be associated with an increased risk of serious infections, according to a study published in the Journal of the American Medical Association. This goes against the conventional wisdom about TNFαs, which as immunosuppresants were expected to raise the risk of infection. The JAMA addresses this issue in an editorial. (Note that there is a difference between an infection like a months-long sore throat, which one AS patient I knew had — and a serious infection requiring hospitalization, which is what this study is talking about.)

And it’s not like AS doesn’t have its own complications, regardless of what meds we’re taking for it, such as an increased risk of heart-related health problems. “Ankylosing spondylitis patients had a 58 percent greater risk of aortic and nonaortic valvular heart disease, compared to the general population. They were 37 percent more likely than the general population to have ischemic heart disease, and 34 percent more likely to have congestive heart failure. They had a 36 percent greater risk of ‘other’ cardiovascular diseases, and a 25 percent greater risk of stroke, compared to those without the disease.”

Finally, some profiles of people with AS in the local media. The Desert Sun looks at La Qunita teen Liam Young, who at 16 years of age has become an advocate for children with arthritis. In the Hastings and St. Leonards Observer, a profile of Kevin Andrews that introduces readers to AS in general.