Newsletter Rhumatologues N°19
Une nouvelle newsletter a été rédigée par le Pr Francis Berenbaum à l’attention de tous les rhumatologues impliqués et portant un intérêt à la cohorte DESIR.
Vous pouvez la consulter en cliquant ici.
Bonne lecture!
Une nouvelle newsletter a été rédigée par le Pr Francis Berenbaum à l’attention de tous les rhumatologues impliqués et portant un intérêt à la cohorte DESIR.
Vous pouvez la consulter en cliquant ici.
Bonne lecture!
Un nouvel article scientifique intitulé « Anterior chest wall pain in recent inflammatory back pain suggestive of spondyloarthritis. data from the DESIR cohort. » a été publié dans le journal J. Rheumatol.
Wendling D, Prati C, Demattei C, Loeuille D, Richette P, Dougados M.
J Rheumatol. 2013 Jul;40(7):1148-52. doi: 10.3899/jrheum.121460.
To determine the prevalence of anterior chest wall (ACW) pain in patients with recent inflammatory back pain (IBP) suggestiveofspondyloarthritis (SpA), and to investigate the influence of ACW pain on the overall features of these patients.
The DESIR cohort is a prospective, multicenter French cohort of patients with early IBP suggestive of SpA, including 708 patients (mean age 33.8 yrs, 53.8% females, 57.3% HLA-B27-positive). ACW pain was defined by at least 1 episode of chest wall painattributed to SpA by the rheumatologist, after ruling out other causes of chest pain. Data on the baseline demographic characteristics, functional status and quality of life, imaging features, bone mineral density, and blood tests were compared in patients with and those without ACW pain. Factors associated with ACWpain were identified by univariate and multivariate analysis (logistic regression).
The prevalence of ACW pain in the DESIR cohort (n = 316/708 patients) was 44.6% (95% CI 40.9-48.3). ACW pain occurred after the first symptoms of IBP in 62%. Localization was diffuse in 41% of the positive cases. A stepwise multivariate analysis found an association between ACW pain and the enthesitis score, involvement of thoracic spine, diagnosis of ankylosing spondylitis (AS), and radiographic abnormalities of sacroiliac joints.
In recent IBP suggestive of SpA, presence of ACW pain is associated with enthesitis, thoracic spine involvement, radiographic sacroiliitis, diagnosis of AS, and with a more severe disease. ACW pain could be interpreted as a diagnostic feature for AS.
ANTERIOR CHEST WALL; INFLAMMATORY BACK PAIN; MANUBRIOSTERNAL; SPONDYLOARTHRITIS; STERNOCLAVICULAR JOINT; STERNOCOSTAL JOINT
Un nouvel article scientifique intitulé « Does the site of magnetic resonance imaging abnormalities match the site of recent-onset inflammatory back pain? The DESIR cohort« vient d’être publié dans le journal Annals of the Rheumatic Diseases.
Blachier M, Coutanceau B, Dougados M, Saraux A, Bastuji-Garin S, Ferkal S, Le Corvoisier P, Farrenq V, Poulain C, Ghaleh B, Canouï-Poitrine F,Claudepierre P.
Ann Rheum Dis. 2013 Jun;72(6):979-85. doi: 10.1136/annrheumdis-2012-201427.
Pour le consulter, merci de cliquer ici.
To assess whether the site of axial pain (thoracic spine, lumbar spine or buttock(s)) was associated with the site of MRI lesions in patients with recent inflammatory back pain (IBP) suggesting spondyloarthritis.
We conducted a cross-sectional study of baseline data in 708 patients with recent IBP from the DESIR cohort. Radiographs of the sacroiliac joints (SIJs) and MRI scans of the SIJs and thoracic and lumbar spine were obtained routinely. Associations between painsites and sites of inflammatory and structural MRI changes were evaluated using separate multivariate logistic regressions.
Of the 648 patients with complete data, 61% had thoracic pain, 91.6% lumbar pain and 79.2% buttock pain. MRI inflammation was seen in 19%, 21% and 46% of patients at the thoracic, lumbar and SIJ sites, respectively. By multivariate analysis, pain was significantly associated with MRI inflammation only at the same site (adjusted OR (aOR)thoracic pain 1.71; 95% CI 1.09 to 2.67; p=0.02; aORlumbar pain 2.53; 95% CI 1.03 to 6.20; p=0.04; aORbuttock pain 2.86; 95% CI 1.84 to 4.46; p<0.0001). Pain site was not significantly associated with the site of structural MRI changes, except for buttock pain and SIJ structural MRI changes (aORbuttock pain 1.89; 95% CI 1.22 to 2.90; p=0.004). The association betweenpain site and site of MRI inflammation persisted in the subgroups with normal or doubtful SIJ radiographs or with Assessment of SpondyloArthritis international Society criteria for axial spondyloarthritis.
The site of pain (thoracic spine, lumbar spine or buttock(s)) is associated with MRI inflammation at the same site in patients with recent IBP.
Un nouvel article scientifique intitulé « Value of high-sensitivity C-reactive protein for classification of early axial spondyloarthritis : results from the DESIR cohort» a été publié dans le journal Annals of the Rheumatic Diseases en janvier 2013.
Navarro-Compán V, van der Heijde D, Combe B, Cosson C, van Gaalen FA.
Ann Rheum Dis. 2013 May;72(5):785-6. doi: 10.1136/annrheumdis-2012-202504.
ABSTRACT
The average delay in axial spondyloarthritis (axSpA) diagnosis after symptom onset is one of the longest among inflammatory rheumatic diseases.1 New tools, such as magnetic resonance imaging,2 have been developed to reduce this delay. Elevated C-reactive protein (CRP) has been incorporated as one of the features for Assessment of SpondyloArthritis international Society (ASAS) SpA criteria,3 and in the Berlin diagnostic algorithm.4 However, CRP levels are elevated in only a minority of early SpA patients.5 More sensitive tests, so-called high-sensitivity CRP (hsCRP), have been developed and can detect lower concentrations of CRP compared with traditional methods.6 HsCRP levels are increased in other rheumatic chronic inflammatory diseases,7 and show a better correlation with disease activity parameters compared with routine CRP in patients with axSpA.8 Therefore, hsCRP could be more sensitive than traditional CRP in diagnosing axial SpA. The aim of this study was to assess the contribution of hsCRP versus CRP to classification of early axSpA using the ASAS criteria.
Un nouvel article intitulé «Psoriasis and phenotype of patients with early inflammatory back pain» – P. Richette, et al. a été publié dans le journal Annals of Rheumatic Diseases en juin 2012.
Pour le consulter, merci de cliquer ici.
Psoriasis and phenotype of patients with early inflammatory back pain.
Richette P, Tubach F, Breban M, Viguier M, Bachelez H, Bardin T, Dougados M.
Ann Rheum Dis. 2013 Apr;72(4):566-71. doi: 10.1136/annrheumdis-2012-201610. Epub 2012 Jun 7.
Psoriasis is an important clinical feature in spondyloarthritis. However, the influence of psoriasis on the clinical, functional and imaging features of patients with inflammatory back pain (IBP) related to spondyloarthritis is not known.
To determine the prevalence of psoriasis and its impact in patients with recent IBP suggestive of spondyloarthritis.
The prevalence of psoriasis was determined in 692 patients (mean age 33.3±8.5 years, 53.8% female, 58.3% human leucocyte antigen B27 positive) included in the DESIR cohort. Demographic characteristics, imaging features and blood tests of patients with and without psoriasiswere compared.
The prevalence of psoriasis was 16.6%. Patients with rather than without psoriasis more often presented with enthesitis (59.1% vs 47.5%; p=0.02) and had more active disease (BASDAI 4.8±1.8 vs 4.4±2.0; p=0.05) and poorer functional status (BASFI 3.6±2.2 vs 3.0±2.3; p=0.006; SF-36 (physical function) 61.9±24.4 vs 66.9±24.9; p=0.04). Patients with psoriasis showed higher levels of C-reactive protein (p=0.02), total cholesterol (p=0.01) and triglycerides (p=0.02). The two groups did not differ in structural changes as assessed by standard x-rays or MRI at the spinal and sacroiliac levels. However, ultrasonography of the Achilles tendon revealed psoriasis associated with bone erosions (p=0.0003) and abnormal vascularisation (p=0.04). Multivariate regression analysis revealed BASFI score (p=0.03), cholesterol level (p=0.02), dactylitis (p=0.0006) and family history of psoriasis (p<0.0001) as independent predictors of psoriasis.
In patients with recent IBP suggestive of spondyloarthritis, psoriasis is associated with active axial disease and frequent concomitant enthesopathy and dactylitis.
La newsletter N° 18 rédigée par le Professeur Alain Saraux le 26 Février 2013 est maintenant disponible sur notre blog en cliquant ici.
Bonne lecture!
La newsletter N°17 rédigée par le Professeur Daniel Wendling le 30 novembre 2012 est maintenant disponible sur notre blog en cliquant ici.
Bonne lecture!
Une nouvelle newsletter a été rédigée par M. Dougados à l’attention de tous les rhumatologues impliqués et portant un intérêt à la cohorte DESIR.
Vous pouvez la consulter en cliquant ici.
Une newsletter a été rédigée à l’attention de tous les radiologues impliqués et portant un intérêt à la cohorte DESIR.
Vous pouvez la consulter en cliquant ici.
Bonne lecture!
Voici la Newsletter Patients N°8 rédigée par le Pr Alain Saraux :
« Madame, Monsieur,
Grâce à votre persévérance, la cohorte DESIR poursuit son chemin vers une meilleureconnaissance de la spondylarthrite.
Quelques chiffres permettent de comprendre combien le travail fourni main dans la main par les patients et par la communauté rhumatologique est fructueux… »
Pour en savoir plus, cliquez ici.