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Du-Moxibustion in a Mouse Model of Ankylosing Spondylitis
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Disease modification in ankylosing spondylitis
1Department of Medicine, 562 Heritage Medical Research Building, University of Alberta, Edmonton, Alberta, Canada. walter.maksymowych@ualberta.ca
Nature Reviews. Rheumatology
|February 4, 2010
Summary
Disease modification in ankylosing spondylitis (AS) involves inflammation and bone changes. Early trials suggest NSAIDs may slow radiographic progression, while anti-TNF therapies show no effect.
Area of Science:
- Rheumatology and Immunology
- Bone Biology
- Medical Imaging
Background:
- Ankylosing spondylitis (AS) involves inflammation, bone destruction, and new bone formation.
- The link between inflammation and new bone formation in AS is unclear, with potential non-inflammatory pathways involved.
- Current assessment of disease modification relies on radiographic scoring, which has a significant delay in detecting progression.
Purpose of the Study:
- To explore the concept of disease modification in ankylosing spondylitis.
- To evaluate the effectiveness of different therapies on radiographic progression in AS.
- To highlight the need for early therapeutic trials in high-risk AS patients.
Main Methods:
- Review of MRI studies on spinal inflammation in AS.
- Analysis of clinical outcomes using the modified Stoke Ankylosing Spondylitis Spine Score.
- Examination of preliminary data from NSAID and anti-TNF therapy trials.
Main Results:
- MRI studies suggest inflammation and new bone formation are coupled but also implicate non-inflammatory pathways.
- The modified Stoke Ankylosing Spondylitis Spine Score requires at least two years to reliably detect radiographic progression.
- Preliminary data indicate cyclooxygenase-2-selective NSAIDs may reduce disease progression over two years, whereas anti-tumor necrosis factor therapies have not shown this effect.
Conclusions:
- Disease modification in AS is complex, involving inflammatory and non-inflammatory processes.
- The delay in radiographic assessment hinders timely therapeutic evaluation.
- Early intervention trials for high-risk AS patients are crucial for effective disease management.
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