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Forsblad-D'Elia, Helena
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Publications (10 of 35) Show all publications
Sveälv, B. G., Täng, M. S., Klingberg, E., Forsblad-d'Elia, H. & Bergfeldt, L. (2015). Prevalence of diastolic dysfunction in patients with ankylosing spondylitis: a cross-sectional study. Scandinavian Journal of Rheumatology, 44(2), 111-117
Open this publication in new window or tab >>Prevalence of diastolic dysfunction in patients with ankylosing spondylitis: a cross-sectional study
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2015 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 44, no 2, p. 111-117Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To determine the prevalence of diastolic dysfunction (DD) in patients with ankylosing spondylitis (AS) by following recommended criteria from the American Society of Echocardiography (ASE) and using single variables reflecting DD.

METHOD: A total of 187 patients with AS (105 men; mean age 51 ± 13 years; mean duration of disease 15 ± 11 years) fulfilled the inclusion criteria and underwent pulsed-wave and tissue Doppler imaging.

RESULTS: By following ASE recommended criteria, we observed that 12% of patients with AS had mild DD. We also compared single standard Doppler values with normal age-stratified reference values and showed a wide variation in the number of patients with AS outside the 95% confidence interval (CI) of normal values depending on the variable chosen (ranging from 1.1% to 30.5%).

CONCLUSIONS: By following recommended criteria, our cross-sectional study shows that DD was infrequent and mild in patients with AS.

Place, publisher, year, edition, pages
Taylor & Francis, 2015
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-102958 (URN)10.3109/03009742.2014.953201 (DOI)000351182100005 ()25421143 (PubMedID)
Available from: 2015-05-12 Created: 2015-05-12 Last updated: 2017-12-04Bibliographically approved
Lie, E., Kristensen, L. E., Forsblad-d'Elia, H., Zverkova-Sandström, T., Askling, J. & Jacobsson, L. T. (2015). The effect of comedication with conventional synthetic disease modifying antirheumatic drugs on TNF inhibitor drug survival in patients with ankylosing spondylitis and undifferentiated spondyloarthritis: results from a nationwide prospective study.. Annals of the Rheumatic Diseases, 74(6), 970-978
Open this publication in new window or tab >>The effect of comedication with conventional synthetic disease modifying antirheumatic drugs on TNF inhibitor drug survival in patients with ankylosing spondylitis and undifferentiated spondyloarthritis: results from a nationwide prospective study.
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2015 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 74, no 6, p. 970-978Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To assess the effect of comedication with conventional synthetic disease modifying antirheumatic drugs (csDMARDs) on retention to tumour necrosis factor inhibitor (TNFi) therapy in patients with ankylosing spondylitis (AS) and undifferentiated spondyloarthritis (uSpA).

METHODS: Data on patients with a clinical diagnosis of AS or uSpA starting treatment with adalimumab, etanercept or infliximab as their first TNFi during 2003-2010 were retrieved from the Swedish national biologics register and linked to national population based registers. Five-year drug survival was analysed by Cox regression with age, sex, baseline csDMARD comedication, TNFi type, prescription year and covariates representing frailty and socioeconomic status. AS and uSpA were analysed separately. Sensitivity analyses included models with csDMARD as a time-dependent covariate and adjustments for additional potential confounders.

RESULTS: 1365 patients with AS and 1155 patients with uSpA were included, of whom 40.8% versus 50.3% used csDMARD comedication at baseline. In the unadjusted analyses superior drug survival was observed for patients using versus not using csDMARD comedication among patients with AS (p<0.001) but not among patients with uSpA (p=0.175). In the multivariable Cox regression analyses comedication with csDMARD was associated with better retention to TNFi therapy both in AS (HR 0.71, p<0.001) and uSpA (HR 0.82, p=0.020). The results were similar with csDMARD comedication as a time-dependent covariate, and the associations were retained when adjusting for erythrocyte sedimentation rate, C-reactive protein, patient global, swollen joints, uveitis, psoriasis and inflammatory bowel disease.

CONCLUSIONS: In this large register study of patients with AS and uSpA, use of csDMARD comedication was associated with better 5-year retention to the first TNFi.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2015
Keyword
Ankylosing Spondylitis, Spondyloarthritis, Anti-TNF, DMARDs (synthetic)
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-102956 (URN)10.1136/annrheumdis-2014-206616 (DOI)000354371200004 ()25710471 (PubMedID)
Available from: 2015-05-12 Created: 2015-05-12 Last updated: 2017-12-04Bibliographically approved
Exarchou, S., Lindström, U., Askling, J., Eriksson, J. K., Forsblad-d'Elia, H., Neovius, M., . . . Jacobsson, L. T. (2015). The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations: a nationwide register study. Arthritis Research & Therapy, 17(1), Article ID 118.
Open this publication in new window or tab >>The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations: a nationwide register study
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2015 (English)In: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 17, no 1, article id 118Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Prevalence estimates of ankylosing spondylitis vary considerably, and there are few nationwide estimates. The present study aimed to describe the national prevalence of clinically diagnosed ankylosing spondylitis in Sweden, stratified according to age, sex, geographical, and socio-economic factors, and according to subgroups with ankylosing spondylitis-related clinical manifestations and pharmacological treatment.

METHODS: All individuals diagnosed with ankylosing spondylitis according to the World Health Organization International Classification of Disease codes, between 1967 and 2009, were identified from the National Patient Register. Data regarding disease manifestations, patient demographics, level of education, pharmacological treatment, and geographical region were retrieved from the National Patient Register and other national registers.

RESULTS: A total of 11,030 cases with an ankylosing spondylitis diagnosis (alive, living in Sweden, and 16 to 64 years old in December 2009) were identified in the National Patient Register, giving a point prevalence of 0.18% in 2009. The prevalence was higher in northern Sweden, and lower in those with a higher level of education. Men had a higher prevalence of ankylosing spondylitis (0.23% versus 0.14%, P < 0.001), a higher frequency of anterior uveitis (25.5% versus 20.0%, P < 0.001) and were more likely to receive tumor necrosis factor inhibitors than women (15.6% versus 11.8% in 2009, P < 0.001). Women were more likely than men to have peripheral arthritis (21.7% versus 15.3%, P < 0.001), psoriasis (8.0% versus 6.9%, P = 0.03), and treatment with oral corticosteroids (14.0% versus 10.4% in 2009, P < 0.001).

CONCLUSION: This nationwide, register-based study demonstrated a prevalence of clinically diagnosed ankylosing spondylitis of 0.18%. It revealed phenotypical and treatment differences between the sexes, as well as geographical and socio-economic differences in disease prevalence.

Place, publisher, year, edition, pages
BioMed Central, 2015
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-102950 (URN)10.1186/s13075-015-0627-0 (DOI)000354162700001 ()25956915 (PubMedID)
Available from: 2015-05-12 Created: 2015-05-12 Last updated: 2017-12-04Bibliographically approved
Lindström, U., Exarchou, S., Sigurdardottir, V., Sundström, B., Askling, J., Eriksson, J. K., . . . Jacobsson, L. (2015). Validity of ankylosing spondylitis and undifferentiated spondyloarthritis diagnoses in the Swedish National Patient Register. Scandinavian Journal of Rheumatology, 44(5), 369-376
Open this publication in new window or tab >>Validity of ankylosing spondylitis and undifferentiated spondyloarthritis diagnoses in the Swedish National Patient Register
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2015 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 44, no 5, p. 369-376Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Epidemiological studies of spondyloarthritis (SpA), using ICD codes from the Swedish National Patient Register (NPR), offer unique possibilities but hinge upon an understanding of the validity of the codes. The aim of this study was to validate the ICD codes for ankylosing spondylitis (AS) and undifferentiated SpA (uSpA) in the NPR against the established classification criteria [modified New York (mNY), Assessment of SpondyloArthritis international Society (ASAS), Amor, and European Spondyloarthropathy Study Group (ESSG) criteria].

METHOD: All patients with an ICD-8/9/10 code of AS or uSpA in the NPR 1966-2009 at a visit to a specialist in rheumatology or internal medicine or corresponding hospitalization, alive and living in Sweden 2009, were identified (n = 20 089). Following a structured procedure to achieve geographical representativeness, 500 random patients with a diagnosis of AS or uSpA in 2007-2009 were selected. Based on a structured review of clinical records, positive predictive values (PPVs) for fulfilling the criteria sets were calculated.

RESULTS: For those having received an ICD code for AS, the PPVs for fulfilling the mNY criteria or any set of SpA criteria were 70% and 89%, respectively. For those with an uSpA diagnosis (and never an AS diagnosis), the corresponding PPVs were 20% and 79%. The subset with both AS and uSpA diagnoses (overlap = 12%) were as likely to fulfil the mNY criteria as the group that had been coded as AS only.

CONCLUSIONS: The diagnosis codes for AS or uSpA had high PPVs, suggesting that our case identification in the Swedish NPR can be used for nationwide, population-based, epidemiological studies of these diseases.

National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-102951 (URN)10.3109/03009742.2015.1010572 (DOI)000369827100006 ()25797539 (PubMedID)
Available from: 2015-05-12 Created: 2015-05-12 Last updated: 2017-12-04Bibliographically approved
Klingberg, E., Nurkkala, M., Carlsten, H. & Forsblad-d'Elia, H. (2014). Biomarkers of bone metabolism in ankylosing spondylitis in relation to osteoproliferation and osteoporosis. Journal of Rheumatology, 41(7), 1349-56
Open this publication in new window or tab >>Biomarkers of bone metabolism in ankylosing spondylitis in relation to osteoproliferation and osteoporosis
2014 (English)In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 41, no 7, p. 1349-56Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To identify biomarkers for bone metabolism in patients with ankylosing spondylitis (AS) and to determine the relationship between these biomarkers and disease activity, back mobility, osteoproliferation, and bone mineral density (BMD).

METHODS: Serum levels of Wingless protein (Wnt-3a), Dickkopf-1 (DKK-1), sclerostin, soluble receptor activator of nuclear factor-κB ligand (sRANKL), and osteoprotegerin were assessed using ELISA. Ankylosing Spondylitis Disease Activity Score-C reactive protein, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis patient global score, and C-reactive protein (CRP) were used as disease activity measures, and Bath Ankylosing Spondylitis Metrology Index (BASMI) as a measure of spinal mobility. Lateral spine radiographs were scored for chronic AS-related changes (mSASSS). BMD was measured with dual-energy x-ray absorptiometry.

RESULTS: Two hundred four patients with AS (NY criteria; 57% men), with a mean age of 50 ± 13 years and disease duration 15 ± 11 years, and 80 age and sex-matched controls were included. The patients with AS had significantly higher serum levels of Wnt-3a (p < 0.001) and lower levels of sclerostin (p = 0.014) and sRANKL (p = 0.047) compared with the controls. High CRP was associated with low sclerostin (r(S) = -0.21, p = 0.003) and DKK-1 (r(S) = -0.14, p = 0.045). In multiple linear regression analyses, increasing BASMI and mSASSS were independently associated with older age, male sex, high CRP, and elevated serum levels of Wnt-3a. In addition, mSASSS remained associated with a high number of smoking pack-years after adjusting for age. Low BMD of femoral neck was associated with high mSASSS after adjusting for age.

CONCLUSION: Serum levels of Wnt-3a are elevated in AS and associated with increased BASMI and mSASSS, independent of age, indicating that Wnt-3a could be a biomarker for the osteoproliferative process.

National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-102959 (URN)10.3899/jrheum.131199 (DOI)000338923700015 ()24931960 (PubMedID)
Available from: 2015-05-12 Created: 2015-05-12 Last updated: 2017-12-04Bibliographically approved
Forsblad-d'Elia, H., Bengtsson, K., Kristensen, L. E. & Jacobsson, L. T. (2014). Drug adherence, response and predictors thereof for tocilizumab in patients with rheumatoid arthritis: results from the Swedish biologics register.. Rheumatology
Open this publication in new window or tab >>Drug adherence, response and predictors thereof for tocilizumab in patients with rheumatoid arthritis: results from the Swedish biologics register.
2014 (English)In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: To evaluate drug adherence, clinical response and predictors thereof for tocilizumab in patients with RA in routine care based on prospectively collected data from the Swedish biologics register, Anti-Rheumatic Therapies in Sweden.

METHODS: RA patients who had started with tocilizumab from September 2008 until March 2012 were identified. Cox regression and logistic regression models were used.

RESULTS: A total of 530 RA patients were included, of whom 80.6% were female, 64.7% were on concomitant DMARDs, of which 300 were on MTX and 12% were biologic naive. The overall 6 month, 1 and 2 year estimated drug continuations were 79%, 64% and 50%, respectively. In the multivariate analyses, a low initial level of CRP [hazard ratio (HR) 0.76/1s.d. (95% CI 0.63, 0.91)], high HAQ score [HR 1.23/1s.d. (95% CI 1.06, 1.44)] and prior exposure to different biologics [HR 1.43 (95% CI 1.12, 1.83)] were predictors for drug termination, whereas concomitant DMARD therapy was not. European League Against Rheumatism (EULAR) good, moderate, and no response were achieved by 184 (46.7%), 133 (33.8%) and 77 (19.5%) patients, respectively. Predictors for EULAR good response vs no response (at 2.5-8 months) were low HAQ [odds ratio (OR) 0.56/1s.d. (95% CI 0.40, 0.78)], high 28-joint DAS [OR 2.0/1s.d. (95% CI 1.44, 2.78)] and not being on prednisolone [OR 0.47 (95% CI 0.25, 0.88)] at baseline.

CONCLUSION: In this RA cohort treated with tocilizumab, the estimated 1 year drug continuation was 64% and 80% of the patients achieved a EULAR response. Drug discontinuation was not predicted by no concomitant DMARD, but by low CRP, high HAQ and prior exposure to biologics.

Identifiers
urn:nbn:se:umu:diva-102957 (URN)10.1093/rheumatology/keu455 (DOI)25505001 (PubMedID)
Available from: 2015-05-12 Created: 2015-05-12 Last updated: 2017-12-04
Engdahl, C., Lagerquist, M. K., Stubelius, A., Andersson, A., Studer, E., Ohlsson, C., . . . Forsblad-d'Elia, H. (2014). Role of androgen and estrogen receptors for the action of dehydroepiandrosterone (DHEA).. Endocrinology, 155(3), 889-96
Open this publication in new window or tab >>Role of androgen and estrogen receptors for the action of dehydroepiandrosterone (DHEA).
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2014 (English)In: Endocrinology, ISSN 0013-7227, E-ISSN 1945-7170, Vol. 155, no 3, p. 889-96Article in journal (Refereed) Published
Abstract [en]

Dehydroepiandrosterone (DHEA) is an abundant steroid hormone, and its mechanism of action is yet to be determined. The aim of this study was to elucidate the importance of androgen receptors (ARs) and estrogen receptors (ERs) for DHEA function. Orchidectomized C57BL/6 mice were treated with DHEA, DHT, 17β-estradiol-3-benzoate (E2), or vehicle. Orchidectomized AR-deficient (ARKO) mice and wild-type (WT) littermates were treated with DHEA or vehicle for 2.5 weeks. At termination, bone mineral density (BMD) was evaluated, thymus and seminal vesicles were weighted, and submandibular glands (SMGs) were histologically examined. To evaluate the in vivo ER activation of the classical estrogen signaling pathway, estrogen response element reporter mice were treated with DHEA, DHT, E2, or vehicle, and a reporter gene was investigated in different sex steroid-sensitive organs after 24 hours. DHEA treatment increased trabecular BMD and thymic atrophy in both WT and ARKO mice. In WT mice, DHEA induced enlargement of glands in the SMGs, whereas this effect was absent in ARKO mice. Furthermore, DHEA was able to induce activation of classical estrogen signaling in bone, thymus, and seminal vesicles but not in the SMGs. In summary, the DHEA effects on trabecular BMD and thymus do not require signaling via AR and DHEA can activate the classical estrogen signaling in these organs. In contrast, DHEA induction of gland size in the SMGs is dependent on AR and does not involve classical estrogen signaling. Thus, both ERs and ARs are involved in mediating the effects of DHEA in an organ-dependent manner.

Identifiers
urn:nbn:se:umu:diva-102960 (URN)10.1210/en.2013-1561 (DOI)24424045 (PubMedID)
Available from: 2015-05-12 Created: 2015-05-12 Last updated: 2017-12-04
Lindström, U., Exarchou, S., Sigurdardottir, V., Sundström, B., Askling, J., Eriksson, J., . . . Jacobsson, L. (2014). Validity of ankylosing spondylitis and spondyloarthritis diagnoses in the Swedish National Patient Register. Paper presented at 15th Annual European Congress of Rheumatology (EULAR), JUN 11-14, 2014, Paris, FRANCE. Annals of the Rheumatic Diseases, 73, 625-626
Open this publication in new window or tab >>Validity of ankylosing spondylitis and spondyloarthritis diagnoses in the Swedish National Patient Register
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2014 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 73, p. 625-626Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Epidemiological studies of spondyloarthritis (SpA) are scarce. Using ICD-codes from the Swedish National Patient Register (NPR) offers unique possibilities for such studies. For this purpose, the validity of these ICD-codes needs to be determined.Objectives: To validate the ICD-codes for ankylosing spondylitis (AS) and SpA in the NPR against established classification criteria (modified New York (mNY), ASAS, Amor and ESSG criteria).Methods: All patients with an ICD-code of AS or SpA in the NPR 1966-2009 at a visit to a specialist in rheumatology or internal medicine, or corresponding hospitalization, were identified (n=20074). Following a structured procedure to achieve geographical representativeness, 500 random patients with a registered diagnosis of AS or SpA in 2007-2009 were selected. A structured review of clinical records, with extraction of necessary information for the established classification criteria was performed and positive predictive values (PPV) were calculated.Results: In this cohort 11472 (34% women) patients had received an AS diagnosis and 11004 (56% women) a SpA diagnosis. The overlap group having received both types of diagnoses had similar frequencies for fulfillment of mNY criteria, symptoms and signs of back disease as the group having been coded as AS only.Of those being coded as AS only, the PPV for fulfilling the mNY, any criteria set and any of the included criteria elements were 70%, 89% and 96% respectively.Of those with SpA (without AS ever) the corresponding PPV values were 20%, 79% and 99% respectively.Conclusions: A diagnosis of AS or SpA (without AS) had a high validity, suggesting that case identification based on ICD-codes in the Swedish NPR can be used for epidemiological studies of these diseases.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2014
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-92068 (URN)10.1136/annrheumdis-2014-eular.2817 (DOI)000346919803295 ()
Conference
15th Annual European Congress of Rheumatology (EULAR), JUN 11-14, 2014, Paris, FRANCE
Note

Supplement: 2, Meeting Abstract: SAT0098

Available from: 2014-08-21 Created: 2014-08-21 Last updated: 2017-12-05Bibliographically approved
Nordmark, G., Wang, C., Vasaitis, L., Eriksson, P., Theander, E., Kvarnström, M., . . . Syvänen, A.-C. (2013). Association of genes in the NF-κB pathway with antibody-positive primary Sjögren's syndrome.. Scandinavian Journal of Immunology, 78(5), 447-54
Open this publication in new window or tab >>Association of genes in the NF-κB pathway with antibody-positive primary Sjögren's syndrome.
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2013 (English)In: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 78, no 5, p. 447-54Article in journal (Refereed) Published
Abstract [en]

Primary Sjögren's syndrome (SS) is a systemic autoimmune inflammatory disease characterized by focal lymphocytic infiltrates in the lachrymal and salivary glands and autoantibodies against the SSA/Ro and SSB/La antigens. Experimental studies have shown an activation of NF-κB in primary SS. NF-κB activation results in inflammation and autoimmunity and is regulated by inhibitory and activating proteins. Genetic studies have shown an association between multiple autoimmune diseases and TNFAIP3 (A20) and TNIP1 (ABIN1), both repressors of NF-κB and of IKBKE (IKKε), which is an NF-κB activator. The aim of this study was to analyse single nucleotide polymorphisms (SNPs) in the IKBKE, NFKB1, TNIP1 and TNFAIP3 genes for association with primary SS. A total of 12 SNPs were genotyped in 1105 patients from Scandinavia (Sweden and Norway, n = 684) and the UK (n = 421) and 4460 controls (Scandinavia, n = 1662, UK, n = 2798). When patients were stratified for the presence of anti-SSA and/or anti-SSB antibodies (n = 868), case-control meta-analysis found an association between antibody-positive primary SS and two SNPs in TNIP1 (P = 3.4 × 10(-5) , OR = 1.33, 95%CI: 1.16-1.52 for rs3792783 and P = 1.3 × 10(-3) , OR = 1.21, 95%CI: 1.08-1.36 for rs7708392). A TNIP1 risk haplotype was associated with antibody-positive primary SS (P = 5.7 × 10(-3) , OR = 1.47, 95%CI: 1.12-1.92). There were no significant associations with IKBKE, NFKB1 or TNFAIP3 in the meta-analysis of the Scandinavian and UK cohorts. We conclude that polymorphisms in TNIP1 are associated with antibody-positive primary SS.

Identifiers
urn:nbn:se:umu:diva-102963 (URN)10.1111/sji.12101 (DOI)23944604 (PubMedID)
Available from: 2015-05-12 Created: 2015-05-12 Last updated: 2017-12-04
Klingberg, E., Lorentzon, M., Göthlin, J., Mellström, D., Geijer, M., Ohlsson, C., . . . Forsblad-d'Elia, H. (2013). Bone microarchitecture in ankylosing spondylitis and the association with bone mineral density, fractures, and syndesmophytes.. Arthritis Research & Therapy, 15(6), R179
Open this publication in new window or tab >>Bone microarchitecture in ankylosing spondylitis and the association with bone mineral density, fractures, and syndesmophytes.
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2013 (English)In: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 15, no 6, p. R179-Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Osteoporosis of the axial skeleton is a known complication of ankylosing spondylitis (AS), but bone loss affecting the peripheral skeleton is less studied. This study on volumetric bone mineral density (vBMD) and bone microarchitecture in AS was conducted to compare peripheral vBMD in AS patients with that in healthy controls, to study vBMD in axial compared with peripheral bone, and to explore the relation between vertebral fractures, spinal osteoproliferation, and peripheral bone microarchitecture and density.

METHODS: High-resolution peripheral quantitative computed tomography (HRpQCT) of ultradistal radius and tibia and QCT and dual-energy x-ray absorptiometry (DXA) of lumbar spine were performed in 69 male AS patients (NY criteria). Spinal radiographs were assessed for vertebral fractures and syndesmophyte formation (mSASSS). The HRpQCT measurements were compared with the measurements of healthy controls.

RESULTS: The AS patients had lower cortical vBMD in radius (P = 0.004) and lower trabecular vBMD in tibia (P = 0.033), than did the controls. Strong correlations were found between trabecular vBMD in lumbar spine, radius (rS = 0.762; P < 0.001), and tibia (rS = 0.712; P < 0.001). When compared with age-matched AS controls, patients with vertebral fractures had lower lumbar cortical vBMD (-22%; P = 0.019), lower cortical cross-sectional area in radius (-28.3%; P = 0.001) and tibia (-24.0%; P = 0.013), and thinner cortical bone in radius (-28.3%; P = 0.001) and tibia (-26.9%; P = 0.016). mSASSS correlated negatively with trabecular vBMD in lumbar spine (rS = -0.620; P < 0.001), radius (rS = -0.400; p = 0.001) and tibia (rS = -0.475; p < 0.001) and also with trabecular thickness in radius (rS = -0.528; P < 0.001) and tibia (rS = -0.488; P < 0.001). Adjusted for age, syndesmophytes were significantly associated with decreasing trabecular vBMD, but increasing cortical vBMD in lumbar spine, but not with increasing cortical thickness or density in peripheral bone. Estimated lumbar vBMD by DXA correlated with trabecular vBMD measured by QCT (rS = 0.636; P < 0.001).

CONCLUSIONS: Lumbar osteoporosis, syndesmophytes, and vertebral fractures were associated with both lower vBMD and deteriorated microarchitecture in peripheral bone. The results indicate that trabecular bone loss is general, whereas osteoproliferation is local in AS.

Identifiers
urn:nbn:se:umu:diva-105289 (URN)10.1186/ar4368 (DOI)24517240 (PubMedID)
Available from: 2015-06-22 Created: 2015-06-22 Last updated: 2017-12-04
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