J Braun

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..To evaluate golimumab's effect on MRI-detected spinal inflammation in ankylosing spondylitis (AS)...

..To assess the efficacy and safety of golimumab over 104 weeks in patients with active ankylosing spondylitis...

..Discontinuation of long-term therapy with infliximab eventually led to relapse of disease activity in all patients but one...

..Patients in large randomized controlled studies of infliximab in RA, PsA, and AS had similar impairment in physical aspects of HRQoL at baseline and showed significantly greater improvement in HRQoL after treatment with infliximab...

..Whether and how spondylitis and syndesmophyte formation are linked are unclear. Our objective was to investigate whether and how spinal inflammation are associated with new bone formation in ankylosing spondylitis...

..TNF antagonist therapy is well tolerated in patients with AS, with a side effect profile consistent with the prior experience of patients with RA...

..There is insufficient evidence for the long-term efficacy and safety of anti-tumour necrosis factor therapy in patients with ankylosing spondylitis (AS). This is the first report on the treatment with infliximab over 5 years...

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..The purpose our study was to analyze the incidence of flares and new onset of IBD in patients with AS treated with anti-TNF agents...

..The new treatment options with tumour necrosis factor blockers seems a breakthrough for patients refractory to conventional treatment...

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..Patients with persistently active disease benefit from therapy with anti-TNF agents. Physiotherapy is of major importance in the general approach to patients with SpA, especially with AS...

..MRI changes can also be quantified. New scoring methods are sensitive to change only 3 months after initiation of therapy with anti-TNF agents...

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..To assess the effect of sulfasalazine (SSZ) on inflammatory back pain (IBP) due to active undifferentiated spondyloarthritis (uSpA) or ankylosing spondylitis in patients with symptom duration <5 years...

..In addition, functional impairments, quality of life and parameters concerned with work must be considered. There are hardly any measuring instruments specific to PsA; many have been developed and used primarily for SpA or RA...

..However, severe infections, including tuberculosis, have been reported. These can be largely prevented by appropriate screening. The benefits of anti-TNF therapy in AS seem to outweigh these shortcomings...

..To update the international recommendations for use of anti-tumour necrosis factor (TNF) agents in the treatment of ankylosing spondylitis...

..To compare the efficacy and safety of subcutaneous (SC) versus oral administration of methotrexate (MTX) in patients with active rheumatoid arthritis (RA)...

..Many of the projects are dependent on financial support especially by industry. In this article the most important theses and arguments from the individual lectures will be presented...

..The value of clinical items defining inflammatory back pain to identify patients with axial spondyloarthritis (SpA) in primary care is unclear...

..To report for the first time on the efficacy and safety of anti-TNF therapy after 8 years of follow-up in patients with active AS, and analyse possible short-term predictors for long-term clinical outcomes...

..New criteria for classification of axial and peripheral spondyloarthritis have recently become available and international recommendations for the management of ankylosing spondylitis were recently published...

..There are now 11 bullet points including 2 new ones, one related to extra-articular manifestations and one to changes in the disease course. With a mean score of 9.1 (range 8-10) the SOR was generally very good...

..Low sclerostin and DKK-1 serum levels, both inhibitors of bone formation, were found to be associated with syndesmophyte formation in patients with AS...

..Although this result does not mean that every patient will be in need of parenteral administration of MTX, it suggests that very active patients and those with a worse prognosis may have more benefit from this strategy...

..The value of IBP for diagnosis of SpA increases in the presence of other more or less sensitive and specific features of SpA such as response to exercise and physical therapy and/or treatment with non-steroidal anti-inflammatory agents...

..The new ASAS classification criteria have helped to improve the early diagnosis of SpA, with MRI and early HLA B27 determination playing an important role...

..To compare the clinical manifestations of spinal disease, peripheral arthritis and enthesitis, and to evaluate the effectiveness of adalimumab in a large cohort of patients with AS in relation to the presence or absence of psoriasis...

..The German guideline recommends that a specific long-term osteoporosis medication be initiated in individuals with a 30% 10-year risk for hip fractures and vertebral fractures...

..There are some differences between the agents.Whether the recent developments of targeted therapies in RA with agents such as rituximab, abatacept and tocilizumab will also work for AS is unknown at present...

..This post hoc analysis of a large, randomized, placebo-controlled trial examined the effect of infliximab on hemoglobin levels, physical function, and fatigue in patients with AS...

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..To assess safety and efficacy of infliximab in patients with ankylosing spondylitis (AS) through 102 weeks...

..AS-specific problems are spinal fractures and atlantoaxial instability, which need careful management including surgery. Joint replacement therapy is established and beneficial for AS-disturbed joints of the hip and knee...

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..The proposed system needs to be evaluated closely and amended as needed to assure its usefulness in clinical and research settings...

..Together, these findings herald an age of more effective treatment of patients with AS with anti-TNFalpha and other emerging biological agents...

..The purpose of this study was to evaluate the efficacy and safety of infliximab treatment of AS for a 1-year period...

..Many clinical trials in these diseases have demonstrated that biological therapy with mAbs directed against TNF-alpha is effective and relatively safe...

..There is currently no universal consensus on nomenclature for spondyloarthropathy (SpA), or on activity and severity criteria for ankylosing spondylitis (AS)...

..Complicated infections including tuberculosis have been reported. These can largely be prevented by appropriate screening. As it stands now, the benefits of anti-TNF therapy in AS seem to outweigh these shortcomings...

..In this open study we examined the efficacy of the TNF-alpha receptor fusion protein etanercept in patients with uSpA...

..These can be largely prevented by appropriate screening. At it stands now, the benefits of antitumor necrosis factor therapy in ankylosing spondylitis seem to outweigh these shortcomings...

..This report provides analyses from a 3-yr extension study, as a follow-up to both the 1- and 2-yr open label extensions of the original 3-month randomized controlled trial of infliximab in patients with AS...

..Tuberculosis can be mostly prevented if patients are checked for previous contact with tuberculosis. Currently, the benefits of anti-TNF therapy in AS seem to outweigh these shortcomings...

..Efforts should be intensified to ensure even more consistent application in daily practice. Doctors should treat their steroid patients on the basis of the clear-cut indications for intervention despite budget problems...

..To estimate the incidence of anterior uveitis in patients with ankylosing spondylitis (AS) who underwent anti-tumor necrosis factor (anti-TNF) therapy, using data from recently performed trials...

..To compare conventional radiography and magnetic resonance imaging (MRI) for detection of chronic changes in the spine of patients with ankylosing spondylitis (AS)...

..Infliximab is approved for the treatment of Crohn disease. In addition, there are now also positive data for infliximab in the treatment of ankylosing spondylitis and for etanercept and infliximab in the treatment of psoriatic arthritis...

..However, it remains to be shown whether patients benefit from long-term treatment, whether radiological progression and ankylosis can be stopped and whether long-term biologic therapy is safe...

..In expectation of the approval of infliximab and etanercept for the treatment of active AS international guidelines for initiation, monitoring and discontinuation of these agents have been recently proposed...

..Thus, it seems probable that etanercept must be administered continuously in most AS patients to achieve permanent inhibition of the inflammatory process...

..The potential role of etanercept on deceleration of chronic spinal changes needs further study...

..5% by STIR). CONCLUSIONS: Spinal inflammation is a common manifestation in patients with AS, and appears more frequently in the TS. The scoring system ASspiMRI-a can be used for evaluation of acute spinal changes in AS...

..CONCLUSION: Etanercept treatment of patients with active AS results in regression of spinal inflammation as assessed by spinal MRI. Inclusion of the thoracic spine in MRI examinations of patients with AS may be of particular importance...

..CONCLUSIONS: Neutralisation of peripheral TNFalpha does not induce a down regulation of the ability of T cells to produce TNFalpha but rather an up regulation, possibly due to a counterregulatory mechanism...

..The objective of this study was to develop candidate classification criteria for axial SpA that include patients with but also without radiographic sacroiliitis...

..TNFalpha blockers have been shown to be highly efficacious in patients with active ankylosing spondylitis (AS)...

..The objective of this article was to study the effect of infliximab on structural changes in AS over 4 yrs...

..Spinal inflammation as depicted by MRI decreased significantly, but a few patients still had some spinal inflammation even after long-term anti-TNF therapy...

..BACKGROUND Treatment options for patients with ankylosing spondylitis are few. We aimed to assess the effectiveness of infliximab, an antibody to tumour necrosis factor (TNF)-alpha, in treatment of such patients...

..To evaluate the role of MRI in predicting a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) improvement of at least 50% (BASDAI 50) upon anti-tumour necrosis factor (TNF) therapy of active ankylosing spondylitis (AS)...

..Infliximab may decelerate radiographic progression in such patients. Larger studies are needed to prove that anti-TNF treatment inhibits structural damage...

..More spinal lesions are detected by the STIR sequence, but the reliability between readings and readers is better for the Gd-DTPA sequence. The ASspiMRI-a is a reliable instrument for evaluating acute spinal changes in AS...

..In AS, NSAIDs, potentially especially coxibs, may even prevent new bone formation due to their inhibitory effect on cyclooxygenase-2...

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..Allergy, lupus-like diseases, and tuberculosis are rare side effects which need to be considered. At first glance, the possible benefits of anti-TNFalpha treatment seem to outweigh these shortcomings, including the high cost...

..There is some evidence that treatment with MTX is safe prior to and after elective surgical procedures. Importantly, disease activity is better controlled when MTX is not interrupted from weekly administration...

..This review article presents the imaging modalities used in AS patients, typical findings, and relevant methods of analysis. The most recent developments are discussed...

..The present translation met with broad approval. To minimize text comprehension problems, patients should be involved in compiling a future patient version...

..To obtain an international consensus about the use of anti-tumour necrosis factor alpha (anti-TNF alpha) for treating patients with ankylosing spondylitis (AS)...

..To examine the potential therapeutic effects of leflunomide in patients with active AS in an open label study...

..This is important since early treatment strategies are increasingly and successfully used to treat inflammatory diseases more efficiently...

..Regular updating will be carried out to keep abreast of new developments in the management of AS...

..Level IV evidence supports surgical interventions in specific patients. CONCLUSION: This extensive literature review forms the evidence base considered in the development of the new ASAS/EULAR recommendations for the management of AS...

..In clinical trials, the assessment of disease response to therapy using the ASAS Response Criteria is a valuable means of determining treatment efficacy and allows comparison of response across trials and interventions...

..Disease activity parameters did not directly correlate with MRI, but both pointed in the same direction. Both types of information may be useful for the definition of response to anti-TNF therapy...

..To analyse the impact of infliximab treatment on the number of hospital inpatient days and days of sick leave in patients with active ankylosing spondylitis (AS)...

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..While infliximab induced a downregulation of the production of the T-helper 1-cytokines IFNgamma and TNFalpha, etanercept treatment triggered rather an upregulation of these cytokines secreted by T cells after in vitro stimulation...

..Our objective was to study the contribution of the lower part of the T-spine to structural damage in patients with ankylosing spondylitis (AS)...

..The ASAS 40% improvement criterion has the advantage of setting a high threshold, but only in patient reported outcomes. The choice between these improvement criteria needs to be based on further validation from upcoming trials...

..To study the long-term efficacy and safety of treatment with infliximab in patients with ankylosing spondylitis (AS) in a real life setting...

..As the patient had also developed arthralgia and symptoms in the upper respiratory tract, he was admitted to our hospital. The test for c-ANCA with specifity for proteinase 3 was positive. There was no history or symptoms of asthma...

..These novel aspects have been presented at the 6(th) International Congress on Spondyloarthropathies in Ghent (October, 2(nd) - 4(th) 2008)...

..CONCLUSIONS: This study shows that treatment with etanercept is efficacious and safe after readministration over 1 yr in patients with active AS not taking DMARDs or steroids...

..In this review we discuss the available literature concerning the treatment of sarcoidosis with methotrexate...

..The translation text was approved by the majority in terms of both form and content. Acceptance and circulation of the German patient version should be evaluated in the near future...

..Other clinical features such as hip arthritis, early onset of disease, dactylitis, oligoarthritis, limitation of spinal mobility and poor efficacy of nonsteroidal antiinflammatory drugs were found to also have negative prognostic value...