A new study presented today at EULAR 2012, the Annual Congress of the European League Against Rheumatism, has identified five biomarkers that may predict the progression of structural damage in the spine of patients with Ankylosing Spondylitis (AS) who are already at high risk of disease progression.
The German study analysed 64 patients from the German Spondyloarthritis Inception Cohort (GESPIC), due to the presence of radiographic spinal damage (syndesmophytes, the strongest predictor of further damage) and elevated blood level of c-reactive protein (CRP, a marker of systemic inflammation, another recently identified predictor of structural damage progression) at baseline. Patients were divided into two groups, Group I patients (progressors) had syndesmophytes at baseline and new syndesmophyte or syndesmophyte growth after two years. Group II patients (non-progressors) had syndesmophytes at baseline but without progression after two years.
The study found key inter-group differences between the progressors and non-progressors, who were at risk for progression due to the presence of syndesmophytes and elevated CRP at baseline. Those patients whose disease progressed had significantly higher serum levels of the biomarkers matrix metalloproteinase 3 (MMP3), bone-morphogenetic protein (BMP) 2, procollagen type II N-propeptide (PIINP) and vascular endothelial growth factor (VEGF) and lower levels of the biomarker osteoprotegerin (OPG), indicating that these may predict the progression of structural damage. These data demonstrate that combinations of biomarkers with clinical parameters might help rheumatologists to identify AS patients with bad prognosis already at the early disease stage. Active and appropriate treatment of such patients my improve a long-term outcome and prevent or retard progression of spinal damage.
Dr. Denis Poddubnyy from Charité Universitätsmedizin Berlin, Germany and lead author of the study highlighted the importance of these results: “Knowing more about why certain patients have disease progression is hugely important. Not only will this help us stratify our patients due to risk but may, in the future, pave the way for more treatment options that target specific markers to be developed.”
Patients were assessed via radiographs of the lumbar and cervical spine performed at baseline and after two years of follow up and independently scored by two trained readers. Serum levels of the following biomarkers were examined: CRP, MMP3, sclerostin, Dickkopf 1, periostin, BMP-2, BMP-7, OPG, VEGF, procollagen type I N-propeptide (PINP), PIINP, C-terminal crosslinked telopeptide of type II, bone alkaline phosphatise soluble receptor activator of kB ligand, cartilage oligomeric matrix protein and bone sialoprotein.
AS, together with rheumatoid arthritis and psoriatic arthritis, is one of the three most common forms of inflammatory arthritis*. More common in men** , AS mainly affects the spine but can also affect other joints, tendons and ligaments. AS describes the condition where some or all of the joints and bones of the spine fuse together. The overall prevalence of AS is 0.5-1% of the general population.***, ****
Abstract Number: OP0091
*The AS Pathway http://www.nass.co.uk/about-as/getting-my-diagnosis/the-as-pathway/. Accessed 1 May 2012
**Arthritis Research Campaign – Ankylosing Spondylitis Case History”. Arthritis Research Campaign. 2009. http://www.arc.org.uk/arthinfo/patpubs/6001/6001.asp. Accessed 1 May 2012
***Braun J, Bollow M, Remlinger G, et al. Prevalence of spondylarthropathies in HLA-B27 positive and negative blood donors. Arthritis Rheum 1998;41(1):58-67.
**** Helmick CG, Felson DT, Lawrence RC, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. Arthritis Rheum 2008;58(1):15-25.
NOTES TO EDITORS:
For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR congress Press Office in Hall 6 on the 3rd floor of the Congress Centre during EULAR 2012 or on:
Onsite tel: +44 7894 386 425
- The European League Against Rheumatism (EULAR) is the organisation which represents the patient, health professional and scientific societies of rheumatology of all the European nations
- In line with The European Union of Medical Specialists (UEMS), EULAR defines rheumatology as including rheumatic diseases of the connective tissue, locomotor and musculoskeletal systems
- EULAR aims to promote, stimulate and support the research, prevention, treatment and rehabilitation of rheumatic diseases. With 45 scientific member societies, 36 PARE organisations and 10 health professionals associations, EULAR underscores the importance of combating rheumatic diseases not only by medical means, but also through a wider context of care for rheumatic patients and a thorough understanding of their social and other needs
- Diseases of the bone and joints such as rheumatoid arthritis and osteoarthritis cause disability in 4-5% of the adult population and are predicted to rise as people live longer
- EULAR 2012 is set to be the biggest rheumatology event in Europe with over 15,000 scientists, physicians, allied health professionals, and related audiences in attendance from over 115 countries. Over the course of the congress, more than 275 oral and 1400 poster abstract presentations will be featured, with 1,010 invited speaker lectures taking place in 190 sessions
- To find out more about the activities of EULAR, visit: www.eular.org