The influence of proinflammatory cytokines on disease activity, quality of life and spinal function in patients with ankylosing spondylitis

Johannes Nossent, Sylvia Sagen, Gunnstein Bakland

Research output: Contribution to journalAbstract/Meeting Abstractpeer-review


Background: Ankylosing spondylitis (AS) is a lifelong inflammatory con- dition where spinal and peripheral arthritis causes pain and functional dis- ability. Measures for disease activity, quality of life and functional limitations in AS are well described, but their relation with the underlying cytokine driven inflammatory process is less well understood. Method: Cohort study of TNFi naïve patients fulfilling modified New York criteria for AS. We collected demographics and clinical data, spinal mobility, Bath Functional Index (BASFI), Dougados Func- tional Index (DFI), Modified Health Assessment Questionnaire (MHAQ), haemoglobin, ESR, CRP, albumen and four inflammatory cytokines (IL‐6, TNF IL12‐23 and IL‐17A). The composite ASDAS‐ CRP was used to classify disease activity as absent, low or high. Result: We included 164 patients (mean age 46 years, 70.1 % males, 90.9 % HLAB27 positive, disease duration 22 yrs., ASDAS‐ CRP 1.8). AS was inactive in 14%, low active in 54% and highly active in 31%. ASDAS‐CRP correlated with MHAQ, DFI, BASFI, spinal mobility measures, the occurrence of peripheral arthritis and ESR across patients with low and high disease activity (all P < 0.05). Cytokine levels did not correlate with scores for ASDAS‐CRP, ESR, BASFI or spinal mobility. Also, there was no difference in gender, disease duration, other extraspinal disease or cytokine levels between patients with no, low or high disease activity (all P > 0.2). Conclusion: Significant disease activity was present in a large pro- portion of patients with longstanding AS not treated with TNFi. Active disease associated with worse quality of life and spinal func- tion, but these were all independent of serum cytokines. These data show that proinflammatory cytokines cannot serve as reliable biomarkers of disease activity A
Original languageEnglish
Pages (from-to)165
JournalInternational Journal of Rheumatic Diseases
Issue numbersupll
Publication statusPublished - 1 Sept 2018
EventAPLAR 2018 Congress - Kaohsiung, Taiwan, Taiwan, Province of China
Duration: 6 Sept 20189 Sept 2018


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