Spondyloarthritis (SpA) is a group of inflammatory conditions causing spine and joint pain and deformity, mostly in young men. Important updates on the epidemiology, diagnosis, and treatment of SpA are presented in the April issue of The American Journal of the Medical Sciences (AJMS), official journal of the Southern Society for Clinical Investigation. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
The special symposium issue includes ten papers presented by a roster of international experts at last year's Annual Research and Education Meeting of the Spondyloarthritis Research and Therapy Network (SPARTAN), held in Houston, Texas. The symposium Guest Editors are Dr. Luis R. Espinoza of the Louisiana State University Health Science Center, Dr. John D. Reveille of University of Texas-Houston Health Science Center, and Dr. Daniel O. Clegg of University of Utah School of Medicine.
How Frequent Is SpA? SPARTAN Participants Share Country-Specific Data
Spondyloarthritis is a relatively common and disabling inflammatory disease. There are several different forms of SpA, marked by destructive arthritis of the spine and other joints. Spondyloarthritis most commonly develops in adolescent boys and young men. The cause is unknown, but SpA tends to run in families. There is no cure, but effective treatments for SpA are available.
A highlight of the 2010 SPARTAN meeting was a series of presentations that help to clarify the rates and characteristics of SpA across North, South, and Central America. Based on the best available data, the overall prevalence of SpA in the United States may be over one percent of the population.
An ongoing National Health and Nutrition Examination Survey (NHANES) study will soon provide more precise estimates of the total prevalence of SpA, as well as specific subtypes—which include ankylosing spondylitis, reactive arthritis, psoriatic arthritis, and inflammatory back pain. The symposium also includes a series of reports on the epidemiology of SpA in Brazil, Argentina, Colombia, Central America, and Mexico.
New Findings on Bone Deformity, MRI Diagnosis, and More
Another article provides an in-depth look at the process of bone deformity in SpA. The bone changes in SpA appear similar to those of rheumatoid arthritis (RA), so the two diseases are often treated the same way. However, recent studies suggest that the processes triggering bone deformity in SpA differ from those in RA. Specific signaling molecules have been identified, suggesting it may be possible to develop specific treatments targeting the processes involved in SpA.
The symposium includes an update on the role of magnetic resonance imaging (MRI) in diagnosing SpA. The MRI finding of inflammation in the sacroiliac joint (the joint between the lower spine and pelvis) appears to be a particularly important sign of SpA—it's found in a significant proportion of young patients with back pain, and even those with no symptoms of back pain or arthritis. Educational programs will be needed to help increase physician awareness of new criteria for the diagnosis of SpA, including sacroiliac joint inflammation.
Another presentation highlights the risk of infections with mycobacterial pathogens related to tuberculosis. The infections may be related to SpA treatments that compromise the immune system, or to the disease itself. Evaluation for these "nontuberculous mycobacteria" may be especially important in patients receiving modern "biologic" therapies for SpA (TNF alpha blockers).
The 2010 SPARTAN meeting "proved to be a successful and collegial exchange of information," Drs. Espinoza, Reveille, and Clegg write in an introductory article. The SPARTAN group is a network of health care professionals dedicated to research, awareness, and treatment of SpA. Members of SPARTAN meet every year to share and disseminate the latest advances in scientific understanding and clinical management of these conditions. The next Annual Research and Education meeting will be held July 29 to 30, 2011, in Portland, Ore.
The American Journal of the Medical Sciences