Zeitschrift für Rheumatologie

, Volume 73, Supplement 2, pp 28–39 | Cite as

DGRh-S3-Leitlinie Axiale Spondyloarthritis inklusive Morbus Bechterew und Frühformen

3 Klinische Symptomatik
  • U. Kiltz
  • M. Rudwaleit
  • J. Sieper
  • D. Krause
  • J.-F. Chenot
  • A. Stallmach
  • S. Jaresch
  • U. Oberschelp
  • E. Schneider
  • B. Swoboda
  • H. Böhm
  • A. Heiligenhaus
  • U. Pleyer
  • W.-H. Böhncke
  • M. Stemmer
  • J. Braun
Leitlinien

German Society for Rheumatology S3 guidelines on axial spondyloarthritis including Bechterew’s disease and early forms

3 Clinical symptoms

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt. U. Kiltz, M. Rudwaleit, J. Sieper, D. Krause, J.-F. Chenot, A. Stallmach, S. Jaresch, U. Oberschelp, E. Schneider, B. Swoboda,·H. Böhm, A. Heiligenhaus, U. Pleyer, W.-H. Böhncke, M. Stemmer und J. Braun geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren. This article is part of a supplement sponsored by AbbVie, Pfizer und UCB.

Literatur

  1. 1.
    Braun J, Sieper J (2007) Ankylosing spondylitis. Lancet 369(9570):1379–1390PubMedCrossRefGoogle Scholar
  2. 2.
    Rojas-Vargas M et al (2009) First signs and symptoms of spondyloarthritis – data from an inception cohort with a disease course of two years or less (REGISPONSER-Early). Rheumatology (Oxford) 48(4):404–409Google Scholar
  3. 3.
    Calin A et al (1977) Clinical history as a screening test for ankylosing spondylitis. JAMA 237(24):2613–2614PubMedCrossRefGoogle Scholar
  4. 4.
    Rudwaleit M et al (2006) Inflammatory back pain in ankylosing spondylitis: a reassessment of the clinical history for application as classification and diagnostic criteria. Arthritis Rheum 54(2):569–578PubMedCrossRefGoogle Scholar
  5. 5.
    Sieper J et al (2009) New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS). Ann Rheum Dis 68(6):784–788PubMedCrossRefGoogle Scholar
  6. 6.
    Landewe R et al (2009) Physical function in ankylosing spondylitis is independently determined by both disease activity and radiographic damage of the spine. Ann Rheum Dis 68(6):863–867PubMedCrossRefGoogle Scholar
  7. 7.
    Machado P et al (2010) Both structural damage and inflammation of the spine contribute to impairment of spinal mobility in patients with ankylosing spondylitis. Ann Rheum Dis 69(8):1465–1470PubMedCrossRefGoogle Scholar
  8. 8.
    Ruta S et al (2011) Prevalence of subclinical enthesopathy in patients with spondyloarthropathy: an ultrasound study. J Clin Rheumatol 17(1):18–22PubMedCrossRefGoogle Scholar
  9. 9.
    Maksymowych WP et al (2009) Development and validation of the Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index. Ann Rheum Dis 68(6):948–953PubMedCrossRefGoogle Scholar
  10. 10.
    Heuft-Dorenbosch L et al (2003) Assessment of enthesitis in ankylosing spondylitis. Ann Rheum Dis 62(2):127–132PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Sidiropoulos PI et al (2008) Evidence-based recommendations for the management of ankylosing spondylitis: systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising rheumatologists. Rheumatology (Oxford) 47(3):355–361Google Scholar
  12. 12.
    Karberg K et al (2005) Bone loss is detected more frequently in patients with ankylosing spondylitis with syndesmophytes. J Rheumatol 32(7):1290–1298PubMedGoogle Scholar
  13. 13.
    Jun JB et al (2006) Femoral bone mineral density is associated with vertebral fractures in patients with ankylosing spondylitis: a cross-sectional study. J Rheumatol 33(8):1637–1641PubMedGoogle Scholar
  14. 14.
    Gratacos J et al (1999) Significant loss of bone mass in patients with early, active ankylosing spondylitis: a followup study. Arthritis Rheum 42(11):2319–2324PubMedCrossRefGoogle Scholar
  15. 15.
    Vosse D et al (2009) Ankylosing spondylitis and the risk of fracture: results from a large primary care-based nested case-control study. Ann Rheum Dis 68(12):1839–1842PubMedCrossRefGoogle Scholar
  16. 16.
    Montala N et al (2011) Prevalence of vertebral fractures by semiautomated morphometry in patients with ankylosing spondylitis. J Rheumatol 38(5):893–897PubMedCrossRefGoogle Scholar
  17. 17.
    Westerveld LA, Verlaan JJ, Oner FC (2009) Spinal fractures in patients with ankylosing spinal disorders: a systematic review of the literature on treatment, neurological status and complications. Eur Spine J 18(2):145–156PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Haywood KL et al (2004) Spinal mobility in ankylosing spondylitis: reliability, validity and responsiveness. Rheumatology (Oxford) 43(6):750–757Google Scholar
  19. 19.
    Wanders A et al (2005) Association between radiographic damage of the spine and spinal mobility for individual patients with ankylosing spondylitis: can assessment of spinal mobility be a proxy for radiographic evaluation? Ann Rheum Dis 64(7):988–994PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Heuft-Dorenbosch L et al (2004) Measurement of spinal mobility in ankylosing spondylitis: comparison of occiput-to-wall and tragus-to-wall distance. J Rheumatol 31(9):1779–1784PubMedGoogle Scholar
  21. 21.
    Deyo RA, Diehr P, Patrick DL (1991) Reproducibility and responsiveness of health status measures. Statistics and strategies for evaluation. Control Clin Trials 12(4 Suppl):142S–158SPubMedCrossRefGoogle Scholar
  22. 22.
    Pile KD et al (1991) Clinical assessment of ankylosing spondylitis: a study of observer variation in spinal measurements. Br J Rheumatol 30(1):29–34PubMedCrossRefGoogle Scholar
  23. 23.
    Gladman DD et al (2007) International spondyloarthritis interobserver reliability exercise – the INSPIRE study: I. Assessment of spinal measures. J Rheumatol 34(8):1733–1739PubMedGoogle Scholar
  24. 24.
    Kennedy LG et al (1995) Ankylosing spondylitis: the correlation between a new metrology score and radiology. Br J Rheumatol 34(8):767–770PubMedCrossRefGoogle Scholar
  25. 25.
    Chandran V et al (2007) Relationship between spinal mobility and radiographic damage in ankylosing spondylitis and psoriatic spondylitis: a comparative analysis. J Rheumatol 34(12):2463–2465PubMedGoogle Scholar
  26. 26.
    Jenkinson TR et al (1994) Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology Index. J Rheumatol 21(9):1694–1698PubMedGoogle Scholar
  27. 27.
    Calin A et al (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol 21(12):2281–2285PubMedGoogle Scholar
  28. 28.
    Garrett S et al (1994) A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 21(12):2286–2291PubMedGoogle Scholar
  29. 29.
    Ruof J, Sangha O, Stucki G (1999) Evaluation of a German version of the Bath Ankylosing Spondylitis Functional Index (BASFI) and Dougados Functional Index (D-FI). Z Rheumatol 58(4):218–225PubMedCrossRefGoogle Scholar
  30. 30.
    Boonen A et al (2009) Spinal radiographic changes in ankylosing spondylitis: association with clinical characteristics and functional outcome. J Rheumatol 36(6):1249–1255PubMedCrossRefGoogle Scholar
  31. 31.
    Ward MM et al (2005) Risk factors for functional limitations in patients with long-standing ankylosing spondylitis. Arthritis Rheum 53(5):710–717PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Daltroy LH et al (1990) A modification of the Health Assessment Questionnaire for the spondyloarthropathies. J Rheumatol 17(7):946–950PubMedGoogle Scholar
  33. 33.
    Doward LC et al (2007) Translation and validation of non-English versions of the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire. Health Qual Life Outcomes 5:7PubMedCentralPubMedCrossRefGoogle Scholar
  34. 34.
    Vander Cruyssen B et al (2007) The epidemiology of ankylosing spondylitis and the commencement of anti-TNF therapy in daily rheumatology practice. Ann Rheum Dis 66(8):1072–1077CrossRefGoogle Scholar
  35. 35.
    Brophy S, Calin A (2001) Ankylosing spondylitis: interaction between genes, joints, age at onset, and disease expression. J Rheumatol 28(10):2283–2288PubMedGoogle Scholar
  36. 36.
    Rudwaleit M et al (2009) The early disease stage in axial spondylarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis Rheum 60(3):717–727PubMedCrossRefGoogle Scholar
  37. 37.
    Kiltz U et al (2012) Do patients with non-radiographic axial spondylarthritis differ from patients with ankylosing spondylitis? Arthritis Care Res (Hoboken) 64(9):1415–1422CrossRefGoogle Scholar
  38. 38.
    Collantes E et al (2007) Disease pattern of spondyloarthropathies in Spain: description of the first national registry (REGISPONSER) extended report. Rheumatology (Oxford) 46(8):1309–1315Google Scholar
  39. 39.
    Bremander A et al (2011) Population-based estimates of common comorbidities and cardiovascular disease in ankylosing spondylitis. Arthritis Care Res (Hoboken) 63(4):550–556CrossRefGoogle Scholar
  40. 40.
    Chorus AM et al (2003) Quality of life and work in patients with rheumatoid arthritis and ankylosing spondylitis of working age. Ann Rheum Dis 62(12):1178–1184PubMedCentralPubMedCrossRefGoogle Scholar
  41. 41.
    Zeboulon N, Dougados M, Gossec L (2008) Prevalence and characteristics of uveitis in the spondyloarthropathies: a systematic literature review. Ann Rheum Dis 67(7):955–959PubMedCrossRefGoogle Scholar
  42. 42.
    Rosenbaum JT (1992) Acute anterior uveitis and spondyloarthropathies. Rheum Dis Clin North Am 18(1):143–151PubMedGoogle Scholar
  43. 43.
    Accorinti M et al (2010) Clinical features and prognosis of HLA B27-associated acute anterior uveitis in an Italian patient population. Ocul Immunol Inflamm 18(2):91–96PubMedCrossRefGoogle Scholar
  44. 44.
    Munoz-Fernandez S et al (2003) Sulfasalazine reduces the number of flares of acute anterior uveitis over a one-year period. J Rheumatol 30(6):1277–1279PubMedGoogle Scholar
  45. 45.
    Benitez-Del-Castillo JM et al (2000) Sulfasalazine in the prevention of anterior uveitis associated with ankylosing spondylitis. Eye (Lond) 14(Pt 3A):340–343Google Scholar
  46. 46.
    Braun J et al (2005) Decreased incidence of anterior uveitis in patients with ankylosing spondylitis treated with the anti-tumor necrosis factor agents infliximab and etanercept. Arthritis Rheum 52(8):2447–2451PubMedCrossRefGoogle Scholar
  47. 47.
    Sieper J et al (2010) Analysis of uveitis rates across all etanercept ankylosing spondylitis clinical trials. Ann Rheum Dis 69(1):226–229PubMedCrossRefGoogle Scholar
  48. 48.
    Rudwaleit M et al (2009) Adalimumab effectively reduces the rate of anterior uveitis flares in patients with active ankylosing spondylitis: results of a prospective open-label study. Ann Rheum Dis 68(5):696–701PubMedCentralPubMedCrossRefGoogle Scholar
  49. 49.
    Mielants H et al (1996) Course of gut inflammation in spondylarthropathies and therapeutic consequences. Baillieres Clin Rheumatol 10(1):147–164PubMedCrossRefGoogle Scholar
  50. 50.
    Mielants H et al (1995) The evolution of spondyloarthropathies in relation to gut histology. III. Relation between gut and joint. J Rheumatol 22(12):2279–2284PubMedGoogle Scholar
  51. 51.
    D’Inca R et al (2009) Articular manifestations in inflammatory bowel disease patients: a prospective study. Dig Liver Dis 41(8):565–569CrossRefGoogle Scholar
  52. 52.
    Peeters H et al (2008) Clinical and genetic factors associated with sacroiliitis in Crohn’s disease. J Gastroenterol Hepatol 23(1):132–137PubMedGoogle Scholar
  53. 53.
    Vavricka SR et al (2011) Frequency and risk factors for extraintestinal manifestations in the Swiss inflammatory bowel disease cohort. Am J Gastroenterol 106(1):110–119PubMedCrossRefGoogle Scholar
  54. 54.
    El Miedany Y et al (2006) The gastrointestinal safety and effect on disease activity of etoricoxib, a selective cox-2 inhibitor in inflammatory bowel diseases. Am J Gastroenterol 101(2):311–317CrossRefGoogle Scholar
  55. 55.
    Hoffmann JC et al (2008) Clinical practice guideline on diagnosis and treatment of Crohn’s disease. Z Gastroenterol 46(9):1094–1146PubMedCrossRefGoogle Scholar
  56. 56.
    Braun J et al (2007) Differences in the incidence of flares or new onset of inflammatory bowel diseases in patients with ankylosing spondylitis exposed to therapy with anti-tumor necrosis factor alpha agents. Arthritis Rheum 57(4):639–647PubMedCrossRefGoogle Scholar
  57. 57.
    Marzo-Ortega H et al (2003) Efficacy of etanercept for treatment of Crohn’s related spondyloarthritis but not colitis. Ann Rheum Dis 62(1):74–76PubMedCentralPubMedCrossRefGoogle Scholar
  58. 58.
    Toussirot E et al (2011) Development of inflammatory bowel disease during anti-TNF-alpha therapy for inflammatory rheumatic disease. A nationwide series. Joint Bone SpineGoogle Scholar
  59. 59.
    Bergfeldt L et al (1982) Ankylosing spondylitis: an important cause of severe disturbances of the cardiac conduction system. Prevalence among 223 pacemaker-treated men. Am J Med 73(2):187–191PubMedCrossRefGoogle Scholar
  60. 60.
    O’Neill TW, Bresnihan B (1992) The heart in ankylosing spondylitis. Ann Rheum Dis 51(6):705–706CrossRefGoogle Scholar
  61. 61.
    Sampaio-Barros PD et al (2007) Pulmonary involvement in ankylosing spondylitis. Clin Rheumatol 26(2):225–230PubMedCrossRefGoogle Scholar
  62. 62.
    El Maghraoui A et al (2004) Lung findings on thoracic high-resolution computed tomography in patients with ankylosing spondylitis. Correlations with disease duration, clinical findings and pulmonary function testing. Clin Rheumatol 23(2):123–128CrossRefGoogle Scholar
  63. 63.
    Souza AS Jr et al (2004) Pulmonary abnormalities in ankylosing spondylitis: inspiratory and expiratory high-resolution CT findings in 17 patients. J Thorac Imaging 19(4):259–263PubMedCrossRefGoogle Scholar
  64. 64.
    Gratacos J et al (1997) Secondary amyloidosis in ankylosing spondylitis. A systematic survey of 137 patients using abdominal fat aspiration. J Rheumatol 24(5):912–915PubMedGoogle Scholar
  65. 65.
    Peters MJ et al (2004) Cardiovascular risk profile of patients with spondylarthropathies, particularly ankylosing spondylitis and psoriatic arthritis. Semin Arthritis Rheum 34(3):585–592PubMedCrossRefGoogle Scholar
  66. 66.
    Heeneman S, Daemen MJ (2007) Cardiovascular risks in spondyloarthritides. Curr Opin Rheumatol 19(4):358–362PubMedCrossRefGoogle Scholar
  67. 67.
    Choe JY et al (2008) No differences of carotid intima-media thickness between young patients with ankylosing spondylitis and healthy controls. Joint Bone Spine 75(5):548–553PubMedCrossRefGoogle Scholar
  68. 68.
    Gonzalez-Juanatey C et al (2009) The high prevalence of subclinical atherosclerosis in patients with ankylosing spondylitis without clinically evident cardiovascular disease. Medicine (Baltimore) 88(6):358–365Google Scholar
  69. 69.
    Peters MJ et al (2010) Signs of accelerated preclinical atherosclerosis in patients with ankylosing spondylitis. J Rheumatol 37(1):161–166PubMedCrossRefGoogle Scholar
  70. 70.
    Peters MJ et al (2010) Ankylosing spondylitis: a risk factor for myocardial infarction? Ann Rheum Dis 69(3):579–581PubMedCrossRefGoogle Scholar
  71. 71.
    Mathieu S et al (2011) Cardiovascular profile in ankylosing spondylitis: a systematic review and meta-analysis. Arthritis Care Res (Hoboken) 63(4):557–563CrossRefGoogle Scholar
  72. 72.
    Halm VP van et al (2006) Increased disease activity is associated with a deteriorated lipid profile in patients with ankylosing spondylitis. Ann Rheum Dis 65(11):1473–1477PubMedCentralPubMedCrossRefGoogle Scholar
  73. 73.
    Spanakis E et al (2006) Modest but sustained increase of serum high density lipoprotein cholesterol levels in patients with inflammatory arthritides treated with infliximab. J Rheumatol 33(12):2440–2446PubMedGoogle Scholar
  74. 74.
    Eijk IC van et al (2009) Improvement of lipid profile is accompanied by atheroprotective alterations in high-density lipoprotein composition upon tumor necrosis factor blockade: a prospective cohort study in ankylosing spondylitis. Arthritis Rheum 60(5):1324–1330PubMedCrossRefGoogle Scholar
  75. 75.
    Eijk IC van et al (2009) Microvascular function is impaired in ankylosing spondylitis and improves after tumour necrosis factor alpha blockade. Ann Rheum Dis 68(3):362–366PubMedCrossRefGoogle Scholar
  76. 76.
    Peters MJ et al (2010) EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis 69(2):325–331PubMedCrossRefGoogle Scholar
  77. 77.
    Tubergen A van et al (2002) Assessment of fatigue in patients with ankylosing spondylitis: a psychometric analysis. Arthritis Rheum 47(1):8–16PubMedCrossRefGoogle Scholar
  78. 78.
    Jones SD et al (1996) Fatigue in ankylosing spondylitis: its prevalence and relationship to disease activity, sleep, and other factors. J Rheumatol 23(3):487–490PubMedGoogle Scholar
  79. 79.
    Dagfinrud H et al (2005) Fatigue in patients with ankylosing spondylitis: a comparison with the general population and associations with clinical and self-reported measures. Arthritis Rheum 53(1):5–11PubMedCrossRefGoogle Scholar
  80. 80.
    Zochling J, Braun J (2009) Mortality in rheumatoid arthritis and ankylosing spondylitis. Clin Exp Rheumatol 27(4 Suppl 55):S127–S130PubMedGoogle Scholar
  81. 81.
    Brown WM, Doll R (1965) Mortality from cancer and other causes after radiotherapy for ankylosing spondylitis. Br Med J 2(5474):1327–1332PubMedCentralPubMedCrossRefGoogle Scholar
  82. 82.
    Wick RR et al (2008) Increased risk of myeloid leukaemia in patients with ankylosing spondylitis following treatment with radium-224. Rheumatology (Oxford) 47(6):855–859Google Scholar
  83. 83.
    Bakland G, Gran JT, Nossent JC (2011) Increased mortality in ankylosing spondylitis is related to disease activity. Ann Rheum Dis 70(11):1921–1925PubMedCrossRefGoogle Scholar
  84. 84.
    Zink A, Minden K (2010) Entzündlich rheumatische Erkrankungen, Heft 49, In: R.-K.I. Berlin (Hrsg). Gesundheitsberichterstattung des BundesGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • U. Kiltz
    • 1
  • M. Rudwaleit
    • 1
  • J. Sieper
    • 1
  • D. Krause
    • 1
  • J.-F. Chenot
    • 2
  • A. Stallmach
    • 3
  • S. Jaresch
    • 3
  • U. Oberschelp
    • 4
  • E. Schneider
    • 4
  • B. Swoboda
    • 4
    • 5
  • H. Böhm
    • 4
    • 5
  • A. Heiligenhaus
    • 6
  • U. Pleyer
    • 6
  • W.-H. Böhncke
    • 7
  • M. Stemmer
    • 8
  • J. Braun
    • 1
  1. 1.Deutsche Gesellschaft für Rheumatologie (DGRh)--
  2. 2.Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM)--
  3. 3.Deutsche Gesellschaft für Innere Medizin (DGIM)--
  4. 4.Deutsche Gesellschaft für Orthopädie und orthopädische Chirurgie (DGOOC)--
  5. 5.Deutsche Gesellschaft für orthopädische Rheumatologie e. V. (DGORh)--
  6. 6.Deutsche ophthalmologische Gesellschaft (DOG)--
  7. 7.Deutsche Dermatologische Gesellschaft (DDG)--
  8. 8.Deutsche Vereinigung Morbus Bechterew (DVMB)--

Personalised recommendations