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Markers Foretell Progressing Spine Damage

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  1. #1
    Donna G Guest

    Default Markers Foretell Progressing Spine Damage




    Markers Foretell Progressing Spine Damage

    By*Nancy Walsh, Staff Writer, MedPage Today
    Published: June 06, 2012

    Reviewed*by*Dori F. Zaleznik, MD; Associate Clinical Professor of
    Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, BSN,
    RN, Nurse Planner


    This study was published as an abstract and presented at a conference.
    These data and conclusions should be considered to be preliminary until
    published in a peer-reviewed journal.

    A study has found a combination of biomarkers that seemed to predict
    radiographic progression in patients with ankylosing spondylitis who had
    syndesmophytes plus elevated C-reactive protein (CRP) at baseline.

    Note that markers of inflammation -- C-reactive protein and matrix
    metalloproteinase 3 -- were both more elevated at baseline in the group
    of patients who went on to show radiographic progression than in those
    who did not progress.

    BERLIN -- Certain biomarkers of bone and cartilage turnover predicted
    which patients with ankylosing spondylitis are most at risk for
    progression of spinal damage, a researcher said here.

    Among patients who already had syndesmophytes present on radiographs and
    had elevated levels of C-reactive protein (CRP), those who developed
    worsening of their spinal damage had higher levels of several markers
    including matrix metalloproteinase 3 (MMP3) (50.9 ng/mL versus 24.1
    ng/mL, P=0.0223), Joachim Sieper, MD, of Charite University in Berlin,
    reported in a press briefing.

    They also had higher levels of other proteins that are markers of bone
    and cartilage turnover, such as procollagen type II N-peptide (216.8
    ng/mL versus 126 ng/mL, P=0.002), Sieper reported at the annual European
    Congress of Rheumatology.

    "In ankylosing spondylitis, patients develop inflammation and pain, and
    eventually stiffness of the spine. We also know that the presence of
    syndesmophytes on x-rays is the strongest predictor of further spine
    damage in ankylosing spondylitis, but this process moves quickly in some
    patients but can take years in others," he said, adding that it would be
    helpful, therefore, if markers could be identified that would predict
    which patients are the likely progressors.

    To investigate this, he and his colleagues enrolled 64 patients who had
    elevated CRP, and assessed them radiographically at baseline and 2
    years. All had syndesmophytes at baseline.

    A total of 26 patients had developed new or worsening syndesmophytes at
    the time of follow-up (group 1), while 38 had not progressed (group 2).

    At baseline, there already were significant differences between
    progressors and nonprogressors on levels of CRP, which were 17.1 in
    those in group 1 and 8.7 in group 2 (P=0.031).

    In addition, levels of MMP3 at baseline in the two groups were 40.2
    ng/mL and 19.5 ng/mL (P=0.016), Sieper reported. Those two baseline
    factors "confirmed that markers of active inflammation can help predict
    radiographic progression of the spine," he said.

    The investigators then compared levels of baseline markers among the 15
    progressors in group 1 and the 19 nonprogressors in group 2 who had high
    CRP and elevated MMP3, finding these further significant differences:
    Bone morphogenetic protein 2, 7.8 versus 5.5 ng/mL, P=0.016
    Procollagen type II N-propeptide, 216.8 versus 126.4 ng/mL, P=0.002
    Vascular endothelial growth factor, 602 versus 350.7 ng/mL, P=0.013
    Osteoprotegerin, 7.8 versus 11.6 pmol/L, P=0.049

    Being able to predict which patients may progress is particularly
    important with regard to treatment, he explained.

    Previous clinical experience has suggested that biologic therapy with
    the antitumor necrosis factor agents does not inhibit radiographic
    progression among patients who already have some disease damage, Sieper
    said.

    In contrast, treatment with conventional nonsteroidal anti-inflammatory
    drugs (NSAIDs) such as indomethacin and diclofenac does seem to be
    beneficial in interfering with the progression of syndesmophytes, "so
    the old NSAIDs might be better in patients with these biomarkers," he
    said.

    Researchers hope to further explore the clinical applicability of
    multiple biomarkers, with the ultimate goal of personalized medicine,
    commented Maxime Dougados, MD, the president of EULAR, during the press
    conference.

    The authors reported no disclosures.

    Primary source: European League Against Rheumatism

    Source reference:
    Poddubnyy D, et al "Prediction of radiographic spinal progression using
    biomarkers in patients with ankylosing spondylitis who are at high risk
    for progression" EULAR 2012; Abstract OP91.

    ..
    ..
    Donna G.
    ..

    1) Rejoice always, Pray continually, Give thanks in all circumstances,
    For this is God's will for you in Christ Jesus. ( I Thessalonians
    5:16-18 NIV )

    2) ANGELS EXIST, but some times, since they don't all have wings, we
    call them FRIENDS......

    3) Just because you're in pain, doesn't mean you have to be one!


  2. #2
    Harvey Guest

    Default Re: Markers Foretell Progressing Spine Damage

    Very interesting,,, Thank you Donna,,,,,,Harv


    "Donna G" wrote in message
    news:[email protected]..




    Markers Foretell Progressing Spine Damage

    By Nancy Walsh, Staff Writer, MedPage Today
    Published: June 06, 2012

    Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of
    Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, BSN,
    RN, Nurse Planner


    This study was published as an abstract and presented at a conference.
    These data and conclusions should be considered to be preliminary until
    published in a peer-reviewed journal.

    A study has found a combination of biomarkers that seemed to predict
    radiographic progression in patients with ankylosing spondylitis who had
    syndesmophytes plus elevated C-reactive protein (CRP) at baseline.

    Note that markers of inflammation -- C-reactive protein and matrix
    metalloproteinase 3 -- were both more elevated at baseline in the group
    of patients who went on to show radiographic progression than in those
    who did not progress.

    BERLIN -- Certain biomarkers of bone and cartilage turnover predicted
    which patients with ankylosing spondylitis are most at risk for
    progression of spinal damage, a researcher said here.

    Among patients who already had syndesmophytes present on radiographs and
    had elevated levels of C-reactive protein (CRP), those who developed
    worsening of their spinal damage had higher levels of several markers
    including matrix metalloproteinase 3 (MMP3) (50.9 ng/mL versus 24.1
    ng/mL, P=0.0223), Joachim Sieper, MD, of Charite University in Berlin,
    reported in a press briefing.

    They also had higher levels of other proteins that are markers of bone
    and cartilage turnover, such as procollagen type II N-peptide (216.8
    ng/mL versus 126 ng/mL, P=0.002), Sieper reported at the annual European
    Congress of Rheumatology.

    "In ankylosing spondylitis, patients develop inflammation and pain, and
    eventually stiffness of the spine. We also know that the presence of
    syndesmophytes on x-rays is the strongest predictor of further spine
    damage in ankylosing spondylitis, but this process moves quickly in some
    patients but can take years in others," he said, adding that it would be
    helpful, therefore, if markers could be identified that would predict
    which patients are the likely progressors.

    To investigate this, he and his colleagues enrolled 64 patients who had
    elevated CRP, and assessed them radiographically at baseline and 2
    years. All had syndesmophytes at baseline.

    A total of 26 patients had developed new or worsening syndesmophytes at
    the time of follow-up (group 1), while 38 had not progressed (group 2).

    At baseline, there already were significant differences between
    progressors and nonprogressors on levels of CRP, which were 17.1 in
    those in group 1 and 8.7 in group 2 (P=0.031).

    In addition, levels of MMP3 at baseline in the two groups were 40.2
    ng/mL and 19.5 ng/mL (P=0.016), Sieper reported. Those two baseline
    factors "confirmed that markers of active inflammation can help predict
    radiographic progression of the spine," he said.

    The investigators then compared levels of baseline markers among the 15
    progressors in group 1 and the 19 nonprogressors in group 2 who had high
    CRP and elevated MMP3, finding these further significant differences:
    Bone morphogenetic protein 2, 7.8 versus 5.5 ng/mL, P=0.016
    Procollagen type II N-propeptide, 216.8 versus 126.4 ng/mL, P=0.002
    Vascular endothelial growth factor, 602 versus 350.7 ng/mL, P=0.013
    Osteoprotegerin, 7.8 versus 11.6 pmol/L, P=0.049

    Being able to predict which patients may progress is particularly
    important with regard to treatment, he explained.

    Previous clinical experience has suggested that biologic therapy with
    the antitumor necrosis factor agents does not inhibit radiographic
    progression among patients who already have some disease damage, Sieper
    said.

    In contrast, treatment with conventional nonsteroidal anti-inflammatory
    drugs (NSAIDs) such as indomethacin and diclofenac does seem to be
    beneficial in interfering with the progression of syndesmophytes, "so
    the old NSAIDs might be better in patients with these biomarkers," he
    said.

    Researchers hope to further explore the clinical applicability of
    multiple biomarkers, with the ultimate goal of personalized medicine,
    commented Maxime Dougados, MD, the president of EULAR, during the press
    conference.

    The authors reported no disclosures.

    Primary source: European League Against Rheumatism

    Source reference:
    Poddubnyy D, et al "Prediction of radiographic spinal progression using
    biomarkers in patients with ankylosing spondylitis who are at high risk
    for progression" EULAR 2012; Abstract OP91.

    ..
    ..
    Donna G.
    ..

    1) Rejoice always, Pray continually, Give thanks in all circumstances,
    For this is God's will for you in Christ Jesus. ( I Thessalonians
    5:16-18 NIV )

    2) ANGELS EXIST, but some times, since they don't all have wings, we
    call them FRIENDS......

    3) Just because you're in pain, doesn't mean you have to be one!


  3. #3
    Donna G Guest

    Default Re: Markers Foretell Progressing Spine Damage




    Hey Harv, how are you doing these days?

    Have they found a new med for you yet?

    ..
    ..
    Donna G.
    ..

    1) Rejoice always, Pray continually, Give thanks in all circumstances,
    For this is God's will for you in Christ Jesus. ( I Thessalonians
    5:16-18 NIV )

    2) ANGELS EXIST, but some times, since they don't all have wings, we
    call them FRIENDS......

    3) Just because you're in pain, doesn't mean you have to be one!


  4. #4
    Harvey Guest

    Default Re: Markers Foretell Progressing Spine Damage

    I am sorry to say that my calls were not returned. I am going to have to
    go through my RD first,,,, I guess. I am back with a lung specialist
    again. What I thought were low sugar problems when I first get up,,,,seem
    to be low oxygen problems. If I can not improve things with medicine,,,
    an oxy bottle is in my future.... Harv


    "Donna G" wrote in message
    news:[email protected]..




    Hey Harv, how are you doing these days?

    Have they found a new med for you yet?

    ..
    ..
    Donna G.
    ..

    1) Rejoice always, Pray continually, Give thanks in all circumstances,
    For this is God's will for you in Christ Jesus. ( I Thessalonians
    5:16-18 NIV )

    2) ANGELS EXIST, but some times, since they don't all have wings, we
    call them FRIENDS......

    3) Just because you're in pain, doesn't mean you have to be one!


  5. #5
    Donna G Guest

    Default Re: Markers Foretell Progressing Spine Damage




    Ahhhh, Harv, I'm sorry to hear that!

    Having been on oxygen, now, myself, since 1993, I can tell you it is a
    bit of an adjustment, but life does go on and you can still do most
    everything you are used to doing. Just with an attachment to you! : )

    Are the lung issues from the previous problems you had where you had to
    take the TB meds and the steroids and such?

    Sure hope your RD can do something about getting you started on
    something that will bring you some relief!

    In my prayers and please keep me posted as to how you make out with all
    of this!

    ..
    ..
    Donna G.
    ..

    1) Rejoice always, Pray continually, Give thanks in all circumstances,
    For this is God's will for you in Christ Jesus. ( I Thessalonians
    5:16-18 NIV )

    2) ANGELS EXIST, but some times, since they don't all have wings, we
    call them FRIENDS......

    3) Just because you're in pain, doesn't mean you have to be one!


  6. #6
    Navy Guest

    Default Re: Markers Foretell Progressing Spine Damage

    On 6/11/2012 1:32 PM, Donna G wrote:
    >
    >

    Have you tried that device advertised on TV that eliminates toting
    oxygen tanks around with you?



    > Ahhhh, Harv, I'm sorry to hear that!
    >
    > Having been on oxygen, now, myself, since 1993, I can tell you it is a
    > bit of an adjustment, but life does go on and you can still do most
    > everything you are used to doing. Just with an attachment to you! : )
    >
    > Are the lung issues from the previous problems you had where you had to
    > take the TB meds and the steroids and such?
    >
    > Sure hope your RD can do something about getting you started on
    > something that will bring you some relief!
    >
    > In my prayers and please keep me posted as to how you make out with all
    > of this!
    >
    > .
    > .
    > Donna G.
    > .
    >
    > 1) Rejoice always, Pray continually, Give thanks in all circumstances,
    > For this is God's will for you in Christ Jesus. ( I Thessalonians
    > 5:16-18 NIV )
    >
    > 2) ANGELS EXIST, but some times, since they don't all have wings, we
    > call them FRIENDS......
    >
    > 3) Just because you're in pain, doesn't mean you have to be one!
    >



    --
    Navy remove the fish

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