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#441814 05/04/11 01:32 AM
Joined: Feb 2006
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drizzit Offline OP
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Interesting read

http://jrheum.org/content/early/2011/03/30/jrheum.100925.abstract

So: Conclusion Our study of AS spines documents that MRI findings predict new bone formation on radiograph. Demonstration of an increased likelihood of developing new bone following resolution of inflammation after anti-TNF therapy supports the theory that TNF-α acts as a brake on new bone formation. Because the number of new syndesmophytes was low, further study is necessary to make firm conclusions.

Just maybe the TNF drugs can prevent fusing if it prevents the inflammation but if you already have inflammation treating it with TNF may increase bone growth in those areas. Am I reading that right?

Last edited by drizzit; 05/04/11 03:38 AM.

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Yes, that how I read it. That sort of gives meaning to "can't win for losing." frown


John
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It would explain why the anti-TNFs do not halt the progression completely. If the area has already been affected there isn't much to be done about it. I have syndesmophytes in my lumbar area that were not there prior to biologics, so I just figured the process had already begun. Still, if this is what I have while taking these meds, I'd hate to think what it would be like were I not taking them.

Interesting, Drizz. Thanks!

Warm hugs,


Kat

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Hey Steve,

I have always been impressed with your ability to read Greek... errr.. I mean medical studies.

In reading conclusion I understand it the same way. However, as with any treatment with AS the objective seems to be able to stay out of enough pain that you can stretch/exercise to try and avoid fusion. That is what my first rheumies always preached.

Thanks for link as always.

Tim


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That does appear to be what they are saying. But in the study they compared areas with CIL treated with anti-TNF to areas with no CIL. (Apples to Oranges) With similar findings in patients that received standard treatment.

My read is that its merely showing that new bone growth happens when imflammation is stopped. No imflammation, no bone growth. That would be a true statement regardless of the method used to stop it. After imflammation stops the body goes into a healing mode, in order to heal the area of bone attacked it must create new bone. This would be the process that causes fusion in AS patients. The cycle of imflammation and healing regardless the method of intervention.


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Chris

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Interesting, so being on the anti-tnf's may prevent further inflammation which could decrease chances of new areas fusing?
But the areas that were inflamed before you started anti-tnf's that are no longer inflamed would increase fusing.

So this is what I understand that if I can prevent further inflammation prevents fusing - there is nothing I can do about the areas that have already been damaged.

I listened to on of the podcasts on the spondy site and they say earlier treatment with anti-tnfs helps to prevent fusing.

Does this make sense?

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I think it does make sense. If you start on the biologic before the inflammation has a chance to cause damage, then you can prevent the damage. Aggressive early treatment would seem to be best, no matter what route you decide to take.

Hugs,


Kat

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That's what I have always been told... And don't forget lots of range of motion exercises. My rheumy is always on me to start yoga... I keep telling him that 6'6" 325lb sasquatch does not look so hot in a leotard.. I'll stick to golf..LOL


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Chris

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Definitely lots of ROM exercises!! As for Yoga, well, you're doc isn't off base with that. Except it bores me stupid. Which is why I prefer Pilates. It engages my brain more.

Personally, I'd love to see you in leotard!! grin

But not playing golf. Golf frustrates me. laugh2

Warm hugs,


Kat

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Golf frustrates me too... But the attire works better! roll


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Chris


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