Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Question: Does humira halt or repair damage?

thank you very much Paul thats all I wanted to know.
Kevin

Thanks paul. That says it better than I was LOL. Perhaps they should change the terms as many now are diagnosed with AS and have no fusion.

My sons both carry AS diagnosis with no fusion either.

Thank you thats all I wanted to know I agree they should change the terms. Im sorry your sons have it I know its just as painfull without fusing and no fun when your young I hope they never develop full AS fusion.
Kevin

It makes me glad doctors can detect it earlier these days. The same article I posted above has a section where the authors discuss a screening program for early detection. In a small run of the screening program, a surprising amount of people turned out to have SpA. I think many people out there have some sort of autoimmune arthritis, but write it off as just "back pain" or "sleeping wrong". Better screening could yield faster diagnoses and therefore faster (and more effective) treatment. The thought of detecting SpA early enough to put it into remission with anti-TNF's is an interesting one, but there is no research on that yet.

In France, apart from Marie Strumpell's (sp?) Disease, they term it 'Spondylo-Arthritique' - the term 'Ankylosing' is not used. Interesting. Yes. I have SpA (AS), no fusion, certainly enthesisis - a big hall mark for SpA, and all , or most, of the add ons of the jigsaw, like achilles tendonitis, planta faciitis, gut problems, Sjogren's, Reynauds, shoulder, elbow, hip, knee, ankle, (big joint) problems. Feet, incl toes, hands, carpel tunel, Cervicals DDD, costo, rib cage, fatigue etc etc etc. Slight psoriasis, but NOT PsA per se! Great fun. Don't weaken, just take another pill...

No. You don't have to fuse to be spondy! Nor yet do you have to be positive for HLA-B27 - can be B27 negative as well and still be a spondy.

SpA is a systemic disease - which point I have just had to enlighten my kinestherapist with...he knows nowt about the condition and is treating SpA patients. (One despairs of em all...!!)

Molly C (France)

Interesting discussion!

To quote from the same link Paul provided: Arthritis_research.com
"Radiographic sacroiliitis grade 2 bilaterally or grade 3 or 4 unilaterally is usually a requirement for making the diagnosis of AS according to the modified New York criteria"

I think to be given a diagnosis of AS, you have to have 'some' reasonable evidence of chronic SI-joint inflammation, that a rheumatologist would have good enough reason to *expect* will lead to erosive damage and bone remodelling. That is, after all, the process of ankylosis which eventually leads to joint fusion, given enough time.

As far as I understand it, new criteria being considered still require active inflammation of the sacroiliac joints, if not the same stage or grade of sacroiliitis damage. So rather than wait for the slow changes to show on plain xrays, they're utilising the higher quality MRI to see evidence of disease, which, coupled with clinical signs, seeks to capture an earlier diagnosis with comparable confidence.

"Clinical experience as well as limited data suggest that a good proportion of patients with inflammation of SI joints on MRI and yet normal or suspicious radiographs will develop radiographic sacroiliitis later on and therefore evolve to AS"

"In general, a combination of several clinical (such as inflammatory back pain, enthesitis, uveitis, or peripheral arthritis), laboratory (such as HLA-B27 or C-reactive protein), and imaging (x-rays or MRI) parameters is necessary for an early diagnosis"

I think that in the absence of effective treatment to control inflammation, that a good percentage of AS patients will suffer 'some' fusion over their lifetime, at least to some extent. AS is a chronic progressive disease process of inflammation, erosion and bone repair (gone amuck.)

If inflammation tends to be mild, more intermittent, or is really well controlled maybe some ASers can escape fusion!? Past the existing damage I'm stuck with, I am still optimistic that mine has considerably slowed down, thanks to Remicade.

Just my two little cents.
mig

Thanks mig
I was just trying to understand how I have severe Ankylosing Spondylitis like you and many others on here and yet someone with no Ankylosing can have the same diagnoses.I know that the inflamation is very painfull but when you add it to the fusion its a totaly different pain.
As Alan would say it really really hurts.I dont want anyone to think Im putting people without fusion down they have my deepest respect and sympathy obviously I know how much it hurts and debilitates I just dont under stand how a Doctor can say they have AS when its not total AS. Im sorry like I say Im not trying to offend or upset anyone I just cant get my head round it.
With Respect to every one. Kevin

It is kind of weird when I actually stop to think about it. The hallmark or classic trait of AS is the bamboo or fused spine. Yet many, the majority actually, of those diagnosed with AS will never fully develop the "classic" symptom.

ya gotta love medical lingo

Thats what to me dosent make sense.