Updates in Axial Spondyloarthritis: Bones and Booze

Apr 11, 2018

Highlights of recent research include a novel predictor of osteoporosis and the surprising effects of alcohol on disease activity.

References1. Kang KY, Goo HY, Park SH, Hong YS. Trabecular bone score as an assessment tool to identify the risk of osteoporosis in axial spondyloarthritis: a case-control study. Rheumatology. 2018;57:462-469.2. Zhao S, Thong D, Duffield SJ, et al. Alcohol and disease activity in axial spondyloarthritis: a cross-sectional study. Rheumatol Int. 2018;38:375-381.

Two recent studies on axial spondyloarthritis (axSpA) focus on (1) the role of trabecular bone quality as a predictor of osteoporosis and (2) alcohol consumption and disease activity in patients with axSpA.^1,2 Scroll through the slides for key concepts as well as take-home points for clinicians.

(Osteoporosis image: ©Lightspring/Shutterstock.com; liquor image: ©Evgeny Karandaev/Shutterstock.com)

axSpA, axial spondyloarthritis; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate.

The average trabecular bone quality score for subjects with axSpA was 1.38 versus 1.43 for controls. The presence of syndesmophytes in patients with axSpA was associated with lower trabecular bone scores (P < .001) but higher bone mineral density (P = .021).

axSpA, axial spondyloarthritis; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate.

ASDAS, Ankylosing Spondylitis Disease Activity Score; axSpA, axial spondyloarthritis; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate.

In multi-adjusted linear models, alcohol drinking was associated with lower disease activity (BASDAI Î² = − 0.83; 95% CI: − 1.49, − 0.17; ASDAS Î² = − 0.36; 95% CI: − 0.66, − 0.05) and functional impairment (BASFI Î² = − 1.40; 95% CI: − 2.12, − 0.68).

Take-home points:
• Alcohol consumption appears to reduce disease activity and functional impairment in axSpA.
• Smoking continues to be associated with increased inflammation and, in this study, depression and anxiety in axSpA.
• Clinicians may counsel patients with axSpA who drink responsibly that there is no reason to abstain based on these findings.