Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in ankylosing spondylitis.

Objectives: To evaluate the efficacy and safety of an oral phosphodiesterase 4 inhibitor, apremilast, in treatment of ankylosing spondylitis (AS) by monitoring symptoms and signs in a pilot study including exploratory investigation of effects of PDE4 inhibition on blood biomarkers of bone biology.

Methods: In this double-blind, placebo-controlled, single-centre, Phase II study, patients with symptomatic AS with active disease on MRI were randomised to apremilast 30 mg BID or placebo over 12 weeks. Bath Indices were monitored serially.

Improving the standard of care for people with ankylosing spondylitis and a new approach to developing specialist ESP-Led AS clinics.

Objectives: In the UK, there is a wide variation in the quality of care that people with ankylosing spondylitis (AS) receive. People with AS require early diagnosis and referral to a specialist team to commence treatment and optimize outcome.

Methods: At East Kent Hospitals University Foundation Trust, a specialist clinic led by an extended scope practitioner (ESP) physiotherapist has been set up for the assessment and monitoring of patients with AS.

Sodium aurothiomalate toxicity and sulphoxidation capacity in rheumatoid arthritic patients.

The association between sulphoxidation capacity and sodium aurothiomalate toxicity was investigated in 65 patients undergoing treatment for rheumatoid arthritis. Of those showing side-effects, 30/37 (81%) were also poor sulphoxidizers compared with only 9/28 (32%) in the group not displaying adverse reactions. A patient with poor sulphoxidation had a nine-fold greater risk of developing toxicity.