Brief in English from Bechterew-Brief No. 81

For this issue, I have translated and patient-adapted an article on "atypical clinical presentation of ankylosing spondylitis" by R. MADER (Haifa, Israel), originally published in Seminars in Arthritis and Rheumatism. After presenting three case histories of AS patients whose disease evolved without characteristic back pain, four subgroups of AS patients are delineated: 1) classic AS with characteristic manifestations, 2) asymptomatic AS with characteristic radiographic findings, 3) asymptomatic AS with extra-articular features as the presenting manifestations, and 4) symptomatic AS without radiographic supporting evidence. All of these groups have to be regarded when the prevalence of AS is investigated. The examples presented show also that an accident may essentially affect the course of the disease.

J. BRANDT, J. SIEPER, and J. BRAUN (Berlin) give a review of the results of experimantal therapy of spondyloarthritides. Among the different treatments which have proven to be effective in rheumatoid arthritis, the TNF-alpha blocker Infliximab has turned out in a small pilot study to be also effective in severe AS. The authors initiated therefore a larger study on this subject and invite patients to participate. Also the effectiveness of Thalidomide, of Pamidronate, and of an internal irradiation by Radium-224 (see below) is discussed in this connection. In a separate box, Prof. Braun explains that an advantage of COX-2 selective NSAIDs like Rofecoxib has not yet been proven for AS.

A short report by L. M. SAVAGE on the international convention organised by the American College of Rheumatologywhich took place in November 1999 in Boston, has been translated from the newsletter of the Spondylitis Association of America. Some misunderstanding contained in the original report concerning the anti-TNF-alpha therapy (see above) could be cleared by correspondence with the authors of the papers referred to.

As has been reported in our March 2000 issue (Bechterew-Brief No. 80), the internal irradiation with Radium-224 is now again available in Germany. In former studies on this treatment, 90% of the AS patients treated had an advantage, with a decrease of pain over many years. DVMB director L. HAMMEL informs all patients interested how this treatment has to be applied for. He asks all participants of a former or new treatment to communicate their experiences.

The article by A. FALKENBACH on the effectiveness of the AS treatment in the radon thermal gallery in Bad Gastein (Austria) is a shortened version of a report presented at the symposium "Radon and Health" which took place in September 1998 in Bad Hofgastein (Austria) (cf. Bechterew-Brief No. 76). The original scientific report is published in the proceedings book on this symposium.

In our column on our international cooperation, we mention that in 24 countries AS societies are existing at present, either as national societies or at least regional or local). Whereas we have heard nothing from Iceland since many years and have therefore deleted this country from our mailing list, the society in France has dissolved by the end of 1999.

DVMB News:
For September 2nd, DVMB announces, on the occasion of its 20th anniversary, an "ankylosing spondylitis day" in Germany with public actions in many cities, to make the public aware of our disease. The actions comprise posters and hand-outs in clinics, chemist’s shops and practices, information distributed by newspapers, radio and television, and stands in public places.

As you will have seen, we print again (on page 1) a cartoon drawn by C. B. Born. He draws for several self-help societies and is ready to work also for societies in other countries. He takes 50 DM = EUR 25.56 for every printed cartoon, also if he draws more than one proposal. Please tell us if you want to get in contact with him.

E. Feldtkeller