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Watad A, McGonagle D, Anis S, Carmeli R, Cohen AD, Tsur AM, Ben-Shabat N, Lidar M, Amital H. TNF inhibitors have a protective role in the risk of dementia in patients with ankylosing spondylitis: Results from a nationwide study. Pharmacol Res 2022; 182:106325. [PMID: 35752359 DOI: 10.1016/j.phrs.2022.106325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/24/2022] [Accepted: 06/20/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Ankylosing spondylitis (AS) is a chronic progressive and debilitating form of arthritis with associated extra-articular features including uveitis, intestinal and lung apical inflammation and psoriasis. Putative associations between AS and neurologic disorders has been relatively overlooked. The purpose of this study is to assess the link between AS and major neurologic disorders and whether treatment with Tumor-Necrosis-Factor inhibitors (TNFi) has an impact on that association. METHODS A retrospective cross-sectional study was carried out based on the Clalit Health Services (CHS) computerized database. AS patients were compared to age- and gender-matched controls with respect to the proportion of Alzheimer's disease (AD), Parkinson's disease (PD), epilepsy, and multiple sclerosis (MS). The impact of AS therapy (biologic vs conventional therapy) was assessed as well. RESULTS 4,082 AS patients and 20,397 age- and gender-matched controls were identified. AS was associated with a higher prevalence of AD (odds-ratio(OR) 1.46 [95%Confidence-interval(CI) 1.13-1.87], p=0.003), epilepsy (OR 2.33 [95%CI 1.75-3.09] p<0.0001) and PD (OR 2.75 [95%CI 2.04-3.72], p<0.0001), whereas no statistically significant association was found for MS. Association with PD remained significant in the multivariate analysis (OR 1.49 [95%CI 1.05- 2.13],p=0.027). Within AS patients, the use of TNFi (OR 0.10 [95%CI 0.01-0.74], p=0.024) were associated with a lowered risk of developing AD. CONCLUSION AS is positively associated with AD, PD, and epilepsy but not MS. AS patients treated with TNFi have lower rates of AD.
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Affiliation(s)
- Abdulla Watad
- Department of Medicine 'B', Sheba Medical Centre, Tel-Hashomer, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Centre, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel; Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Molecular Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK.
| | - Dennis McGonagle
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Molecular Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK
| | - Saar Anis
- Department of Neurology, Sheba Medical Center, Ramat Gan, Israel
| | - Reut Carmeli
- Department of Medicine 'B', Sheba Medical Centre, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Arnon D Cohen
- Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Avishai M Tsur
- Department of Medicine 'B', Sheba Medical Centre, Tel-Hashomer, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Centre, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel; Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Niv Ben-Shabat
- Department of Medicine 'B', Sheba Medical Centre, Tel-Hashomer, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Centre, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Merav Lidar
- Rheumatology unit, Sheba Medical Centre, Ramat Gan, Israel
| | - Howard Amital
- Department of Medicine 'B', Sheba Medical Centre, Tel-Hashomer, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Centre, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel
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Engel A, Adler OB, Carmeli R. [Computed tomography in the diagnosis of popliteal artery entrapment syndrome]. Harefuah 1991; 121:437-8. [PMID: 1786892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Popliteal artery entrapment syndrome (PAES), a rare cause of lower limb ischemia, is due to an anomalous relationship between the popliteal artery and the gastrocnemius muscle in the popliteal fossa. Hypertrophy of the muscle, or its anomalous insertion, can displace or compress the artery, leading to stenosis or obstruction. It is clinically manifested by intermittent claudication and most often occurs in young, healthy men. Arteriography is the method of choice to demonstrate vascular lesions, but it can only visualize change in the course of vessels or intrinsic lesions. Due to its high spatial and density resolution, CT scan can differentiate between bony structures, vessels, muscles, and fatty tissue in the popliteal fossa. It is therefore a very useful supporting examination in PAES and can demonstrate whether or not stenosis or occlusion of the artery results from causes outside the artery itself.
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Affiliation(s)
- A Engel
- Dept. of Diagnostic Radiology, Rambam Medical Center, Haifa
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