Anti-TNF - 2nd Preliminary judgement from NICE - 19th July 2007
HEALTH: Charity calls for introduction of anti-TNF therapy to be speeded up - EDP 3rd Jan 2006 by Mark Nicholls
Report on Anti-TNF - June 2004 by Fergus Rogers (Director NASS)
Ankylosing Spondylitis is a painful, progressive, rheumatic disease, mainly of the spine. It can also affect other joints, tendons and ligaments
and other areas such as eyes and heart.
Ankylosing means fusing together. Spondylitis indicates inflammation involving the joints of the spine. It is important to be aware
that the entire fusing of the spine is not the norm. Many people will only have partial fusion, sometimes limited to
the pelvic bones.
The inflammatory process is at the site of a joint or where tendons and/or ligaments grow into bone. As a reaction to the inflammation, a small amount of bone erosion occurs. After the inflammation has subsided, a healing process takes place with the growth of new bone. After repeated attacks, this additional bone growth can surround a disc. Therefore, two vertebrae can become one by this merging process. The exercises we should be carrying out are designed to prevent or slow this process.
The cause is not yet known. However 96% of clinically diagnosed people
in this country share the same genetic cell marker 'HLA B27' (Human Leucocyte Antigen B27). This is related to white blood cells
and is quite different from red cell groups such as A, B, O and rhesus markers.
There is evidence that an outside environmental process must be responsible for initiating the condition and its flare-ups.
It could be that a normally quite harmless micro-organism, which would normally be dealt with by our immune system, sets up an
adverse reaction after coming into contact with the B27 individual. In most cases this leads to inflammation of the sacroiliac joints
and to different areas of the spine.
The average age of onset is twenty-four years old and the sex distribution is two and a half males for every one female.
Typically affects YOUNG people (late teens and twenties) with GRADUAL onset of pain, with pain worse in the MORNING and improves with EXERCISE.