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Spinal Diseases: HELP
Articles by Mike Johannes Leonardus Peters
Based on 21 articles published since 2008
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Between 2008 and 2019, M. J. L. Peters wrote the following 21 articles about Spinal Diseases.
 
+ Citations + Abstracts
1 Guideline EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. 2017

Agca, R / Heslinga, S C / Rollefstad, S / Heslinga, M / McInnes, I B / Peters, M J L / Kvien, T K / Dougados, M / Radner, H / Atzeni, F / Primdahl, J / Södergren, A / Wallberg Jonsson, S / van Rompay, J / Zabalan, C / Pedersen, T R / Jacobsson, L / de Vlam, K / Gonzalez-Gay, M A / Semb, A G / Kitas, G D / Smulders, Y M / Szekanecz, Z / Sattar, N / Symmons, D P M / Nurmohamed, M T. ·Departments of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade & VU University Medical Center, Amsterdam, The Netherlands. · Department of Rheumatology, Preventive Cardio-Rheuma Clinic, Diakonhjemmet Hospital, Oslo, Norway. · College of Medical, Veterinary and Life Sciences, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK. · Internal and Vascular Medicine, VU University Medical Center, Amsterdam, The Netherlands. · Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · Department of Rheumatology, Paris Descartes University, Hôpital Cochin. Assistance Publique, Hôpitaux de Paris INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, Paris, France. · Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna, Vienna, Austria. · IRCCS Galeazzi Orthopedic Institute, Milan, Italy. · Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark. · Sygehus Sønderjylland (Hospital of Southern Jutland), Aabenraa, Denmark. · King Christian 10's Hospital for Rheumatic Diseases, Graasten, Denmark. · Department of Public Health and Clinical Medicine/Rheumatology, University of Umeå, Umeå, Sweden. · PARE (patient research partners), Sint-Joris-Weert, Belgium. · Romanian League Against Rheumatism (Vice-President) and Board Member (General Secretary) of AGORA, the Platform of S-E organisations for patients with RMDs, Bucharest, Romania. · Oslo University Hospital, Ullevål, Center for Preventive Medicine and Medical Faculty, University of Oslo, Oslo, Norway. · Department of Rheumatology & Inflammation Research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg and Section of Rheumatology, Lund, Sweden. · Department of Clinical Sciences Malmö, Lund University, Lund, Sweden. · Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium. · University of Cantabria, IDIVAL, Santander, Spain. · Head of Research and Development, Academic Affairs Dudley Group NHS Foundation Trust, Arthritis Research UK Centre for Epidemiology, University of Manchester, Russells Hall Hospital, Clinical Research Unit, Dudley, UK. · Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, University of Debrecen, Debrecen, Hungary. · Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK. · Department of Rheumatology and Musculoskeletal Epidemiology, Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK. · Department of Rheumatology Reade, Amsterdam Rheumatology and Immunology Center, Reade & VU University Medical Center, Amsterdam, The Netherlands. ·Ann Rheum Dis · Pubmed #27697765.

ABSTRACT: Patients with rheumatoid arthritis (RA) and other inflammatory joint disorders (IJD) have increased cardiovascular disease (CVD) risk compared with the general population. In 2009, the European League Against Rheumatism (EULAR) taskforce recommended screening, identification of CVD risk factors and CVD risk management largely based on expert opinion. In view of substantial new evidence, an update was conducted with the aim of producing CVD risk management recommendations for patients with IJD that now incorporates an increasing evidence base. A multidisciplinary steering committee (representing 13 European countries) comprised 26 members including patient representatives, rheumatologists, cardiologists, internists, epidemiologists, a health professional and fellows. Systematic literature searches were performed and evidence was categorised according to standard guidelines. The evidence was discussed and summarised by the experts in the course of a consensus finding and voting process. Three overarching principles were defined. First, there is a higher risk for CVD in patients with RA, and this may also apply to ankylosing spondylitis and psoriatic arthritis. Second, the rheumatologist is responsible for CVD risk management in patients with IJD. Third, the use of non-steroidal anti-inflammatory drugs and corticosteroids should be in accordance with treatment-specific recommendations from EULAR and Assessment of Spondyloarthritis International Society. Ten recommendations were defined, of which one is new and six were changed compared with the 2009 recommendations. Each designated an appropriate evidence support level. The present update extends on the evidence that CVD risk in the whole spectrum of IJD is increased. This underscores the need for CVD risk management in these patients. These recommendations are defined to provide assistance in CVD risk management in IJD, based on expert opinion and scientific evidence.

2 Guideline EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. 2010

Peters, M J L / Symmons, D P M / McCarey, D / Dijkmans, B A C / Nicola, P / Kvien, T K / McInnes, I B / Haentzschel, H / Gonzalez-Gay, M A / Provan, S / Semb, A / Sidiropoulos, P / Kitas, G / Smulders, Y M / Soubrier, M / Szekanecz, Z / Sattar, N / Nurmohamed, M T. ·Department of Rheumatology, VU University Medical Centre, Amsterdam, The Netherlands. ·Ann Rheum Dis · Pubmed #19773290.

ABSTRACT: OBJECTIVES: To develop evidence-based EULAR recommendations for cardiovascular (CV) risk management in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA). METHODS: A multidisciplinary expert committee was convened as a task force of the EULAR Standing Committee for Clinical Affairs (ESCCA), comprising 18 members including rheumatologists, cardiologists, internists and epidemiologists, representing nine European countries. Problem areas and related keywords for systematic literature research were identified. A systematic literature research was performed using MedLine, Embase and the Cochrane library through to May 2008. Based on this literature review and in accordance with the EULAR's "standardised operating procedures", the multidisciplinary steering committee formulated evidence-based and expert opinion-based recommendations for CV risk screening and management in patients with inflammatory arthritis. RESULTS: Annual CV risk assessment using national guidelines is recommended for all patients with RA and should be considered for all patients with AS and PsA. Any CV risk factors identified should be managed according to local guidelines. If no local guidelines are available, CV risk management should be carried out according to the SCORE function. In addition to appropriate CV risk management, aggressive suppression of the inflammatory process is recommended to further lower the CV risk. CONCLUSIONS: Ten recommendations were made for CV risk management in patients with RA, AS and PsA. The strength of the recommendations differed between RA on the one hand, and AS and PsA, on the other, as evidence for an increased CV risk is most compelling for RA.

3 Review Diastolic left ventricular dysfunction in ankylosing spondylitis--a systematic review and meta-analysis. 2014

Heslinga, Sjoerd C / Van Dongen, Carlo J / Konings, Thelma C / Peters, Mike J / Van der Horst-Bruinsma, Irene E / Smulders, Yvo M / Nurmohamed, Michael T. ·Department of Rheumatology, Reade, Amsterdam, the Netherlands; Department of Rheumatology, VU University Medical Centre, Amsterdam, the Netherlands; Department of Internal Medicine, VU University Medical Centre, Amsterdam, the Netherlands. · Department of Rheumatology, Reade, Amsterdam, the Netherlands. · Department of Cardiology, VU University Medical Centre, Amsterdam, the Netherlands. · Department of Internal Medicine, VU University Medical Centre, Amsterdam, the Netherlands. · Department of Rheumatology, Reade, Amsterdam, the Netherlands; Department of Rheumatology, VU University Medical Centre, Amsterdam, the Netherlands. · Department of Rheumatology, Reade, Amsterdam, the Netherlands; Department of Rheumatology, VU University Medical Centre, Amsterdam, the Netherlands; Department of Internal Medicine, VU University Medical Centre, Amsterdam, the Netherlands. Electronic address: mt.nurmohamed@vumc.nl. ·Semin Arthritis Rheum · Pubmed #24655534.

ABSTRACT: OBJECTIVES: Ankylosing spondylitis (AS) is associated with increased mortality largely due to cardiovascular disease. Diastolic left ventricular (LV) dysfunction serves as a precursor to chronic heart failure and may cause morbidity and mortality. A systematic literature search was conducted to determine the prevalence of diastolic LV dysfunction in patients with AS. METHODS: We identified all echocardiographic studies investigating diastolic LV function in patients with AS. The initial search yielded 166 studies of which 11 met the inclusion criteria. RESULTS: Compared to control subjects, AS patients had a worse E/A ratio [mean difference -0.13 m/s (95% CI: -0.19 to -0.07)], a prolonged deceleration time [mean difference 13.90 ms (95% CI: 6.03-21.78)], and a prolonged mean isovolumetric relaxation time [mean difference 8.06 ms (95% CI: 3.23-12.89)], all suggestive of diastolic LV dysfunction. The best way to establish diastolic LV dysfunction, however, is to combine E/A ratio, deceleration time, and isovolumetric relaxation time. The latter has been done in 3 studies, all reaffirming an increased prevalence rate of diastolic LV dysfunction in AS patients as compared with control subjects, i.e., 9% versus 0%, 30% versus 12%, and 45% versus 18%, respectively. CONCLUSIONS: Our observations support the current evidence base for an increased risk of diastolic LV dysfunction in AS. However, larger studies are needed to investigate the exact magnitude of diastolic LV dysfunction and its clinical relevance in patients with AS.

4 Review Cardiovascular comorbidities in patients with psoriatic arthritis: a systematic review. 2013

Jamnitski, Anna / Symmons, Deborah / Peters, Mike J L / Sattar, Naveed / McInnes, Iain / Nurmohamed, Michael T. ·Department of Rheumatology, Jan van Breemen Research Institute/READE, Dr Jan van Breemenstraat 2, 1056 AB Amsterdam, The Netherlands. ·Ann Rheum Dis · Pubmed #22532629.

ABSTRACT: OBJECTIVE: Data regarding cardiovascular comorbidity and cardiovascular risk factors in patients with psoriatic arthritis (PsA) are limited. To evaluate the cardiovascular risk profile, a systematic literature search was performed to provide an extensive summary of all studies available on cardiovascular risk in PsA. METHODS: Medline, EMBASE and the Cochrane library were searched from January 1966 to April 2011 for English language articles on data concerning cardiovascular diseases and cardiovascular risk factors in PsA. Review articles, case reports and studies on psoriasis alone were excluded. RESULTS: Twenty-eight articles were included in this review. Studies on all-cause mortality revealed mixed results. Available data on cardiovascular disease appeared more consistent, indicating an increased cardiovascular mortality and morbidity in PsA. Commensurate with this, surrogate markers of subclinical atherosclerosis, arterial stiffness and cardiovascular risk factors, for example hypertension, dyslipidaemia, obesity and metabolic-related factors, were more prominent in PsA compared with controls. Suppression of inflammation was linked with a favourable effect on cardiovascular surrogate markers, for example carotid intima media thickness and endothelial dysfunction, in several (un)controlled studies. CONCLUSION: Most studies point towards an increased cardiovascular risk in PsA, broadly on a par with the risk level in rheumatoid arthritis, emphasising the need for similar cardiovascular risk management in both conditions. Further studies are needed to indicate whether inflammatory suppression or modification of traditional cardiovascular risk factors, or both, will reduce cardiovascular risk.

5 Clinical Trial Erythrocyte sedimentation rate, C-reactive protein level, and serum amyloid a protein for patient selection and monitoring of anti-tumor necrosis factor treatment in ankylosing spondylitis. 2009

de Vries, Mirjam K / van Eijk, Izhar C / van der Horst-Bruinsma, Irene E / Peters, Mike J L / Nurmohamed, Michael T / Dijkmans, Ben A C / Hazenberg, Bouke P C / Wolbink, Gerrit J. ·VU University Medical Centre, Amsterdam, The Netherlands. ·Arthritis Rheum · Pubmed #19877087.

ABSTRACT: OBJECTIVE: To study the usefulness of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum amyloid A (SAA) for response prediction and monitoring of anti-tumor necrosis factor (anti-TNF) treatment in ankylosing spondylitis (AS) patients. METHODS: Patients were included consecutively before starting etanercept or infliximab treatment. ASsessment in Ankylosing Spondylitis (ASAS) response, defined as a 50% improvement or an absolute improvement of 2 points of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; 0-10 scale), was assessed at 3 months. Inflammatory markers and the BASDAI were collected at baseline and 1 and 3 months. Longitudinal data analysis was performed to compare associations between inflammatory markers and the BASDAI over time by calculating standardized betas. Predictive values of baseline levels of inflammatory markers for ASAS response were calculated. RESULTS: In total, 155 patients were included, of whom, after 3 months of treatment, 70% in the etanercept cohort and 71% in the infliximab cohort responded. All markers, notably SAA, decreased significantly (P < 0.0001). Standardized betas were 0.49 for ESR, 0.43 for CRP, and 0.39 for SAA. Normal baseline levels of CRP and SAA were significantly associated with nonresponse. A combination of elevated CRP and SAA levels at baseline revealed the highest predictive value (81%) for ASAS response. CONCLUSION: ESR, CRP, and SAA were significantly associated with the BASDAI over 3 months, and the association with ESR was the strongest. Elevated baseline CRP and SAA levels revealed the highest predictive value for response. Together, this study demonstrates that inflammatory markers, and notably CRP and SAA, may facilitate patient selection and monitoring of efficacy of anti-TNF treatment in AS, and could be added to response criteria.

6 Article Assessment of aortic stiffness in patients with ankylosing spondylitis using cardiovascular magnetic resonance. 2018

Biesbroek, P Stefan / Heslinga, Sjoerd C / van de Ven, Peter M / Peters, Mike J L / Amier, Raquel P / Konings, Thelma C / Maroules, Christopher D / Ayers, Colby / Joshi, Parag H / van der Horst-Bruinsma, Irene E / van Halm, Vokko P / van Rossum, Albert C / Nurmohamed, Michael T / Nijveldt, Robin. ·Department of Cardiology, 5F, VU University Medical Center, De Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands. · Netherlands Heart Institute, Utrecht, The Netherlands. · Amsterdam Rheumatology and immunology Center, Rheumatology, Reade, Amsterdam, The Netherlands. · Amsterdam Rheumatology and immunology Center, Rheumatology, VU University Medical Center, Amsterdam, The Netherlands. · Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands. · Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands. · Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA. · Department of Clinical Science, University of Texas Southwestern Medical Center, Dallas, TX, USA. · Department of Medicine (Cardiology), University of Texas Southwestern Medical Center, Dallas, TX, USA. · Department of Cardiology, 5F, VU University Medical Center, De Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands. Robin@nijveldt.net. ·Clin Rheumatol · Pubmed #29754182.

ABSTRACT: To evaluate aortic stiffness in patients with ankylosing spondylitis (AS) using cardiovascular magnetic resonance (CMR) and to assess its association with AS characteristics and left ventricular (LV) remodeling. In this prospective study, 14 consecutive AS patients were each matched to two controls without cardiovascular symptoms or known cardiovascular disease who underwent CMR imaging for the assessment of aortic arch pulse wave velocity (PWV) at 1.5 Tesla. To enhance comparability of the samples, matching was done with replacement resulting in 20 unique controls. Only AS patients with abnormal findings on screening echocardiography were included in this exploratory study. Cine CMR was used to assess LV geometry and systolic function, and late gadolinium enhancement was performed to determine the presence of myocardial hyperenhancement (i.e., fibrosis). Aortic arch PWV was significantly higher in the AS group compared with the control group (median 9.7 m/s, interquartile range [IQR] 7.1 to 11.8 vs. 6.1 m/s, IQR 4.6 to 7.6 m/s; p < 0.001). PWV was positively associated with functional disability as measured by BASFI (R: 0.62; p = 0.018). Three patients (21%) with a non-ischemic pattern of hyperenhancement showed increased PWV (11.7, 12.3, and 16.5 m/s) as compared to the 11 patients without hyperenhancement (9.0 m/s, IQR 6.6 to 10.5 m/s; p = 0.022). PWV was inversely associated with LV ejection fraction (R: - 0.63; p = 0.015), but was not found to be statistically correlated to LV volumes or mass. Aortic arch PWV was increased in our cohort of patients with AS. Higher PWV in the aortic arch was associated with functional disability, the presence of non-ischemic hyperenhancement, and reduced LV systolic function.

7 Article Insights into cardiac involvement in ankylosing spondylitis from cardiovascular magnetic resonance. 2017

Biesbroek, P Stefan / Heslinga, Sjoerd C / Konings, Thelma C / van der Horst-Bruinsma, Irene E / Hofman, Mark B M / van de Ven, Peter M / Kamp, Otto / van Halm, Vokko P / Peters, Mike J L / Smulders, Yvo M / van Rossum, Albert C / Nurmohamed, Mike T / Nijveldt, Robin. ·Departments of Cardiology, VU University Medical Center, Amsterdam, The Netherlands. · Netherlands Heart Institute, Utrecht, The Netherlands. · Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade Amsterdam, The Netherlands. · Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands. · Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands. · Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands. · Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands. ·Heart · Pubmed #27852696.

ABSTRACT: OBJECTIVE: To evaluate cardiac involvement in patients with ankylosing spondylitis using cardiac magnetic resonance (CMR). METHODS: Patients with ankylosing spondylitis without cardiovascular symptoms or known cardiovascular disease were screened by transthoracic echocardiography (TTE) for participation in this exploratory CMR study. We prospectively enrolled 15 ankylosing spondylitis patients with an abnormal TTE for further tissue characterisation using late gadolinium enhancement (LGE) and T1 mapping. T1 mapping was used to calculate myocardial extracellular volume (ECV). Disease activity was assessed by C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) measurements. RESULTS: In the total of 15 included patients, 14 had a complete CMR exam (mean age 62 years, 93% male and mean disease duration 21 years). Left ventricular (LV) diastolic dysfunction was the most common finding on TTE (79%), followed by aortic root dilatation (14%), right ventricular (RV) dilatation (7%) and RV dysfunction (7%). CMR revealed focal hyperenhancement in three patients (21%), all with a particular pattern of enhancement. LV dysfunction, as defined by a LV ejection fraction below 55%, was observed in five patients (36%). Myocardial ECV was correlated with the CRP concentration (R=0.78, p<0.01) and ESR level (R CONCLUSIONS: In patients with ankylosing spondylitis, CMR with cine imaging and LGE identified global LV dysfunction and focal areas of hyperenhancement. Myocardial ECV, quantified by CMR T1 mapping, was associated with the degree of disease activity. These results may suggest the presence of cardiac involvement in ankylosing spondylitis and may show the potential of ECV as a marker for disease monitoring.

8 Article Reduction of Inflammation Drives Lipid Changes in Ankylosing Spondylitis. 2015

Heslinga, Sjoerd C / Peters, Mike J / Ter Wee, Marieke M / van der Horst-Bruinsma, Irene E / van Sijl, Alper M / Smulders, Yvo M / Nurmohamed, Michael T. ·From the Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade and VU University Medical Center; and Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.S.C. Heslinga, MD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; M.J. Peters, MD, PhD, Department of Internal Medicine, VU University Medical Center; M.M. ter Wee, MSc, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; A.M. van Sijl, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center; Y.M. Smulders, Professor, Doctor, Department of Internal Medicine, VU University Medical Center; M.T. Nurmohamed, Professor, Doctor, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, and VU University Medical Center. ·J Rheumatol · Pubmed #26329334.

ABSTRACT: OBJECTIVE: To investigate the effects of changing inflammation on lipid levels in ankylosing spondylitis. METHODS: In a cohort of 230 patients, lipid levels were measured at baseline and after 52 weeks of treatment with tumor necrosis factor-α-blocking agents (anti-TNF). RESULTS: Total cholesterol (TC; +4.6%), low-density lipoprotein cholesterol (+4.3%), and high-density lipoprotein cholesterol (HDL-C; +3.7%) increased upon treatment. Changes were most evident in patients with substantial reduction in inflammatory levels (TC +8.2% vs +1.6% and HDL-C +8.3% vs +2.2% in patients with C-reactive protein ≥ 10 mg/l normalizing upon treatment vs CRP < 10 mg/l throughout treatment period). CONCLUSION: Anti-TNF therapy results in lipid changes mostly when inflammation is appreciably modified.

9 Article Cardiovascular risk management in patients with active ankylosing spondylitis: a detailed evaluation. 2015

Heslinga, Sjoerd C / Van den Oever, Inge A / Van Sijl, Alper M / Peters, Mike J / Van der Horst-Bruinsma, Irene E / Smulders, Yvo M / Nurmohamed, Michael T. ·Department of Rheumatology, Reade, Amsterdam, Netherlands. s.heslinga@reade.nl. · Department of Rheumatology, VU University Medical Centre, Amsterdam, Netherlands. s.heslinga@reade.nl. · Department of Internal Medicine, VU University Medical Centre, Amsterdam, Netherlands. s.heslinga@reade.nl. · Department of Rheumatology, Reade, Amsterdam, Netherlands. i.vd.oever@reade.nl. · Department of Rheumatology, VU University Medical Centre, Amsterdam, Netherlands. i.vd.oever@reade.nl. · Department of Rheumatology, Reade, Amsterdam, Netherlands. a.v.sijl@reade.nl. · Department of Rheumatology, VU University Medical Centre, Amsterdam, Netherlands. a.v.sijl@reade.nl. · Department of Internal Medicine, VU University Medical Centre, Amsterdam, Netherlands. a.v.sijl@reade.nl. · Department of Internal Medicine, VU University Medical Centre, Amsterdam, Netherlands. mjl.peters@vumc.nl. · Department of Rheumatology, Reade, Amsterdam, Netherlands. ie.vanderhorst@vumc.nl. · Department of Rheumatology, VU University Medical Centre, Amsterdam, Netherlands. ie.vanderhorst@vumc.nl. · Department of Internal Medicine, VU University Medical Centre, Amsterdam, Netherlands. y.smulders@vumc.nl. · Department of Rheumatology, Reade, Amsterdam, Netherlands. m.nurmohamed@reade.nl. · Department of Rheumatology, VU University Medical Centre, Amsterdam, Netherlands. m.nurmohamed@reade.nl. · Department of Internal Medicine, VU University Medical Centre, Amsterdam, Netherlands. m.nurmohamed@reade.nl. ·BMC Musculoskelet Disord · Pubmed #25886634.

ABSTRACT: BACKGROUND: Ankylosing spondylitis (AS) is an inflammatory disease with documented elevated cardiovascular (CV) risk due to systemic inflammation and a higher prevalence of CV risk factors. CV risk management (CV-RM) could be an effective method to reduce CV mortality and morbidity in AS patients. We assessed CV risk and evaluated guideline adherence according to the Dutch CV-RM guideline. METHODS: This study was conducted with a cohort of consecutive AS patients eligible for treatment with a tumor necrosis factor (TNF) -α inhibitor. Data from the Dutch National Institute for Public Health and Environment was used to compare the prevalence of CV risk factors in AS patients with the Dutch background population. RESULTS: In total, 254 consecutive AS patients were included. The prevalences of hypertension (41% vs 31%) and smoking (43% vs 27%) were substantially higher in AS patients as compared to the general Dutch background population. Of 138 AS patients older than 40 years the 10-years CV risk could be calculated. Fifty-one of these 138 patients (37%) had an indication for CV risk treatment. CV risk treatment was initiated in 42 of the 51 (82%), however, in only 12 of the 51 (24%) patients treatment targets for either hypertension or hypercholesterolemia were reached. CONCLUSION: The increased rates of hypertension and smoking illustrate the importance of CV-RM in AS patients. Although the majority of all AS patients eligible for CV-RM received CV risk medication, CV-RM remains a challenge for treating physicians, as treatment targets were not achieved in three-quarter of the eligible patients.

10 Article Tumour necrosis factor blocking agents and progression of subclinical atherosclerosis in patients with ankylosing spondylitis. 2015

van Sijl, Alper M / van Eijk, Izhar C / Peters, Mike J L / Serné, Erik H / van der Horst-Bruinsma, Irene E / Smulders, Yvo M / Nurmohamed, Michael T. ·Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands Jan van Breemen Research Institute | Reade, Amsterdam, The Netherlands Department of Internal Medicine, Institute for Cardiovascular Research (ICAR), VU University Medical Center, Amsterdam, The Netherlands. · Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands. · Department of Internal Medicine, Institute for Cardiovascular Research (ICAR), VU University Medical Center, Amsterdam, The Netherlands. ·Ann Rheum Dis · Pubmed #24092419.

ABSTRACT: BACKGROUND: Ankylosing spondylitis (AS) is associated with an increased cardiovascular risk that might be due to the chronic underlying inflammatory process. We investigated whether subclinical atherosclerosis of the carotid artery in patients with AS was reduced after anti-inflammatory treatment with tumour necrosis factor (TNF) inhibitors in a prospective observational cohort study. METHODS: 67 out of 81 AS patients who used TNF inhibitors and underwent ultrasonography at baseline returned for follow-up after 4.9 years. Of all patients, 12 (15%) discontinued the use of TNF inhibitors. Assessments of medication use, AS-related factors and cardiovascular risk factors were measured at baseline and repeated at follow-up. B-mode carotid ultrasonography was used to investigate arterial wall parameters, including carotid intima-media thickness (cIMT) and Young's elastic modulus (YEM). RESULTS: After a median 4.9 years of follow-up, cIMT did not change significantly (paired t test +0.011 mm, p=0.561) in those who continued the use of TNF inhibitors, while cIMT increased substantially (+0.057 mm, p=0.069) in those who did not continue their use of TNF inhibitors. The effect of TNF inhibitors was mainly mediated by a subsequent decrease in AS disease activity. Vascular elasticity (as measured with YEM) did not change significantly in patients who discontinued TNF inhibitors or those who continued TNF inhibitors. CONCLUSIONS: The use of TNF inhibitors might stabilise or slow down the progression of subclinical atherosclerosis in AS patients, reflecting a decreased cardiovascular risk in these patients.

11 Article Increased risk for chronic comorbid disorders in patients with inflammatory arthritis: a population based study. 2013

Ursum, Jennie / Nielen, Mark M J / Twisk, Jos W R / Peters, Mike J L / Schellevis, François G / Nurmohamed, Michael T / Korevaar, Joke C. ·NIVEL (Netherlands Institute for Health Services Research), PO Box 1568, Utrecht 3500, BN, the Netherlands. j.ursum@nivel.nl. ·BMC Fam Pract · Pubmed #24364915.

ABSTRACT: BACKGROUND: Studies determining the development of a wide variety of different comorbid disorders in inflammatory arthritis (IA) patients are scarce, however, this knowledge could be helpful in optimising preventive care in IA patients. The aim of this study is to establish the risk that new chronic comorbid disorders in newly diagnosed patients with IA in a primary care setting are developed. METHODS: This is a nested-case-control study from 2001-2010 using data from electronic medical patient records in general practice. In total, 3,354 patients with newly diagnosed IA were selected. Each patient was matched with two control patients of the same age and sex in the same general practice. The development of 121 chronic comorbid disorders of index and control patients was compared using Cox regression. RESULTS: After a median follow-up period of 2.8 years, 56% of the IA-patients had developed at least one chronic comorbid disorder after the onset of IA, compared to 46% of the control patients (p < 0.05). The most frequent developed comorbid disorders after the onset of IA were of cardiovascular (23%), and musculoskeletal (17%) origin. The highest hazard ratios (HRs) were found for anaemia (HR 2.0 [95% CI: 1.4-2.7]) osteoporosis (HR 1.9 [1.4-2.4]), and COPD (HR 1.8 [1.4-2.3]). CONCLUSION: Patients with IA developed more chronic comorbid disorders after the onset of IA than one might expect based on age and sex. Since comorbidity has a large impact on the disease course, quality of life, and possibly on treatment itself, prevention of comorbidity should be one of the main targets in the treatment of IA patients.

12 Article Coexistence of hypothyroidism with inflammatory arthritis is associated with cardiovascular disease in women. 2012

Raterman, Hennie G / Nielen, Mark M J / Peters, Mike J L / Verheij, Robert A / Nurmohamed, Michael T / Schellevis, Francois G. ·Department of Rheumatology, VU University Medical Center, Amsterdam, Netherlands. ·Ann Rheum Dis · Pubmed #22419774.

ABSTRACT: OBJECTIVES: Hypothyroidism and inflammatory arthritis tend to coexist, but data on this association are sparse. In terms of cardiovascular risk, this association may have clinical relevance as this coexistence may carry an additional cardiovascular risk. This study calculates, first, the prevalence of hypothyroidism in patients with inflammatory arthritis and, second, the cardiovascular disease (CVD) prevalence rate in patients with either hypothyroidism or inflammatory arthritis, or both. METHODS: Data from the Netherlands Information Network of General Practice, a representative Dutch sample of 360,000 registered patients, were used. Prevalence rates of hypothyroidism were calculated, and multilevel logistic regression analyses were used to calculate CVD prevalence rates. RESULTS: Hypothyroidism prevalence was 6.5% in female patients with arthritis compared to 3.9% in controls (p<0.001). CVD prevalence was 4.3% in patients with hypothyroidism, 5.9% in patients with inflammatory arthritis, 14.3% in patients with hypothyroid inflammatory arthritis and 2.1% in controls. Adjusted CVD prevalence rates were 1.2 (95% CI 0.99 to 1.4) for hypothyroidism, 1.5 (95% CI 1.1 to 2.0) for inflammatory arthritis and 3.7 (95% CI 1.7 to 8.0) for hypothyroid inflammatory arthritis as compared with controls. CONCLUSIONS: These data raise awareness on the coexistence of hypothyroidism and inflammatory arthritis and emphasise the importance of cardiovascular risk management in these patients, particularly when hypothyroidism and inflammatory arthritis coexist.

13 Article The relationship between disease-related characteristics and conduction disturbances in ankylosing spondylitis. 2010

Dik, V K / Peters, M J L / Dijkmans, P A / Van der Weijden, M A C / De Vries, M K / Dijkmans, B A C / Van der Horst-Bruinsma, I E / Nurmohamed, M T. ·Department of Rheumatology, VU University Medical Centre, Amsterdam, The Netherlands. ·Scand J Rheumatol · Pubmed #20132069.

ABSTRACT: OBJECTIVES: Ankylosing spondylitis (AS) is associated with an increased cardiovascular (CV) risk. Conduction disturbances (CD) may explain the CV burden, as they are independently associated with cardiac disease. The aim of this study was (i) to determine the prevalence of CD in AS, and (ii) to evaluate the relationship between CD and demographic and AS-related characteristics. METHODS: A rheumatological evaluation assessing demographic and AS-related characteristics and a resting standard 12-lead electrocardiogram (ECG) were performed in 131 consecutive AS patients. RESULTS: A first-degree atrioventricular (AV) block was found in six (4.6%) patients. One (0.8%) patient suffered from a complete right bundle branch block (RBBB) and one (0.8%) patient had a left anterior hemiblock. A prolonged QRS (pQRS) interval was observed in 38 (29.2%) patients, including those with a complete or incomplete BBB. Age, disease duration, and body mass index (BMI) were significantly associated with the PR interval, and male gender, disease duration, and the Bath Ankylosing Spondylitis Metrology Index (BASMI) with the QRS interval. In multivariate analyses, disease duration remained independently associated with both the PR and the QRS intervals. CONCLUSION: Intraventricular CD is highly prevalent in AS, particularly in patients with long-standing disease. Further research is needed to determine whether intraventricular CD contribute to the increased CV risk and long-term CV mortality in AS.

14 Article Signs of accelerated preclinical atherosclerosis in patients with ankylosing spondylitis. 2010

Peters, Mike J L / van Eijk, Izhar C / Smulders, Yvo M / Serne, Erik / Dijkmans, Ben A C / van der Horst-Bruinsma, Irene E / Nurmohamed, Michael T. ·VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands. ·J Rheumatol · Pubmed #19955053.

ABSTRACT: OBJECTIVE: Preliminary evidence suggests that ankylosing spondylitis (AS) is associated with an increased cardiovascular (CV) risk. We investigated subclinical atherosclerosis and arterial stiffness in patients with AS compared with controls, and identified CV and AS related risk factors for atherosclerotic disease. METHODS: A total of 59 patients with AS who were scheduled for etanercept treatment according to the ASsessments in Ankylosing Spondylitis guidelines and 30 healthy controls were recruited. Subclinical atherosclerosis was assessed as the average intima-media thickness (IMT) of the common carotid artery. Arterial stiffness was determined by distensibility, compliance, and Young's elastic modulus of the carotid artery. RESULTS: AS patients had a greater IMT (0.62 +/- 0.09 mm vs 0.57 +/- 0.09 mm in controls; p = 0.02), a difference that remained after adjustment for traditional CV risk factors. AS was associated with higher carotid pulse pressure (47 +/- 7 mm Hg vs 44 +/- 8 mm Hg in controls; p = 0.04), but this was not due to local vessel wall properties. Among AS patients, age and body mass index (BMI) were determinants of IMT. Age, BMI, total cholesterol, triglycerides, and disease duration were identified as determinants of stiffness indices. No relationship was found between large-vessel properties and higher Bath AS disease indices or C-reactive protein values. CONCLUSION: AS was associated with subclinical atherosclerosis and arterial stiffness, supporting epidemiological evidence of an increased CV risk in these patients. Whether these differences are due to AS or to a higher prevalence of CV risk factors in patients with AS remains to be determined.

15 Article Lack of effect of TNFalpha blockade therapy on circulating adiponectin levels in patients with autoimmune disease: results from two independent prospective studies. 2010

Peters, Mike J L / Watt, Pauline / Cherry, Lynne / Welsh, Paul / Henninger, Eric / Dijkmans, Ben A C / McInnes, Iain B / Nurmohamed, Michael T / Sattar, Naveed. ·Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands. mjl.peters@vumc.nl ·Ann Rheum Dis · Pubmed #19640853.

ABSTRACT: BACKGROUND: Adiponectin is an anti-inflammatory and potentially antiatherogenic molecule. Some recent reports suggest that tumour necrosis factor alpha (TNFalpha) blockade therapy increases circulating adiponectin levels, but data are sparse and inconsistent. METHODS: Data from a double-blind placebo controlled study of onercept in 126 patients with psoriatic arthritis (PsA) and from pre- and post-adalimumab treatment in 171 patients with rheumatoid arthritis (RA) were used to examine the effect of TNFalpha blockade therapy on adiponectin. RESULTS: Despite expected associations of adiponectin with gender and baseline high-density lipoprotein cholesterol and triglyceride, adiponectin levels did not change over time with TNFalpha blockade therapy in either group. The mean+/-SD absolute change in adiponectin levels was -0.23+/-4.6 microg/ml in patients with PsA treated with combined onercept 50 mg and onercept 100 mg (vs placebo, p=0.60) and 0.28+/-3.23 microg/ml in patients with RA treated with adalimumab (vs baseline, p=0.66). CONCLUSION: These results do not support a significant effect of TNFalpha blockade therapy on circulating adiponectin levels in patients with autoimmune disease.

16 Article Ankylosing spondylitis: a risk factor for myocardial infarction? 2010

Peters, M J L / Visman, I / Nielen, M M J / Van Dillen, N / Verheij, R A / van der Horst-Bruinsma, I E / Dijkmans, B A C / Nurmohamed, M T. ·Departments of Internal Medicine and Rheumatology, VU University Medical Centre, Amsterdam, Netherlands. ·Ann Rheum Dis · Pubmed #19403516.

ABSTRACT: OBJECTIVE: To ascertain the prevalence of myocardial infarction (MI) in ankylosing spondylitis (AS) relative to that in the general population. METHODS: A questionnaire was sent to 593 patients with AS, aged between 50 and 75 years and registered at the Jan van Breemen Institute or VU University Medical Centre. A total of 383 (65%) patients with AS returned their questionnaire that covered the primary outcome, (non-fatal) MI. The prevalence of MI was calculated with data from the general population provided by Netherlands Information Network of General Practice databases as reference. RESULTS: The overall prevalence for MI was 4.4% in patients with AS versus 1.2% in the general population, resulting in an age- and gender-adjusted odds ratio of 3.1 (95% CI 1.9 to 5.1) for patients with AS. When non-responders (35%) were considered as non-MI the odds ratio decreased to 1.9 (95% CI 1.2 to 3.2). CONCLUSIONS: These observations indicate that the prevalence of MI is increased in patients with AS.

17 Article Improvement of lipid profile is accompanied by atheroprotective alterations in high-density lipoprotein composition upon tumor necrosis factor blockade: a prospective cohort study in ankylosing spondylitis. 2009

van Eijk, I C / de Vries, M K / Levels, J H M / Peters, M J L / Huizer, E E / Dijkmans, B A C / van der Horst-Bruinsma, I E / Hazenberg, B P C / van de Stadt, R J / Wolbink, G J / Nurmohamed, M T. ·Jan van Breemen Institute, Amsterdam, The Netherlands. ·Arthritis Rheum · Pubmed #19404933.

ABSTRACT: OBJECTIVE: Cardiovascular mortality is increased in ankylosing spondylitis (AS), and inflammation plays an important role. Inflammation deteriorates the lipid profile and alters high-density lipoprotein cholesterol (HDL-c) composition, reflected by increased concentrations of serum amyloid A (SAA) within the particle. Anti-tumor necrosis factor (anti-TNF) treatment may improve these parameters. We therefore undertook the present study to investigate the effects of etanercept on lipid profile and HDL composition in AS. METHODS: In 92 AS patients, lipid levels and their association with the inflammation markers C-reactive protein (CRP), erythrocyte sedimentation rate, and SAA were evaluated serially during 3 months of etanercept treatment. HDL composition and its relationship to inflammation markers was determined in a subgroup of patients, using surface-enhanced laser desorption/ionization time-of-flight analysis. RESULTS: With anti-TNF treatment, levels of all parameters of inflammation decreased significantly, whereas total cholesterol, HDL-c, and apolipoprotein A-I (Apo A-I) levels increased significantly. This resulted in a better total cholesterol:HDL-c ratio (from 3.9 to 3.7) (although the difference was not statistically significant), and an improved Apo B:Apo A-I ratio, which decreased by 7.5% over time (P=0.008). In general, increases in levels of all lipid parameters were associated with reductions in inflammatory activity. In addition, SAA was present at high levels within HDL particles from AS patients with increased CRP levels and disappeared during treatment, in parallel with declining plasma levels of SAA. CONCLUSION: Our results show for the first time that during anti-TNF therapy for AS, along with favorable changes in the lipid profile, HDL composition is actually altered whereby SAA disappears from the HDL particle, increasing its atheroprotective ability. These findings demonstrate the importance of understanding the role of functional characteristics of HDL-c in cardiovascular diseases related to chronic inflammatory conditions.

18 Article Microvascular function is impaired in ankylosing spondylitis and improves after tumour necrosis factor alpha blockade. 2009

van Eijk, I C / Peters, M J L / Serné, E H / van der Horst-Bruinsma, I E / Dijkmans, B A C / Smulders, Y M / Nurmohamed, M T. ·Department of Rheumatology, Jan van Breemen Institute, Amsterdam, The Netherlands. ·Ann Rheum Dis · Pubmed #18390569.

ABSTRACT: OBJECTIVES: Ankylosing spondylitis (AS) is associated with increased cardiovascular morbidity and mortality. Microvascular function has been linked to several risk factors for cardiovascular disease. Inflammation in AS may cause microvascular dysfunction. To test this, we assessed microvascular function in (a) patients with AS compared to healthy controls and (b) patients with AS before and after 1 month of anti-tumour necrosis factor (TNF)alpha treatment with etanercept. METHODS: A total of 15 consecutive patients with AS, who were scheduled for etanercept treatment according to the Assessment in Ankylosing Spondylitis (ASAS) group guidelines, and 12 healthy controls matched for age and sex, were recruited. Endothelium-dependent and independent vasodilatation in skin were evaluated with laser Doppler fluxmetry after iontophoresis of acetylcholine and sodium nitroprusside, respectively. Videomicroscopy was used to measure recruitment of skin capillaries after arterial occlusion. RESULTS: Compared to healthy controls, patients with AS had impaired endothelium-dependent vasodilatation and capillary recruitment. Following anti-TNFalpha treatment, microvascular function improved significantly for endothelium-dependent vasodilatation (p = 0.03) and capillary recruitment (p = 0.006). A significant correlation was observed between changes in endothelium-dependent vasodilatation and changes in erythrocyte sedimentation rate (ESR) (r = -0.56; p = 0.03). CONCLUSION: Microvascular dysfunction is present in patients with AS with active disease, but improves as inflammation regresses after TNFalpha blockade.

19 Article Immunogenicity does not influence treatment with etanercept in patients with ankylosing spondylitis. 2009

de Vries, M K / van der Horst-Bruinsma, I E / Nurmohamed, M T / Aarden, L A / Stapel, S O / Peters, M J L / van Denderen, J C / Dijkmans, B A C / Wolbink, G J. ·VU University Medical Center, Amsterdam, The Netherlands. mk.devries@vumc.nl ·Ann Rheum Dis · Pubmed #18375542.

ABSTRACT: BACKGROUND: Immunogenicity, specifically the onset of antibodies against tumour necrosis factor (TNF) blocking agents, seems to play an important role in non-response to treatment with these drugs. OBJECTIVES: To assess the relation of clinical response of ankylosing spondylitis (AS) to etanercept with etanercept levels, and the presence of antibodies to etanercept. METHODS: Patients with AS were treated with etanercept 25 mg twice weekly, according to the international Assessment in Ankylosing Spondylitis (ASAS) working group consensus statement. Sera were collected at baseline and after 3 and 6 months of treatment. Clinical response was defined as a 50% improvement or as an absolute improvement of 2 points on a (0-10 scale) Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score. Functional etanercept levels were measured by a newly developed ELISA, measuring the binding of etanercept to TNF. Antibodies against etanercept were measured with a two-site assay and antigen binding test. Clinical data were used to correlate disease activity with serum etanercept levels. RESULTS: In all, 53 consecutive patients were included. After 3 months of treatment 40 patients (76%) fulfilled the response criteria. Mean etanercept levels were 2.7 mg/litre and 3.0 mg/litre after 3 and 6 months respectively. Characteristics and etanercept levels of responders and non-responders were similar. No antibodies to etanercept were detected with any of the assays. CONCLUSION: Etanercept levels of responders and non-responders were similar and no antibodies to etanercept were detected with any of the assays. This study indicates that etanercept is much less immunogenic compared with the other TNF-blocking agents.

20 Minor Response to: 'The influence of inflammation in the development of subclinical atherosclerosis in psoriatic arthritis' by Gonzalez-Gay et al. 2014

Nurmohamed, Michael T / Jamnitski, Anna / Symmons, Deborah / Peters, Mike Johannes Leonardus / Sattar, Naveed / McInnes, Iain. ·Department of Rheumatology and Internal Medicine, VUMC, , Amsterdam, The Netherlands. ·Ann Rheum Dis · Pubmed #24577335.

ABSTRACT: -- No abstract --

21 Minor Prevalence of cardiovascular diseases in psoriatic arthritis resembles that of rheumatoid arthritis. 2011

Jamnitski, A / Visman, I M / Peters, M J L / Boers, M / Dijkmans, B A C / Nurmohamed, M T. · ·Ann Rheum Dis · Pubmed #20956406.

ABSTRACT: -- No abstract --