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Poddubnyy lab

Early diagnosis and effective therapy of chronic inflammatory spine disease

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Spondyloarthritides

We investigate disease mechanisms and disease progression of spondyloarthritis (SpA) and try to improve diagnostics and therapy, with a focus on early diagnosis of axSpA.

We established a referral network with primary care physicians and orthopaedic surgeons for the early recognition of patients at high risk of axSpA. A self-referral program (bechterew-check.de) has been developed and evaluated as a part of the OptiRef project. A nation-wide study to identify the optimal referred strategy (the MASTER study) was conducted. We also initiated the development of the international recommendation for early recognition of axSpA under the auspices of the Assessment of Spondyloarthritis International Society (ASAS).

In order to study the natural course of SpA, we initiated a prospective cohort of patients with axial spondyloarthritis, the German Early Spondyloarthritis Inception Cohort – GESPIC – in which more than 700 patients with early axial spondyloarthritis (axSpA) have provided information on the natural course of axSpA at the early stage. In this cohort, predictors of a long-term outcome and of structural damage development in the sacroiliac joints and in the spine, including various biomarkers (ArthroMark project) and metabolic factors (Metarthros project) are studied. Most recently, GESPIC was extended to patients with early Crohn’s disease and acute anterior uveitis in order to study factors (including microbiome) associated with the development of arthritis phenotype.

We participate in the BMBF supported PROCLAIR consortium with a subproject that investigates disease burden, standards of care and disease related costs based on claims data linked to a survey in axSpA. We could show that patients with axSpA have a high prevalence of depressive symptoms related to both disease and socioeconomic factors. Analyses of the costs of illness in axSpA patients treated with and without biologics as well as the analysis of factors associated with a still large diagnostic delay are ongoing.

Moreover, we performed a number of clinical trials analyzing the effect of different treatment options like glucocorticoids, TNF blockers and other biologics, such as ustekinumab, in the treatment of axial spondyloarthritis. In 2016 we initiated the large multicenter study CONSUL aimed at investigation of the effect of treatment with NSAIDs added to anti-TNF therapy versus anti-TNF therapy alone on progression of structural damage in the spine over two years in patients with ankylosing spondylitis. In the ongoing NEUROIMPA project we investigate intraarticular treatment options in patients with arthritis of the knee joint.

Keywords
Spondyloarthritis
Ankylosing spondylitis
Diagnosis
Treatment

Spondyloarthritides Prof. Dr. Denis Poddubnyy Phone +49 (0)30 450 514 582 Denis.Poddubnyy@charite.de more
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Group leader
Prof. Dr. Denis Poddubnyy

Scientists
Prof. Dr. Joachim Sieper
PD Dr. Hildrun Haibel
PD Dr. Uta Syrbe
Dr. Susanne Lüders
Dr. Burkhard Muche
Dr. Fabian Proft
Dr. Mikhail Protopopov
Dr. Judith Rademacher
Valeria Rios Rodriguez
Dr. Laura Spiller
Inge Spiller, Dr. Anne-Katrin Weber

MD students
Agnes Hartl, Lorraine Tietz
Henning Weineck

Technical assistance
Beate Buss, Annegret Langdon
Claudia Lorenz, Bianca Mandt
Anna-Lisa Meinke
Martina Seipel, Petra Tietz

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Prof. D. Baeten, Amsterdam University, Niederlande

Prof. J. Braun, Rheumazentrum Ruhrgebiet, Herne

Prof. G.-R. Burmester, Med. Klinik mit S Rheumatologie, Charité Universitätsmedizin Berlin

PD Dr. Klaus Dornmair, Ludwig-Maximilians-Universität, München

PD Dr. Berthold Hoppe, UKB Berlin

Dr. J. Listing, Prof. A. Zink, Epidemiologie, DRFZ Berlin

Prof. A. Radbruch, Dr. A. Grützkau, Dr. A. Kruglov, Dr. H.-D. Chang, Dr. C. Giesecke, DRFZ Berlin

Prof. M. Ostergaard, Dr. S. Pedersen, University of Copenhagen, Denmark

Prof. Uwe Pleyer, Augenheilkunde, Charité Universitätsmedizin Berlin

Prof. Britta Siegmund, Gastroenterologie, Charité Universitätsmedizin Berlin

Prof. C. Stein, Anästhesiologie, Charité Universitätsmedizin Berlin

Prof. A. Thiel, Immunologie im BCRT, Charité Universitätsmedizin Berlin

Prof. R. Lories, Universität Leuven, Belgien

Prof. G. Schett, Universität Erlangen

Prof. D. van der Heijde, Leiden, Niederlande

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  1. “Soluble markers of glucose and and energy turnover in patients with arthritis” – Teilprojekt im Verbund „METARTHROS“. Laufzeit: 2015-2018, Funding: BMBF.
  2. „The role of inflammation in the development of structural damage in the spine in patients with axial SpA” – Teilprojekt im Verbund „ArthroMark“. Laufzeit: 2015-2018, Funding: BMBF.
  3. „Gesundheitsversorgung und Krankheitslast bei Personen mit ankylosierender Spondylitis“ – Teilprojekt im Verbund „PROCLAIR“. Laufzeit: 2015-2018, Funding: BMBF.
  4. Klinische Studie “The Effect of NSAIDs Added to Anti-TNF Therapy Versus Anti-TNF Therapy Alone on Progression of Structural Damage in the Spine in Ankylosing Spondylitis (CONSUL)”. Laufzeit: 2016-2020, Funding: BMBF.
  5. “Establishing and Validation of a Self-Referral Tool for Early Recognition of Patients with axial SpA”. Laufzeit: 2016-2019, Funding: Novartis.
  6. Project “The role of gut microbiota in the development of arthritis phenotype in patients with inflammatory bowel disease: a prospective cohort study”. Laufzeit: 2016-2018, Funding: Berlin Institute of Health.
  7. Project “Early recognition of axial spondyloarthritis in patients with uveitis”. Laufzeit: 2017-2019, Funding: Abbvie.
  8. Klinische Studie „Intraartikuläre Injektionen von Opioiden bei chronischer Arthritis“ – Teilprojekt im Verbund „NEUROIMPA“. Laufzeit: 2015-2018, Funding: BMBF.
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1: Sieper J, Poddubnyy D. Axial spondyloarthritis. Lancet. 2017 Jul 1;390(10089):73-84. doi: 10.1016/S0140-6736(16)31591-4.

2: Poddubnyy D, Protopopov M, Haibel H, Braun J, Rudwaleit M, Sieper J. High disease activity according to the Ankylosing Spondylitis Disease Activity Score is associated with accelerated radiographic spinal progression in patients with early axial spondyloarthritis: results from the GErman SPondyloarthritis Inception Cohort. Ann Rheum Dis. 2016 Dec;75(12):2114-2118.

3: Poddubnyy D, Listing J, Haibel H, Knüppel S, Rudwaleit M, Sieper J. Functional relevance of radiographic spinal progression in axial spondyloarthritis: results from the GErman SPondyloarthritis Inception Cohort. Rheumatology (Oxford). 2018 Jan 24. doi: 10.1093/rheumatology/kex475. [Epub ahead of print]

4: Hartl A, Sieper J, Syrbe U, Listing J, Hermann KG, Rudwaleit M, Poddubnyy D. Serum levels of leptin and high molecular weight adiponectin are inversely associated with radiographic spinal progression in patients with ankylosing spondylitis: results from the ENRADAS trial. Arthritis Res Ther. 2017 Jun 15;19(1):140.

5: Poddubnyy D, Fedorova A, Listing J, Haibel H, Baraliakos X, Braun J, Sieper J. Physical Function and Spinal Mobility Remain Stable Despite Radiographic Spinal
Progression in Patients with Ankylosing Spondylitis Treated with TNF-α Inhibitors for Up to 10 Years. J Rheumatol. 2016 Dec;43(12):2142-2148.

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