“At the University of Texas Health Science Center at Houston, we have been interested in studying long-term outcomes of ankylosing spondylitis (AS) such as spinal disease. Over their lifetimes, roughly one-third of AS patients experience radiographic disease limited to their sacroiliac joints while others develop severe radiographic disease resulting in complete spinal fusion. The inability to identify which patients will have radiographic progression have hampered clinical trials to study this outcome. Therefore, there is a critical, unmet need to define AS patterns/endotypes with distinct spinal disease trajectories and to identify reliable biomarkers that predict these endotypes. Our long-term goal is to help AS patients by predicting their risk of long-term spinal damage, informing them a priori, and allowing timely initiation of potential disease-modifying treatment before irreversible spinal damage has occurred. Our overall objectives in the UTHSC-H Spondyloarthritis Program are to (i) develop algorithms that will identify AS radiographic spinal damage patterns through molecular data and (ii) characterize the integral biologic pathways responsible for spinal damage. Through the longitudinal multicenter “Prospective Study of Ankylosing Spondylitis” PSOAS cohort, patients have volunteered to provide radiographs and biosamples of DNA, RNA, and serum over decades. We recently have begun to obtain molecular data of these biosamples in terms of Whole-ExomeSequencing, RNA-Seq and apatamer-based proteomic screens. We hope to combine these different levels of molecular biology with the longitudinal clinical data provided by investigators and patients. Since joining faculty at UTHSC-H in August 2018, we have published several manuscripts that have used longitudinal and latent variable modeling to understand the rich axSpa dataset at UTHSCH. We have published several manuscripts on comorbidities, clinical features, and patient-reported outcomes in AS. I have also started an NIH-funded investigator-initiated clinic trial in AxSpa patients. I hope this trial can bring direct benefit to persons with axSpa at the trial completion, given the adaptive, clinical trial design.”
