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Anti-TNF-alpha therapy for ankylosing spondylitis.

Son JH, Cha SW - Clin Orthop Surg (2010)

Bottom Line: The mean erythrocyte sedimentation rate and C-reactive protein were decreased significantly by the etanercept treatment.A serious infection was observed as a complication in 1 case.These results suggest that etanercept can induce significant improvement in most patients with less damage.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Kosin University Gospel Hospital, Busan, Korea. jhson@ns.kosinmed.or.kr

ABSTRACT

Background: This review evaluated the safety and efficacy of etanercept in patients with ankylosing spondylitis (AS).

Methods: Of 59 patients with AS, this study reviewed 11 patients who were refractory to conventional therapy and treated with etanercept from September 2005 to January 2008. The mean follow-up duration was 13.6 months. The general improvement was evaluated by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and adverse effects, complications and inflammatory markers were also assessed.

Results: The mean BASDAI decreased from 7.1 +/- 1.6 before treatment to 4.2 +/- 1.8 at 3 months after the etanercept treatment (p = 0.001). The mean erythrocyte sedimentation rate and C-reactive protein were decreased significantly by the etanercept treatment. The greatest improvement in symptoms was enthesitis, followed by skin involvement and morning stiffness. There was a significant difference in the improvement in BASDAI along with the follow up duration (p = 0.04). A serious infection was observed as a complication in 1 case.

Conclusions: These results suggest that etanercept can induce significant improvement in most patients with less damage. A trial of tumor necrosis factor inhibition is indicated in all AS patients who do not achieve adequate disease control with disease-modifying antirheumatic drugs, such as methotrexate, leflunomide etc. The patients treated with etanercept should be educated about the possibility of infection and monitored closely.

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Related in: MedlinePlus

Mean Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores of the patients who received etanercept at wk 0, 12. The mean BASDAI scores decreased from the baseline (p = 0.001).
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Figure 1: Mean Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores of the patients who received etanercept at wk 0, 12. The mean BASDAI scores decreased from the baseline (p = 0.001).

Mentions: Before the etanercept treatment, the mean BASDAI was 7.1 ± 1.6 (fatigue, 7.6 ± 1.5; symptoms of the axial skeleton, 7.7 ± 1.6; peripheral arthritis, 6 ± 3.6; enthesitis or skin involvement, 7.1 ± 2.6; level of morning stiffness, 8 ± 2; duration of morning stiffness, 5.3 ± 3.7). The mean BASDAI decreased by 45% to 4.2 ± 1.8 at the 3rd month of the etanercept treatment. Fatigue was reduced by 30% to 5.2 ± 1.5 on average, the symptoms of the axial skeleton improved by 36% to 4.6 ± 1.5, and the level of peripheral arthritis decreased by 43% to 3.2 ± 3.5. The symptoms associated with enthesitis or skin involvement were reduced by 49% to 3.3 ± 2.6. The mean level of morning stiffness decreased by 40% to 4.9 ± 2 and the mean duration of morning stiffness was shortened by 51% to 3.3 ± 2.6. Enthesitis, skin involvement, and morning stiffness showed most improvement since the use of etanercept (Fig. 1). The mean BASDAI was decreased 45% from 7.1 ± 1.6 to 4.2 ± 1.8 using etanercept (p = 0.001).


Anti-TNF-alpha therapy for ankylosing spondylitis.

Son JH, Cha SW - Clin Orthop Surg (2010)

Mean Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores of the patients who received etanercept at wk 0, 12. The mean BASDAI scores decreased from the baseline (p = 0.001).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2824092&req=5

Figure 1: Mean Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores of the patients who received etanercept at wk 0, 12. The mean BASDAI scores decreased from the baseline (p = 0.001).
Mentions: Before the etanercept treatment, the mean BASDAI was 7.1 ± 1.6 (fatigue, 7.6 ± 1.5; symptoms of the axial skeleton, 7.7 ± 1.6; peripheral arthritis, 6 ± 3.6; enthesitis or skin involvement, 7.1 ± 2.6; level of morning stiffness, 8 ± 2; duration of morning stiffness, 5.3 ± 3.7). The mean BASDAI decreased by 45% to 4.2 ± 1.8 at the 3rd month of the etanercept treatment. Fatigue was reduced by 30% to 5.2 ± 1.5 on average, the symptoms of the axial skeleton improved by 36% to 4.6 ± 1.5, and the level of peripheral arthritis decreased by 43% to 3.2 ± 3.5. The symptoms associated with enthesitis or skin involvement were reduced by 49% to 3.3 ± 2.6. The mean level of morning stiffness decreased by 40% to 4.9 ± 2 and the mean duration of morning stiffness was shortened by 51% to 3.3 ± 2.6. Enthesitis, skin involvement, and morning stiffness showed most improvement since the use of etanercept (Fig. 1). The mean BASDAI was decreased 45% from 7.1 ± 1.6 to 4.2 ± 1.8 using etanercept (p = 0.001).

Bottom Line: The mean erythrocyte sedimentation rate and C-reactive protein were decreased significantly by the etanercept treatment.A serious infection was observed as a complication in 1 case.These results suggest that etanercept can induce significant improvement in most patients with less damage.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Kosin University Gospel Hospital, Busan, Korea. jhson@ns.kosinmed.or.kr

ABSTRACT

Background: This review evaluated the safety and efficacy of etanercept in patients with ankylosing spondylitis (AS).

Methods: Of 59 patients with AS, this study reviewed 11 patients who were refractory to conventional therapy and treated with etanercept from September 2005 to January 2008. The mean follow-up duration was 13.6 months. The general improvement was evaluated by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and adverse effects, complications and inflammatory markers were also assessed.

Results: The mean BASDAI decreased from 7.1 +/- 1.6 before treatment to 4.2 +/- 1.8 at 3 months after the etanercept treatment (p = 0.001). The mean erythrocyte sedimentation rate and C-reactive protein were decreased significantly by the etanercept treatment. The greatest improvement in symptoms was enthesitis, followed by skin involvement and morning stiffness. There was a significant difference in the improvement in BASDAI along with the follow up duration (p = 0.04). A serious infection was observed as a complication in 1 case.

Conclusions: These results suggest that etanercept can induce significant improvement in most patients with less damage. A trial of tumor necrosis factor inhibition is indicated in all AS patients who do not achieve adequate disease control with disease-modifying antirheumatic drugs, such as methotrexate, leflunomide etc. The patients treated with etanercept should be educated about the possibility of infection and monitored closely.

Show MeSH
Related in: MedlinePlus