Anti-TNF-alpha Therapy for Ankylosing Spondylitis.
- Author:
Jung Hwan SON
1
;
Sang Won CHA
Author Information
- Publication Type:Original Article
- Keywords: Tumor necrosis factor-alpha; Etanercept; Ankylosing spondylitis
- MeSH: Adult; Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage/adverse effects; Antirheumatic Agents/*administration & dosage/adverse effects; Blood Sedimentation; C-Reactive Protein/analysis; Drug Administration Schedule; Female; Humans; Immunoglobulin G/*administration & dosage/adverse effects; Injections, Subcutaneous; Male; Middle Aged; Receptors, Tumor Necrosis Factor/*administration & dosage; Spondylitis, Ankylosing/diagnosis/*drug therapy; Tumor Necrosis Factor-alpha/*antagonists & inhibitors; Young Adult
- From:Clinics in Orthopedic Surgery 2010;2(1):28-33
- CountryRepublic of Korea
- Language:English
- 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.
