依那西普和传统合成改变病情抗风湿药序贯治疗轻中度强直性脊柱炎的中期疗效随访研究

doi:10.13418/j.issn.1001-165x.2023.1.18

Abstract

Abstract: Objective To evaluate etanercept and conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) in treating ankylosing spondylitis (AS) and its mid-term therapeutic effect among mild-to-moderate AS patients. Methods Sixty-four patients diagnosed with mild-to-moderate AS treating in our department from 2017 to 2018 were enrolled. Etanercept was used in the short term during the active stage of the disease, and csDMARDs combination was used for oral administration during the remission stage. Clinical remission rate was assessed before treatment, 3, 6 and 12 months after treatment. Tthe therapeutic effect was evaluated by BASFI, BASDAI and SQOL-AS scales. Results Patients Global, BASFI, BASDAI and ASDAS-CRP scores, CRP and ESR values decreased (P<0.05), while SQOL-AS scores increased (P<0.05) at 3, 6 and 12 months of follow-up. At the end of the follow-up, 85.9% and 79.7% of all enrolled patients achieved ASAS 20, ASAS 40 remission criteria, respectively. No tuberculosis, opportunistic infection or tumor occurred during the treatment. Conclusions For mild to moderate AS, the sequential combination of etanercept and csDMARDs shows satisfied mid-term therapeutic efficacy and expects to be an alternative treatment for those low-income AS patients.

Key words: Ankylosing spondylitis (AS); , Conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs); , , Therapy

CLC Number:

R681.51

Jiang Weizhou, Hu Yong, Song Minkai, Liu Huan, Huang Wenhua, Xiao Jun. Sequential application of etanercept and csDMARDs in treating ankylosing spondylitis: A prospectively mid-term follow-up study[J]. Chinese Journal of Clinical Anatomy, 2023, 41(1): 97-104.

References 15

[1]	Maxwell LJ, Zochling J, Boonen A, et al. TNF-alpha inhibitors for ankylosing spondylitis[J]. Cochrane Database Syst Rev, 2015(4): Cd005468. DOI: 10.1002/14651858.CD005468.pub2.
[2]	Ward MM, Deodhar A, Gensler LS, et al. 2019 Update of the American college of rheumatology/spondylitis association of America/spondyloarthritis research and treatment network recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis[J]. Arthritis Care Res (Hoboken), 2019, 71(10): 1285-1299. DOI: 10.1002/acr.24025.
[3]	Tam LS, Wei JC. 2018 APLAR axial spondyloarthritis treatment recommendations[J]. Int J Rheum Dis, 2019, 22(3): 340-356. DOI: 10.1111/1756-185X.13510.
[4]	Chan J, Gladman D. Oral treatment options for AS and PsA: DMARDs and small-molecule inhibitors[J]. Best Pract Res Clin Rheumatol, 2018, 32(3): 415-426. DOI: 10.1016/j.berh.2018.08.003.
[5]	Linden SVD, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis[J]. Arthritis Rheum, 1984, 27(4): 361-368. DOI: 10.1002/art.1780270401.
[6]	Smolen JS, Braun J, Dougados M, et al. Extended report: treating spondyloarthritis, including ankylosing spondylitis and psoriatic arthritis, to target: recommendations of an international task force[J]. Ann Rheum Dis, 2014, 73(1): 6. DOI: 10.1136/annrheumdis-2013-203419.
[7]	Braun J, Van dHB, Irene E, et al. Clinical efficacy and safety of etanercept versus sulfasalazine in patients with ankylosing spondylitis: a randomized, double-blind trial[J]. Arthritis Rheum, 2011, 63(6): 1543. DOI: 10.1002/art.30223.
[8]	Kádár G, Balázs E, Soós B, et al. Disease activity after the discontinuation of biological therapy in inflammatory rheumatic diseases[J]. Clin Rheumatol, 2014, 33(3): 329-333. DOI: 10.1007/s10067-014-2508-3.
[9]	Osman MS, Maksymowych WP. An update on the use of tumor necrosis factor alpha inhibitors in the treatment of ankylosing spondylitis[J]. Expert Rev Clin Immunol, 2017, 13(2): 125-131. DOI: 10.1080/1744666X.2016.1218761.
[10]	Tong Q, Cai Q, De MT, et al. Adverse events of anti-tumor necrosis factor α therapy in ankylosing spondylitis[J]. Plos One, 2015, 10(3): e0119897. DOI: 10.1371/journal.pone.0119897.
[11]	Strand V, Balsa A, Al-Saleh J, et al. Immunogenicity of biologics in chronic inflammatory diseases: a systematic review[J]. BioDrugs, 2017, 31(4): 299-316. DOI: 10.1007/s40259-017-0231-8.
[12]	Steiman AJ, Pope JE, Thiessen-Philbrook H, et al. Non-biologic disease-modifying antirheumatic drugs (DMARDs) improve pain in inflammatory arthritis (IA): a systematic literature review of randomized controlled trials[J]. Rheumatol Int, 2013, 33(5): 1105-1120. DOI: 10.1007/s00296-012-2619-6.
[13]	Yu HC, Lu MC, Huang KY, et al. Sulfasalazine treatment suppresses the formation of HLA-B27 heavy chain homodimer in patients with ankylosing spondylitis[J]. Int J Mol Sci, 2015, 17(1): 46. DOI: 10.3390/ijms17010046.
[14]	Relas H, Kautiainen H, Puolakka K, et al. Survival of disease-modifying antirheumatic drugs used as the first antirheumatic medication in the treatment of ankylosing spondylitis in Finland. A nationwide population-based register study[J]. Clin Rheumatol, 2014, 33(8): 1135-1138. DOI: 10.1007/s10067-014-2700-5.
[15]	O'Dell JR, Leff R, Paulsen G, et al. Treatment of rheumatoid arthritis with methotrexate and hydroxychloroquine, methotrexate and sulfasalazine, or a combination of the three medications: Results of a two-year, randomized, double-blind, placebo-controlled trial[J]. Arthritis Rheum, 2002, 46(5): 1164. DOI: 10.1002/art.10228.

Sequential application of etanercept and csDMARDs in treating ankylosing spondylitis: A prospectively mid-term follow-up study

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References 15

Related Articles 15

Metrics

Comments

Recommended 0

[1]	Jiang Jianhong, Duan Renpeng, Li Xiaofeng. Application of three-dimensional visualization technology in the anatomical variations of hilar bile ducts in Chinese population [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 1-4.
[2]	Guo Hongzhi, Wang Yu, Zhang Jiaqi, Liang Haibin, Ma Ziwei, Feng Wei, Wu You, Si Ziyi. Evaluation of placental vascular structure in preeclampsia by vascular casting combined with CT three-dimensional model [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 5-10.
[3]	Li Jiawei, Zhang Jing, Li Canran, Lan Wenjie, Ji Qingyu, Guo Zhiyong, Zhang Yunfeng, Liu Qi, Chen Qingwei, Li Xiaohe. X-ray measurement of proximal femur anatomical parameters in Mongolian population [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 11-16.
[4]	. Digital measurement and clinical significance of occipitocervical Angle and posterior occipitocervical Angle in children and adolescents [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 17-20.
[5]	Li Wen, Yang Siyi, Huang Lei, Qing Jiwen, Jiang Songtao, Zhang Lei. Morphological characteristics and clinical significance of Lisfranc ligament based on MRI [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 21-25.
[6]	Li Fanfan, Xu Yang, Wang Xiaoxu. Therapeutic effect of shikonin on the treatment of granuloma lobular mastitis in model rats by regulating Nrf2/HO-1 signaling pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 26-32.
[7]	Wang Xinghang, Ding Jiayuan, Li Fang, Bao Cuifen, Yan Lijing. Ginsenoside Rg1 reduces the inflammatory response of microglia after oxygen glucose deprivation/resupply by inhibiting the NLRP3 inflammasome pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 33-41.
[8]	Cheng Yingying, Wu Jianjun, Cai Haiyan , Jiao Xunwen, Ma Jiangbo, Ding Yinxiu. Activation and functional changes of astrocytes cultured in vitro under inflammatory stimulation [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 42-46.
[9]	Qi Zhi, Yang Li, Jia Qiuye, Chen Haolun, Duan Zhaoda, Wu Chunyun. Edaravone regulates Sirt3 expression in lipopolysaccharide-activated microglia via MAPKs signaling pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 47-53.
[10]	Zhang Jingjing, Wang Hongxin. Protective effect of Baicalin on rats with pulmonary hypertension through PDGF/P38 MAPK signaling pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 54-58.
[11]	Yue Qin, Chen Rongli, Xiong Jingxi, Wang Tingyi, Cai Zhiheng, Yi Qiushi, Zeng Xinyi. Effect of Bletilla striata polysaccharides on the choke-area of cross-boundary flap in rats [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 59-64.
[12]	Li Xiaoyu , Zhang Lei , Fu Lei , Li Dongbo , Wang Guoyou. Finite element study on the treatment of Sanders type II calcaneal fracture with three-step reduction method [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 65-70.
[13]	Wu Yanfei, Ma Jianxiong, Lu Bin, Wang Ying, Bai Haohao, Jin Hongzhen, Ma Xinlong. Study on the correlation between the reconstruction of grayscale values using CT post-processing technology and the compressive strength of the endplate [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 71-76.
[14]	Zhuang Wanqiang, Tang Yi, Luo Yonggang, Zhang Hui. An early and mid-term retrospective study of the effects of arthroscopy combined with high tibial osteotomy on patellar position and patellofemoral joint function [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 77-82.
[15]	Luo Ying, Dou Weiyu, Wu Xiaohang, Chen Jingkun, Peng Changgui, Pan Jianying . Risk factors of postoperative complications of calcaneal fractures treated with hippocampal plate internal fixation through minimally invasive method [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 83-88.