Factors associated with ASDAS remission in a long-term study of ankylosing spondylitis patients under tumor necrosis factor inhibitors

Advances in Rheumatology

Andrea Y. Shimabuco¹  Julio C. B. Moraes¹  Carla G. S. Saad¹  Percival D. Sampaio-Barros¹  alves²  Eloisa Bonfa²  Ana Cristina de M. Ribeiro²  Celio R. Gonç³  Mariana G. Waisberg³  Claudia Goldenstein-Schainberg³ 

[1] Faculdade de Medicina da Universidade de São Paulo, Brazil;o Paulo, Sã

关键词: Ankylosing spondylitis;    Anti-TNF;    Co-medication;    Remission;    Switch;   

DOI  :  10.1186/s42358-018-0040-x

学科分类：过敏症与临床免疫学

来源: Springer

【 摘 要 】

To determine the clinical and demographic factors associated with disease remission and drug survival in patients with ankylosing spondylitis (AS) on TNF inhibitors. Data from a longitudinal electronic database of AS patients under anti-TNF therapy between June/2004 and August/2013. Demographic, clinical parameters, disease activity by ASDAS remission (< 1.3) and inactive/low (< 2.1) were analyzed to characterize reasons for drug survival and switching of anti-TNF. Among 117 AS patients, 69 (59%) were prescribed only one anti-TNF, 48 (41%) switched to a second anti-TNF and 13 (11%) to a third anti-TNF. Considering ASDAS-CRP < 1.3, 31 (39%) patients were inactive at the end of the study. Non-switchers (P = 0.04), younger age (P = 0.004), non-smoking (P = 0.016), shorter disease duration (P = 0.047), more frequent use of SSZ (P = 0.037) and lower BASDAI (P = 0.027), BASMI (P = 0.034) and BASFI (P = 0.003) at baseline were associated with remission. In the multivariate analysis younger age (P = 0.016) and lower BASDAI (P = 0.032) remained as remission predictors. This study supports that ASDAS-CRP remission is an achievable goal not only for non-switchers but also for second anti-TNF, particularly in patients with younger age and lower BASDAI at baseline. Co-medication and non-smoker status seems to have a beneficial effect in anti-TNF response in this population.

【 授权许可】

CC BY