Low BASDAI score alone is not a good predictor of anti-tumor necrosis factor treatment efficacy in ankylosing spondylitis: a retrospective cohort study

BMC Musculoskeletal Disorders

Kyung Bin Joo¹  Seunghun Lee¹  Ji-Hui Shin²  Bora Nam²  Tae-Han Lee²  Tae-Hwan Kim²  Bon San Koo³  Jin-Ju Kim⁴ 

[1] Department of Radiology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea;Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 222-1 Wangsimni-ro, Seongdong-gu, 04763, Seoul, Republic of Korea;Department of Rheumatology, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, South Korea;Medical Affairs, AbbVie Ltd., Seoul, South Korea;

关键词: Ankylosing spondylitis;    Disease activity;    Ankylosing spondylitis disease activity score (ASDAS);    Bath Ankylosing spondylitis disease activity index (BASDAI);    Anti-tumor necrosis factor (anti-TNF);   

DOI  :  10.1186/s12891-020-03941-8

来源: Springer

【 摘 要 】

BackgroundThe purpose of this study was to determine the prevalence of high disease activity as measured using the Ankylosing Spondylitis Disease Activity Score (ASDAS) in ankylosing spondylitis (AS) patients who nonetheless have low Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores after anti-tumor necrosis factor (TNF) treatment. Its clinical impact on anti-TNF survival was also investigated.MethodsWe conducted a single-centre retrospective cohort study of AS patients having low BASDAI scores (< 4) and available ASDAS-C-reactive protein (CRP) data after 3 months of first-line anti-TNF treatment. Patients were grouped into high-ASDAS (≥ 2.1) and low-ASDAS (< 2.1) groups according to the ASDAS-CRP after 3 months of anti-TNF treatment. Their characteristics were compared. And survival analyses were carried out using Kaplan–Meier curves and log-rank test with the event being discontinuation of anti-TNF treatment due to lack/loss of efficacy.ResultsAmong 116 AS patients with low BASDAI scores after 3 months of anti-TNF treatment, 38.8% were grouped into the high-ASDAS group. The high-ASDAS group tended to have greater disease activity after 9 months of treatment (BASDAI 2.9 ± 1.1 vs. 2.3 ± 1.4, p=0.007; ASDAS-CRP 1.8 ± 0.6 vs. 1.5 ± 0.7, p=0.079; proportion of high ASDAS-CRP 27.8% vs. 13.8%, p=0.094) and greater risk of discontinuing anti-TNF treatment due to lack/loss of efficacy than the low-ASDAS group (p=0.011).ConclusionsA relatively high proportion of AS patients with low BASDAI scores had high ASDAS-CRP. These low-BASDAI/high-ASDAS-CRP patients also had a greater risk for discontinuation of anti-TNF treatment due to low/lack of efficacy than the low-ASDAS group. The use of the ASDAS-CRP alone or in addition to the BASDAI may improve the assessment of AS patients treated with anti-TNF agents.

【 授权许可】

CC BY