Factors associated with ASDAS remission in a long-term study of ankylosing spondylitis patients under tumor necrosis factor inhibitors
AUTOR(ES)
Shimabuco, Andrea Y.
FONTE
Adv. rheumatol.
DATA DE PUBLICAÇÃO
29/07/2019
RESUMO
Abstract Objective: To determine the clinical and demographic factors associated with disease remission and drug survival in patients with ankylosing spondylitis (AS) on TNF inhibitors. Methods: 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. Results: 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. Conclusion: 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. Comedication and non-smoker status seems to have a beneficial effect in anti-TNF response in this population.
Documentos Relacionados
- A tumor necrosis factor-responsive long-term-culture-initiating cell is associated with the stromal layer of mouse long-term bone marrow cultures.
- Reiter's syndrome: long-term follow-up in relation to development of ankylosing spondylitis.
- Long-term inhibition of tumor growth by tumor necrosis factor in the absence of cachexia or T-cell immunity.
- Induction of long-term remission in advanced hepatocellular carcinoma with percutaneous isolated liver chemoperfusion.
- A haematological study of patients receiving long-term treatment with trimethoprim and sulphonamide