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KMID : 1207720100020010028
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Clinics in Orthopedic Surgery
2010 Volume.2 No. 1 p.28 ~ p.33
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Anti-TNF-α Therapy for Ankylosing Spondylitis
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Son Jung-Hwan
Cha Sang-Won
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Abstract
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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.
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KEYWORD
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Tumor necrosis factor-alpha, Etanercept, Ankylosing spondylitis
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