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

Nam, Bora; Koo, Bon San; Lee, Tae Han; Shin, Ji Hui; Kim, Jin Ju; Lee, Seunghun; Joo, Kyung Bin; Kim, So Yeon

doi:10.1186/s12891-020-03941-8

Cited by 8 publications

(9 citation statements)

References 33 publications

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“…The Kruskal Wallis test was used for comparison of the suicidal ideation scale scores between the multiple independent groups. The level of statistical significance in nonparametric multiple comparisons was determined with the Bonferroni correction (p scores[35]. Based on the parametric distribution of the data, psychometric assessment scales of remission/mild and moderate RA patients were compared with Students t-test and AS patients at remission or non-remission were compared with Mann-Whitney U test.…”

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confidence: 99%

Effects of the COVID-19 pandemic on psychology and disease activity in patients with ankylosing spondylitis and rheumatoid arthritis

Gıca¹,

Akkubak²,

Aksoy³

et al. 2021

Turk J Med Sci

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Background/aim: The COVID-19 outbreak is known to increase stress levels of most patients with chronic diseases. Patients with Ankylosing Spondylitis (AS) and Rheumatoid Arthritis (RA) are highly susceptible to environmental stress. In the current study, we aimed to determine how the COVID-19 pandemic psychologically affected patients with chronic progressive diseases such as AS and RA and the effects of these psychological factors on disease activity.Materials and methods: Age and gender-matched patients with AS (n=80), RA (n=80), and healthy controls (n=80) were included in the study. All participants were evaluated with the "Perceived COVID-19 Threat Form (PCTF)", "Suicide-Ideation Scale (SIS)", "Hospital Anxiety and Depression Scale (HADS)", "The Ability to Cope with Trauma (PACT)" and "Psychological General Well-Being Index (PGWB)" scales. BASDAI was used in patients with AS and DAS28 was used in patients with RA to assess disease severity.Results: Compared to healthy individuals, patients with RA and AS had lower PGWB scores and higher HADS depression and anxiety subscale scores. Almost all psychometric assessment test scores were worse in AS patients with high-disease activity compared to those in low-disease activity. PACT scores were higher in patients with moderate RA compared to patients with mild RA (p=0.006). While a positive correlation was identified between BASDAI and most of the psychometric assessment test scores (r=0 .36 for PCTF, r= 0.53 for depressive scores, r= 0.54 for anxiety scores, r= 0.57 for suicidal 2 ideation), DAS28 scores were found to be associated only with PACT total and PACT perceived forward-focused subscale scores (r= -.26 and r= .33, respectively). Conclusion:Psychologically, AS and RA patients were found to be worse off compared to healthy controls. The perceived COVID threat and psychological status were associated with disease activity in AS, but not RA patients. Patients with chronic illnesses may be more vulnerable to the psychological effects of the pandemic, which can worsen disease activity.

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confidence: 99%

Effects of the COVID-19 pandemic on psychology and disease activity in patients with ankylosing spondylitis and rheumatoid arthritis

Gıca¹,

Akkubak²,

Aksoy³

et al. 2021

Turk J Med Sci

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“…Still, quantification of osteoblastic activity demonstrated that the SUV max decreased, stayed similar, or, on rare occasion, showed only a minor increase. These data indicate that the magnitude of the treatment effect at the structural level, as assessed by imaging, may not necessarily reflect the magnitude of its effect on treatment outcomes, which might depend on the tool used to assess global disease activity or on the effect of comorbidities, such as concomitant fibromyalgia (28–31). Another explanation for this observation may be that, in some patients, treatment with TNFi but also with other bDMARDs needs >6 months to reach its full potency with regard to clinical outcomes and structural changes (32,33).…”

Section: Discussionmentioning

confidence: 99%

Effects of Anti–Tumor Necrosis Factor Therapy on Osteoblastic Activity at Sites of Inflammatory and Structural Lesions in Radiographic Axial Spondyloarthritis: A Prospective Proof‐of‐Concept Study Using Positron Emission Tomography/Magnetic Resonance Imaging of the Sacroiliac Joints and Spine

Bruckmann

Rischpler

Tsiami

et al. 2022

Arthritis & Rheumatology

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Objective Proof‐of‐concept trial to determine the effects of tumor necrosis factor inhibitor (TNFi) therapy on osteoblastic activity at sites of inflammatory and structural lesions in patients with radiographic axial spondyloarthritis (SpA), using fluorine 18–labeled NaF (18F‐NaF) positron emission tomography/magnetic resonance imaging (PET/MRI). Methods Sixteen patients with clinically active radiographic axial SpA were prospectively enrolled to receive TNFi treatment and undergo 18F‐NaF PET/MRI of the sacroiliac (SI) joints and spine at baseline and at a follow‐up visit 3–6 months after treatment initiation. Three readers (1 for PET/MRI and 2 for conventional MRI) evaluated all images, blinded to time point. Bone marrow edema, structural lesions (i.e., fat lesions, sclerosis, erosions, and ankylosis), and 18F‐NaF uptake at SI joint quadrants and vertebral corners (VCs) were recorded. Results Overall, 11 male and 5 female patients (mean age ± SD 38.6 ± 12.0 years) were followed up for a mean duration of 4.6 months (range 3–6). 18F‐NaF PET/MRI was conducted on SI joints for 16 patients and the spine for 10; 128 SI joint quadrants and 920 VCs were analyzed at each time point. At baseline, 18F‐NaF uptake was demonstrated in 96.0% of SI joint quadrants with bone marrow edema, 94.2% with sclerosis, and 88.3% with fat lesions. At follow‐up, 65.3% of SI joint quadrants with bone marrow edema (P < 0.001), 33.8% with sclerosis (P = 0.23), and 24.5% with fat lesions (P = 0.01) had less 18F‐NaF uptake, compared with baseline. For VCs, 18F‐NaF uptake at baseline was found in 81.5% of edges with sclerosis, 41.9% with fat lesions, and 33.7% with bone marrow edema. At follow‐up, 73.5% of VCs with bone marrow edema (P = 0.01), 53.3% with fat lesions (P = 0.03), and 55.6% with sclerosis (P = 0.16) showed less 18F‐NaF uptake, compared with baseline. Conclusion Anti‐TNF antibody treatment led to a significant decrease in osteoblastic activity within 3–6 months, especially, but not solely, at sites of inflammation. Larger data sets are needed for confirmation of the antiosteoblastic effects of TNFi for the prevention of radiographic progression in axial SpA.

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“…However, it's worth noting that there are other markers of plasma atherogenicity, such as AIP [ 30 ]. Firth, the Ankylosing Spondylitis Disease Activity Score (ASDAS) which is a more disease-specific and objective disease activity index than ESR and CRP levels, could not be utilized in our study [ 31 ]. Another limitation of our study is the relatively short follow-up duration, highlighting the importance of conducting further studies with longer observation periods.…”

Section: Discussionmentioning

confidence: 99%

Impact of anti-tumor necrosis factor treatment on lipid profiles in Korean patients with ankylosing spondylitis

Kwon,

Choi,

Shin

et al. 2023

J Rheum Dis

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Objective To investigate the effects of anti-tumor necrosis factor (TNF) treatment on lipid profiles and identify risk factors for an increase in total cholesterol (TC) after the anti-TNF treatment in ankylosing spondylitis (AS) patients. Methods This retrospective cohort study analyzed AS patients who received the first-line anti-TNF treatment. Patients with at least nine months of follow-up were included; those who were under 18 years or on any lipid-lowering agent were excluded. A linear mixed model was used to assess the impact of anti-TNF inhibitors on disease activity and lipid profile (TC, low-density lipoprotein [LDL], high-density lipoprotein [HDL], and triglycerides [TG]). Univariable and multivariable linear regression were used to identify risk factors for an increase in TC after 3 months of anti-TNF treatment. Results A total of 315 AS patients were enrolled (78.1% male, median age 32.0 [26.0~41.0]). TC, HDL, and TG levels significantly increased particularly within the first 3 months of anti-TNF treatment, while LDL level did not show significant changes. Changes in inflammatory markers and lipid particles (TC, LDL, TG) were correlated over time, but HDL showed no significant correlation. Older age, higher baseline erythrocyte sedimentation rate, and lower baseline LDL level were related to an increase in TC after 3 months of the anti-TNF treatment. Conclusion In AS patients, anti-TNF treatment has been found to increase lipid particles, potentially due to its anti-inflammatory effects. Future research should explore the underlying mechanism and the clinical implications of dyslipidemia, particularly the occurrence of cardiovascular events, following anti-TNF treatment in AS patients.

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

Cited by 8 publications

References 33 publications

Effects of the COVID-19 pandemic on psychology and disease activity in patients with ankylosing spondylitis and rheumatoid arthritis

Effects of the COVID-19 pandemic on psychology and disease activity in patients with ankylosing spondylitis and rheumatoid arthritis

Effects of Anti–Tumor Necrosis Factor Therapy on Osteoblastic Activity at Sites of Inflammatory and Structural Lesions in Radiographic Axial Spondyloarthritis: A Prospective Proof‐of‐Concept Study Using Positron Emission Tomography/Magnetic Resonance Imaging of the Sacroiliac Joints and Spine

Impact of anti-tumor necrosis factor treatment on lipid profiles in Korean patients with ankylosing spondylitis

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