Medical management of ankylosing spondylitis

Khalessi, Alexander A.; Oh, Bryan C.; Wang, Michael Y.

doi:10.3171/foc/2008/24/1/e4

Cited by 10 publications

(3 citation statements)

References 15 publications

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“…A recent Norwegian study showed that the cessation of physical work in patients with AS occurred at an average disease duration of 15.6 years [2] . Currently, there is no cure for AS, but available therapies, such as individualized physical therapy and nonsteroidal anti-inflammatory drugs (NSAIDs), target symptoms and pain [3] .…”

Section: Introductionmentioning

confidence: 99%

Population pharmacokinetics of rhTNFR-Fc in healthy Chinese volunteers and in Chinese patients with Ankylosing spondylitis

Fang

Wang

et al. 2010

Acta Pharmacol Sin

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Aim:To investigate the population pharmacokinetics of recombinant human tumor necrosis factor receptor-Fc fusion protein (rhTNFRFc) administered via subcutaneous (SC) injection in healthy Chinese volunteers and in Chinese patients with ankylosing spondylitis (AS). Methods: Thirty-two healthy volunteers were randomly assigned to receive a single SC injection of 12.5, 25, 37.5, or 50 mg of rhTNFRFc. Twenty male patients with moderate AS were randomly assigned to receive seven consecutive SC injections of rhTNFR-Fc at either 25 mg twice a week (BIW) or 50 mg once a week (QW). Population pharmacokinetic (PK) analysis was applied to obtain PK parameters of rhTNFR-Fc by the NONMEM method. Results: The data were best described by a one-compartment model with lag time. We found that gender had a significant effect on the apparent clearance (CL/F), with the male CL/F ratio being only 0.665 times the female ratio; the absorption coefficient (F) of multiple dosages of rhTNFR-Fc was only 0.674 times that of a single dosage. The outcome parameters were CL/F (female: 0.168 L/h, male: 0.110 L/h), the apparent volume of distribution (Vd/F: 15.5 L), the absorption rate constant (Ka) (single dosage: 0.0605 h -1 , multiple dosage: 0.0408 h -1 ), and the lag time (T lag : 1.03 h). The inter-individual variability in the CL/F, Vd/F, Ka, and T lag were 33.3%, 42.7%, 55.6%, and 81.8%, respectively. Conclusion: Chinese females have a higher CL/F than Chinese males, and multiple dosings can significantly decrease the absorption of rhTNFR-Fc (SC). The population PK parameters of rhTNFR-Fc in healthy Chinese volunteers and patients with AS were similar to those reported for subjects in published American studies.

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Section: Introductionmentioning

confidence: 99%

Population pharmacokinetics of rhTNFR-Fc in healthy Chinese volunteers and in Chinese patients with Ankylosing spondylitis

Fang

Wang

et al. 2010

Acta Pharmacol Sin

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“… Favorable outcomes of treatment with TNF-α inhibitors are expected if 1) duration of symptoms is short and 2) the result of C-reactive protein examination is positive. Latent tuberculosis should be examined before administration since some reports indicate that the incidence rate of tuberculosis is elevated due to TNF-α inhibitors 20) . …”

Section: Dignosis and Medical Management Of Ankylosing Spondylitismentioning

confidence: 99%

“…Latent tuberculosis should be examined before administration since some reports indicate that the incidence rate of tuberculosis is elevated due to TNF-α inhibitors 20) .…”

Section: Dignosis and Medical Management Of Ankylosing Spondylitismentioning

confidence: 99%

Medical Treatment of Ankylosing Spondylitis

Moon

Kim

2014

Hip & Pelvis

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The diagnosis of ankylosing spondylitis is often delayed due to ambiguous clinical manifestations and strict diagnostic criteria. However, imaging techniques such as magnetic resonance imaging have been found effective for the early diagnosis of non-radiographic sacroiliitis. New tumor necrosis factor alpha (TNF-α) inhibitors have good efficacy for patients with persistently high disease activity despite conventional nonsteroidal anti-inflammatory drug treatment. Thus, early diagnosis and aggressive treatments are essential for ankylosing spondylitis patients. Because many patients complain of musculoskeletal pains, especially around the sacroiliac joint area, hip specialists should be informed of up-to-date knowledge. In this review, we discuss new diagnostic criteria for ankylosing spondylitis, administration methods of TNF-α inhibitors, and the long-term follow-up results for patients treated with TNF-α inhibitors.

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