Real life experience confirms sustained response to long-term biologics and switching in ankylosing spondylitis

Coates, Laura C.; Cawkwell, Lorna; Ng, Nora; Bennett, Alexander N.; Bryer, Domini; Fraser, Alexander; Emery, Paul; Marzo‐Ortega, Helena

doi:10.1093/rheumatology/ken094

Cited by 77 publications

(43 citation statements)

References 16 publications

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“…Thirty three patients were treated with a single medication for 24 months and decreased BASDAI, BASFI and CRP values more than >20 g/dL were achieved. 5 In our study, the initial rate of concomitant DMARDs and NSAIDs at baseline was 91.52% and 54.23%, respectively. During treatment with any one of these three drugs, 23.72% of the patients discontinued DMARDs, while 10.16% discontinued NSAIDs.…”

Section: Discussionmentioning

confidence: 49%

“…Due to another uveitis episode with INF, the patient was switched to ADA, which led to another uveitis episode. 5 Braun et al 32 reported that the incidence of acute anterior uveitis per 100 patient years was 15.6 in the placebo group, and 6.8 per 100 patient year in the anti-TNF group. The INF treatment was also reported to inhibit the exacerbation of uveitis.…”

Section: Discussionmentioning

confidence: 99%

“…No serious side effects were observed. 26 Coates et al 5 conducted a study including 113 patients using either INF, ETA or ADA. The mean duration for use of TNF blockers was 21 (range 1 to 88) months.…”

Section: Discussionmentioning

confidence: 99%

“…Tumor necrosis factor-alpha (TNF-a) blockers have been introduced in many studies as a novel and effective alternative for the treatment of AS patients who are refractory to NSAIDs and DMARDs. [5][6][7] An optimal treatment for AS should target both symptomatic relief of pain, stiffness and fatigue, offering biological benefits for the reduction or prevention of joint damages and ankylosis. 3 Recent randomized controlled studies conducted with TNF blockers have demonstrated that these drugs are effective in the treatment of spinal pain, limited mobility and function, and also extra-spinal involvement.…”

mentioning

confidence: 99%

“…3 Recent randomized controlled studies conducted with TNF blockers have demonstrated that these drugs are effective in the treatment of spinal pain, limited mobility and function, and also extra-spinal involvement. 5,8,9 In clinical practice, however, the optimal duration for use of these agents and the safety profile of TNF blockers have not been elucidated yet. In the update version of the literature review on the treatment with biologics, Baraliakos et al 10 showed strong evidences on the long-term efficacy and safety of TNF blockers in AS patients.…”

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confidence: 99%

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Efficacy of Tumor Necrosis Factor Inhibitors in Patients With Ankylosing Spondylitis

et al. 2014

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Objectives: This study aims to investigate the efficacy of tumor necrosis factor-alpha blockers such as infliximab, etanercept, and adalimumab in the treatment of ankylosing spondylitis. Patients and methods:The outcome of tumor necrosis factor-alpha blocker treatment was analyzed retrospectively in 59 patients with ankylosing spondylitis who were being treated in our clinic during last nine years. The patients' Assessment of SpondyloArthritis International Society (ASAS) 20 and ASAS 40 response rates, adverse drugs effects, and treatment compliance were evaluated. Results: ASAS 20 response was achieved by 89.8% of the patients in the third month, and by 93.2% in the sixth month. ASAS 40 response was achieved by 61% of the patients in the third and sixth month. No statistically significant difference was detected between the three tumor necrosis factor-alpha blockers with regards to the ASAS 40 response rates. Mild infections, observed in 31 of the patients, were the most common side effects. Serious side effect was observed in only one patient. The number of patients who withdrew from the treatment for various reasons was six. Conclusion: Treatment with infliximab, etanercept, or adalimumab is clinically effective and safe.

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Efficacy of Tumor Necrosis Factor Inhibitors in Patients With Ankylosing Spondylitis

et al. 2014

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Efficacy and safety of golimumab in patients with ankylosing spondylitis: Results of a randomized, double‐blind, placebo‐controlled, phase III trial

Inman

Davis

Heijde

et al. 2008

Arthritis & Rheumatism

538

327

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Objective. To evaluate the efficacy and safety of golimumab in patients with ankylosing spondylitis (AS) in the GO-RAISE study.Methods. Patients with active AS, a Bath AS Disease Activity Index (BASDAI) score >4, and a back pain score of >4 were randomly assigned in a 1.8:1.8:1 ratio to receive subcutaneous injections of golimumab (50 mg or 100 mg) or placebo every 4 weeks. The primary end point was the proportion of patients with at least 20% improvement in the ASsessment in AS (ASAS20) criteria at week 14.Results. At randomization, 138, 140, and 78 patients were assigned to the 50-mg, 100-mg, and placebo groups, respectively. After 14 weeks, 59.4%, 60.0%, and 21.8% of patients, respectively, were ASAS20 responders (P < 0.001). A 40% improvement in the ASAS criteria at week 24 occurred in 43.5%, 54.3%, and 15.4% of patients, respectively. Patients receiving golimumab also showed significant improvement in the physical and mental component summary scores of the Short Form 36 Health Survey, the Jenkins Sleep Evaluation Questionnaire score, the BASDAI score, and the Bath AS Functional Index score, but not the Bath AS Metrology Index score. Through week 24, 85.6% of golimumab-treated patients and 76.6% of patients in the placebo group had >1 adverse event, and 5.4% and 6.5% of patients, respectively, had >1 serious adverse event. Eight golimumab-treated patients and 1 placebo-treated patient had markedly abnormal liver enzyme values (>100% increase from baseline and a value >150 IU/liter), which were transient.Conclusion. Golimumab was effective and well tolerated in a large cohort of patients with AS during a 24-week study period.Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown etiology that involves the sacroiliac joints, axial skeleton, entheses, and peripheral joints. Chronic inflammation of entheses potentially leads to new bone formation in the form of syndesmophytes and ankylosis of vertebrae and joints, primarily in the axial skeleton. Patients may also have extraarticular ClinicalTrials.gov identifier: NCT00265083.

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Ankylosing Spondylitis

Braun¹,

Yu²

2009

A Clinician's Pearls and Myths in Rheumatology

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Real life experience confirms sustained response to long-term biologics and switching in ankylosing spondylitis

Cited by 77 publications

References 16 publications

Efficacy of Tumor Necrosis Factor Inhibitors in Patients With Ankylosing Spondylitis

Efficacy of Tumor Necrosis Factor Inhibitors in Patients With Ankylosing Spondylitis

Efficacy and safety of golimumab in patients with ankylosing spondylitis: Results of a randomized, double‐blind, placebo‐controlled, phase III trial

Ankylosing Spondylitis

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