Radiographic progression of ankylosing spondylitis after up to two years of treatment with etanercept
Radiographic progression of ankylosing spondylitis after up to two years of treatment with etanercept
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DOI：
10.1002/art.23471
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发表时间：
2008-05-01
影响因子：
--
通讯作者：
Davis, J. C., Jr.
中科院分区：
文献类型：
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作者：
van der Heijde, D.;Landewe, R.;Davis, J. C., Jr.
Objective.研究依那西普治疗对强直性脊柱炎（AS）患者影像学进展的影响。既往参加过24周依那西普治疗的随机、双盲、安慰剂对照试验的AS患者入组72周开放标签扩展试验。将接受依那西普（25 mg，每周两次）治疗长达96周的患者的颈椎和腰椎X线片与未接受抗肿瘤坏死因子a（抗TNF α）药物治疗的大型患病率队列（强直性脊柱炎国际研究[OASIS]结局评估）患者的X线片进行比较。将两个研究人群中患者在相隔96周的2个时间点获得的X线片数字化，并由2名对患者组和序列设盲的独立阅片人阅读。主要终点是96周时改良斯托克AS脊柱评分的变化。（mSASSS）.结果。共有257例接受依那西普治疗的患者与来自OASIS研究的175例接受依那西普治疗的患者进行了比较。接受依那西普治疗的患者mSASSS较基线的变化（平均值+/- SD 0.91 +/- 2.45）与接受OASIS治疗的患者（0.95 +/- 3.18）无显著差异。与其他炎症性风湿性疾病如类风湿性关节炎和银屑病关节炎不同，AS的结构进展似乎与TNF无关，尽管TNF是导致这种疾病炎症引起的体征和症状的原因。
Objective. To investigate the affect of etanercept therapy on radiographic progression in patients with ankylosing spondylitis (AS).Methods. Patients with AS who had previously participated in a 24-week randomized, double-blind, placebo-controlled trial of etanercept therapy were enrolled in a 72-week open-label extension. Radiographs of the cervical and lumbar spine from patients who received etanercept (25 mg twice weekly) for up to 96 weeks were compared with radiographs from patients in a large prevalence cohort (Outcome Assessments in Ankylosing Spondylitis International Study [OASIS]) who had not been treated with anti-tumor necrosis factor a (anti-TNF alpha) agents. Radiographs obtained at 2 time points up to 96 weeks apart from patients in both study populations were digitized and read by 2 independent readers who were blinded with regard to patient group and sequence. The primary end point was the 96-week change in the modified Stoke AS Spine Score. (mSASSS).Results. A total of 257 patients treated with etanercept were compared with 175 unselected patients from the OASIS study. There was no significant difference in the change in the mSASSS from baseline among patients who received etanercept (mean +/- SD 0.91 +/- 2.45) versus those from the OASIS group (0.95 +/- 3.18).Conclusion. Unlike other inflammatory rheumatic diseases such as rheumatoid arthritis and psoriatic arthritis, structural progression in AS seems to be independent of TNF, despite the fact that TNF is responsible for the signs and symptoms due to inflammation in this disease.