Article
Efficacy of infliximab in treatment of active early ankylosing spondylitis
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Published: | September 12, 2014 |
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Background: To evaluate efficacy of infliximab in patients with highly active early AS
Methods: 21 patients (male -15, female - 6, mean age 34,6 years) with definite AS based on the modified New York criteria set (mean disease duration - 3,7 years). 16 patients had axial AS, 5 patients also had peripheral arthritis. All patients had highly active early AS (mean ASDASCRP 3,8; mean BASDAI - 6,9) with decreased physical function (mean BASFI 5,7), and had radiographic sacroiliitis. Active inflammatory changes on MRI were found in all patients (sacroiliac joints - 5 patients, thoracic andlumbar spine - 4, combined - 12). All patients were treated with infliximab 5mg/kg, follow-up period was 48 weeks. The primary end point was ASAS20 response at Week 12. Secondary end points were BASFI, BASDAI, ASDASCRP scores at week 24
Results: After 12 weeks of treatment 18 patients achieved an ASAS20 response, and 3 fulfilled ASAS criteria for partial remission. After 24 weeks all patients achieved an ASAS20 response. At week 12, BASDAI (mean 2,3), BASFI (mean 1,8), ASDASCRP(mean 1,2) scores decreased significantly (p< 0,05). 14 patients (73,7%) cancelled NSAID intake because of low pain levels, others had decreased the dose of NSAIDs. After 24 weeks active inflammatory changes on MRI were found in 4 patients. No serious adverse events were registered.
Conclusion: In patients with active early AS, infliximab treatment resulted in rapid and clinically significant improvement in the signs and symptoms of active disease, including active inflammatory changes on MRI.