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Treatment decision in patient with ankylosing spondylitis in remission

Year 2021, , 49 - 52, 20.01.2021

Hüseyin Turgut Elbek Özer

https://doi.org/10.19161/etd.863658
Cited By: 1

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) may attain 9 to 35% remission rates in patients with
ankylosing spondylitis, this rate may rise to 16 to 62% in anti-TNF users. Following withdrawal of
biologics there is 47 to 76% relapse rate in one year. Dose reduction or standard dosing of anti-TNF
therapies yields comparable rates of remission maintenance in one year (53.5% vs. 61.4%). NSAIDs
have shown to retard radiologic progression and decrease mortality in AS patients. NSAIDs should be
used on demand in stable patients. Physical therapy is also recommended after the remission.

Keywords

Ankylosing spondylitis remission non-steroidal anti-inflammatory drug anti-TNF biologic agents.

References

  • Poddubnyy D, Gensler LS. Spontaneous, drug-induced, and drug-free remission in peripheral and axial spondyloarthritis. Best Pract Res Clin Rheumatol 2014 Oct; 28 (5): 807-18.
  • van der Heijde D, Baraf HS, Ramos-Remus C, et al. Evaluation of the efficacy of etoricoxib in ankylosing spondylitis: results of a fifty-two-week, randomized, controlled study. Arthritis Rheum 2005; 52: 1205-15.
  • Sieper J, Lenaerts J, Wollenhaupt J, et al. Efficacy and safety of infliximab plus naproxen versus naproxen alone in patients with early, active axial spondyloarthritis: results from the double-blind, placebo-controlled INFAST study, Part 1. Ann Rheum Dis 2014; 73: 101-7.
  • van der Heijde D, Dijkmans B, Geusens P, et al. Efficacy and safety of infliximab in patients with ankylosing spondylitis: results of a randomized, placebo-controlled trial (ASSERT) Arthritis Rheum 2005;52:582-91.
  • Davis JC, Jr, Van Der Heijde D, Braun J, et al. Recombinant human tumor necrosis factor receptor (etanercept) for treating ankylosing spondylitis: a randomized, controlled trial. Arthritis Rheum 2003; 48: 3230-6.
  • van der Heijde D, Kivitz A, Schiff MH, et al. Efficacy and safety of adalimumab in patients with ankylosing spondylitis: results of a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2006; 54: 2136-46.
  • Inman RD, Davis JC, Jr, Heijde D, et al. Efficacy and safety of golimumab in patients with ankylosing spondylitis: results of a randomized, double-blind, placebo-controlled, phase III trial. Arthritis Rheum 2008; 58: 3402-12.
  • Landewé R, Braun J, Deodhar A, et al. Efficacy of certolizumab pegol on signs and symptoms of axial spondyloarthritis including ankylosing spondylitis: 24-week results of a double-blind randomised placebocontrolled Phase 3 study. Ann Rheum Dis 2014; 73 (1):39-47.
  • Barkham N, Keen HI, Coates LC, et al. Clinical and imaging efficacy of infliximab in HLA-B27-Positive patients with magnetic resonance imaging-determined early sacroiliitis. Arthritis Rheum 2009; 60: 946-54.
  • Song IH, Althoff CE, Haibel H, et al. Frequency and duration of drug-free remission after 1 year of treatment with etanercept versus sulfasalazine in early axial spondyloarthritis: 2 year data of the ESTHER trial. Ann Rheum Dis 2012; 71: 1212-5. 52 Ege Tıp Dergisi / Ege Journal of Medicine
  • Sieper J, van der Heijde D, Dougados M, et al. Efficacy and safety of adalimumab in patients with nonradiographic axial spondyloarthritis: results of a randomised placebo-controlled trial (ABILITY-1) Ann Rheum Dis 2013; 72: 815-22.
  • Dougados M, van der Heijde D, Sieper J, Braun J, et al. The symptomatic efficacy of etanercept and its effects on objective signs of inflammation in early nonradiographic axial spondyloarthritis: a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheumatol 2014 Aug; 66 (8): 2091-102.
  • Spadaro A, Lubrano E, Marchesoni A, et al. Remission in ankylosing spondylitis treated with anti-TNF-α drugs: a national multicentre study. Rheumatology (Oxford) 2013 Oct; 52 (10): 1914-9.
  • Haibel H, Heldmann F, Braun J, Listing J, Kupper H, Sieper J. Long-term efficacy of adalimumab after drug withdrawal and retreatment in patients with active non-radiographically evident axial spondyloarthritis who experience a flare. Arthritis Rheum 2013 65 (8): 2211-3.
  • Cantini F, Niccoli L, Cassarà E, Kaloudi O, Nannini C. Duration of remission after halving of the etanercept dose in patients with ankylosing spondylitis: a randomized, prospective, long-term, follow-up study. Biologics 2013; 7: 1-6.
  • Landewé R, Sieper J, Mease P, et al. Efficacy and safety of continuing versus withdrawing adalimumab therapy in maintaining remission in patients with non-radiographic axial spondyloarthritis (ABILITY-3): a multicentre, randomised, double-blind study. Lancet 2018 Jul 14; 392 (10142): 134-44.
  • Moreno M, Gratacós J, Torrente-Segarra V, et al. REMINEA study Group. Withdrawal of infliximab therapy in ankylosing spondylitis in persistent clinical remission, results from the REMINEA study. Arthritis Res Ther 2019 Apr 5; 21 (1):88.
  • Kaltsonoudis E, Pelechas E, Voulgari PV, Drosos AA. Maintained Clinical Remission in Ankylosing Spondylitis Patients Switched from Reference Infliximab to Its Biosimilar: An 18-Month Comparative OpenLabel Study. J Clin Med 2019 Jul 2; 8 (7). pii: E956. doi: 10.3390/jcm8070956.
  • Gratacós J, Pontes C, Juanola X, et al. REDES-TNF investigators. Non-inferiority of dose reduction versus standard dosing of TNF-inhibitors in axial spondyloarthritis. Arthritis Res Ther 2019 Jan 8; 21 (1):11. doi: 10.1186/s13075-018-1772-z.
  • Carron P, Varkas G, Renson T, Colman R, Elewaut D, Van den Bosch F. High Rate of Drug-Free Remission After Induction Therapy With Golimumab in Early Peripheral Spondyloarthritis. Arthritis Rheumatol 2018 Nov; 70 (11): 1769-77.
  • Sieper J, Landewé R, Magrey M, et al. Predictors of remission in patients with non-radiographic axial spondyloarthritis receiving open-label adalimumab in the ABILITY-3 study. RMD Open 2019 Jun 7; 5 (1): e000917.
  • Wanders A, Heijde Dv, Landewé R, et al. Nonsteroidal antiinflammatory drugs reduce radiographic progression in patients with ankylosing spondylitis: a randomized clinical trial. Arthritis Rheum 2005 Jun; 52 (6): 1756-65.
  • Kroon F, Landewé R, Dougados M, van der Heijde D. Continuous NSAID use reverts the effects of inflammation on radiographic progression in patients with ankylosing spondylitis. Ann Rheum Dis 2012 Oct; 71 (10): 1623-9.
  • Sieper J, Listing J, Poddubnyy D, et al. Effect of continuous versus on-demand treatment of ankylosing spondylitis with diclofenac over 2 years on radiographic progression of the spine: results from a randomised multicentre trial (ENRADAS). Ann Rheum Dis 2016 Aug; 75 (8): 1438-43.
  • Bakland G, Gran JT, Nossent JC. Increased mortality in ankylosing spondylitis is related to disease activity. Ann Rheum Dis 2011 Nov; 70 (11): 1921-5.
  • Haroon NN, Paterson JM, Li P, Inman RD, Haroon N. Patients With Ankylosing Spondylitis Have Increased Cardiovascular and Cerebrovascular Mortality: A Population-Based Study. Ann Intern Med 2015 Sep 15; 163 (6): 409-16.
  • Ward MM, Deodhar A, Gensler LS, et al. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis. Arthritis Care Res (Hoboken) 2019 Oct; 71 (10): 1285-99

Remisyonda olan ankilozan spondilit hastasında tedavi kararı

Year 2021, , 49 - 52, 20.01.2021

Hüseyin Turgut Elbek Özer

https://doi.org/10.19161/etd.863658
Cited By: 1

Abstract

Ankilozan spondilitte non-steroid anti-inflamatuvar ilaçlarda (NSAİİ) %9-35’e varan oranlarda anti-TNF
ajanlarında %16-62 oranlarında remisyon sağlandığı görülmüştür. Biyolojik ilaç kesimini takiben bir yıl
içerisinde hastalarda %47-76 oranlarında relaps görülmüştür. Remisyon sonrası doz azaltılması, tam
doz tedavi devamı ile karşılaştırıldığında benzer oranlarda remisyon sürdürülmüştür (%53,5’e karşı
%61,4). Ankilozan spondilitte NSAİİ’ın kullanımının radyolojik progresyonu gerilettiği ve azalmış
mortalite ile ilişkili olduğu gösterilmiştir. NSAİİ’ın gerektiği durumlarda kullanılması önerilmektedir.
Egzersiz programlarına remisyon sonrasında da devam edilmelidir.

Keywords

Ankilozan spondilit remisyon non-steroid anti-inflamatuvar ilaçlar anti-TNF biyolojik ilaçlar

References

  • Poddubnyy D, Gensler LS. Spontaneous, drug-induced, and drug-free remission in peripheral and axial spondyloarthritis. Best Pract Res Clin Rheumatol 2014 Oct; 28 (5): 807-18.
  • van der Heijde D, Baraf HS, Ramos-Remus C, et al. Evaluation of the efficacy of etoricoxib in ankylosing spondylitis: results of a fifty-two-week, randomized, controlled study. Arthritis Rheum 2005; 52: 1205-15.
  • Sieper J, Lenaerts J, Wollenhaupt J, et al. Efficacy and safety of infliximab plus naproxen versus naproxen alone in patients with early, active axial spondyloarthritis: results from the double-blind, placebo-controlled INFAST study, Part 1. Ann Rheum Dis 2014; 73: 101-7.
  • van der Heijde D, Dijkmans B, Geusens P, et al. Efficacy and safety of infliximab in patients with ankylosing spondylitis: results of a randomized, placebo-controlled trial (ASSERT) Arthritis Rheum 2005;52:582-91.
  • Davis JC, Jr, Van Der Heijde D, Braun J, et al. Recombinant human tumor necrosis factor receptor (etanercept) for treating ankylosing spondylitis: a randomized, controlled trial. Arthritis Rheum 2003; 48: 3230-6.
  • van der Heijde D, Kivitz A, Schiff MH, et al. Efficacy and safety of adalimumab in patients with ankylosing spondylitis: results of a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2006; 54: 2136-46.
  • Inman RD, Davis JC, Jr, Heijde D, et al. Efficacy and safety of golimumab in patients with ankylosing spondylitis: results of a randomized, double-blind, placebo-controlled, phase III trial. Arthritis Rheum 2008; 58: 3402-12.
  • Landewé R, Braun J, Deodhar A, et al. Efficacy of certolizumab pegol on signs and symptoms of axial spondyloarthritis including ankylosing spondylitis: 24-week results of a double-blind randomised placebocontrolled Phase 3 study. Ann Rheum Dis 2014; 73 (1):39-47.
  • Barkham N, Keen HI, Coates LC, et al. Clinical and imaging efficacy of infliximab in HLA-B27-Positive patients with magnetic resonance imaging-determined early sacroiliitis. Arthritis Rheum 2009; 60: 946-54.
  • Song IH, Althoff CE, Haibel H, et al. Frequency and duration of drug-free remission after 1 year of treatment with etanercept versus sulfasalazine in early axial spondyloarthritis: 2 year data of the ESTHER trial. Ann Rheum Dis 2012; 71: 1212-5. 52 Ege Tıp Dergisi / Ege Journal of Medicine
  • Sieper J, van der Heijde D, Dougados M, et al. Efficacy and safety of adalimumab in patients with nonradiographic axial spondyloarthritis: results of a randomised placebo-controlled trial (ABILITY-1) Ann Rheum Dis 2013; 72: 815-22.
  • Dougados M, van der Heijde D, Sieper J, Braun J, et al. The symptomatic efficacy of etanercept and its effects on objective signs of inflammation in early nonradiographic axial spondyloarthritis: a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheumatol 2014 Aug; 66 (8): 2091-102.
  • Spadaro A, Lubrano E, Marchesoni A, et al. Remission in ankylosing spondylitis treated with anti-TNF-α drugs: a national multicentre study. Rheumatology (Oxford) 2013 Oct; 52 (10): 1914-9.
  • Haibel H, Heldmann F, Braun J, Listing J, Kupper H, Sieper J. Long-term efficacy of adalimumab after drug withdrawal and retreatment in patients with active non-radiographically evident axial spondyloarthritis who experience a flare. Arthritis Rheum 2013 65 (8): 2211-3.
  • Cantini F, Niccoli L, Cassarà E, Kaloudi O, Nannini C. Duration of remission after halving of the etanercept dose in patients with ankylosing spondylitis: a randomized, prospective, long-term, follow-up study. Biologics 2013; 7: 1-6.
  • Landewé R, Sieper J, Mease P, et al. Efficacy and safety of continuing versus withdrawing adalimumab therapy in maintaining remission in patients with non-radiographic axial spondyloarthritis (ABILITY-3): a multicentre, randomised, double-blind study. Lancet 2018 Jul 14; 392 (10142): 134-44.
  • Moreno M, Gratacós J, Torrente-Segarra V, et al. REMINEA study Group. Withdrawal of infliximab therapy in ankylosing spondylitis in persistent clinical remission, results from the REMINEA study. Arthritis Res Ther 2019 Apr 5; 21 (1):88.
  • Kaltsonoudis E, Pelechas E, Voulgari PV, Drosos AA. Maintained Clinical Remission in Ankylosing Spondylitis Patients Switched from Reference Infliximab to Its Biosimilar: An 18-Month Comparative OpenLabel Study. J Clin Med 2019 Jul 2; 8 (7). pii: E956. doi: 10.3390/jcm8070956.
  • Gratacós J, Pontes C, Juanola X, et al. REDES-TNF investigators. Non-inferiority of dose reduction versus standard dosing of TNF-inhibitors in axial spondyloarthritis. Arthritis Res Ther 2019 Jan 8; 21 (1):11. doi: 10.1186/s13075-018-1772-z.
  • Carron P, Varkas G, Renson T, Colman R, Elewaut D, Van den Bosch F. High Rate of Drug-Free Remission After Induction Therapy With Golimumab in Early Peripheral Spondyloarthritis. Arthritis Rheumatol 2018 Nov; 70 (11): 1769-77.
  • Sieper J, Landewé R, Magrey M, et al. Predictors of remission in patients with non-radiographic axial spondyloarthritis receiving open-label adalimumab in the ABILITY-3 study. RMD Open 2019 Jun 7; 5 (1): e000917.
  • Wanders A, Heijde Dv, Landewé R, et al. Nonsteroidal antiinflammatory drugs reduce radiographic progression in patients with ankylosing spondylitis: a randomized clinical trial. Arthritis Rheum 2005 Jun; 52 (6): 1756-65.
  • Kroon F, Landewé R, Dougados M, van der Heijde D. Continuous NSAID use reverts the effects of inflammation on radiographic progression in patients with ankylosing spondylitis. Ann Rheum Dis 2012 Oct; 71 (10): 1623-9.
  • Sieper J, Listing J, Poddubnyy D, et al. Effect of continuous versus on-demand treatment of ankylosing spondylitis with diclofenac over 2 years on radiographic progression of the spine: results from a randomised multicentre trial (ENRADAS). Ann Rheum Dis 2016 Aug; 75 (8): 1438-43.
  • Bakland G, Gran JT, Nossent JC. Increased mortality in ankylosing spondylitis is related to disease activity. Ann Rheum Dis 2011 Nov; 70 (11): 1921-5.
  • Haroon NN, Paterson JM, Li P, Inman RD, Haroon N. Patients With Ankylosing Spondylitis Have Increased Cardiovascular and Cerebrovascular Mortality: A Population-Based Study. Ann Intern Med 2015 Sep 15; 163 (6): 409-16.
  • Ward MM, Deodhar A, Gensler LS, et al. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis. Arthritis Care Res (Hoboken) 2019 Oct; 71 (10): 1285-99
There are 27 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Case Reports
Authors

Hüseyin Turgut Elbek Özer

Publication Date January 20, 2021
Submission Date April 6, 2020
Published in Issue Year 2021

Cite

Vancouver Özer HTE. Remisyonda olan ankilozan spondilit hastasında tedavi kararı. ETD. 2021:49-52.

Cited By

CURRENT TREATMENT APPROACHES IN ANKYLOSING SPONDILITIS
TURKISH MEDICAL STUDENT JOURNAL
https://doi.org/10.4274/tmsj.galenos.2023.2022-6-1

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