Abstract | BACKGROUND: OBJECTIVE: To identify parameters predicting the clinical response to TNF blockers in AS. METHODS: Patients with active AS participated in two placebo controlled, randomised trials conducted in Germany with infliximab (n = 69) and etanercept ( n = 30), respectively. For inclusion in either trial patients had to have high disease activity (BASDAI >or=4) and a spinal pain score (numerical rating scale 0-10) >or=4 despite treatment with NSAIDs. A major clinical response was defined as a 50% improvement of the initial BASDAI (BASDAI 50) after 12 weeks' treatment with active drug. Logistic regression likelihood ratio tests (univariate and multivariate), Student's t test, and chi(2) tests were performed. RESULTS: Univariate analysis showed the following to be predictors of a major response (BASDAI 50) to treatment: shorter disease duration (p = 0.003); lower BASFI (p = 0.007); younger age (p = 0.009); raised ESR (p = 0.033); raised CRP (p = 0.035). After adjustment for disease duration, BASFI, ESR, and CRP, but not age, remained significantly associated. After adjustment for disease duration and for BASFI, ESR, CRP, and in addition, a higher BASDAI were significantly associated with response. The best multivariate model built by stepwise regression contained the covariables disease duration, BASFI, BASDAI, and CRP. CONCLUSION: A shorter disease duration, younger age, and a lower BASFI are predictors of a major clinical response to TNF blockers in active AS. Raised CRP and a higher BASDAI may also be valuable predictors. These data need to be confirmed in further studies.
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Authors | M Rudwaleit, J Listing, J Brandt, J Braun, J Sieper |
Journal | Annals of the rheumatic diseases
(Ann Rheum Dis)
Vol. 63
Issue 6
Pg. 665-70
(Jun 2004)
ISSN: 0003-4967 [Print] England |
PMID | 15037444
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antibodies, Monoclonal
- Antirheumatic Agents
- HLA-B27 Antigen
- Immunoglobulin G
- Receptors, Tumor Necrosis Factor
- Tumor Necrosis Factor-alpha
- C-Reactive Protein
- Infliximab
- Etanercept
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Topics |
- Adult
- Age Factors
- Antibodies, Monoclonal
(therapeutic use)
- Antirheumatic Agents
(therapeutic use)
- C-Reactive Protein
(analysis)
- Etanercept
- Female
- HLA-B27 Antigen
(analysis)
- Humans
- Immunoglobulin G
(therapeutic use)
- Infliximab
- Male
- Receptors, Tumor Necrosis Factor
(therapeutic use)
- Severity of Illness Index
- Spondylitis, Ankylosing
(drug therapy, physiopathology)
- Time Factors
- Treatment Outcome
- Tumor Necrosis Factor-alpha
(antagonists & inhibitors)
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