Although there was radiographic spinal progression, spinal mobility and physical function were consistent in patients with ankylosing spondylitis who were treated with up to 10 years of anti-tumor necrosis factor-alpha inhibitors, according to a recently published study.
“Although rapid and clinically relevant radiographic spinal progression might occur in patients with ankylosing spondylitis, the majority of patients preserve their functional status and spinal mobility given a good control of disease [activity].” Denis Poddubnyy, MD, in the Department of Gastroenterology, Infectology and Rheumatology at Charité Universitätsmedizin Berlin, told Healio Rheumatology.
Poddubnyy and colleagues assessed 43 patients who received infliximab and 17 who received etanercept for ankylosing spondylitis. Both groups with spinal radiographs performed at baseline and at years 2, 4, 6, 8 and 10. Patients were scored according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS); Bath Ankylosing Spondylitis Functional Index (BASFI); Bath Ankylosing Spondylitis Metrology Index (BASMI); and Bath Ankylosing Spondylitis Disease Activity Index (BASDA).
The researchers found BASFI and BASMI remained stable at low levels up to 10 years, despite radiographic progression. There was no association between mSASSS and BASFI. However, there was an association between mSASS and BASMI (beta association factor = 0.05), as well as between BASDAI and function (beta factor = 0.64) and between BASDAI and mobility (beta factor = 0.14).
These results suggest inflammation reduction can outweigh the functional effect of structural damage progression, the researchers wrote.
“Therefore, controlling disease activity should be the primary treatment aim in ankylosing spondylitis,” Poddubnyy said. – by Will Offit
Disclosure: The researchers report no relevant financial disclosures.