TNF blockers inhibit spinal radiographic progression in ankylosing spondylitis by reducing disease activity: results from the Swiss Clinical Quality Management cohort.

Détails

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Etat: Serval
Version: Final published version
Licence: CC BY-NC 4.0
ID Serval
serval:BIB_F867122A195D
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
TNF blockers inhibit spinal radiographic progression in ankylosing spondylitis by reducing disease activity: results from the Swiss Clinical Quality Management cohort.
Périodique
Annals of the rheumatic diseases
Auteur(s)
Molnar C., Scherer A., Baraliakos X., de Hooge M., Micheroli R., Exer P., Kissling R.O., Tamborrini G., Wildi L.M., Nissen M.J., Zufferey P., Bernhard J., Weber U., Landewé RBM, van der Heijde D., Ciurea A.
Collaborateur(s)
Rheumatologists of the Swiss Clinical Quality Management Program
ISSN
1468-2060 (Electronic)
ISSN-L
0003-4967
Statut éditorial
Publié
Date de publication
01/2018
Peer-reviewed
Oui
Volume
77
Numéro
1
Pages
63-69
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
To analyse the impact of tumour necrosis factor inhibitors (TNFis) on spinal radiographic progression in ankylosing spondylitis (AS).
Patients with AS in the Swiss Clinical Quality Management cohort with up to 10 years of follow-up and radiographic assessments every 2 years were included. Radiographs were scored by two readers according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) with known chronology. The relationship between TNFi use before a 2-year radiographic interval and progression within the interval was investigated using binomial generalised estimating equation models with adjustment for potential confounding and multiple imputation of missing values. Ankylosing Spondylitis Disease Activity Score (ASDAS) was regarded as mediating the effect of TNFi on progression and added to the model in a sensitivity analysis.
A total of 432 patients with AS contributed to data for 616 radiographic intervals. Radiographic progression was defined as an increase in ≥2 mSASSS units in 2 years. Mean (SD) mSASSS increase was 0.9 (2.6) units in 2 years. Prior use of TNFi reduced the odds of progression by 50% (OR 0.50, 95% CI 0.28 to 0.88) in the multivariable analysis. While no direct effect of TNFi on progression was present in an analysis including time-varying ASDAS (OR 0.61, 95% CI 0.34 to 1.08), the indirect effect, via a reduction in ASDAS, was statistically significant (OR 0.75, 95% CI 0.59 to 0.97).
TNFis are associated with a reduction of spinal radiographic progression in patients with AS. This effect seems mediated through the inhibiting effect of TNFi on disease activity.

Mots-clé
Adult, Axis, Cervical Vertebra/diagnostic imaging, Axis, Cervical Vertebra/pathology, Cohort Studies, Disease Progression, Female, Follow-Up Studies, Humans, Lumbar Vertebrae/diagnostic imaging, Lumbar Vertebrae/pathology, Male, Middle Aged, Multivariate Analysis, Radiography, Severity of Illness Index, Spine/diagnostic imaging, Spine/pathology, Spondylitis, Ankylosing/diagnostic imaging, Spondylitis, Ankylosing/drug therapy, Spondylitis, Ankylosing/pathology, Switzerland, Treatment Outcome, Tumor Necrosis Factor-alpha/antagonists & inhibitors, ankylosing spondylitis, anti-tnf, epidemiology
Pubmed
Web of science
Open Access
Oui
Création de la notice
09/10/2017 10:04
Dernière modification de la notice
29/05/2019 7:10
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