TNF blockers inhibit spinal radiographic progression in ankylosing spondylitis by reducing disease activity: results from the Swiss Clinical Quality Management cohort
| Autor: | Molnar, Christoph, Scherer, Almut, Baraliakos, Xenofon, de Hooge, Manouk, Micheroli, Raphael, Exer, Pascale, Kissling, Rudolf O, Tamborrini, Giorgio, Wildi, Lukas M, Nissen, Michael J, Zufferey, Pascal, Bernhard, Jürg, Weber, Ulrich, Landewé, Robert B M, van der Heijde, Désirée, Ciurea, Adrian, Rheumatologists of the Swiss Clinical Quality Management Program |
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| Přispěvatelé: | University of Zurich, Ciurea, Adrian, Rheumatologists of the Swiss Clinical Quality Management Program, AII - Inflammatory diseases, Clinical Immunology and Rheumatology, AII - Amsterdam institute for Infection and Immunity |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Male Multivariate analysis Radiography 2745 Rheumatology Severity of Illness Index Cohort Studies 0302 clinical medicine Epidemiology Axis Cervical Vertebra/diagnostic imaging Immunology and Allergy Axis Cervical Vertebra ddc:616 Lumbar Vertebrae Confounding tnf 10051 Rheumatology Clinic and Institute of Physical Medicine Middle Aged Treatment Outcome Spine/diagnostic imaging/pathology Cohort 2723 Immunology and Allergy Disease Progression 10046 Balgrist University Hospital Swiss Spinal Cord Injury Center epidemiology Female Switzerland Cohort study Adult medicine.medical_specialty Lumbar Vertebrae/diagnostic imaging Immunology 610 Medicine & health General Biochemistry Genetics and Molecular Biology 03 medical and health sciences Rheumatology 1300 General Biochemistry Genetics and Molecular Biology anti Internal medicine Severity of illness ankylosing spondylitis medicine Humans Spondylitis Ankylosing Axis Cervical Vertebra/pathology Follow-Up Studies Lumbar Vertebrae/pathology Multivariate Analysis Spine/diagnostic imaging Spine/pathology Spondylitis Ankylosing/diagnostic imaging Spondylitis Ankylosing/drug therapy Spondylitis Ankylosing/pathology Tumor Necrosis Factor-alpha/antagonists & inhibitors anti-tnf 030203 arthritis & rheumatology Ankylosing spondylitis 2403 Immunology Tumor Necrosis Factor-alpha business.industry medicine.disease Spine Axis Cervical Vertebra/diagnostic imaging/pathology Surgery respiratory tract diseases Spondylitis Ankylosing/diagnostic imaging/drug therapy/pathology 030104 developmental biology Lumbar Vertebrae/diagnostic imaging/pathology business |
| Zdroj: | 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, R B M, van der Heijde, D, Ciurea, A & Rheumatologists of the Swiss Clinical Quality Management Program 2018, ' TNF blockers inhibit spinal radiographic progression in ankylosing spondylitis by reducing disease activity : results from the Swiss Clinical Quality Management cohort ', Annals of the Rheumatic Diseases, vol. 77, no. 1, pp. 63-69 . https://doi.org/10.1136/annrheumdis-2017-211544 Annals of the rheumatic diseases, vol. 77, no. 1, pp. 63-69 Annals of the Rheumatic Diseases, Vol. 77, No 1 (2018) pp. 63-69 Annals of the Rheumatic Diseases, 77(1), 63-69 Annals of the rheumatic diseases, 77(1), 63-69. BMJ Publishing Group |
| ISSN: | 0003-4967 |
| DOI: | 10.1136/annrheumdis-2017-211544 |
| Popis: | ObjectivesTo analyse the impact of tumour necrosis factor inhibitors (TNFis) on spinal radiographic progression in ankylosing spondylitis (AS).MethodsPatients 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.ResultsA 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).ConclusionTNFis 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. |
| Databáze: | OpenAIRE |
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