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First-line anti-TNF agents yield high rate of long-term response, well tolerated in patients with AS, study demonstrates

Tuesday, June 19 2007 | Comments
Evidence Grade 0 What's This?
The majority of patients who receive biologic therapies in the treatment of ankylosing spondylitis exhibit an efficacious response that is sustained long term, according to findings from a recent study.

To determine the long-term effect of biologic therapy on patients with AS treated in a community setting, researchers examined data from all patients who received a prescription for anti-tumor necrosis factor therapy for >=12 weeks at Leeds Teaching Hospitals Trust during the past 10 years. Data, including Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores, Bath Ankylosing Spondylitis Functional Index (BASFI) scores, and C-reactive protein (CRP) levels, were available for 118 patients.

Mean duration of treatment was 16.7 months. Eighteen percent of patients (n=21) received biologic therapy for >2 years, and of these patients, 57% received therapy for >3 years.

On average, BASDAI scores improved 44%, BASFI scores improved 34%, and CRP levels improved 68% during the treatment period. When the analysis was confined to those who received >2 years of therapy, mean improvements in these measures were 50%, 20%, and 83%, respectively. In an analysis that included only those patients who received >3 years of therapy, BASDAI scores improved 70%, BASFI scores improved 32%, and CRP levels improved 83%.

Only 6.7% of patients had to stop or switch therapies because of adverse events, the majority of which were mild and included skin rashes and raised liver function tests, according to the authors. However, 2 patients discontinued therapy because of neurological complications that improved after treatment cessation.

A total of 93 patients (78%) responded to a first-line biologic therapy, and response rates were maintained at 24 months and 36 months. Nonresponse was observed in only 15% of patients with AS (n=18), and 63% of patients continued to receive the first biologic drug prescribed to them after nearly 2 years.

"The majority of [patients with AS] treated with biologics show an efficacious response to these therapies that is sustained over time with only a minority of patients discontinuing the drug because of side effects," the authors concluded. "On subgroup analysis, our results show that response as shown by the BASDAI and BASFI may improve over time on those patients staying on biologics." (Coates LC, et al. Abstract FRI0372.)

This information may concern uses that have not been approved by the Food and Drug Administration.

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