Factors associated with ASDAS remission in a long-term study of ankylosing spondylitis patients under tumor necrosis factor inhibitors

Autor(es)

Shimabuco, Andrea Y. ^[1] ; Goncalves, Celio R. ^[1] ; Moraes, Julio C. B. ^[1] ; Waisberg, Mariana G. ^[1] ; Ribeiro, Ana Cristina de M. ^[1] ; Sampaio-Barros, Percival D. ^[1] ; Goldenstein-Schainberg, Claudia ^[1] ; Bonfa, Eloisa ^[1] ; Saad, Carla G. S. ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Fac Med, Av Dr Amaldo, 455 3 Andar, Sala 3131, BR-01246903 Sao Paulo, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: ADVANCES IN RHEUMATOLOGY; v. 58, DEC 4 2018.
• Citações Web of Science: 0

Resumo

Abstract Objective: To determine the clinical and demographic factors associated with disease remission and drug survival in patients with ankylosing spondylitis (AS) on TNF inhibitors. Methods: Data from a longitudinal electronic database of AS patients under anti-TNF therapy between June/2004 and August/2013. Demographic, clinical parameters, disease activity by ASDAS remission (< 1.3) and inactive/low (< 2.1) were analyzed to characterize reasons for drug survival and switching of anti-TNF. Results: Among 117 AS patients, 69 (59%) were prescribed only one anti-TNF, 48 (41%) switched to a second anti-TNF and 13 (11%) to a third anti-TNF. Considering ASDAS-CRP < 1.3, 31 (39%) patients were inactive at the end of the study. Non-switchers (P = 0.04), younger age (P = 0.004), non-smoking (P = 0.016), shorter disease duration (P = 0.047), more frequent use of SSZ (P = 0.037) and lower BASDAI (P = 0.027), BASMI (P = 0.034) and BASFI (P = 0.003) at baseline were associated with remission. In the multivariate analysis younger age (P = 0.016) and lower BASDAI (P = 0.032) remained as remission predictors. Conclusion: This study supports that ASDAS-CRP remission is an achievable goal not only for non-switchers but also for second anti-TNF, particularly in patients with younger age and lower BASDAI at baseline. Comedication and non-smoker status seems to have a beneficial effect in anti-TNF response in this population. (AU)

• Processo FAPESP: 15/03756-4 - Avaliação da relevância dos níveis sanguíneos de drogas utilizadas em doenças autoimunes reumatológicas no acompanhamento da segurança, eficácia e aderência à terapêutica
• Beneficiário: Eloisa Silva Dutra de Oliveira Bonfá
• Modalidade de apoio: Auxílio à Pesquisa - Temático