Lee Sang-Hoon, Lee Yeon-Ah, Hong Seung-Jae, Yang Hyung-In
Department of Rheumatology, College of Medicine, Kyunghee University, Seoul, South Korea.
Clin Rheumatol. 2008 Feb;27(2):179-81. doi: 10.1007/s10067-007-0674-2. Epub 2007 Sep 15.
Specific antagonists of tumor necrosis factor (TNFalpha) have rapidly gain popularity for the treatment of ankylosing spondylitis (AS). The dose of etanercept has not been determined in Asia, especially in Korea. This study was designed to investigate the maintaining effect of low-dose (25 mg/week) etanercept in Korean patients with AS and after discontinuation, the duration to be aggravated. Patients who had active AS [Bath AS Disease Activity Index (BASDAI) > or =4] were treated with 50 mg of etanercept per week for 3 months. After that, for 6 months, the patients were treated with 25 mg of etanercept per week. We evaluated the serum erythrocyte sediment rate (ESR), C-reactive protein (CRP), and BASDAI every 1 month for 3 months and every 2-3 months during the remaining 6 months. After all schedules of treatment were finished, we reevaluated ESR, CRP, and BASDAI every 4 months until recurrence. Twenty-seven AS patients received etanercept. Twenty-three patients completed treatment for 3 months with a dose of 50 mg/week. Among them, 18 completed for 6 months with a dose of 25 mg/week and discontinued. Mean age was 30.0 +/- 5.4 years and mean disease duration was 7.5 +/- 6.5 years. These 18 patients were evaluated for BASDAI, ESR, and CRP every 4 weeks. After discontinuation, mean duration to recur was 9.2 +/- 6.1 weeks. Twenty-five milligrams of etanercept per week is effective enough to maintain remission in AS. After discontinuation, this effect was maintained by using a dose of 50 mg of etanercept per week.
肿瘤坏死因子(TNFα)特异性拮抗剂已迅速在强直性脊柱炎(AS)治疗中受到广泛欢迎。在亚洲,尤其是韩国,依那西普的剂量尚未确定。本研究旨在调查低剂量(25毫克/周)依那西普对韩国AS患者的维持疗效以及停药后病情加重的持续时间。活动性AS患者[巴斯强直性脊柱炎疾病活动指数(BASDAI)≥4]接受每周50毫克依那西普治疗3个月。之后,患者接受每周25毫克依那西普治疗6个月。我们在3个月内每1个月评估一次血清红细胞沉降率(ESR)、C反应蛋白(CRP)和BASDAI,在剩余6个月内每2 - 3个月评估一次。在所有治疗方案结束后,我们每4个月重新评估ESR、CRP和BASDAI,直至病情复发。27例AS患者接受了依那西普治疗。23例患者完成了每周50毫克剂量的3个月治疗。其中,18例完成了每周25毫克剂量的6个月治疗并停药。平均年龄为30.0±5.4岁,平均病程为7.5±6.5年。对这18例患者每4周评估一次BASDAI、ESR和CRP。停药后,平均复发持续时间为9.2±6.1周。每周25毫克依那西普足以有效维持AS患者的缓解状态。停药后,通过每周使用50毫克依那西普可维持这种疗效。