Rheumatol Int. 2012 May;32(5):1305-9. doi: 10.1007/s00296-011-1797-y. Epub 2011 Feb 1.
To investigate a group of Irish ankylosing spondylitis patients: current prescription practice for TNF blockers and patient response. All patients presenting with ankylosing spondylitis (AS) and treated with TNF-alpha between January 2006 and 2008 in the midwestern region of Ireland were studied. Response was evaluated using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and CRP results at 6 months. A total of 47 AS patients (32 men: 15 women, mean age 37.7 years, median disease duration 20 years, 80% HLA B27 positive) were identified; 66% were on disease-modifying anti-rheumatic drugs (DMARDs) concomitantly. All patients satisfied BSR/ASAS disease severity criteria for TNF-alpha at baseline, and mean BASDAI was 6.2, BASFI 6.9, and CRP 27.5 mg/L. At 6 months, these had reduced to a mean BASDAI of 3.8, BASFI 4.6, and CRP of 8.9 mg/L. Patients with advanced AS (disease duration >10 years, mean BASFI 7.5) responded at least as well. No allergies or serious side effects were encountered, and one patient successfully switched TNF agent due to secondary failure. Initial good responses at 6 months were seen to be maintained in sub-group analysis at 12 months. Disease severity in patients gaining access to treatment for active AS with TNF blockers in Ireland is very high. Patients mainly satisfy international guidelines for the use of biologics (BSR, EULAR) with some minor exceptions. High disease activity and long disease duration may predict better treatment response. Response rates were good and treatment was well tolerated, and no differences in response were noted between the 3 agents employed.
目前 TNF 阻滞剂的处方实践和患者的反应。在爱尔兰中西部地区，2006 年 1 月至 2008 年间，对所有出现强直性脊柱炎（AS）并接受 TNF-α治疗的患者进行了研究。使用 Bath 强直性脊柱炎疾病活动指数（BASDAI）、Bath 强直性脊柱炎功能指数（BASFI）和 CRP 结果在 6 个月时评估反应。共确定了 47 例 AS 患者（32 名男性：15 名女性，平均年龄 37.7 岁，中位疾病持续时间 20 年，80% HLA B27 阳性）；66%同时使用改善病情的抗风湿药物（DMARDs）。所有患者在基线时均符合 BSR/ASAS 对 TNF-α的疾病严重程度标准，平均 BASDAI 为 6.2，BASFI 为 6.9，CRP 为 27.5mg/L。6 个月时，这些指标降至平均 BASDAI 3.8，BASFI 4.6，CRP 8.9mg/L。患有晚期 AS（病程>10 年，平均 BASFI 7.5）的患者反应至少同样好。未发现过敏或严重副作用，一名患者因继发失败而成功更换 TNF 药物。在亚组分析中，在 12 个月时观察到初始良好反应得以维持。在爱尔兰，接受 TNF 阻滞剂治疗活动性 AS 的患者疾病严重程度非常高。患者主要符合生物制剂的国际指南（BSR、EULAR），只有一些较小的例外。高疾病活动度和长病程可能预示着更好的治疗反应。反应率良好，治疗耐受性好，三种药物的反应无差异。
