Department of Health Sciences, School of Medicine, University of Molise, Campobasso, Italy.
Clin Exp Rheumatol. 2011 Jan-Feb;29(1):80-4. Epub 2011 Feb 23.
To investigate the effectiveness of etanercept on axial manifestations of a group of patients with established psoriatic arthritis (PsA).
This was a multicentre observational study. PsA was classified based on the CASPAR criteria. Inclusion criteria were refractory PsA with axial manifestations and suitability for anti TNF-α therapy. Effectiveness was defined according to the ASAS response criteria (BASDAI: 50% relative or absolute change of 20mm and expert opinion in favour of continuation), and on the improvements of BASFI, anthropometric measures, PASI, ESR and CRP at 12 months. PASI 50 and 75 were also assessed, as well as the ACR20 and ACR50 response criteria for patients with peripheral arthritis. Comparisons between baseline and after 12-month treatment were done using the Wilcoxon signed rank test for the end-points considered.
The study included 32 patients (25/7 M/F; median age 51yrs; 25th-75th percentiles: 34.5-58.7; median disease duration 14.5 yrs; 25th-75th percentiles: 9.2-17.00). Effectiveness of etanercept was observed in 72% of patients for the BASDAI (p<0.001), in 68% for the BASFI (p<0.001), in 76% for ESR (p<0.001) and in 68% of patients for CRP (p<0.01). The PASI improved in 72% of patients treated (p<0.0001), while PASI 50 and PASI 75 was reached in 81% and 55% of patients, respectively. ACR 20 and 50 was reached in 78 and 56% of patients with peripheral involvement respectively.
The present study has shown that etanercept is effective on axial manifestations of established PsA, confirming the positive effects of anti TNF-α therapy on clinical manifestations of the disease.
研究依那西普对一组已确诊的银屑病关节炎（PsA）患者的轴性表现的疗效。
这是一项多中心观察性研究。根据 CASPAR 标准对 PsA 进行分类。纳入标准为有轴性表现且适合接受抗 TNF-α 治疗的难治性 PsA。根据 ASAS 缓解标准（BASDAI：20mm 的 50%或绝对值变化，且专家意见倾向于继续治疗），以及 12 个月时 BASFI、人体测量学指标、PASI、ESR 和 CRP 的改善情况来定义疗效。还评估了 PASI 50 和 75 的达标情况，以及外周关节炎患者的 ACR20 和 ACR50 缓解标准。使用 Wilcoxon 符号秩检验比较基线和治疗 12 个月后的终点值。
该研究纳入了 32 名患者（25/7 名男性/女性；中位年龄 51 岁；25%至 75%分位数：34.5-58.7；中位病程 14.5 年；25%至 75%分位数：9.2-17.0）。依那西普治疗对 BASDAI 的有效率为 72%（p<0.001），对 BASFI 为 68%（p<0.001），对 ESR 为 76%（p<0.001），对 CRP 为 68%（p<0.01）。72%的患者 PASI 得到改善（p<0.0001），分别有 81%和 55%的患者达到 PASI 50 和 PASI 75。有外周关节受累的患者分别有 78%和 56%达到 ACR 20 和 ACR 50。
本研究表明，依那西普对已确诊的银屑病关节炎的轴性表现有效，证实了抗 TNF-α 治疗对疾病临床表现的积极作用。
