Inflammation Disease Area, Specialty Care Business Unit, Pfizer Inc., 500 Arcola Road, Collegeville, PA 19422, USA.
J Rheumatol. 2012 Apr;39(4):836-40. doi: 10.3899/jrheum.110885. Epub 2012 Feb 15.
Etanercept, a fully human tumor necrosis factor soluble receptor, is effective in treatment of ankylosing spondylitis (AS). Current guidelines suggest sulfasalazine (SSZ) treatment as initial therapy for the management of patients with AS with peripheral arthritis versus therapy with biologics. We compared the efficacy of etanercept with SSZ in patients with AS with peripheral joint involvement.
The efficacy of etanercept 50 mg once weekly was compared with that of SSZ up to 3 g daily in subjects with ≥ 1 swollen peripheral joint at baseline, using data from a 16-week randomized double-blind study in subjects with AS. Efficacy was assessed by the Assessment in AS criteria and the Bath AS Disease Activity, Functional, and Metrology indices. The last observation carried forward method was used for imputation of missing values.
Of 566 subjects included in original study, 181 (etanercept 121; SSZ 60) had ≥ 1 swollen peripheral joint and 364 (etanercept 250; SSZ 124) had none at baseline. AS patients treated with etanercept showed significantly greater improvement than those treated with SSZ in all joint assessments regardless of swollen joint involvement.
In this analysis, etanercept was significantly more effective than SSZ for management of patients with AS and peripheral joint involvement.
依那西普是一种完全人源化肿瘤坏死因子可溶性受体，对治疗强直性脊柱炎（AS）有效。目前的指南建议柳氮磺胺吡啶（SSZ）治疗作为伴外周关节炎的 AS 患者的初始治疗，而非生物制剂治疗。我们比较了依那西普和 SSZ 在伴外周关节受累的 AS 患者中的疗效。
使用 AS 受试者 16 周随机双盲研究的数据，比较了基线时有≥1 个肿胀外周关节的受试者中每周一次 50mg 依那西普与每日 3g SSZ 的疗效。采用 AS 评估标准和巴斯 AS 疾病活动度、功能和计量学指数评估疗效。采用末次观察值结转法对缺失值进行插补。
在原始研究的 566 例受试者中，181 例（依那西普 121 例；SSZ 60 例）有≥1 个肿胀外周关节，364 例（依那西普 250 例；SSZ 124 例）无肿胀关节。无论肿胀关节是否受累，接受依那西普治疗的 AS 患者在所有关节评估中均显著优于接受 SSZ 治疗的患者。
在这项分析中，与 SSZ 相比，依那西普在治疗伴外周关节受累的 AS 患者方面更有效。
