Lee Jeong Seok, Song Yeong Wook, Kim Tae Hwan, Chung Won Tae, Lee Seung Geun, Park Sung Hwan, Song Gwan Gyu, Yu Dae Young, Xu Stephen, Lee Eun Young
Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Division of Rheumatology, Department of Internal Medicine, Hanyang University Seoul Hospital, Seoul, Korea.
Korean J Intern Med. 2018 May;33(3):622-628. doi: 10.3904/kjim.2016.046. Epub 2017 Jan 20.
BACKGROUND/AIMS: For patients with ankylosing spondylitis (AS), golimumab has consistent efficacy in controlling disease activity over 5 years but its benefit in preventing radiographic progression was less clear at 4 years. To predict radiographic progression, we analyzed the baseline characteristics of AS patients in a Korean population.
Sixty-eight Korean patients with AS participated in the phase 3, multicenter, randomized, placebo-controlled, double-blind trial (GO-RAISE) which has previously been described. Baseline modified stoke AS spine score (mSASSS) and change in mSASSS from baseline (ΔmSASSS) until week 208 were analyzed in the Korean patients enrolled in the GO-RAISE study.
Although Korean patients had lower baseline mSASSS compared to non-Korean patients and received active management, radiographic progression was not prevented. Korean patients who did not undergo radiographic progression of spinal lesions of AS were younger and had shorter symptomatic duration, lower Bath AS functional and metrology indices, better chest expansion, and lower baseline mSASSS. The baseline mSASSS and ΔmSASSS were positively correlated in Korean AS patients ( < 0.001). Radiographic progression was more prevalent (80.0%) when baseline mSASSS > 10 and less common (13.0%) with baseline mSASSS = 0.
In Korean AS patients, radiographic progression of the spine after 4 years was predicted effectively by the initial severity of the spinal lesion(s) in patients treated with golimumab.
背景/目的：对于强直性脊柱炎（AS）患者，戈利木单抗在5年时间里控制疾病活动具有持续疗效，但在4年时其预防影像学进展的益处尚不清楚。为了预测影像学进展，我们分析了韩国人群中AS患者的基线特征。
68例韩国AS患者参与了先前已描述的3期、多中心、随机、安慰剂对照、双盲试验（GO-RAISE）。对GO-RAISE研究中纳入的韩国患者的基线改良斯托克AS脊柱评分（mSASSS）以及从基线至第208周mSASSS的变化（ΔmSASSS）进行了分析。
尽管韩国患者与非韩国患者相比基线mSASSS较低且接受了积极治疗，但仍未能预防影像学进展。未发生AS脊柱病变影像学进展的韩国患者更年轻，症状持续时间更短，巴斯强直性脊柱炎功能和计量指数更低，胸廓扩张度更好，基线mSASSS更低。在韩国AS患者中，基线mSASSS与ΔmSASSS呈正相关（<0.001）。当基线mSASSS>10时，影像学进展更为普遍（80.0%），而基线mSASSS = 0时则较少见（13.0%）。
在韩国AS患者中，接受戈利木单抗治疗的患者脊柱4年后的影像学进展可通过脊柱病变的初始严重程度有效预测。
