Shim Man R
Department of Medicine, Rheumatology Division, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Open Access Rheumatol. 2019 Jul 9;11:173-177. doi: 10.2147/OARRR.S212456. eCollection 2019.
Ankylosing spondylitis (AS) is a chronic and progressive inflammatory disorder that primarily affects the axial skeleton. Unfortunately, diagnosis of AS is often delayed compared to other rheumatologic conditions. It is not uncommon for patients to already have an advanced disease when the correct diagnosis is eventually made. TNF inhibitors are well-known and effective treatment options in patients with AS. However, many clinical trials have excluded patients with advanced AS. This paper reports a 45-year-old male with newly diagnosed AS with already fused sacroiliac joints, lumbar spine, and cervical spine. Due to persistent and severe pain despite having taken multiple NSAIDs, etanercept was prescribed. After 4 years of treatment, the patient continues to experience marked improvement of his AS symptoms without any significant adverse effects. This case illustrates etanercept can be an effective treatment in patients with advanced AS and is well tolerated. An extensive literature review is also carried out regarding this topic.
强直性脊柱炎（AS）是一种主要影响中轴骨骼的慢性进行性炎症性疾病。不幸的是，与其他风湿性疾病相比，AS的诊断往往会延迟。当最终做出正确诊断时，患者已患有晚期疾病的情况并不少见。肿瘤坏死因子（TNF）抑制剂是AS患者中众所周知且有效的治疗选择。然而，许多临床试验都排除了晚期AS患者。本文报告了一名45岁男性，新诊断为AS，其骶髂关节、腰椎和颈椎已融合。尽管服用了多种非甾体抗炎药，但由于持续且严重的疼痛，仍开具了依那西普。经过4年的治疗，患者的AS症状持续显著改善，且无任何明显不良反应。该病例表明依那西普对晚期AS患者可能是一种有效的治疗方法，且耐受性良好。本文还就该主题进行了广泛的文献综述。
