Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia.
Moscow Research and Practical Centre on Addictions of Moscow, Department of Public Health, 37/1 Lyublinskaya Str., 109390 Moscow, Russia.
Curr Rheumatol Rev. 2024;20(5):501-513. doi: 10.2174/0115733971289295240223095751.
Ankylosing spondylitis (AS) is a chronic inflammatory disease known for causing pain, stiffness, and reduced mobility in the axial skeleton. Adalimumab, a tumor necrosis factor (TNF) inhibitor, has emerged as a promising therapeutic option for AS.
This systematic review involved a comprehensive search of randomized controlled trials related to AS treatment, conducted in major databases such as MEDLINE, Google Scholar, and PubMed. The search terms encompassed ankylosing spondylitis, adalimumab, methotrexate, other non-biologic DMARDs, glucocorticoids, NSAIDs, and analgesics. A total of 14 randomized controlled trials with 4,500 participants were included in the review.
The review's results revealed that adalimumab demonstrated notable superiority when compared to a placebo. It effectively reduced disease activity, improved physical function, and lowered inflammatory markers such as C-reactive protein and erythrocyte sedimentation rate. Adalimumab demonstrated a favorable safety profile, with adverse events comparable to those observed with placebo.
Based on the results, adalimumab is deemed an effective treatment for AS, showcasing its potential as a first-line therapeutic option. Notably, no significant increase in adverse events was observed compared to placebo. However, the conclusion emphasizes the need for further studies with extended follow-up durations to ascertain the long-term efficacy and safety of adalimumab in AS management. This systematic review provides valuable insights supporting the use of adalimumab in the treatment of AS and underscores the importance of ongoing investigations into its long-term effects to optimize its clinical utilization in AS patients.
强直性脊柱炎(AS)是一种慢性炎症性疾病,其特征为轴性骨骼疼痛、僵硬和活动度下降。肿瘤坏死因子(TNF)抑制剂阿达木单抗已成为治疗 AS 的一种有前途的选择。
本系统评价综合检索了 MEDLINE、Google Scholar 和 PubMed 等主要数据库中与 AS 治疗相关的随机对照试验。检索词包括强直性脊柱炎、阿达木单抗、甲氨蝶呤、其他非生物 DMARDs、糖皮质激素、非甾体抗炎药和镇痛药。共纳入 14 项涉及 4500 名参与者的随机对照试验。
该综述结果表明,阿达木单抗与安慰剂相比具有显著优势。它能有效降低疾病活动度、改善身体功能,并降低 C 反应蛋白和红细胞沉降率等炎症标志物。阿达木单抗具有良好的安全性,不良反应与安慰剂相似。
基于这些结果,阿达木单抗被认为是治疗 AS 的有效药物,有望成为一线治疗选择。与安慰剂相比,未见不良反应显著增加。然而,该结论强调需要进一步进行延长随访时间的研究,以确定阿达木单抗在 AS 管理中的长期疗效和安全性。本系统评价提供了支持阿达木单抗治疗 AS 的有价值的见解,并强调了对其长期影响进行持续研究的重要性,以优化其在 AS 患者中的临床应用。