Ankylosing Spondylitis


ACR: Etanercept Improves Disease Activity In Ankylosing Spondylitis
By Maria Bishop
Special to DG News

PHILADELPHIA, PA -- November 3, 2000 -- The treatment of ankylosing spondylitis with tumour-necrosing factor-alpha agents shows a great deal of promise, noted United States researchers at the 64th Annual Scientific Meeting of the American College of Rheumatology (ACR) in Philadelphia, Pennsylvania.

Researchers stated that etanercept can significantly improve the disease activity in ankylosing spondylitis (AS), a painful and debilitating rheumatic disease that causes arthritis of the spine and sacroiliac joints, predominantly.

Few treatments are currently available for AS and none have yet been able to show that they alter the course of this disease. If not treated, AS can eventually fuse the entire spine. Recent observations suggest that tumour-necrosing factor-alpha may play a role in the pathogenesis of AS.

Jennifer D. Gorman, MD, of the Department of Medicine-Rheumatology, University of California-SF, San Francisco, California, led a small team of researchers in a four-month trial examining 16 adults, who, despite treatment, continued to have very active AS. These patients were randomized to etanercept (25 mg twice weekly) or placebo.

Participants in this trial were allowed to continue their previous treatment regimens of non-steroidal anti-inflammatory drugs and disease-modifying anti-rheumatic drugs at stable dosages throughout the study.

Primary outcome measures were duration of morning stiffness, visual assessment of nocturnal spinal pain, Bath Ankylosing Spondylitis Functional Index (BASFI), patient global assessment (PiGA) and swollen joint count (SJC).

Response was defined as a 20 percent or greater improvement in three of the five measures-one of which had to be morning stiffness or spinal pain, without worsening in any measure.

Eleven patients completed the study and went on to participate in a
six-month open-label extension trial. Seven of those 11 completed the extension. Those seven patients showed a mean improvement in morning stiffness of 92.3 percent and an improvement in spinal pain of 68.2 percent.  Improvements in BASFI, PiGA and SJC were 55.7 percent, 47.9 percent and 59.1 percent, respectively.
No serious adverse events were reported, although injection-site reaction was considered a frequent side effect.

The researchers concluded that this study provided valuable understanding to the knowledge of tumour-necrosing factor-alpha inhibitors in the treatment of AS.

This research was supported by Immunex Corporation.

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