AB0658 Influence of Known Risk Factors on Spinal Radiographic Progression in Ankylosing Spondylitis Patients Receiving Long-Term Treatment with TNF Inhibitors: Results from The Glas Cohort

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 1129.2-1130
Author(s):  
F. Maas ◽  
S. Arends ◽  
F.R. Wink ◽  
E. van der Veer ◽  
R. Bos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ankylosing Spondylitis ◽  
Radiographic Progression ◽  
Term Treatment ◽  
Tnf Inhibitors ◽  
Long Term Treatment

scholarly journals Sustained Low Disease Activity Measured By ASDAS Slow Radiographic Spinal Progression in Axial Spondyloarthritis Patients Treated With TNF-inhibitors. Data from REGISPONSERBIO

2021 ◽  
Author(s):  
Maria Llop ◽  
Mireia Moreno ◽  
Victoria Navarro-Compán ◽  
Xavier Juanola ◽  
Eugenio de Miguel ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Radiographic Progression ◽  
Axial Spondyloarthritis ◽  
Term Treatment ◽  
Tnf Inhibitors ◽  
Low Disease Activity ◽  
Long Term Treatment

Abstract Background: To evaluate the influence of the disease activity on radiographic progression in axial spondyloarthritis (axSpA) patients treated with TNF inhibitors (TNFi).Methods: The study included 101 axSpA patients from the Spanish Register of Biological Therapy in Spondyloarthritides (REGISPONSERBIO), which had clinical data and radiographic assessment available. Patients were classified into 2 groups based on the duration of TNFi treatment at baseline: i) long-term treatment (≥4 years) and ii) no long-term treatment (< 4 years). Radiographs were scored by two readers according to the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) with known chronology. Disease activity differences between patients’ groups at each time point were assessed using a linear mixed-effect model.Results: Radiographic progression was defined as an increase in ≥2 mSASSS units. At inclusion, approximately half of the patients (45.5%) were receiving long-term treatment with TNFi (≥4 years). In this group of subjects, a significant difference in averaged Ankylosing Spondylitis disease Activity Score (ASDAS) across follow-up was found between progressors and non-progressors (2.33 vs 1.76, p=0.027, respectively). In patients not under long-term TNFi treatment (54.5%) though, no significant ASDAS differences were observed between progressors and non-progressors until the third year of follow-up. Furthermore, no significant differences were found in progression status, when disease activity was measured by Bath Ankylosing spondylitis Disease Activity Index (BASDAI) and C reactive protein (CRP).Conclusions: Patients on long-term TNFi treatment with a mean sustained low disease activity measures by ASDAS presented lower radiographic progression than those with active disease.

TNF-Inhibitoren verlangsamen die radiologische Progression bei Patienten mit ankylosierender Spondylitis

2020 ◽  
pp. 1-3
Author(s):  
Carmen-Marina Mihai
Keyword(s):  
Ankylosing Spondylitis ◽  
Structural Model ◽  
Radiographic Progression ◽  
Term Treatment ◽  
Marginal Structural Model ◽  
Real World Data ◽  
Change Rate ◽  
Long Term Treatment ◽  
The Difference

<b>Objectives:</b> Tumour necrosis factor inhibitors (TNFis) have been suggested to slow radiographic progression in patients with ankylosing spondylitis. However, limitations such as variations in disease activity, complex drug administration and short follow-up duration make it difficult to determine the effect of TNFis on radiographic progression. The aim of the study was to investigate whether long-term treatment with TNFis can reduce radiographic progression in patients with ankylosing spondylitis using 18-year longitudinal real-world data. <b>Methods:</b> This retrospective study was conducted between January 2001 and December 2018 at a single centre. Among the 1280 patients whose electronic medical records were reviewed, data of 595 patients exposed to TNFis at least once were included. Among them, time intervals of TNFi exposure or non-exposure were determined in 338 patients (‹on the TNFis› or ‹off the TNFis› intervals, respectively). The difference in the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) change rate between ‹on the TNFis› and ‹off the TNFis› intervals was investigated. <b>Results:</b> We obtained 2364 intervals of 338 patients (1281 ‹on the TNFis› and 1083 ‹off the TNFis› intervals). In the marginal structural model for inverse probability of treatment weighting, the change rate of mSASSS significantly decreased with the use of TNFis (β = –0.112, p = 0.004), and the adjusted mSASSS changes were 0.848 and 0.960 per year during ‹on the TNFis› and ‹off the TNFis› intervals, respectively. <b>Conclusion:</b> Compared with treatment without TNFis, treatment with TNFis slowed radiologic progression significantly.

The crystal arthropathies

2013 ◽  
Vol 6 (11) ◽  
pp. 681-687 ◽  
Author(s):  
Robert A Jones ◽  
Brian Quilty
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Inflammatory Arthritis ◽  
Term Treatment ◽  
Routine Practice ◽  
Treatment Goals ◽  
Crystal Arthropathies ◽  
Long Term Treatment

Unlike many other forms of inflammatory arthritis, the crystal arthropathies are routinely diagnosed and managed in primary care. Gout, in particular, is relatively commonplace and rates of other types of crystal-related arthritis are predicted to increase. These are, therefore, conditions that GPs and trainees will regularly encounter during routine practice. While the clinical features and pathophysiology of gout and pseudo-gout are well described, the long-term treatment goals and options of management are often less well understood, and opportunities to assess for associated co-morbidities can easily be missed. GPs can be central in optimising management by promptly and appropriately addressing acute symptoms, preventing recurrent attacks, minimising disability and work absences, reducing cardiovascular risk factors, improving general health and enhancing quality of life.

scholarly journals Tumor-necrosis Factor Inhibitors Improve Aortic Stiffness in Patients With Longstanding Rheumatoid Arthritis

2020 ◽  
Author(s):  
Alessandro Giollo ◽  
Giovanni Cioffi ◽  
Federica Ognibeni ◽  
Giovanni Orsolini ◽  
Andrea Dalbeni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Aortic Stiffness ◽  
Term Treatment ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Long Term Treatment ◽  
Necrosis Factor

Abstract Background. Major cardiovascular disease (CVD) benefits of disease-modifying anti-rheumatic drugs (DMARDs) therapy occur in early RA patients with treat-to-target strategy. However, it is unknown whether long-term DMARDs treatment in established RA could be useful to improve CVD risk profile.Methods. Ultrasound aortic stiffness index (AoSI) has to be considered a proxy outcome measure in established RA patients. We measured AoSI in a group of RA patients on long-term treatment with tumour necrosis factor inhibitors (TNFi) or conventional synthetic DMARDs (csDMARDs). Eligible participants were assessed at baseline and after 12 months; changes in serum lipids, glucose and arterial blood pressure were assessed. All patients were on stable medications during the entire follow-up. Results. We included 107 (64 TNFi and 43 csDMARDs) RA patients. Most patients (74%) were in remission or low disease activity and had some CVD risk factors (45.8% hypertension, 59.8% dyslipidemia, 45.3% smoking). The two groups did not differ significantly for baseline AoSI (5.95±3.73% vs 6.08±4.20%, p=0.867). Follow-up AoSI was significantly increased from baseline in the csDMARDs group (+1.00%; p<0.0001) but not in the TNFi group (+0.15%, p=0.477). Patients on TNFi had significantly lower follow-up AoSI from baseline than the csDMARD group (-1.02%, p<0.001; ANCOVA corrected for baseline AoSI, age and systolic blood pressure). Furthermore, follow-up AoSI was significantly lower in TNFi users with 1-2 or >2 CVD risk factors than in those without. Conclusion. Long-term treatment with TNFi was associated with reduced aortic stiffness in patients with established RA and several CVD risk factors.

scholarly journals Usefulness of Nonvalved Spacers for Administration of Inhaled Steroids in Young Children with Recurrent Wheezing and Risk Factors for Asthma

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Carlos Kofman ◽  
Alejandro Teper
Keyword(s):  
Risk Factors ◽  
Fluticasone Propionate ◽  
Young Children ◽  
Respiratory Symptoms ◽  
Term Treatment ◽  
Recurrent Wheezing ◽  
Inhaled Steroids ◽  
Long Term Treatment ◽  
Metered Dose

Background. In vitro and scintigraphic studies have suggested that effectiveness of metered-dose inhalers (MDI) with nonvalved spacers (NVS) is similar to that of MDI with valved holding chambers (VHC). Nevertheless, there are no clinical studies that compare these techniques in long-term treatment with inhaled steroids in young children with recurrent wheezing and risk factors for asthma. Objective. To compare the efficacy of a long-term treatment with Fluticasone Propionate administered by an MDI through both type of spacers, with and without valves, in young children with recurrent wheezing and risk factors for asthma. Patients and Methods. Outpatient children (6 to 20 months old) with recurrent wheezing and risk factors for asthma were randomized to receive a 6-month treatment with metered-dose inhaler (MDI) of Fluticasone Propionate 125 mcg BID through an NVS or through a VHC. Parents recorded daily their child’s respiratory symptoms and rescue medication use. Results. 46 patients of 13.4 ± 5 months old were studied. During the study period, the NVS group (n=25) experienced 3.9 ± 2.4 obstructive exacerbations, and the VHC group (n=21) had 2.6 ± 1.6 (p=0.031). The NVS group had 17.4 ± 14% of days with respiratory symptoms, and the VHC group had 9.7 ± 7% (p=0.019). The NVS group spent 29.8 ± 22 days on albuterol while the VHC group spent 17.9 ± 11 days (p=0.022). Conclusion. Long-term treatment with inhaled steroids administered by MDI and NVS is less effective than such treatment by MDI and VHC in infants with recurrent wheezing and risk factors for asthma.

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