scholarly journals AB0468 IS THE USE OF INTERLEUKIN 17 INHIBITORS IN SPONDYLOARTHRITIS RELATED TO THE CLINICAL MANIFESTATIONS? 12-MONTH EXPERIENCE OF ONE RHEUMATOLOGY CENTER

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1261.1-1261
Author(s):  
M. Khapsirokova ◽  
Z. Kolkhidova ◽  
S. Erdes
Keyword(s):  
Psoriatic Arthritis ◽  
Biological Therapy ◽  
Clinical Manifestations ◽  
Previous Treatment ◽  
Interleukin 17 ◽  
Disease Modifying Antirheumatic Drugs ◽  
Peripheral Arthritis ◽  
Antirheumatic Drugs ◽  
Male Patients ◽  
Necrosis Factor

Background:Therapy with interleukin 17 (iIL17) inhibitors in Russia is indicated for patients with ankylosing spondylitis (AS) or psoriatic arthritis (PSA). If standard therapy is ineffective in these diseases, both tumor necrosis factor inhibitors (iTNF) and iIL17 can be prescribed as the first biologics.Objectives:To study the clinical features of patients with spondyloarthritis (SPA) who were first prescribed iIL17 in a rheumatology center for 12 months.Methods:During the period from January to December 2019, iIL17 was initiated to 43 SPA patients. To compare the clinical picture, the study additionally included 40 SPA patients who were prescribed iTNF during the same period. The diagnosis of AS was based on the mNY criteria, and psoriatic arthritis was based on the CASPAR criteria. In the combined group of 83 patients, AS was in 52 (62.7%), and PSA – in 31; the age of patients was 39.3±10.8 years, and the duration of the disease was 15.1±8.2 years; men were 47 (56.6%).Results:In the iIL17 group, AS had 23 (53.5%) patients, and PSA – 20 (46.5%), while in the iTNF group, respectively, 29 (72.5%) and 11 (27.5%; χ2=3.2, p=0.76). Among the patients who were prescribed iIL17, men were 29 (67%), and in the iTNF group – 18 (45%; χ2=4.2, p=0.04). In terms of activity indicators (ESR, CRP, BASDAI ASDAS-CRP), patients who were prescribed iIL17 or iTNF did not differ significantly from each other. Peripheral arthritis, dactylitis, and entesitis were observed with almost the same frequency in both groups. In the iIL17 group, there were almost 2 times more patients with psoriasis (53.5% and 25.0%; p<0.05) than in group iTNF and among them, significantly more frequent the patients had previous experience of iTNF treatment (41,9% and 17.5%; p<0.05). Disease-modifying antirheumatic drugs often received patients in iTNF group (80.0% and 48.8%; p<0.05).Conclusion:Thus, in clinical practice iIL17 often prescribed for SPA male patients with psoriasis and previous treatment experience by iTNF. The activity of the disease and the presence of non-axial manifestations practically do not affect the choice of biological therapy.Disclosure of Interests:None declared.

Treatment: DMARDs

2016 ◽  
Author(s):  
Denis Poddubnyy ◽  
Hildrun Haibel
Keyword(s):  
Structural Damage ◽  
Clinical Effect ◽  
Axial Spondyloarthritis ◽  
Disease Modifying Antirheumatic Drugs ◽  
Peripheral Arthritis ◽  
Antirheumatic Drugs ◽  
Positive Clinical Effect ◽  
Axial Disease ◽  
Disease Modifying ◽  
Necrosis Factor

In axial spondyloarthritis (axSpA) there is little evidence to support use of classical synthetic disease-modifying antirheumatic drugs (DMARDs), with the majority of studies performed in advanced ankylosing spondylitis. Sulfasalazine is the best investigated DMARD in axSpA. Its positive clinical effect, if any, seems to be more prominent in the presence of peripheral arthritis, although a certain proportion of patients with axial disease might benefit from sulfasalazine therapy. Available data indicate that there is no evidence that methotrexate might be effective in axial disease, and only marginal evidence exists in support of methotrexate use in case of peripheral involvement. No true disease-modifying properties (e.g. retardation of structural damage progression in the spine) have been demonstrated for DMARDs in axSpA to date. Efficacy of a combination therapy (e.g. methotrexate plus sulfasalazine) as well as benefits of methotrexate (or other DMARDs) in addition to tumour necrosis factor α‎ inhibitors in axSpA remain uncertain.

Spondyloarthropathies

2011 ◽  
Author(s):  
Sandeep Bawa ◽  
Paul Wordsworth ◽  
Inoshi Atukorala
Keyword(s):  
Positive Association ◽  
Joint Involvement ◽  
Hla B27 ◽  
Resonance Imaging ◽  
Disease Modifying Antirheumatic Drugs ◽  
Peripheral Arthritis ◽  
Antirheumatic Drugs ◽  
Skeletal Involvement ◽  
Inflammatory Drugs ◽  
Necrosis Factor

♦ Spondyloarthropathies are related conditions typically associated with axial skeletal involvement, absence of rheumatoid factor, familial clustering, and a variable positive association with HLA-B27♦ Ankylosing spondylitis is the prototype with sacroiliac joint involvement being a prerequisite for diagnosis♦ Diagnosis is frequently delayed for several years but the use of magnetic resonance imaging to detect sacroiliitis greatly facilitates the establishment of an early diagnosis♦ Psoriatic arthritis, reactive arthritis, and enteropathic arthritis have prominent peripheral joint involvement with variable degrees of spinal involvement♦ Non-steroidal anti-inflammatory drugs and physical therapy are the cornerstones of management but slow-acting disease-modifying antirheumatic drugs only have a role in peripheral arthritis♦ Anti-tumour necrosis factor biologic agents have revolutionized the treatment of the spondyloarthropathies.

scholarly journals AB0712 THE INCIDENCE OF SARS-СOV-2 INFECTION IN PATIENTS WITH RHEUMATIC DISEASES ON THERAPY BIOLOGICAL DISEASE MODIFYING ANTIRHEUMATIC DRUGS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1387.3-1388
Author(s):  
A. Dadalova ◽  
E. Vasilenko ◽  
R. Samigullina ◽  
V. Mazurov
Keyword(s):  
Rheumatic Diseases ◽  
Interleukin 6 ◽  
Kinase Inhibitors ◽  
Biological Therapy ◽  
Janus Kinase ◽  
Interleukin 17 ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Tnf Α ◽  
Disease Modifying

Background:At the moment, a highly relevant issue is the course of SARS-CoV-2 infection in patients with rheumatic pathology, especially, those receiving therapy with biological disease modifying antirheumatic drugs.Objectives:of the current study to assess the prevalence and course of SARS-CoV-2 infection in patients receiving various biological disease modifying antirheumatic drugs.Methods:to assess the severity of the course of SARS-CoV-2, discharged epicrisis from hospitals or the conclusion of computed tomography were used. The average age of the patients ranged from 41.4 + 11.6 years. In the evaluated sample, 47 patients (49.47%) were males. Among the infected of SARS-CoV-2 were patients with rheumatoid arthritis - 45 (47.4%), spondyloarthritis - 39 (41.1%), systemic connective tissue diseases - 11 (11.5%).Results:Since March 2020, among the 1319 patients with rheumatic diseases observed at the St. Petersburg Center of therapy biological disease modifying antirheumatic drugs, 95 patients (7,2%) had SARS-CoV-2 infection. In 57,9% (55 patients) there was a mild course of infection, in 35,8% of cases (34 patients) - a moderate course, in 6,3% (6 patients) - a severe course. Inpatient treatment was received by 29,5% (28 patients). A favorable outcome was noted in 95.8%, and a lethal outcome in 4,2%. The use of interleukin-6 inhibitors was required in 2,1% of patients (2) due to the development of a cytokine storm. The structure of the received biological therapy in the severity of the course is shown in Table 1.Table 1.The structure of the received biological therapy in the severity of the course SARS-CoV-2 infectionMild courseCT-1 (<25%)CT-2 (25-50%)CT-3 (50-75%)CT-4 (>75%)TNF-α inhibitors, n (%)30 (31,6)11 (11,6)7 (7,3)3 (3,2)0 (0,0)anti B-cell therapy (rituximab), n (%)2 (2,1)1 (1,1)2 (2,1)1 (1,1)2 (2,1)Abatacept, n (%)3 (3.2)0 (0,0)2 (2,1)0 (0,0)0 (0,0)Janus kinase inhibitors, n (%)5 (5,3)1 (1,1)1 (1,1)0 (0,0)0 (0,0)Interleukin-6 inhibitors, n (%)6 (6,3)0 (0,0)0 (0,0)0 (0,0)0 (0,0)Interleukin-17 inhibitors, n (%)8 (8,4) 2 (2,1) 2 (2,1)0 (0,0)0 (0,0)Other, n (%)1 (1,1)4 (4,2)1 (1,1)0 (0,0)0 (0,0)Among 95 infected patients, who were observed in the center, 51 received therapy with TNF-α inhibitors (8.5% of the total number of patients receiving therapy), 8 - rituximab therapy (2.7%), 5 - abatacept (6.3%), 7 - Janus kinase inhibitors (0.9%), 6 – interleukin-6 inhibitors (9.2), 12 - interleukin -17 inhibitors (14.1%), 6 patients treated with other drugs (10%).Conclusion:Taking into account the SARS-CoV-2 pandemic, further study of the course of infection in patients with rheumatic diseases, including those receiving biological therapy, is required. More information is also needed on the safety and efficacy of vaccination in this patient population.Disclosure of Interests:None declared

Association of previous treatment with anti-tumour necrosis factor inhibitors with the effectiveness of secukinumab in the treatment of psoriatic arthritis: systematic review and meta-analysis

Rheumatology ◽  
2020 ◽  
Vol 59 (12) ◽  
pp. 3657-3665
Author(s):  
Yantao Xu ◽  
Yuting Li ◽  
Mengyuan Dong ◽  
Zi’ang Gao ◽  
Xiang Chen ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Meta Analysis ◽  
Previous Treatment ◽  
Cochrane Library ◽  
Acr20 Response ◽  
Naive Group ◽  
American College Of Rheumatology ◽  
History Of ◽  
Effectiveness Data ◽  
Necrosis Factor

Abstract Objectives We sought to systematically investigate the effectiveness of secukinumab in psoriatic arthritis (PsA) patients who previously received TNFs inhibitor (TNFi) treatment and those who were TNFi naïve. Methods Databases (PubMed, EMBase and Cochrane library) and ClinicalTrials.gov were searched from inception to 22 May 2020 for randomized control trails and observational studies of secukinumab, with or without a history of previous anti-TNFi treatment, in PsA. Effectiveness data were extracted and combined using a random-effects meta-analysis. The ACR20 and ACR50 (20% and 50% improvement in American College of Rheumatology response criteria) responses were the endpoints. Results Six randomized controlled trials that reported the effectiveness of secukinumab by previous anti-TNFi treatment were included. Among patients exposed to a prior anti-TNFi treatment (n = 738), 33.7% (249/738) of patients achieved an ACR20 response. In contrast, in the anti-TNFi-naïve group (n = 1754), 49.8% (873/1754) of patients achieved an ACR20 response. Prior treatment with anti-TNFi was significantly associated with a poorer response to secukinumab compared with the anti-TNFi-naïve group with an effect size of 2.09 (95% CI: 1.69, 2.58). Conclusion Some patients benefit from switching from TNFi to secukinumab, but previous anti-TNFi treatment is associated with poorer effectiveness of secukinumab.

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