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J Clin Diagn Res. 2016 Jul;10(7):OC29-32. doi: 10.7860/JCDR/2016/19960.8172. Epub 2016 Jul 1.

Biologics Use in Asian Indian Patients with Ankylosing Spondylitis: A Physician's Perspective.

Author information

1
Rheumatologist, INHS Asvini , Colaba, Mumbai, Maharashtra, India .
2
Consultant Rheumatologist, UB Area , Bareilley, Uttar Pradesh, India .
3
Rheumatologist, Command Hospital , Alipore, Kolkata, West Bengal, India .
4
Head, Department of Medicine, INHS Asvini , Colaba, Mumbai, Maharashtra, India .
5
Resident, Department of Medicine, INHS Asvini , Colaba, Mumbai, Maharashtra, India .

Abstract

INTRODUCTION:

Ankylosing Spondylitis (AS) with non-steroidal anti-inflammatory drug (NSAID) therapeutic failure is treated with biologics.

AIM:

To compare the clinical outcomes of different biologics for Asian Indian patients with AS who have NSAID therapeutic failure.

MATERIALS AND METHODS:

Thirty-five AS patients with NSAID failure were administered Etanercept (n=15) (50mg SQ, weekly) or Infliximab (n=20) (5mg/kg IV every 2(nd) month) based on patient convenience or physician discretion as per 2015 ACR/SAA/SPARTAN recommendations. Baseline demographic details, time to diagnosis, disease duration, presence of low backache, early morning stiffness, peripheral joint and extraarticular involvement, ESR, CRP values and HLA-B27 score were obtained. Baseline values of scores of BASMI-3 and MASES were calculated. To monitor the disease activity, BASDAI and ASDAS-ESR scores were recorded at baseline, and after 6 months and 12 months of therapy initiation.

STATISTICAL ANALYSIS:

Comparison of means: independent samples t-test; comparison of parameters over time: repeated measures ANOVA.

RESULTS:

Both groups were comparable in all parameters at therapy initiation except in the baseline BASMI-3 score which was significantly higher in patients who received Etanercept. Over 12 months of treatment, the reduction in disease activity, as evidenced by reduction in the mean BASDAI and ASDAS-ESR scores was statistically significant for all patients when considered together, as well as when Etanercept and Infliximab were considered separately (p<0.0001 in all cases). However, there was no statistically significant difference in the magnitude of reduction in the mean BASDAI and ASDAS-ESR scores between patients who received Etanercept and those who received infliximab (p=0.696 and 0.618 respectively).

CONCLUSION:

Etanercept and Infliximab offer statistically similar reduction in disease severity in Asian Indian AS patients with NSAID failure. Further studies with larger sample size are warranted.

KEYWORDS:

Disease activity; Etanercept; Infliximab; Spondyloarthritis

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