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Vol. 17. Issue 4.
Pages 192-196 (April 2021)
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Vol. 17. Issue 4.
Pages 192-196 (April 2021)
Original Article
DOI: 10.1016/j.reumae.2019.07.006
Comparison of disease activity in patients with ankylosing spondylitis under TNFi or NSAID treatment, is there any difference? An observational study
Comparación de la actividad de la enfermedad en pacientes de espondilitis anquilosante con terapia de anti-TNF o AINE. ¿Existe alguna diferencia? Estudio observacional
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Mireia Morenoa, Marta Arévaloa,
Corresponding author
toneta.4@gmail.com

Corresponding author.
, Marc Zamorab, Caridad Pontesc, Juan Carlos Olivad, Jordi Gratacósa
a Rheumatology Department, University Hospital Parc Taulí, I3PT Universitat Autònoma de Barcelona, Sabadell (Barcelona), Spain
b Universitat Autònoma de Barcelona (UAB), Spain
c Clinical Pharmacology Unit, Universitat Autònoma de Barcelona, Sabadell (Barcelona), Spain
d Statistics Department, University Hospital Parc Taulí, I3PT Universitat Autònoma de Barcelona, Sabadell (Barcelona), Spain
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Tables (2)
Table 1. Comparative analysis of clinical and demographic characteristic of patients included according to treatment (NSAID or TNFi).
Table 2. Analysis of variables associated to low disease activity or inactive disease.
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Abstract
Objective

To assess whether there are any real-life differences between ankylosing spondylitis (AS) patients treated with NSAID or TNF inhibitors (TNFi) regarding disease activity.

Methods

This is an observational transversal unicentric study with retrospective retrieval of data from clinical records of all AS patients attended in our hospital. We compared clinical activity measured by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores between patients treated with NSAID and those treated with TNFi, in terms of low disease activity defined as BASDAI<4, and inactivity when BASDAI2. As secondary variables, we also collected epidemiological, clinical and radiological data from all those patients.

Results

A total of 152 AS patients (81% male), with an average age of 49.45±12.38 years and a disease duration of 13.5±9.79 years were included in the study. Eighty-nine patients (58.6%) were treated with NSAID and 63 (41.4%) with TNFi. The proportion of patients with low disease activity and inactive disease was significantly higher in the TNFi treatment group compared to the NSAID group (81 vs. 47, P=.0001) and (44 vs. 24, P=.007), respectively. Patients treated with NSAIDs also showed significantly more global pain and night pain than those under TNFi therapy. The BASFI score and especially the type of treatment (NSAID or TNFI) were the only variables independently associated with low disease activity or inactive disease.

Conclusion

In real world practice, AS patients under TNFi treatment show a better control of clinical symptoms than those under NSAIDs.

Keywords:
Ankylosing spondylitis
NSAID
TNFi
BASDAI
Resumen
Objetivo

Evaluar si existen diferencias entre los pacientes con espondilitis anquilosante (EA) tratados con AINE o inhibidores del TNF (anti-TNF), con relación a la actividad de la enfermedad en la vida real.

Métodos

Estudio observacional transversal unicéntrico con recopilación retrospectiva de datos de historias clínicas de todos los pacientes de EA examinados en nuestro hospital. Comparamos la actividad clínica, medida con la puntuación del Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), entre los pacientes tratados con AINE y los tratados con anti-TNF, en términos de baja actividad de la enfermedad definida como BASDAI<4 e inactividad, con BASDAI2. Como variables secundarias recopilamos también los datos clínicos, epidemiológicos y radiológicos de dichos pacientes.

Resultados

Incluimos en el estudio un total de 152 pacientes de EA (81% varones), con una edad media de 49,45±12,38años y una duración de la enfermedad de 13,5±9,79años. Ochenta y nueve pacientes (58,6%) fueron tratados con AINE y 63 (41,4%) con anti-TNF. La proporción de pacientes con baja actividad de la enfermedad e inactividad fue significativamente superior en el grupo de terapia anti-TNF, en comparación con el grupo AINE: 81 vs. 47, p=0,0001, y 44 vs. 24, p=0,007, respectivamente. Los pacientes tratados con AINE reflejaron también un dolor global significativamente mayor que aquellos con terapia de anti-TNF. La puntuación BASFI, y especialmente el tipo de tratamiento (AINE o anti-TNF), fueron las únicas variables independientemente asociadas a baja actividad de la enfermedad o a inactividad de esta.

Conclusión

En la práctica real, los pacientes de EA con terapia anti-TNF reflejan un mejor control de los síntomas clínicos que aquellos con tratamiento de AINE.

Palabras clave:
Espondilitis anquilosante
AINE
Anti-TNF
BASDAI

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