The Clinical Analysis Of The Effects Of Etanercept On Ankylosing Spondylitis

The main symptom of ankylosing spondylitis(AS)is inflammatory spinal pain;with time,some patients develop ankylosis and spinal immobility.AS causes destruction and fusion of the spinal vertebrae and sacroiliac joints,which lead to the progressive and irreversible destruction of structure and loss of function,and finally disability with decreased quality of life.In the past several decades,treatment of AS was roughly dependent on non-steroidal anti-inflammatory agents(NSAIDS)and disease modifying anti-rheumatic drugs(DMARDS).But the effectiveness of relieving the disease is largely limited.In the new of the raising of biological agents,systemic assessment and exploration of biological agents on treating AS are important for the development of new therapeutic strategy.Tumor necrosis factor-?(TNF-?)is an important cytokine in mediating the pathogenesis of AS.For patients who still have high activity after NSAIDS/DMARDS therapy,anti-tumour necrosis factor(anti-TNF)agent is their only option available.Etanercept(Eta)is a recombinant human tumor necrosis factor-a receptor ?:IgG Fc-? fusion protein for injection.In this study,Eta was used to treat AS patients who still have high activity after NSAIDS/DMARDS therapy.The effectiveness and adverse effects were monitored during the 24 w treatment period.Sixty-four(51 male,13 female)qualified AS patients aged 33.64 ± 9.37 years old with 72.80 ± 52.12 m of disease history were enrolled in this study.Their body mass index(BMI)was 23.0 ± 2.82.All the patients were injected with Eta 50 mg(q.w.)for 24 w.ASAS curative effect index,clinical indicators,Bath AS metrology index(BASMI)to define spinal activity,and AS disease activity score C-reactive protein(ASDAS-CRP)were observed and analyzed.After the injection of Eta 50 mg(q.w.)for 24 w,all the data of the patients were analyzed.The level of VAS of spinal pain,PGA,BASDAI,BASFI,CRP,and ESR significantly improved after the patients were treated 2 w.At the end of 24 w of treatment,the improvement of ASAS20,ASAS40,and ASAS5/6 was 95.31%,87.50%,and 89.06%respectively;and 70.31%of patients achieved partial remission.The adverse reactions during the observation were rash(4.69%),upper respiratory infection(10.94%),and urinary tract infection(3.12%),without serious adverse events.The results of the present study showed that pain and morning stiffness were improved in the early 2 w.ESR and CRP were reduced to normal with no rebound following the continual treatment.All the clinical indicators were improved significantly after 24 w treatment.Eta did not increase the risk for infection and liver damage.All the results provided the first line evidence for treatment AS patients who still have high activity after NSAIDS/DMARDS therapy.