The Analysis Of Therapeutic Effects Of Adamumab On Ankylosing Spondylitis Patients

Ankylosing spondylitis(AS)is the most common form of(SpA)in spinal arthritis.It is a chronic immune-mediated inflammatory disease characterized by its primary influence on tendons,ligaments and articular capsules,and the development of inflammatory low back pain.Stiff and sexual restriction,some patients can eventually cause spinal joint injury,irreversible joint fusion and disability.In addition,AS can simultaneously develop specific organ involvement,including anterior uveitis,psoriasis,inflammatory bowel disease,with cardio-pulmonary,and so on.The increased risk of onset has a serious impact on the quality of life of patients.Non-steroidal anti-inflammatory drugs(NSAIDs)and anti-rheumatic agents(DMARDs)are the first-line therapy for AS.In 60%of the patients,80%of the patients showed a good symptom relief effect.In addition to their positive effects on pain,These two drugs can also reduce the levels of acute phase reactants and the signal intensity of bone marrow edema of sacroiliac(SI)joint on MRI in patients with AS.However,cardiovascular and gastrointestinal side effects may occur in the course of treatment.The clinical effects of DMARDs including sulfasalazine(SSZ)and methotrexate(MTX)in the treatment of SpA are still controversial.Most of them believe that only peripheral joints are effective and can effectively improve pern pheral joint injury.In the last two decades,tumor necrosis factor-?(TNF-?)inhibitors can be used to treat active AS patients,including NSAIDs and DMARDs,and can relieve the symptoms of AS rapidly.Significant improvements in quality of life and reduced risk of long-term disability have been shown to reduce the clinical signs and symptoms of active diseases and inflammatory levels in patients with AS.TNF-? inhibitors mainly include the use of etanercept(Eta),infliximab,(IFX),adalimumab(Ada),and so on.Among them,Ada is an all-human monoclonal antibody against TNF-?,which can specifically bind to human TNF-? and prevent it from binding to effector cells and exert its biological effect in AS,Psoriasis Crohn's disease and some autoimmune diseases have been widely used in the treatment of ankylosing spondylitis.In this paper we mainly study the clinical efficacy and adverse reactions of Ada in the treatment of ankylosing spondylitis.A total of 67 active AS patients(54 males and 13 females,age 34.54 ± 9.58 years,height 170.32±8.51cm,body weight 70.50 ±12.75kg,body mass index 24.24 ± 3.62kg/m2),who met the criteria and were able to complete the whole clinical observation,were selected.The course of disease was 85.41 ±73.09 m.67 patients who met the active AS criteria were enrolled in the study.The treatment time of NSAIDs or DMARDs was more than 4 weeks,and the patients were ineffective or intolerableFrom the beginning of clinical observation,Ada 40 mg was injected subcutaneously(every 2 weeks)in 67 patients,and the injection cycle was 24 weeks.To evaluate the efficacy and safety of Ada,the main therapeutic measures:ASAS 20,ASAS 40,and 70 were 97.01%,91.04%,76.11%,respectively,at 24 weeks after treatment,and reached ASAS 20,ASAS 40,and ASAS 70,which were evaluated according to the criteria of ASAS 20,ASAS 40,and ASAS 70,respectively.Secondary outcomes:2w,4w,8w,12w,18w,24w after treatment,compared with baseline values,Bath AS disease activity index(BASDAI),Bath AS functional index(BASFI),spondylar pain VAS(visual analogue scale)score,spinal inflammation,Patient Total Assessment Index(PGA),Bath AS Metrological Index(BASMI),erythrocyte sedimentation rate(ESR),C reactive protein(CRP)were improved to some extent.According to the results of this experiment,Ada had a significant effect on the treatment of ankylosing spondylitis,and the side effects occurred at the same time.There were 4 cases(5.97%)of rash at injection site,8 cases(11.94%)of upper respiratory tract infection,and 8 cases(11.94%)of upper respiratory tract infection.There were 2 cases(2.99%)with urinary tract infection and 3 cases(4.48%)with abnormal liver function.No other serious adverse events were seen.Within 24 weeks after treatment with Ada,the response rate of ASAS20,ASAS40,ASAS70 was increased,and the overall response rate was more than 75%.During the first 8 weeks,the remission rate of ASAS20,ASAS40 increased significantly,while the increase of ASAS20,ASAS40 rate decreased from 8 weeks to 24 weeks,but the therapeutic effect was still maintained to a certain extent,the remission rate of ASAS70 maintained a significant upward trend in 24 weeks,and there was no significant difference in the response rate between 8 weeks and 24 weeks after treatment.Within 2 weeks,symptoms such as morning stiffness,PGA,low back pain and other symptoms relieved rapidly,and ESR,CRP decreased to the normal range,after which There are no serious adverse events,such as tuberculosis,tumor,hepatitis B,severe infection,and so on.Ada provides a new way to treat AS patients with active and ineffective traditional drug therapy.