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Ngo MD, Zummer M, Andersen KM, Richard N. First Biologic Drug Persistence in Patients With Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: A Real-World Canadian Physicians' Experience. J Clin Rheumatol 2022; 28:e210-e216. [PMID: 33394832 DOI: 10.1097/rhu.0000000000001693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
METHODS Data were obtained from persons enrolled in the SpondyloArthritis Research Consortium of Canada registry between 2003 and 2018. Kaplan-Meier curves were constructed from the time of biologic initiation until discontinuation and compared using the log-rank test. Subanalyses were performed according to calendar year and disease activity. Cox proportional hazards models were used to identify factors associated with discontinuation. RESULTS We identified 385 biologic-naive persons. Overall, the 349 AS participants had longer persistence to their first biologic than the 36 nr-axSpA subjects (p < 0.01). The Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index decreased by 2.3 points (95% confidence interval [CI], 1.9-2.7) and 3.2 points (95% CI, 2.6-3.7), respectively, in the first year and were stable thereafter. Adjusting for sex, human leukocyte antigen B27, and smoking status, nr-axSpA patients were more likely to discontinue their biologic than AS patients (hazards ratio, 1.65; 95% CI, 1.03-2.62). CONCLUSIONS In this real-world study, AS patients had longer persistence to their first biologic compared with nr-axSpA, with disease subtype being the most significant predictor of treatment persistence. Future studies should be targeted at assessing long-term clinical outcome of axSpA in the real-world setting.
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Affiliation(s)
- Minh-Duc Ngo
- From the Faculty of Medicine, Université Laval, Québec, Canada
| | - Michel Zummer
- Division of Rheumatology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, Québec, Canada
| | | | - Nicolas Richard
- Division of Rheumatology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, Québec, Canada
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Lee YJ, Kim MJ, Jo S, Jin SH, Park PR, Park K, Song HC, Kim J, Kim JY, Shim SC, Kim TH, Hong SJ, Kang H, Kim TJ, Won EJ. Clonorchis sinensis-Derived Protein Attenuates Inflammation and New Bone Formation in Ankylosing Spondylitis. Front Immunol 2021; 12:615369. [PMID: 33717104 PMCID: PMC7947613 DOI: 10.3389/fimmu.2021.615369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 01/18/2021] [Indexed: 12/17/2022] Open
Abstract
Helminth infections and their components have been shown to have the potential to modulate and attenuate immune responses. The objective of this study was to evaluate the potential protective effects of Clonorchis sinensis-derived protein (CSp) on ankylosing spondylitis (AS). Cytotoxicity of CSp at different doses was assessed by MTS and flow cytometry before performing experiments. Peripheral blood mononuclear cells (PBMCs) and synovial fluid mononuclear cells (SFMCs) were obtained from AS patients. Inflammatory cytokine-producing cells were analyzed using flow cytometry. The levels of INF- γ , IL-17A, TNF-α, and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA). SKG mice were treated with CSp or vehicles. Inflammation and new bone formation were evaluated using immunohistochemistry, positron emission tomography (PET), and micro-computed tomography (CT). Treatment with CSp resulted in no reduced cell viability of PBMCs or SFMCs until 24 h. In experiments culturing PBMCs and SFMCs, the frequencies of IFN- γ and IL-17A producing cells were significantly reduced after CSp treatment. In the SKG mouse model, CSp treatment significantly suppressed arthritis, enthesitis, and enteritis. Micro-CT analysis of hind paw revealed reduced new bone formation in CSp-treated mice than in vehicle-treated mice. We provide the first evidence demonstrating that CSp can ameliorate clinical signs and cytokine derangements in AS. In addition, such CSp treatment could reduce the new bone formation of AS.
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Affiliation(s)
- Yu Jeong Lee
- Department of Parasitology and Tropical Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Moon-Ju Kim
- Department of Parasitology and Tropical Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Sungsin Jo
- Department of Rheumatology, Hanyang University Institute for Rheumatology Research, Seoul, South Korea
| | - So-Hee Jin
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Pu-Reum Park
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Kijeong Park
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Ho-Chun Song
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Jahae Kim
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Ji-Young Kim
- Division of Rheumatology, Daejeon Rheumatoid & Degenerative Arthritis Center, Chungnam National University Hospital, Daejeon, South Korea
| | - Seung Cheol Shim
- Division of Rheumatology, Daejeon Rheumatoid & Degenerative Arthritis Center, Chungnam National University Hospital, Daejeon, South Korea
| | - Tae-Hwan Kim
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
| | - Sung-Jong Hong
- Department of Medical Environmental Biology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Hyundeok Kang
- Department of Biomedical Systems Informatics, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Tae-Jong Kim
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Eun Jeong Won
- Department of Parasitology and Tropical Medicine, Chonnam National University Medical School, Gwangju, South Korea
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Goupille P, Harid N, Flipo RM. Axial Spondyloarthritis Disease Activity Cutoffs at Golimumab Initiation in the French GO-PRACTICE Study: Parallels With the German GO-NICE Study. J Rheumatol 2020; 47:1844-1846. [PMID: 33060324 DOI: 10.3899/jrheum.200172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Philippe Goupille
- University of Tours, EA GICC 7501, and Department of Rheumatology, University Hospital of Tours, Tours
| | | | - René-Marc Flipo
- Department of Rheumatology, Roger Salengro University Hospital, Lille, France
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Abstract
Drug treatment in patients with axial spondylarthritis (axSpA) aims to modify symptoms and complaints and currently includes the substance groups of nonsteroidal anti-inflammatory drugs (NSAID) and biologicals (disease-modifying antirheumatic drugs, bDMARDS). Treatment with NSAIDs is the first line treatment according to international and national recommendations. Patients with persisting high disease activity despite continuous standard treatment with NSAIDs, should be treated with biologicals. In Germany treatment with tumor necosis factor (TNF) inhibitors or interleukin 17 inhibitor (secukinumab) are currently approved for treating patients with ankylosing spondylitis (AS). Treatment of patients with non-radiographic axSpA (nr-axSpA) is restricted to TNF inhibitors (except infliximab) in Germany. The efficacy and safety are documented for both substance groups; however, due to the longer time since approval longitudinal data for TNF inhibitors are more robust and the data contain information about switching within a substance group. Although overall retention rates of TNF inhibitors are similar despite the difference in formation of antidrug antibodies, data from cohorts provide information about long-term loss of efficacy, switching and also discontinuation strategies. In the meantime, various biosimilars have been approved for infliximab, etanercept and adalimumab. Conventional basic treatment (csDMARDs) and in particular intra-articular administration of glucocorticoids can only be prescribed for axSpA patients with peripheral arthritis.
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Affiliation(s)
- U Kiltz
- Rheumazentrum Ruhrgebiet, Claudiusstr. 45, 44649, Herne, Deutschland.
| | - J Braun
- Rheumazentrum Ruhrgebiet, Claudiusstr. 45, 44649, Herne, Deutschland.,Ruhr-Universität Bochum, Bochum, Deutschland
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