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Remission in nonradiographic axial spondyloarthritis treated with anti-tumor necrosis factor-α drugs: an Italian multicenter study.
J Rheumatol. 2015 Feb; 42(2):258-63.JR

Abstract

OBJECTIVE

To investigate the possibility of achieving partial remission (PR) in patients with nonradiographic axial spondyloarthritis (nr-axSpA) versus ankylosing spondylitis (AS) treated with anti-tumor necrosis factor (TNF)-α antagonists, such as adalimumab (ADA), etanercept (ETN), and infliximab (IFX), in a real clinical practice setting. The Assessment of SpondyloArthritis international Society (ASAS) 20, ASAS40, and Ankylosing Spondylitis Disease Activity Score were also calculated.

METHODS

A retrospective study was conducted in patients with axSpA treated with ADA, ETN, and IFX from 2000 to 2013. All patients fulfilled the ASAS or the modified New York criteria. PR was reached when the score was < 20 mm (on a visual analog scale of 0-100 mm) in each of these domains: (1) patient global assessment, (2) pain, (3) function, and (4) inflammation.

RESULTS

A total of 321 patients with axSpA were treated. Among them, 62 were nr-axSpA while the remaining 259 were AS. Log-rank test to compare survival curves showed that the probability of obtaining PR in nr-axSpA and AS during treatment with anti-TNF-α was not significantly different. At 12 weeks of exposure to the first anti-TNF-α drug, PR was achieved in 7 patients with nr-axSpA (11.3%) and in 68 patients with AS (26.2%).

CONCLUSION

Our results, obtained from clinical practice, showed that PR is an achievable target of anti-TNF-α treatment in nr-axSpA. The PR rate, as a reliable indicator of sustained effectiveness, is similar in nr-axSpA and in AS.

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    Lubrano E
    Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise, Campobasso; Dipartimento di Medicina Interna e Specialità Mediche, L'Unità Operativa Complessa (UOC) di Reumatologia "Sapienza" Università di Roma, Rome; Rheumatology Unit, Orthopedic Institute G. Pini, Milan; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza; Rheumatology Unit, Department of Medicine, Dipartimento di Medicina (DIMED), University of Padua, Padua; S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise; F.M. Perrotta, MD, Dipartimento di Medicina Interna e Specialità Mediche, UOC di Reumatologia "Sapienza" Università di Roma; A. Marchesoni, MD, Rheumatology Unit, Orthopedic Institute G. Pini; S. D'Angelo, MD; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; R. Ramonda, MD; L. Punzi, MD, Rheumatology Unit, DIMED, University of Padua; O. Addimanda, MD; C. Salvarani, MD, S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia. enniolubrano@hotmail.com.
    Perrotta FM
    Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise, Campobasso; Dipartimento di Medicina Interna e Specialità Mediche, L'Unità Operativa Complessa (UOC) di Reumatologia "Sapienza" Università di Roma, Rome; Rheumatology Unit, Orthopedic Institute G. Pini, Milan; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza; Rheumatology Unit, Department of Medicine, Dipartimento di Medicina (DIMED), University of Padua, Padua; S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise; F.M. Perrotta, MD, Dipartimento di Medicina Interna e Specialità Mediche, UOC di Reumatologia "Sapienza" Università di Roma; A. Marchesoni, MD, Rheumatology Unit, Orthopedic Institute G. Pini; S. D'Angelo, MD; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; R. Ramonda, MD; L. Punzi, MD, Rheumatology Unit, DIMED, University of Padua; O. Addimanda, MD; C. Salvarani, MD, S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia.
    Marchesoni A
    Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise, Campobasso; Dipartimento di Medicina Interna e Specialità Mediche, L'Unità Operativa Complessa (UOC) di Reumatologia "Sapienza" Università di Roma, Rome; Rheumatology Unit, Orthopedic Institute G. Pini, Milan; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza; Rheumatology Unit, Department of Medicine, Dipartimento di Medicina (DIMED), University of Padua, Padua; S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise; F.M. Perrotta, MD, Dipartimento di Medicina Interna e Specialità Mediche, UOC di Reumatologia "Sapienza" Università di Roma; A. Marchesoni, MD, Rheumatology Unit, Orthopedic Institute G. Pini; S. D'Angelo, MD; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; R. Ramonda, MD; L. Punzi, MD, Rheumatology Unit, DIMED, University of Padua; O. Addimanda, MD; C. Salvarani, MD, S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia.
    D'Angelo S
    Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise, Campobasso; Dipartimento di Medicina Interna e Specialità Mediche, L'Unità Operativa Complessa (UOC) di Reumatologia "Sapienza" Università di Roma, Rome; Rheumatology Unit, Orthopedic Institute G. Pini, Milan; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza; Rheumatology Unit, Department of Medicine, Dipartimento di Medicina (DIMED), University of Padua, Padua; S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise; F.M. Perrotta, MD, Dipartimento di Medicina Interna e Specialità Mediche, UOC di Reumatologia "Sapienza" Università di Roma; A. Marchesoni, MD, Rheumatology Unit, Orthopedic Institute G. Pini; S. D'Angelo, MD; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; R. Ramonda, MD; L. Punzi, MD, Rheumatology Unit, DIMED, University of Padua; O. Addimanda, MD; C. Salvarani, MD, S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia.
    Ramonda R
    Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise, Campobasso; Dipartimento di Medicina Interna e Specialità Mediche, L'Unità Operativa Complessa (UOC) di Reumatologia "Sapienza" Università di Roma, Rome; Rheumatology Unit, Orthopedic Institute G. Pini, Milan; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza; Rheumatology Unit, Department of Medicine, Dipartimento di Medicina (DIMED), University of Padua, Padua; S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise; F.M. Perrotta, MD, Dipartimento di Medicina Interna e Specialità Mediche, UOC di Reumatologia "Sapienza" Università di Roma; A. Marchesoni, MD, Rheumatology Unit, Orthopedic Institute G. Pini; S. D'Angelo, MD; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; R. Ramonda, MD; L. Punzi, MD, Rheumatology Unit, DIMED, University of Padua; O. Addimanda, MD; C. Salvarani, MD, S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia.
    Addimanda O
    Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise, Campobasso; Dipartimento di Medicina Interna e Specialità Mediche, L'Unità Operativa Complessa (UOC) di Reumatologia "Sapienza" Università di Roma, Rome; Rheumatology Unit, Orthopedic Institute G. Pini, Milan; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza; Rheumatology Unit, Department of Medicine, Dipartimento di Medicina (DIMED), University of Padua, Padua; S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise; F.M. Perrotta, MD, Dipartimento di Medicina Interna e Specialità Mediche, UOC di Reumatologia "Sapienza" Università di Roma; A. Marchesoni, MD, Rheumatology Unit, Orthopedic Institute G. Pini; S. D'Angelo, MD; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; R. Ramonda, MD; L. Punzi, MD, Rheumatology Unit, DIMED, University of Padua; O. Addimanda, MD; C. Salvarani, MD, S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia.
    Olivieri I
    Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise, Campobasso; Dipartimento di Medicina Interna e Specialità Mediche, L'Unità Operativa Complessa (UOC) di Reumatologia "Sapienza" Università di Roma, Rome; Rheumatology Unit, Orthopedic Institute G. Pini, Milan; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza; Rheumatology Unit, Department of Medicine, Dipartimento di Medicina (DIMED), University of Padua, Padua; S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise; F.M. Perrotta, MD, Dipartimento di Medicina Interna e Specialità Mediche, UOC di Reumatologia "Sapienza" Università di Roma; A. Marchesoni, MD, Rheumatology Unit, Orthopedic Institute G. Pini; S. D'Angelo, MD; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; R. Ramonda, MD; L. Punzi, MD, Rheumatology Unit, DIMED, University of Padua; O. Addimanda, MD; C. Salvarani, MD, S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia.
    Punzi L
    Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise, Campobasso; Dipartimento di Medicina Interna e Specialità Mediche, L'Unità Operativa Complessa (UOC) di Reumatologia "Sapienza" Università di Roma, Rome; Rheumatology Unit, Orthopedic Institute G. Pini, Milan; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza; Rheumatology Unit, Department of Medicine, Dipartimento di Medicina (DIMED), University of Padua, Padua; S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise; F.M. Perrotta, MD, Dipartimento di Medicina Interna e Specialità Mediche, UOC di Reumatologia "Sapienza" Università di Roma; A. Marchesoni, MD, Rheumatology Unit, Orthopedic Institute G. Pini; S. D'Angelo, MD; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; R. Ramonda, MD; L. Punzi, MD, Rheumatology Unit, DIMED, University of Padua; O. Addimanda, MD; C. Salvarani, MD, S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia.
    Salvarani C
    Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise, Campobasso; Dipartimento di Medicina Interna e Specialità Mediche, L'Unità Operativa Complessa (UOC) di Reumatologia "Sapienza" Università di Roma, Rome; Rheumatology Unit, Orthopedic Institute G. Pini, Milan; Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza; Rheumatology Unit, Department of Medicine, Dipartimento di Medicina (DIMED), University of Padua, Padua; S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia, Reggio Emilia, Italy.E. Lubrano, MD, PhD, Academic Rheumatology Unit, Department of Medicine and Health Science, University of Molise; F.M. Perrotta, MD, Dipartimento di Medicina Interna e Specialità Mediche, UOC di Reumatologia "Sapienza" Università di Roma; A. Marchesoni, MD, Rheumatology Unit, Orthopedic Institute G. Pini; S. D'Angelo, MD; I. Olivieri, MD, Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera; R. Ramonda, MD; L. Punzi, MD, Rheumatology Unit, DIMED, University of Padua; O. Addimanda, MD; C. Salvarani, MD, S.C. Reumatologia, Dipartimento Medicina Interna e Specialità Mediche Arcispedale Santa Maria Nuova, Azienda Ospedaliera-IRCCS di Reggio Emilia.

    MeSH

    AdalimumabAdultAnti-Inflammatory AgentsAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedEtanerceptFemaleHumansImmunoglobulin GInfliximabItalyMaleMiddle AgedReceptors, Tumor Necrosis FactorRemission InductionRetrospective StudiesSpondylarthritisTreatment OutcomeTumor Necrosis Factor-alpha

    Pub Type(s)

    Journal Article
    Multicenter Study

    Language

    eng

    PubMed ID

    25512483

    Citation

    Lubrano, Ennio, et al. "Remission in Nonradiographic Axial Spondyloarthritis Treated With Anti-tumor Necrosis Factor-α Drugs: an Italian Multicenter Study." The Journal of Rheumatology, vol. 42, no. 2, 2015, pp. 258-63.
    Lubrano E, Perrotta FM, Marchesoni A, et al. Remission in nonradiographic axial spondyloarthritis treated with anti-tumor necrosis factor-α drugs: an Italian multicenter study. J Rheumatol. 2015;42(2):258-63.
    Lubrano, E., Perrotta, F. M., Marchesoni, A., D'Angelo, S., Ramonda, R., Addimanda, O., Olivieri, I., Punzi, L., & Salvarani, C. (2015). Remission in nonradiographic axial spondyloarthritis treated with anti-tumor necrosis factor-α drugs: an Italian multicenter study. The Journal of Rheumatology, 42(2), 258-63. https://doi.org/10.3899/jrheum.140811
    Lubrano E, et al. Remission in Nonradiographic Axial Spondyloarthritis Treated With Anti-tumor Necrosis Factor-α Drugs: an Italian Multicenter Study. J Rheumatol. 2015;42(2):258-63. PubMed PMID: 25512483.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Remission in nonradiographic axial spondyloarthritis treated with anti-tumor necrosis factor-α drugs: an Italian multicenter study. AU - Lubrano,Ennio, AU - Perrotta,Fabio Massimo, AU - Marchesoni,Antonio, AU - D'Angelo,Salvatore, AU - Ramonda,Roberta, AU - Addimanda,Olga, AU - Olivieri,Ignazio, AU - Punzi,Leonardo, AU - Salvarani,Carlo, Y1 - 2014/12/15/ PY - 2014/12/17/entrez PY - 2014/12/17/pubmed PY - 2015/10/8/medline KW - ANKYLOSING SPONDYLITIS KW - ANTI-TNF-α DRUGS KW - NONRADIOGRAPHIC AXIAL SPONDYLOARTHRITIS KW - REMISSION SP - 258 EP - 63 JF - The Journal of rheumatology JO - J. Rheumatol. VL - 42 IS - 2 N2 - OBJECTIVE: To investigate the possibility of achieving partial remission (PR) in patients with nonradiographic axial spondyloarthritis (nr-axSpA) versus ankylosing spondylitis (AS) treated with anti-tumor necrosis factor (TNF)-α antagonists, such as adalimumab (ADA), etanercept (ETN), and infliximab (IFX), in a real clinical practice setting. The Assessment of SpondyloArthritis international Society (ASAS) 20, ASAS40, and Ankylosing Spondylitis Disease Activity Score were also calculated. METHODS: A retrospective study was conducted in patients with axSpA treated with ADA, ETN, and IFX from 2000 to 2013. All patients fulfilled the ASAS or the modified New York criteria. PR was reached when the score was < 20 mm (on a visual analog scale of 0-100 mm) in each of these domains: (1) patient global assessment, (2) pain, (3) function, and (4) inflammation. RESULTS: A total of 321 patients with axSpA were treated. Among them, 62 were nr-axSpA while the remaining 259 were AS. Log-rank test to compare survival curves showed that the probability of obtaining PR in nr-axSpA and AS during treatment with anti-TNF-α was not significantly different. At 12 weeks of exposure to the first anti-TNF-α drug, PR was achieved in 7 patients with nr-axSpA (11.3%) and in 68 patients with AS (26.2%). CONCLUSION: Our results, obtained from clinical practice, showed that PR is an achievable target of anti-TNF-α treatment in nr-axSpA. The PR rate, as a reliable indicator of sustained effectiveness, is similar in nr-axSpA and in AS. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/25512483/Remission_in_nonradiographic_axial_spondyloarthritis_treated_with_anti_tumor_necrosis_factor_α_drugs:_an_Italian_multicenter_study_ L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&amp;pmid=25512483 DB - PRIME DP - Unbound Medicine ER -
    Grapherence [↓7]

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