Adalimumab significantly reduces inflammation and serum DKK‐1 level but increases fatty deposition in lumbar spine in active ankylosing spondylitis

Abstract

Our study found that adalimumab was highly effective in reducing inflammation in active AS patients, but it was accompanied by the formation of FDL in the lumbar spine and decrease in serum DKK-1 levels.

Tumour necrosis factor-α inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis: a systematic review and economic evaluation

“…Using both randomisation method details and a baseline assessment to judge the risk of selection bias, 15 trials were judged as having a low risk of selection bias, five trials were judged as having an unclear risk 51,71,86,96,112 and four as having a high risk; 50,79,83,101 in one of these four trials the risk was deemed likely to be a result of a chance effect. 79 The risk of performance bias arising from lack of blinding of participants and personnel was low in 20 trials, unclear in three trials 55,57,64 and high in the one head-to-head trial, in which blinding would have been difficult to achieve because of the different modes and timings of delivery (weekly injection for etanercept vs. 6-weekly infusion for infliximab). 88 All except one of the trials were at low risk of detection bias, as they were all adequately placebo controlled (except the head-to-head trial), with nearly all the key outcomes being self-reported by patients (a notable exception being BASMI).…”

“…In two of the trials with unclear risk judgements, there were nevertheless reasons to suspect the possibility of important bias (see Appendix 3). 55,71 Of the studies with missing data which also reported details on the populations and imputations used in analyses, 'last observation carried forward' (LOCF) was used; this was done using a modified intention-to-treat (mITT) approach in just over half the trials (in which patients had to have received at least one dose of treatment) and an intention-to-treat (ITT) approach in the remaining trials (see Appendix 3). There was no evidence of reporting bias in any of the trials with all being judged as low risk, except for one trial with an unclear risk of bias.…”

“…There was no evidence of reporting bias in any of the trials with all being judged as low risk, except for one trial with an unclear risk of bias. 55 …”

“…55,71,79,83,101 Further details can be found in Appendix 3. A sensitivity analysis of the nr-AxSpA trials was not performed, as the one trial judged to have a high risk of bias had only 40 patients; 50 any effect arising from the removal of such a small study would have been likely to have been minimal.…”

Alteration of Bone Turnover Markers in Canonical Wingless Pathway in Patients With Ankylosing Spondylitis

“…5,6 In theory, the activation of Wnt pathway would be facilitated by decreased expression of DKK-1, while the serum expression of DKK-1 in AS has been controversial. [7][8][9][10][11][12][13][14][15][16][17][18] To the best of our knowledge, other components of Wnt pathway have not yet been studied.…”