High intraindividual week-to-week variability in BASDAI and BASFI values: Are several evaluations needed before starting or stopping TNFα antagonist therapy for spondyloarthropathies?

Berthelot, Jean‐Marie; Tortellier, L.; Lavy-Bregeon, Delphine; Goff, Benoît Le; Maugars, Yves

doi:10.1016/j.jbspin.2007.05.018

Cited by 32 publications

(9 citation statements)

References 11 publications

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“…Despite the fact that the BASDAI is a validated instrument used in many clinical trials as an outcome parameter for disease activity, it remains a subjective parameter that is based on a patient questionnaire. A previous study showed that the BASDAI has a high intraindividual week‐to‐week variability (2). Theoretically, a high BASDAI can be caused by 3 factors, including a high level of 1) ankylosis or joint destruction, 2) psychological stress, or 3) inflammation.…”

Section: Introductionmentioning

confidence: 99%

Erythrocyte sedimentation rate, C‐reactive protein level, and serum amyloid A protein for patient selection and monitoring of anti–tumor necrosis factor treatment in ankylosing spondylitis

Vries¹,

Eijk²,

Horst-Bruinsma³

et al. 2009

Arthritis & Rheumatism

111

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Objective. To study the usefulness of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum amyloid A (SAA) for response prediction and monitoring of anti-tumor necrosis factor (anti-TNF) treatment in ankylosing spondylitis (AS) patients. Methods. Patients were included consecutively before starting etanercept or infliximab treatment. ASsessment in Ankylosing Spondylitis (ASAS) response, defined as a 50% improvement or an absolute improvement of 2 points of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; 0 -10 scale), was assessed at 3 months. Inflammatory markers and the BASDAI were collected at baseline and 1 and 3 months. Longitudinal data analysis was performed to compare associations between inflammatory markers and the BASDAI over time by calculating standardized betas. Predictive values of baseline levels of inflammatory markers for ASAS response were calculated. Results. In total, 155 patients were included, of whom, after 3 months of treatment, 70% in the etanercept cohort and 71% in the infliximab cohort responded. All markers, notably SAA, decreased significantly (P < 0.0001). Standardized betas were 0.49 for ESR, 0.43 for CRP, and 0.39 for SAA. Normal baseline levels of CRP and SAA were significantly associated with nonresponse. A combination of elevated CRP and SAA levels at baseline revealed the highest predictive value (81%) for ASAS response. Conclusion. ESR, CRP, and SAA were significantly associated with the BASDAI over 3 months, and the association with ESR was the strongest. Elevated baseline CRP and SAA levels revealed the highest predictive value for response. Together, this study demonstrates that inflammatory markers, and notably CRP and SAA, may facilitate patient selection and monitoring of efficacy of anti-TNF treatment in AS, and could be added to response criteria.

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Section: Introductionmentioning

confidence: 99%

Erythrocyte sedimentation rate, C‐reactive protein level, and serum amyloid A protein for patient selection and monitoring of anti–tumor necrosis factor treatment in ankylosing spondylitis

Vries¹,

Eijk²,

Horst-Bruinsma³

et al. 2009

Arthritis & Rheumatism

111

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“…The high intraindividual week-to-week variability in these tools that has been reported [20] is in contrast to the data for the clinical trials. The proposal to perform several clinical evaluations within a short period of time before starting anti-TNF therapy may not be feasible in daily clinical practice.…”

Section: Outcome Parametersmentioning

confidence: 63%

Biologic Therapies for Spondyloarthritis: What Is New?

Baraliakos

Braun

2012

Curr Rheumatol Rep

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The course of axial spondyloarthritis (axSpA), including ankylosing spondylitis (AS), is strongly influenced by the degree of disease activity over time, which is mainly based on inflammation, and by the impairment of function, which is based on structural damage-mainly, new bone formation-and inflammation. In AS, nonsteroidal anti-inflammatory agents are currently recommended as the first choice of medical therapy, and there is also a clear role for regular exercise and physiotherapy in order to preserve and prevent loss of spinal mobility. For patients who have insufficiently responded to conventional medications, there are now four biologics approved for the treatment of patients with active AS in many countries, all directed against TNFα: infliximab, etanercept, adalimumab, and golimumab; studies with certolizumab are currently ongoing. Several studies with patients classified as nonradiographic axSpA have also shown a good response to TNF blockers; in patients with early disease and high CRP levels, the response rates were even better. Long-term studies with TNF blockers have shown declining retention rates over time but sustained clinical efficacy in the patients who remained on treatment. States of drug-free remission are rarely reached and only for relatively short periods of time. More studies including magnetic resonance imaging (MRI) are needed to further examine the lack of effect of anti-TNF treatment on radiographic progression in the axial skeleton. Whether the effect of an early intervention with biologics will prevent the development of bone growth in patients with nonradiographic axial SpA remains to be seen. Biologics other than TNF blockers are currently not recommended for the treatment of patients with axSpA, because of insufficient evidence of clinically relevant efficacy. The anti-IL-17a antibody secukinumab may be efficacious, on the basis of a proof-of-concept trial. Finally, first data on biosimilars of TNF blockers have recently been presented.

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“…Данные методы нашли широкое применение во многих странах мира [5]. Недостатками этих индексов являются субъективность оценки больным своего состояния, на которую могут оказывать выраженное влияние психоэмоциональный фон, беспокойство и депрессия [7], отсутствие возможности проверить достоверность результатов при помощи каких-либо объективных лабораторно-инструментальных показателей, градация активности только на высокую и низкую. У больных АС с вовлечением в процесс периферических суставов при подсчете индекса BASDAI активность заболевания получается выше, чем у лиц с изолированным аксиальным поражением, из-за дополнительного вклада вопроса о периферических суставах [8].…”

Section: Introductionunclassified

Estimation of disease activity in patients with ankylosing spondylitis in the real practice of a rheumatologist in Russia (Part 2)

Volnukhin¹,

Галушко²,

Бочкова³

et al. 2012

rsp

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High intraindividual week-to-week variability in BASDAI and BASFI values: Are several evaluations needed before starting or stopping TNFα antagonist therapy for spondyloarthropathies?

Cited by 32 publications

References 11 publications

Erythrocyte sedimentation rate, C‐reactive protein level, and serum amyloid A protein for patient selection and monitoring of anti–tumor necrosis factor treatment in ankylosing spondylitis

Erythrocyte sedimentation rate, C‐reactive protein level, and serum amyloid A protein for patient selection and monitoring of anti–tumor necrosis factor treatment in ankylosing spondylitis

Biologic Therapies for Spondyloarthritis: What Is New?

Estimation of disease activity in patients with ankylosing spondylitis in the real practice of a rheumatologist in Russia (Part 2)

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