Cohort study of ankylosing spondylitis in the central Europe region: disease activity, ways of treatment and possibilities of biological therapy application


Authors: K. Pavelka
Authors‘ workplace: Revmatologický ústav, Praha
Published in: Čes. Revmatol., 16, 2008, No. 2, p. 64-69.
Category: Original Papers

Overview

Ankylosing spondylitis (AS) is an inflammatory disease from the group of spondylarthropathies, which manifests sacroiliitis, spondylitis, enthesitis, sometimes peripheral arthritis and extra-articular symptoms, as well. It has a significant influence on patients‘ morbidity and in practice, it is often recognized too late, its course is insufficiently monitored and no efficient therapy is usually administred. The aim of the study was to obtain demographic and clinical data on the course of AS in clinical practice in the Central and Eastern Europe region. Furthermore, the frequency of patients indicated to anti-TNF therapy was investigated. The study dealt with methodological aspect, as well, to which extent the patient’s subjective statement on the level of his ailment (BASDAI) correlates to the specialist’s opinion on the suitability of anti-TNF therapy indication. The study was based on a questionnaire filled out by an erudite rheumatologist. In addition to demographic indicators, anamnestic data on comorbidities, previous and present therapy, disease activity and the quality of life (BASDAI, BASFI, ASQol) have been monitored. The patients with AS, who had not yet been treated with anti-TNF therapy, were included to the study.

A total of 1650 patients were included in the study, thereof 1506 were evaluated. Patients from 7 countries were concerned (Austria, Czech Republic, Slovakia, Poland, Hungary, Romania, Slovenia). A total of 281 rheumatologists included the patients (3–5 each). 913 patients (61 %) were marked by medicine doctors as candidates for anti-TNF therapy. While comparing candidates and non-candidates, it was found out that candidates for anti-TNF therapy were younger, they had higher BASDAI, BASFI, ASQol, more frequent enthesopathies, involvement of hips and higher erythrocyte sedimentation rate and CRP. Nevertheless, 38 % of these candidates for anti-TNF therapy met the ASAS criteria for anti-TNF therapy and only 16 % of non-candidates did. So it seems that the BASDAI evaluation is very important for anti-TNF therapy indication, indeed, but the specialist’s evaluation is no less important, as well.

Key words:
ankylosing spondylitides, anti-TNF therapy


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Labels
Dermatology & STDs Paediatric rheumatology Rheumatology
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