title: 'It's magic stuff': the experiences of patients with ankylosing spondylitis taking anti-TNF-alpha medication.
abstract: BACKGROUND
  Several studies have identified the efficacy of anti-tumour necrosis factor-alpha (anti-TNF-alpha) treatment in ankylosing spondylitis (AS). However, few studies have explored the perceptions of patients taking this new medication. The aim of this study was to explore the impact of anti-TNF-alpha on the quality of life of people with AS.
  
  
  METHODS
  A qualitative approach was adopted to provide a holistic understanding of participants' views and experiences in the context of their overall lives. Semi-structured interviews were undertaken and transcribed verbatim. Data were analysed using thematic analysis. Ethical approval and informed consent were obtained.
  
  
  RESULTS
  Eight people participated and described a significant improvement in their physical and psychological status, leading to a more positive outlook on their life. Specific areas highlighted were employment, activities of daily living, hobbies and relationships with partners and family, some of which are not captured by current AS-specific outcome measures. Negative aspects of anti-TNF-alpha use were described as the inconvenience of monitoring and issues relating to travelling abroad. All participants expressed concern about the possibility of being withdrawn from treatment and the perceived impact this would have on their lives.
  
  
  CONCLUSIONS
  Anti-TNF-alpha treatment has a positive impact on the lives of people with AS, such that a major concern is being withdrawn from treatment, highlighting the need to provide tailored support to people being withdrawn from treatment. To capture the full impact of anti-TNF-alpha treatment, further consideration needs to be given to the choice of appropriate outcome measures.
authors.affiliation: North Lancashire Teaching Primary Care Trust, Blackpool, UK.
authors.forename: J
authors.initials: J
authors.lastname: Stockdale
authors.forename: L
authors.initials: L
authors.lastname: Goodacre
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D012074:Remission Induction; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha