title: Efficacy of antitumor necrosis factor(α) agents on patients with ankylosing spondylitis.
abstract: OBJECTIVE
  This study was designed to investigate the efficacy of antitumor necrosis factor(TNF)(a) agents (etanercept, infliximab, golimumab or adalimumab) in ankylosing spondylitis (AS).
  
  
  METHODS
  A literature search was done using PubMed, Embaseand Cochrane databases. The reference section of all primary studies was inspected for additional references, and only those reporting the results of a randomized-controlled trial comparing etanercept, infliximab or adalimumab with placebo for patients with AS were included in this analysis.
  
  
  RESULTS
  Eleven trials with 1851 patients were included. Compared with placebo, anti-TNF(α) agents was associated with significantly higher rates of Assessment in Ankylosing Spondylitis (ASAS) 20 responders (risk ratio [RR]: 2.45, 95% confidence interval [CI]: 2.13-2.82; P < 0.00001), ASAS 50 responders (RR: 3.77, 95% CI: 2.87-4.95; P < 0.00001), ASAS 70 responders (RR: 3.25, 95% CI: 1.97-5.35; P < 0.00001) and patients with partial remission (RR: 5.39, 95% CI: 3.25-8.93; P < 0.00001). In addition, there were more patients with at least 50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index score in the experimental groups (RR: 3.07, 95% CI: 2.44-3.86; P < 0.00001). Most adverse events in both treatment groups were mild or moderate in severity.
  
  
  CONCLUSIONS
  Anti-TNF(a) agents is an effective and well-tolerated treatment for reducing clinical symptoms of AS.
authors.affiliation: Department of Medical Examination Center (LR, RL), The First Affiliated Hospital, Chongqing Medical University, Chongqing, China; and Department of Forensic Medicine (LR, JL, RT, SZ, LW), College of Basic Medicine, Chongqing Medical University, Chongqing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Ren
authors.forename: Jianbo
authors.initials: J
authors.lastname: Li
authors.forename: Rong
authors.initials: R
authors.lastname: Luo
authors.forename: Renkuan
authors.initials: R
authors.lastname: Tang
authors.forename: Sumin
authors.initials: S
authors.lastname: Zhu
authors.forename: Lihua
authors.initials: L
authors.lastname: Wan
mesh_terms: D000068879:Adalimumab; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D000068800:Etanercept; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000627:therapeutic use*; D000069285:Infliximab; D016032:Randomized Controlled Trials as Topic; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000276:immunology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; C529000:golimumab; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept