Predictive Factors of Clinical Response of Infliximab Therapy in Active Nonradiographic Axial Spondyloarthritis Patients.
OBJECTIVE
To evaluate the efficiency and the predictive factors of clinical response of infliximab in active nonradiographic axial spondyloarthritis patients.


METHODS
Active nonradiographic patients fulfilling ESSG criteria for SpA but not fulfilling modified New York criteria were included. All patients received infliximab treatment for 24 weeks. The primary endpoint was ASAS20 response at weeks 12 and 24. The abilities of baseline parameters and response at week 2 to predict ASAS20 response at weeks 12 and 24 were assessed using ROC curve and logistic regression analysis, respectively.


RESULTS
Of 70 axial SpA patients included, the proportions of patients achieving an ASAS20 response at weeks 2, 6, 12, and 24 were 85.7%, 88.6%, 87.1%, and 84.3%, respectively. Baseline MRI sacroiliitis score (AUC = 0.791; P = 0.005), CRP (AUC = 0.75; P = 0.017), and ASDAS (AUC = 0.778, P = 0.007) significantly predicted ASAS20 response at week 12. However, only ASDAS (AUC = 0.696, P = 0.040) significantly predicted ASAS20 response at week 24. Achievement of ASAS20 response after the first infliximab infusion was a significant predictor of subsequent ASAS20 response at weeks 12 and 24 (wald χ(2) = 6.87, P = 0.009, and wald χ(2) = 5.171, P = 0.023).


CONCLUSIONS
Infliximab shows efficiency in active nonradiographic axial spondyloarthritis patients. ASDAS score and first-dose response could help predicting clinical efficacy of infliximab therapy in these patients.
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Zhiming
Z
Lin
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Zetao
Z
Liao
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Jianlin
J
Huang
Medical Affairs, Xian-Janssen Pharmaceutical Ltd, Beijing, China.
Maixing
M
Ai
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Yunfeng
Y
Pan
Department of Rheumatology, Dongguan People's Hospital, Guangdong, China.
Henglian
H
Wu
Medical Affairs, Xian-Janssen Pharmaceutical Ltd, Beijing, China.
Jun
J
Lu
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Shuangyan
S
Cao
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Li
L
Li
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Qiujing
Q
Wei
Department of Rheumatology, The Affiliated Hospital of Guangdong Medical College, Guangzhou, China.
Deshen
D
Tang
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Yanlin
Y
Wei
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Tianwang
T
Li
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Yuqiong
Y
Wu
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Manlong
M
Xu
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Qiuxia
Q
Li
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Ou
O
Jin
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Buyun
B
Yu
Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Tianhe Road No. 600, Guangzhou 510630, China.
Jieruo
J
Gu
D018501:Antirheumatic Agents / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000008:administration & dosage*; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000175:diagnosis* / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
D018501:Antirheumatic Agents; D000069285:Infliximab