title: Tumor Necrosis Factor-α Inhibition in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Treatment Response, Drug Survival, and Patient Outcome.
abstract: OBJECTIVE
  The purpose of this study was to (1) evaluate baseline characteristics of nonradiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) treated with tumor necrosis factor-α inhibitors (TNFi), (2) assess the response to first TNFi treatment, and (3) compare drug-survival duration and rates.
  
  
  METHODS
  Inclusion criteria were patients with axSpA who initiated first TNFi treatment between April 2001 and July 2014 and were followed up for at least 3 months. Efficacy criteria were an improvement of at least 2 points (on a 0-10 scale) or a 50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Baseline characteristics, responses at 12 months, and drug survival were compared between AS and nr-axSpA.
  
  
  RESULTS
  A total of 361 patients were included in the study (AS, n = 263 and nr-axSpA, n = 98). Patients with AS were more often men (65.02% vs 45.92%, p = 0.001) and had longer symptom duration (11.71 ± 9.52 vs 7.34 ± 9.30 yrs, p < 0.001). Median levels of acute-phase reactants (C-reactive protein and erythrocyte sedimentation rate) were significantly higher in patients with AS (p < 0.001 for both). Median BASDAI scores at first TNFi initiation were not higher in patients with nr-axSpA than in patients with AS (59, 49-70 vs 60, 50-70, p = 0.73). BASDAI 20 and BASDAI 50 response rates at 12 months were not statistically different between patients with AS and patients with nr-axSpA (74.58% vs 64.58%, p = 0.19 and 61.02% vs 50.00%, p = 0.19, respectively). No statistically significant difference in terms of survival was observed between patients with AS and nr-axSpA (p = 1.00).
  
  
  CONCLUSIONS
  Treatment response and drug survival were similar in patients with AS and nr-axSpA after first TNFi initiation.
authors.affiliation: From the Department of Rheumatology, and Department of Biostatistics, Lille University Hospital, Lille, France.J. Corli, Resident, Department of Rheumatology, Lille University Hospital; R. Flipo, MD, PhD, Department of Rheumatology, Lille University Hospital; P. Philippe, MD, Department of Rheumatology, Lille University Hospital; A. Bera-Louville, MD, Department of Rheumatology, Lille University Hospital; H. Béhal, MSc, Department of Biostatistics, Lille University Hospital; C. Wibaux, MD, Department of Rheumatology, Lille University Hospital; J. Paccou, MD, PhD, Department of Rheumatology, Lille University Hospital.
authors.forename: Justine
authors.initials: J
authors.lastname: Corli
authors.affiliation: From the Department of Rheumatology, and Department of Biostatistics, Lille University Hospital, Lille, France.J. Corli, Resident, Department of Rheumatology, Lille University Hospital; R. Flipo, MD, PhD, Department of Rheumatology, Lille University Hospital; P. Philippe, MD, Department of Rheumatology, Lille University Hospital; A. Bera-Louville, MD, Department of Rheumatology, Lille University Hospital; H. Béhal, MSc, Department of Biostatistics, Lille University Hospital; C. Wibaux, MD, Department of Rheumatology, Lille University Hospital; J. Paccou, MD, PhD, Department of Rheumatology, Lille University Hospital.
authors.forename: René-Marc
authors.initials: RM
authors.lastname: Flipo
authors.affiliation: From the Department of Rheumatology, and Department of Biostatistics, Lille University Hospital, Lille, France.J. Corli, Resident, Department of Rheumatology, Lille University Hospital; R. Flipo, MD, PhD, Department of Rheumatology, Lille University Hospital; P. Philippe, MD, Department of Rheumatology, Lille University Hospital; A. Bera-Louville, MD, Department of Rheumatology, Lille University Hospital; H. Béhal, MSc, Department of Biostatistics, Lille University Hospital; C. Wibaux, MD, Department of Rheumatology, Lille University Hospital; J. Paccou, MD, PhD, Department of Rheumatology, Lille University Hospital.
authors.forename: Peggy
authors.initials: P
authors.lastname: Philippe
authors.affiliation: From the Department of Rheumatology, and Department of Biostatistics, Lille University Hospital, Lille, France.J. Corli, Resident, Department of Rheumatology, Lille University Hospital; R. Flipo, MD, PhD, Department of Rheumatology, Lille University Hospital; P. Philippe, MD, Department of Rheumatology, Lille University Hospital; A. Bera-Louville, MD, Department of Rheumatology, Lille University Hospital; H. Béhal, MSc, Department of Biostatistics, Lille University Hospital; C. Wibaux, MD, Department of Rheumatology, Lille University Hospital; J. Paccou, MD, PhD, Department of Rheumatology, Lille University Hospital.
authors.forename: Anne
authors.initials: A
authors.lastname: Bera-Louville
authors.affiliation: From the Department of Rheumatology, and Department of Biostatistics, Lille University Hospital, Lille, France.J. Corli, Resident, Department of Rheumatology, Lille University Hospital; R. Flipo, MD, PhD, Department of Rheumatology, Lille University Hospital; P. Philippe, MD, Department of Rheumatology, Lille University Hospital; A. Bera-Louville, MD, Department of Rheumatology, Lille University Hospital; H. Béhal, MSc, Department of Biostatistics, Lille University Hospital; C. Wibaux, MD, Department of Rheumatology, Lille University Hospital; J. Paccou, MD, PhD, Department of Rheumatology, Lille University Hospital.
authors.forename: Hélène
authors.initials: H
authors.lastname: Béhal
authors.affiliation: From the Department of Rheumatology, and Department of Biostatistics, Lille University Hospital, Lille, France.J. Corli, Resident, Department of Rheumatology, Lille University Hospital; R. Flipo, MD, PhD, Department of Rheumatology, Lille University Hospital; P. Philippe, MD, Department of Rheumatology, Lille University Hospital; A. Bera-Louville, MD, Department of Rheumatology, Lille University Hospital; H. Béhal, MSc, Department of Biostatistics, Lille University Hospital; C. Wibaux, MD, Department of Rheumatology, Lille University Hospital; J. Paccou, MD, PhD, Department of Rheumatology, Lille University Hospital.
authors.forename: Cécile
authors.initials: C
authors.lastname: Wibaux
authors.affiliation: From the Department of Rheumatology, and Department of Biostatistics, Lille University Hospital, Lille, France.J. Corli, Resident, Department of Rheumatology, Lille University Hospital; R. Flipo, MD, PhD, Department of Rheumatology, Lille University Hospital; P. Philippe, MD, Department of Rheumatology, Lille University Hospital; A. Bera-Louville, MD, Department of Rheumatology, Lille University Hospital; H. Béhal, MSc, Department of Biostatistics, Lille University Hospital; C. Wibaux, MD, Department of Rheumatology, Lille University Hospital; J. Paccou, MD, PhD, Department of Rheumatology, Lille University Hospital. julienpaccou@yahoo.fr.
authors.forename: Julien
authors.initials: J
authors.lastname: Paccou
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D025241:Spondylarthritis / Q000175:diagnosis* / Q000188:drug therapy*; D013167:Spondylitis, Ankylosing / Q000175:diagnosis* / Q000188:drug therapy*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000008:administration & dosage / Q000037:antagonists & inhibitors* / Q000493:pharmacokinetics
chemical_list: D014409:Tumor Necrosis Factor-alpha
keywords: ANKYLOSING SPONDYLITIS; DRUG SURVIVAL; NONRADIOGRAPHIC AXIAL SPONDYLOARTHRITIS; TNF-α INHIBITION; TREATMENT RESPONSE