AI Summary & Key Takeaways
AI InsightHowever, HLA-B27 positivity in AS patients is not observed to create any significant difference on the disease activity decrease caused by Anti-TNF treatment.
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Abstract
INTRODUCTION:To evaluate the possible effects of HLA-B27 positivity in male Ankylosing Spondylitis (AS) patients receiving Anti-TNF treatment on the Anti-TNF treatment effectivity. MATERIALS AND METHODS: The data of 30 male AS patients who have been receiving anti-TNF treatment for three years have been retrospectively inspected. Anti-TNF agents used by the patients, demographic data and laboratory activity parameters were recorded. Patients’ levels of pain were evaluated by visual analog scale (VAS) whereas disease activity was evaluated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and functional status was evaluated by Bath Ankylosing Spondylitis Function Index (BASFI). Patients were separated into two groups as HLA-B27 (+) (11 patients) and HLA-B27 (-) (19 patients) and disease activity and function parameters were compared. BASDAI and BASFI were evaluated initially and after 1 year follow up. RESULTS: 11 out of 30 male AS patients who were included in the retrospective analysis were HLA_B27 (+). The average age of the HLA-B27 (+) patients was 38.18±8.18 years whereas the average age of HLA-B27 (-) patients was 40.57±5.89 years. The groups did not have statistically significant difference in terms of their average ages (p>0.05). There was no difference between the groups in terms of the duration of the disease (HLA-B27 (+): 15.9±7.4 years, HLA-B27 (-): 15.89±4.71 years, p>0.05). There were no significant differences observed in the initial average BASDAI (HLA-B27 (+): 6.15±1.41, HLA-B27 (-): 6.72±1.1) and BASFI (HLA-B27 (+): 5.59±1.9, (-): 5.97±1.49) values (p>0.05). No prominent effect of HLA-B27 positivity to first, second and third year anti-TNF activity was observed when the groups were compared according to the disease activity evaluated by BASDAI (p>0.05). On the other hand, functional parameters evaluated by BASFI on HLA-B27 (+) patients on the first year of Anti-TNF treatment were inspected to be more significantly recovered (p=0,016), yet there were no differences between the groups on the second and third years. CONCLUSION: Compared to the HLA-B27 (-) patients, anti-TNF treatment in HLA-B27 (+) patients is seen to cause more prominent improvement in functional parameters. However, HLA-B27 positivity in AS patients is not observed to create any significant difference on the disease activity decrease caused by Anti-TNF treatment.
Özet
AMAÇ: Anti-TNF tedavi alan erkek Ankilozan Spondilit (AS)hastalarında HLA-B27 pozitifliğinin anti-TNF tedavi etkinliğiüzerindeki olası etkilerini araştırmaktır.MATERYAL VE METOD: Bir yıldır anti-TNF tedavi alan 30 erkekAS hastasının verileri retrospektif olarak incelendi. Hastalarınkullandığı anti-TNF tedavi ajanları, demografik veriler ve laboratuvaraktivite parametreleri kaydedildi. Hastaların ağrı düzeyleri VizüelAnalog Skala (VAS), Hastalık aktivitesi Bath ankilozan spondilithastalık aktivite indeksi (BASHAİ), fonksiyonel durum Bathankilozan spondilit fonksiyon indeksi (BASFİ) ile değerlendirildi.Hastalar HLA-B27 (+) (11 hasta) ve HLA-B27 (-) (19 hasta) olmaküzere 2 gruba ayrıldı ve hastalık aktivite ve fonksiyon parametrelerikarşılaştırıldı. BASHAİ ve BASFİ değerlendirmeleri tedavi öncesi ve1. yıl sonunda yapıldı.BULGULAR: Retrospektif analize dahil edilen 30 erkek AShastasının 11’inde HLA-B27 (+)’ti. HLA-B27 (+) hastaların yaşortalamaları 38.18±8.18 yıl, HLA-B27 (-) hastaların yaş ortalamaları40.57±5.89 yıldı. Grupların yaş ortalamaları açısından istatistikselanlamlı fark yoktu (p>0.05). Ortalama hastalık süreleri açısındangruplar arasında fark yoktu (HLA-B27 (+) :15.9±7.4 yıl, HLA-B27(-): 15.89±4.71 yıl, p>0.05). Grupların başlangıç ortalama BASHAI(HLA-B27 (+):6.15±1.41, negatif: 6.72±1.1) ve BASFİ (HLA-B27 (+):5.59±1.9, HLA-B27(-) : 5.97±1.49) değerleri arasında da istatistikselolarak anlamlı farklılık tespit edilmedi (p>0.05). Gruplar BASHAIile bakılan hastalık aktivitesi açısından karşılaştırıldığında HLA-B27pozitifliğinin 1. yıl anti-TNF etkinliğine belirgin etkisi saptanmadı(p>0.05). Bununla beraber HLA-B27 (+) hastalarda anti-TNF tedaviile 1.yılda BASFİ ile değerlendirilen fonksiyonel parametrelerindaha belirgin olarak düzeldiği tespit edildi (p=0.016).SONUÇ: HLA-B27 (+) AS hastalarında anti-TNF tedavi HLA-B27(-) hastalara göre fonksiyonel parametrelerde 1 yılda belirgindüzelme sağladığı gözlendi. Bununla birlikte HLA-B27 pozitifliğininAS’li hastalarda anti-TNF tedavisi ile elde edilen hastalık aktiviteazalması üzerinde belirgin fark yaratmadığı gözlendi.