• Am. J. Med. Sci. · Dec 2013

    Review Meta Analysis

    Efficacy of antitumor necrosis factor(α) agents on patients with ankylosing spondylitis.

    • Lei Ren, Jianbo Li, Rong Luo, Renkuan Tang, Sumin Zhu, and Lihua Wan.
    • 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.
    • Am. J. Med. Sci. 2013 Dec 1;346(6):455-61.

    ObjectivesThis study was designed to investigate the efficacy of antitumor necrosis factor(TNF)(a) agents (etanercept, infliximab, golimumab or adalimumab) in ankylosing spondylitis (AS).MethodsA 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.ResultsEleven 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.ConclusionsAnti-TNF(a) agents is an effective and well-tolerated treatment for reducing clinical symptoms of AS.

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