Treatment of patients with advanced ankylosing spondylitis with etanercept (Enbrel) led to significant improvements in pain, function, and respiratory parameters, a randomized trial found.
At week 12, the mean change on the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was significantly greater in patients receiving etanercept compared with those receiving placebo (−26 versus −14, P=0.008), according to Maxime Dougados, MD, of Paris-Descartes University in France, and colleagues.
Significant differences also were seen on the Bath Functional Activity Index (BASFI), with a mean change from baseline in the etanercept group of −22 compared with −10 (P=0.004) in the placebo group, Dougados and colleagues reported in the May issue of Annals of the Rheumatic Diseases.
Previous studies have shown that tumor necrosis factor (TNF)-inhibiting drugs such as etanercept can be useful in alleviating the signs and symptoms of early inflammatory ankylosing spondylitis.
However, most of those studies did not include patients with severe spinal ankylosis, in whom structural ossification has occurred.
To determine if even patients with severe, advanced spinal involvement could benefit from anti-TNF therapy, the investigators enrolled 82 patients with vertebral fusion and refractory disease as defined by a BASDAI score of 40 or higher.
Advanced disease was defined as the presence of at least two intervertebral adjacent bridges at the cervical or lumbar spine level or three at the thoracic level.
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