Treatment of patients with ankylosing spondilitis — real clinical practice

V.I. Mazurova, E.A. Vasilenko, E.A. Trofimov, A.M. Dadalova, R.R. Samigullina, I.Z. Gaydukova

North-western State Medical University named after I.I. Mechnikov, Saint Petersburg

Aim: to determine the efficacy and safety of therapy with golimumab in patients with active radipgraphic axial spondyloarthritis (r-AxSpA).

Patients and Methods: the article presents the results of the Monitoring program on activity, functional state and comorbidity in patients with AxSpA of the North-Western Federal district (LADOGA). The statistical assay included 40 patients with r-AxSpA of high activity and receiving therapy with golimumab at a dosage of 50 mg once a month for 24 weeks. BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and ASDAS (Ankylosing Spondylitis Disease Activity Score) indices were used to determine the disease activity, the overall assessment of the patient’s health on a visual-analogue scale (VAS); the BASFI index (Bath Ankylosing Spondylitis Functional Index) was used to assess the functional state. 

Results: the ASDAS index decreased to 1.63±0.66 units 6 months after the beginning of therapy with golimumab. Low disease activ ity (ASDAS<1.3) was achieved in 12 patients (30%). Average activity (ASDAS 1.3–2.1) preserved in 16 patients. There was a decrease in the disease activity in this group: initially, ASDAS was 2.6±0.63, and after 6 months from the beginning of therapy — 1.78±0.31. High disease activity (ASDAS>2.1) persisted in 10 patients (25%). There was a less effective result in patients in whom golimumab is the second or third GEBD (ASDAS at the beginning of therapy — 2.85±0.87, after 6 months — 1.84±0.34). If golimumab was the first GEBD, then ASDAS at the beginning of therapy was 3.1±1.1, and after 24 weeks — 1.46±0.2.

Conclusion: in case of NSAIDs ineffectiveness or intolerance, which are the first-line agents in therapy for patients with AxSpA, the alternative way is the TNFα inhibitors. Patients who have not experienced the effect of other TNFα inhibitors can be recommended therapy with golimumab.

Keywords: radiographic axial spondyloarthritis, therapy, NSAIDs, TNFα inhibitors, golimumab.

For citation: Mazurova V.I., Vasilenko E.A., Trofimov E.A. et al. Treatment of patients with ankylosing spondilitis — real clinical practice. RMJ. 2019;12:37–40.