NDLI: Effects of tumor necrosis factor- inhibitors on new bone formation in ankylosing spondylitis.

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Effects of tumor necrosis factor- inhibitors on new bone formation in ankylosing spondylitis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Zhang, Jing-Ru Liu, Xiao-Juan Xu, Wei-Dong Dai, Sheng-Ming
Description	Country affiliation: China Author Affiliation: Zhang JR ( Department of Rheumatology and Immunology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai 200433, China.); Liu XJ ( Department of Rheumatology and Immunology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai 200433, China.); Xu WD ( Department of Joint Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.); Dai SM ( Department of Rheumatology and Immunology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai 200433, China. Electronic address: dsm@medmail.com.cn.)
Abstract	OBJECTIVES: To better understand the effect of TNF- inhibitors (TNFi) on new bone formation in ankylosing spondylitis (AS) patients. METHODS: We systematically searched the articles in EMBASE and PubMed. RESULTS: Fifteen articles were enrolled. In all the 9 TNFi-treated cohorts, the vertebral corners with inflammatory lesions at baseline were at higher risk to develop new syndesmophytes than those without inflammatory lesions, although a few syndesmophytes also developed at the vertebral corners without inflammatory lesions at baseline. The advanced inflammatory lesions including fat deposition on baseline MRI showed a higher risk for syndesmophyte formation than the acute inflammatory lesions. Because the number of analyzed vertebral corners were too small, it might not be true that new syndesmophytes developed more frequently at the corners with inflammatory lesions completely resolved than those with persistent inflammation after TNFi treatment. Four studies with 2-year follow-up revealed null effect of TNFi on radiographic progression compared with historical controls with lower disease activity, and 3 studies with ≥4-year follow-up proved inhibitory effect of TNFi on new bone formation in AS patients. Patients with a delay of >10 years in starting TNFi therapy were more likely to experience radiographic progression as compared to those who started earlier. CONCLUSIONS: In TNFi treated AS patients, baseline inflammation is linked with syndesmophyte development. An earlier initiation of TNFi therapy may slow the radiographic progression in AS, and TNFi may lose its benefit of retarding new bone formation at advanced stage of AS especially after the focal fat infiltration or syndesmophyte formation.
File Format	HTM / HTML
ISSN	1297319X
Issue Number	3
Journal	Joint Bone Spine
Volume Number	83
e-ISSN	17787254
Language	English
Publisher	Elsevier
Publisher Date	2016-05-01
Publisher Place	France
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Rheumatology
Content Type	Text
Resource Type	Article
Subject	Rheumatology

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