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Associations between inflammation, nocturnal back pain and fatigue in ankylosing spondylitis and improvements with etanercept therapy.
- Source :
-
The Journal of international medical research [J Int Med Res] 2013 Aug; Vol. 41 (4), pp. 1150-9. Date of Electronic Publication: 2013 Jun 26. - Publication Year :
- 2013
-
Abstract
- Objectives: To investigate the relationships between inflammation, nocturnal back pain and fatigue in ankylosing spondylitis (AS) and the impact of 12 weeks' etanercept treatment versus sulfasalazine or placebo.<br />Methods: Data were combined from four clinical trials for patients with AS who received at least one dose of etanercept, sulfasalazine or placebo and had at least one postbaseline assessment value. Linear regression was performed (controlling for site, protocol and demographics), to explore the relationship between inflammation (C-reactive protein [CRP]), nocturnal back pain (visual analog scale [VAS] 0-100 mm) and fatigue (VAS 0-100 mm Bath AS Disease Activity Index fatigue item).<br />Results: Out of 1283 patients (etanercept, n = 867; sulfasalazine, n = 187; placebo, n = 229), improvement in nocturnal back pain was a significant predictor of improvement in fatigue. Significant correlations were found between nocturnal back pain and fatigue, but not CRP levels. Etanercept provided significantly greater pain/fatigue improvement than sulfasalazine or placebo. Improvements in nocturnal back pain and fatigue had weak relationships with improvement in inflammation (CRP level).<br />Conclusions: AS patients treated with etanercept demonstrated superior improvement in nocturnal back pain and fatigue versus sulfasalazine or placebo. Decrease in nocturnal back pain can improve fatigue. Assessing treatment response using CRP levels alone may be misleading without also examining patient-reported outcomes such as back pain and fatigue.
- Subjects :
- Adult
Back Pain blood
Back Pain complications
Back Pain physiopathology
C-Reactive Protein metabolism
Etanercept
Fatigue blood
Fatigue complications
Fatigue physiopathology
Female
Humans
Inflammation blood
Inflammation complications
Inflammation drug therapy
Inflammation physiopathology
Male
Pain Measurement
Periodicity
Severity of Illness Index
Spondylitis, Ankylosing blood
Spondylitis, Ankylosing complications
Spondylitis, Ankylosing physiopathology
Sulfasalazine therapeutic use
Treatment Outcome
Anti-Inflammatory Agents, Non-Steroidal therapeutic use
Back Pain drug therapy
Fatigue drug therapy
Immunoglobulin G therapeutic use
Receptors, Tumor Necrosis Factor therapeutic use
Spondylitis, Ankylosing drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1473-2300
- Volume :
- 41
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Journal of international medical research
- Publication Type :
- Academic Journal
- Accession number :
- 23803306
- Full Text :
- https://doi.org/10.1177/0300060513488501