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A multicenter report of biologic agents for the treatment of secondary amyloidosis in Turkish rheumatoid arthritis and ankylosing spondylitis patients.
- Source :
-
Rheumatology international [Rheumatol Int] 2016 Jul; Vol. 36 (7), pp. 945-53. Date of Electronic Publication: 2016 May 24. - Publication Year :
- 2016
-
Abstract
- In this multicenter, retrospective study, we evaluated the efficacy and safety of biologic therapies, including anti-TNFs, in secondary (AA) amyloidosis patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA). In addition, the frequency of secondary amyloidosis in RA and AS patients in a single center was estimated. Fifty-one AS (39M, 12F, mean age: 46.7) and 30 RA patients (11M, 19F, mean age: 51.7) with AA amyloidosis from 16 different centers in Turkey were included. Clinical and demographical features of patients were obtained from medical charts. A composite response index (CRI) to biologic therapy-based on creatinine level, proteinuria and disease activity-was used to evaluate the efficacy of treatment. The mean annual incidence of AA amyloidosis in RA and AS patients was 0.23 and 0.42/1000 patients/year, respectively. The point prevalence in RA and AS groups was 4.59 and 7.58/1000, respectively. In RA group with AA amyloidosis, effective response was obtained in 52.2 % of patients according to CRI. RA patients with RF positivity and more initial disease activity tended to have higher response rates to therapy (p values, 0.069 and 0.056). After biologic therapy (median 17 months), two RA patients died and two developed tuberculosis. In AS group, 45.7 % of patients fulfilled the criteria of good response according to CRI. AS patients with higher CRP levels at the time of AA diagnosis and at the beginning of anti-TNF therapy had higher response rates (p values, 0.011 and 0.017). During follow-up after anti-TNF therapy (median 38 months), one patient died and tuberculosis developed in two patients. Biologic therapy seems to be effective in at least half of RA and AS patients with AA amyloidosis. Tuberculosis was the most important safety concern.
- Subjects :
- Adult
Aged
Amyloidosis diagnosis
Amyloidosis epidemiology
Amyloidosis immunology
Arthritis, Rheumatoid diagnosis
Arthritis, Rheumatoid epidemiology
Arthritis, Rheumatoid immunology
Biological Products adverse effects
Disease Progression
Female
Humans
Immunocompromised Host
Immunosuppressive Agents adverse effects
Incidence
Male
Middle Aged
Opportunistic Infections chemically induced
Opportunistic Infections epidemiology
Opportunistic Infections immunology
Prevalence
Remission Induction
Retrospective Studies
Risk Factors
Spondylitis, Ankylosing diagnosis
Spondylitis, Ankylosing epidemiology
Spondylitis, Ankylosing immunology
Time Factors
Treatment Outcome
Tuberculosis chemically induced
Tuberculosis epidemiology
Tuberculosis immunology
Tumor Necrosis Factor-alpha immunology
Turkey epidemiology
Amyloidosis drug therapy
Arthritis, Rheumatoid drug therapy
Biological Products therapeutic use
Immunosuppressive Agents therapeutic use
Spondylitis, Ankylosing drug therapy
Tumor Necrosis Factor-alpha antagonists & inhibitors
Subjects
Details
- Language :
- English
- ISSN :
- 1437-160X
- Volume :
- 36
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Rheumatology international
- Publication Type :
- Academic Journal
- Accession number :
- 27221456
- Full Text :
- https://doi.org/10.1007/s00296-016-3500-9