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Effects of tumor necrosis factor-α inhibitors on new bone formation in ankylosing spondylitis
- Source :
- Joint Bone Spine. 83:257-264
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- Objectives To better understand the effect of TNF-α 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.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Pathology
Radiography
Inflammation
Gastroenterology
Persistent inflammation
03 medical and health sciences
0302 clinical medicine
Rheumatology
Osteogenesis
Internal medicine
medicine
Humans
Spondylitis, Ankylosing
Bone formation
Tumor necrosis factor α
Inhibitory effect
030203 arthritis & rheumatology
Syndesmophyte
Ankylosing spondylitis
Tumor Necrosis Factor-alpha
business.industry
medicine.disease
030104 developmental biology
Antirheumatic Agents
medicine.symptom
business
Subjects
Details
- ISSN :
- 1297319X
- Volume :
- 83
- Database :
- OpenAIRE
- Journal :
- Joint Bone Spine
- Accession number :
- edsair.doi.dedup.....424808d604b6905ca28dfa777e928a30