Does Late Axial Spondyloarthropathy Diagnosis Cause Extra Anti-TNF Therapy?

Abstract

Introduction: Ankylosing Spondylitis (AS) is a chronic inflammatory rheumatic disease that mainly characterized by sacroiliac joint and spine involvement. Although there is no clear evidence that any of these agent prevent the radiologic progression, anti-TNF drugs provide significant improvements in the disease activity score, functional index and quality of life. In AS patients, knowledge of the factors that determine the need for anti-TNF treatment will be associated with fewer complication sand better treatment. The purpose of this study is to investigate the possible factors which willmark the transition to the anti-TNF therapy in AS patients. Materials and Methods: This study was conducted in the Rheumatology division of the Internal medicine department of the Ondokuz Mayis University of Medicine hospital between January 2012- June 2015. The study protocol was approved by the Ethics Committee of Ondokuz Mayis University. A total of 165 patients, who were diagnosed as AS according to the ASAS classification criteria, were enrolled in this study. There were 85 women (51.5%) and 80 men (48.5%), aged between 15-69. Patients were divided into two groups according to their use of anti-TNF drug. Results: A total of 165 Ax-SpA patients (85 women and 80 men) were included in the study. The mean age was 37.82±11.24 years. The mean duration of the disease was 4.59±5.35 years. male gender, uveitis, delay in diagnosis, elevations in sedimentation CRP levels, increase in disease activity and functional indexes such as BASDAI and BASFI scores shows the more frequent need for anti-TNF drug use. Conclusion: In our study, patients who needed anti-TNF treatment had a longer time between symptom onset and diagnosis than patients who did not hear. The delay in diagnosing these patients leads to a delay in treatment so that the focus of inflammation increases and these patients need more anti-TNF as this window of opportunity escapes.