AS progression slowed by infliximab

The progression of ankylosing spondylitis (AS) may be slowed by anti-tumor necrosis factor (TNF) alpha therapy, according to a recent report.Introducing their findings Dr Juergen Braun and colleagues comment that whilst anti-TNF alpha therapy is effective in treating AS and results in improved of spinal inflammation, "it is unclear whether anti-TNF treatment affects chronic spinal changes in AS".Therefore, to analyse the effect of infliximab on the radiographic course of AS over two years the authors evaluated complete sets of lateral radiographs of the cervical spine and lumbar spine in 82 patients. Forty-one of these subjects had been treated with infliximab (5 mg/kg/6 weeks) as part of a recent randomised controlled trial, compared with those managed with conventional therapy (n=41). Overall, patients in the infliximab group were older, had a longer disease duration, and more radiographic damage at baseline.The investigators report that patients treated with infliximab showed less radiographic change over two years, as assessed by the modified Stokes AS Spinal Score. Also, patients with baseline radiographic damage who were treated with infliximab showed a trend for less radiographic progression. No correlations between clinical parameters and radiographic progression were found.Dr Braun's team comments that whilst patients with prevalent radiographic damage are prone to develop more damage over time, infliximab may reduce the rate of this progression. In concluding the authors call for further studies to confirm that anti-TNF treatment inhibits structural damage. Reference...