The Effect of Anti-Tumor Necrosis Factor Therapy on Radiographic Progression in Definite Ankylosing Spondylitis

Jürgen Braun and colleagues looked at radiographic progression in patients with ankylosing spondylitis treated with tumor necrosis factor antagonists. Data from three different trials with golimumab was analysed. The interesting and maybe startling news is: golimumab did not prevent radiographic changes. Patients in the group with higher dosage even showed more progression.
Ankylosing spondylitis and rheumatoid arthritis are different diseases! TNF inhibitors reduce drmatically radiographic progression in rheumatoid arthritis, but they fail in ankylosing spondylitis to do so. What are TNF inhibitors good for in ankylosing spondylitis? Shouldn’t we stop prescribing TNF inhibitors in ankylosing spondylitis? Please no! TNF inhibitors in ankylosing spondylitis reduce disease activity and pain.


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The Effect of Anti-Tumor Necrosis Factor Therapy with Two Different Doses of Golimumab on Radiographic Progression in Definite Ankylosing Spondylitis: 4-Year Results.
Jürgen Braun1, Desirée van der Heijde2, Kay-Geert Hermann3, Xenofon Baraliakos4, Atul Deodhar5, Anna Beutler6, Michael Mack6, Weichun Xu7, Benjamin Hsu8, Robert D. Inman9 and GO-RAISE Clinical Investigators.
1Rheumazentrum Ruhrgebiet, Herne, Germany, 2Leiden University Medical Center, Leiden, Netherlands, 3Charite Medical School, Berlin, Germany, 4Ruhr-University Bochum, Herne, Germany, 5Oregon Health & Science University, Portland, OR, 6Centocor R&D, a division of Johnson & Johnson Pharmaceutical Research & Development, LLC, Malvern, PA, 7Centocor R&D, a division of Johnson & Johnson Pharmaceutical Research & Development, LLC, Malvern, 8Centocor R&D, a division of J&J Pharmaceutical R& D, LLC/Univ. of Pennsylvania, Malvern/Philadelphia, PA, 9Toronto Western Research Institute, University Health Network and University of Toronto, Toronto, ON
Conclusion: Changes in mSASSS from baseline to wk104 and wk208 indicated that anti-TNF treatment with GLM does not prevent radiographic progression in the spine of pts with AS. There was a trend to more radiographic changes in the group with the higher GLM dosage.