Efficacy of etanercept in the treatment of the entheseal pathology in resistant spondylarthropathy: A clinical and magnetic resonance imaging study

摘要: Objective To determine the effect of tumor necrosis factor α (TNFα) blockade with etanercept on clinical manifestations resistant spondylarthropathy (SpA) and axial peripheral entheseal lesions using magnetic resonance imaging (MRI). Methods We performed a descriptive longitudinal study 10 SpA patients, all whom had active inflammatory back pain involvement. Patients were treated 25 mg subcutaneous twice weekly for 6 months. Clinical assessments included count, visual analog scale (VAS) scores spinal during day night, VAS pain, Bath Ankylosing Spondylitis Functional Index (BASFI), Disease Activity (BASDAI), Quality Life (ASQoL) questionnaire. MRI scans sacroiliac (SI) joints, lumbar spine, affected joints 1.5T scanner employing T1-weighted, T2-weighted fat-suppressed (FS), T1-weighted FS postgadolinium sequences at baseline Enthesitis associated osteitis scored semiquantitatively in pre- posttreatment scans. Results There was statistically significant improvement functional parameters (P = 0.008 score P BASFI, 0.005 BASDAI) as well quality life ASQoL) Nine patients total 44 MRI-detectable lesions. These seen SI (n 15 lesions), or cervical spine 9 22 5 7 lesions). Overall, 86% MRI-detected either regressed completely improved. No new developed. Conclusion These findings suggest that TNFα is markedly effective controlling to disease-modifying antirheumatic drugs. This marked enthesitis pathology determined by MRI.