Treatment efficacy of etanercept and MTX combination therapy for ankylosing spondylitis hip joint lesion in Chinese population

Rheumatol Int. 2012 Jun;32(6):1663-7. doi: 10.1007/s00296-011-1844-8. Epub 2011 Mar 9.

Abstract

To investigate the efficacy of etanercept and MTX (methotrexate) combination therapy in Chinese patients with ankylosing spondylitis hip joint lesion, the possible courses and maintenance protocol, altogether 97 ankylosing spondylitis patients fulfilling the modified New York criteria with hip joint lesion were enrolled in a 12-month trial treated with combined etanercept and MTX. All these patients were required to be poor responders to SSZ (Sulfasalazine) or MTX therapy for 6 consecutive months or the longer. Etanercept was administered subcutaneously twice a week at a fixed dosage of 25 mg for the first six months, followed by 25 mg once a week in patients with good control of both symptoms and radiological progression, or twice a week for another six months in patients with BASDAI > or = 4. Combined MTX was administered intravenously once a week at the dosage of 15 mg. Demographics, clinical and laboratory features, physical function and quality of life using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), Harris hip score, and radiological assessment using the BASRI-hip index were recorded. Most patients achieved pain release at the end point of assessment. Significant improvement in Bath AS Disease Activity Index (BASDAI) (P < 0.05), Bath AS Functional Activity Index (BASFI) (P < 0.05), and Harris hip score (P < 0.05) was demonstrated. Radiographic progression was recorded as no exacerbation or alleviated. Larger interval between two etanercept administrations would provide similar advantages to standard method and possibly less adverse events if MTX was combined. Etanercept and MTX combination therapy was beneficial to ankylosing spondylitis patients with hip joint lesion, and staged dosage deduction in the long term proved to be effective as well as adverse event preventing.

MeSH terms

  • Adolescent
  • Adult
  • Asian Continental Ancestry Group
  • China / epidemiology
  • Disability Evaluation
  • Disease Progression
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Etanercept
  • Female
  • Hip Joint / diagnostic imaging
  • Hip Joint / drug effects*
  • Hip Joint / pathology
  • Hip Joint / physiopathology
  • Humans
  • Immunoglobulin G / administration & dosage*
  • Immunoglobulin G / adverse effects
  • Immunologic Factors / administration & dosage*
  • Immunologic Factors / adverse effects
  • Male
  • Methotrexate / administration & dosage*
  • Methotrexate / adverse effects
  • Radiography
  • Receptors, Tumor Necrosis Factor / administration & dosage*
  • Recovery of Function
  • Spondylitis, Ankylosing / diagnosis
  • Spondylitis, Ankylosing / drug therapy*
  • Spondylitis, Ankylosing / ethnology
  • Spondylitis, Ankylosing / physiopathology
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Immunoglobulin G
  • Immunologic Factors
  • Receptors, Tumor Necrosis Factor
  • Etanercept
  • Methotrexate