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Objective@#To investigate the effects of anti-tumor necrosis factor (TNF) treatment on lipid profiles and identify risk factors for an increase in total cholesterol (TC) after the anti-TNF treatment in ankylosing spondylitis (AS) patients. @*Methods@#This retrospective cohort study analyzed AS patients who received the first-line anti-TNF treatment. Patients with at least nine months of follow-up were included; those who were under 18 years or on any lipid-lowering agent were excluded. A linear mixed model was used to assess the impact of anti-TNF inhibitors on disease activity and lipid profile (TC, low-density lipoprotein [LDL], high-density lipoprotein [HDL], and triglycerides [TG]). Univariable and multivariable linear regression were used to identify risk factors for an increase in TC after 3 months of anti-TNF treatment. @*Results@#A total of 315 AS patients were enrolled (78.1% male, median age 32.0 [26.0~41.0]). TC, HDL, and TG levels significantly increased particularly within the first 3 months of anti-TNF treatment, while LDL level did not show significant changes.Changes in inflammatory markers and lipid particles (TC, LDL, TG) were correlated over time, but HDL showed no significant correlation. Older age, higher baseline erythrocyte sedimentation rate, and lower baseline LDL level were related to an increase in TC after 3 months of the anti-TNF treatment. @*Conclusion@#In AS patients, anti-TNF treatment has been found to increase lipid particles, potentially due to its anti-inflammatory effects. Future research should explore the underlying mechanism and the clinical implications of dyslipidemia, particularly the occurrence of cardiovascular events, following anti-TNF treatment in AS patients.
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Objective@#Although nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment for ankylosing spondylitis (AS), their effect on kidney function remains unclear. This longitudinal study investigated the correlation between long-term NSAID use and kidney function in patients with AS using electronic medical records. @*Methods@#The electronic medical records of 1,280 patients with AS collected from a single center between January 2001 and December 2018 were reviewed. The Assessment of Spondyloarthritis International Society (ASAS) NSAID Intake Score was used to determine the cumulative dose of all NSAIDs prescribed for a different time intervals. Each ASAS NSAID Intake Score was obtained for intervals of 6 months, 1 year, 2 years, 3 years, 5 years, and 10 years. The correlation between the ASAS NSAID Intake Score and final estimated glomerular filtration rate (eGFR) for each interval was investigated. @*Results@#The mean ASAS Intake Scores for 6-month, 1-year, 2-year, 3-year, 5-year, and 10-year intervals were 55.30, 49.28, 44.84, 44.14, 44.61, and 41.17, respectively. At each interval, the pearson correlation coefficients were −0.018 (95% CI: −0.031 to −0.006, p=0.004), −0.021 (95% CI: −0.039 to −0.004, p=0.018), −0.045 (95% CI: −0.071 to −0.019, p=0.001), −0.069 (95% CI: −0.102 to −0.037, p<0.001), −0.070 (95% CI: −0.114 to −0.026, p=0.002), −0.019 (95% CI: −0.099 to 0.062, p=0.645), respectively. There was a very weak negative relationship between ASAS Intake Score and eGFR at each interval. @*Conclusion@#Long-term NSAID use did not correlate with kidney function based on real-world data in patients with AS.
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Background/Aims@#Biologics are very effective drugs for patients with ankylosing spondylitis (AS). However, there are patients who are not responding to biologics. This study aimed to evaluate the level of tumor necrosis factor α (TNF-α), interleukin (IL)-23, and IL-17 from synovial fluid in patients with AS and rheumatoid arthritis (RA) and differences of the level of those cytokines according to drugs. @*Methods@#Synovial fluid was obtained from 34 patients (42 samples) with AS and 45 patients (47 samples) with RA with active arthritis of the knee, and the cytokine levels were measured. The differences in the levels between patients treated with and without biologics (biologics and non-biologics groups, respectively) were analyzed in AS and RA. The correlations between cytokines were examined in the non-biologics and biologics groups. @*Results@#The TNF-α level in AS was significantly lower than that in RA (p = 0.016). The IL-17 and IL-23 levels were not different between AS and RA (p = 0.409 and p = 0.562, respectively). In AS and RA, TNF-α, IL-17, and IL-23 showed good correlation among each other in the non-biologics group. However, there was no significant correlation in biologics group. In some patients in the AS group, the IL-17 or IL-23 level was markedly elevated in the biologics group. @*Conclusions@#Treatment with biologics affects the cytokine profile in inflammatory synovial fluid in patients with both AS and RA. Furthermore, IL-23 and IL-17 cytokine might be an important factor in some patients who are unresponsive to biologics in AS.
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OBJECTIVE: Uveitis is the most common extra-articular manifestation occurring in patients with ankylosing spondylitis (AS). This study examined the characteristics of uveitis in patients with AS using a questionnaire survey. METHODS: A questionnaire-based survey was given to patients enrolled in an AS registry at a rheumatology clinic in a tertiary hospital between September 2015 and December 2015. The patients responded to several questions and sub-questions related to uveitis. RESULTS: A total of 750 patients participated in the survey. The number of patients diagnosed with uveitis in the ophthalmology department was 218 (29%). The most common symptoms in patients with uveitis were ocular injection (61%), eye pain (54%), and decreased visual acuity (51%). Interestingly, 91 of the 532 patients (17%) who had not been diagnosed with uveitis before also experienced similar symptoms, such as tearing, ocular injection, and eye pain. The number of patients who experienced a flare of uveitis more than once a year was 109 (50%), and 124 patients with uveitis responded that the treatment of AS had no significant effect on the prevention of uveitis recurrence. CONCLUSION: The clinical characteristics of uveitis that patients experience was investigated through surveys. Because uveitis in patients with AS is not well diagnosed and treated, active screening for suspected symptoms and the prevention of a recurrence is needed.