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Wang Y, Zhou Z, Chen L, He X, Li H, Huang Y, Pu Y. Efficacy of Duhuo Jisheng Decoction in Treating Ankylosing Spondylitis: Clinical Evidence and Potential Mechanisms. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:3305773. [PMID: 35419071 PMCID: PMC9001112 DOI: 10.1155/2022/3305773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/18/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022]
Abstract
Background Duhuo Jisheng Decoction (DHJSD) is an ancient compound widely used in the treatment of ankylosing spondylitis (AS). However, its efficacy is controversial, and its mechanism of action is not clear enough. Using meta-analysis and network pharmacology, our study evaluated the clinical efficacy of DHJSD in the treatment of AS and explored its mechanisms of action. Methods We searched medical databases, including Embase, PubMed, the China National Knowledge Infrastructure databases, Wanfang, and the Chinese Scientific Journal Database, to identify studies that met the inclusion criteria. RevMan 5.3 software was used for the meta-analysis. The compounds and the potential protein targets of DHJSD were obtained from the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database and analysis platform. AS was treated as a search query in the NCBI, PharmGKB, TTD, DrugBank, and OMIM databases to obtain disease-related genes. The overlapping targets of DHJSD and AS were identified, and then Gene Ontology functional enrichment and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed. Cytoscape was employed to construct a drug-compound-target network and a protein-protein interaction (PPI) network. CytoHubba was utilized to select the hub genes. Results A total of 10 studies involving 860 participants were included in the meta-analysis. Compared with the control, DHJSD treatment significantly improved clinical symptoms; reduced the erythrocyte sedimentation rate (ESR), the C-reactive protein (CPR), and interleukin 6 (IL-6) levels; increased the degree of motion of the chest; reduced the visual analog scale (VAS) pain score; reduced Schober's test values; reduced the finger-to-floor distance; reduced the duration of morning stiffness. However, the differences were not statistically significant in the Bath Ankylosing Spondylitis Functional Index scores, the Bath Ankylosing Spondylitis Disease Activity Index scores, the bone Gla-containing protein (BGP) levels, or the bone alkaline phosphatase (BALP) levels. In terms of adverse events, DHJSD treatment of AS reduced the incidence of gastrointestinal events, the incidence of skin events, and the incidence of abnormal liver function; however, there was no statistically significant reduction in the incidence of adverse renal function events. Subgroup analysis showed that in the treatment of AS, the clinical effect of DHJSD for AS was better than that of the controls for both treatment durations, ≤2 months and >2 months. A total of 178 active compounds and 47 related potential targets were identified for DHJSD in the treatment of AS, including four hub genes (CXCL8, PTGS2, VEGFA, and STAT3). The core active ingredients of DHJSD in the treatment of AS were mainly quercetin, kaempferol, licochalcone A, and isorhamnetin. DHJSD treatment of AS-related pathways mainly involved the IL-17 signaling pathway, the TNF signaling pathway, and the rheumatoid arthritis signaling pathway. Conclusion The above results suggest that DHJSD acts on AS through multiple targets, components, and pathways with significant clinical efficacy. Future studies may further explore the active components of DHJSD.
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Affiliation(s)
- Yi Wang
- Department of Orthopedic, Chongqing Jiangbei hospital of Traditional Chinese Medicine, Chongqing 400020, China
- Chongqing Key Laboratory of Traditional Chinese Medicine for Prevention and Cure of Metabolic Diseases, Chongqing Medical University, College of Traditional Chinese Medicine, Chongqing 400016, China
| | - Zhihua Zhou
- Department of Orthopedic, Chongqing Jiangbei hospital of Traditional Chinese Medicine, Chongqing 400020, China
| | - Li Chen
- Department of Orthopedic, Chongqing Jiangbei hospital of Traditional Chinese Medicine, Chongqing 400020, China
| | - Xiangwei He
- Department of Orthopedic, Chongqing Jiangbei hospital of Traditional Chinese Medicine, Chongqing 400020, China
| | - Hui Li
- Department of Orthopedic, Chongqing Jiangbei hospital of Traditional Chinese Medicine, Chongqing 400020, China
| | - Yingru Huang
- Chongqing Key Laboratory of Traditional Chinese Medicine for Prevention and Cure of Metabolic Diseases, Chongqing Medical University, College of Traditional Chinese Medicine, Chongqing 400016, China
| | - Yu Pu
- Department of Orthopedic, Chongqing Jiangbei hospital of Traditional Chinese Medicine, Chongqing 400020, China
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Wielińska J, Świerkot J, Kolossa K, Bugaj B, Chaszczewska-Markowska M, Jeka S, Bogunia-Kubik K. Polymorphisms within Genes Coding for IL-17A and F and Their Receptor as Clinical Hallmarks in Ankylosing Spondylitis. Mediators Inflamm 2021; 2021:3125922. [PMID: 34744511 PMCID: PMC8566063 DOI: 10.1155/2021/3125922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/21/2021] [Indexed: 12/17/2022] Open
Abstract
IL-17A and IL-17F together with their coreceptor (IL-17RA/RC) were reported to play a significant role in the pathogenesis of spondyloarthritis. The group of axial spondyloarthritis comprises ankylosing spondylitis (AS), a rheumatic disease characterized by chronic inflammation of the joints in the spine. This study is aimed at investigating IL-17A, IL-17F, IL-17RA, and IL-17RC polymorphisms as potential biomarkers of disease susceptibility, clinical parameters, and anti-TNF treatment outcome in a cohort of Polish ankylosing spondylitis patients. In total, 328 subjects, including 138 AS patients and 190 healthy volunteers, participated in the study. Genotyping of IL-17A rs2275913 (G/A), IL-17F rs763780 (A/G), IL-17RA rs4819554 (A/G), and IL-17RC rs708567 (G/A) was performed on real-time PCR instrument using LightSNiP assays. No significant differences were revealed in genotype and allele distribution between patients and controls despite the association of the IL-17RC rs708567 AA homozygosity with the earlier onset of the disease. Moreover, some relationships between IL-17F rs763780 and IL-17RA rs4819554 polymorphisms with clinical parameters related to the disease activity and anti-TNF treatment outcome were observed. IL-17F rs763780 G allele was found to be associated with high disease activity and BASDAI after 6 months and poor response to the treatment while higher VAS values were more common among IL-17RA rs4819554 G variant carriers. In conclusion, the IL-17F rs763780 polymorphism should be considered as a promising biomarker of disease activity and anti-TNF treatment outcome. The IL-17RA rs48419554 G allele may serve as a potential marker of disease severity in Polish AS patients.
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Affiliation(s)
- Joanna Wielińska
- Laboratory of Clinical Immunogenetics and Pharmacogenetics, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, R. Weigla 12, 53-114 Wroclaw, Poland
| | - Jerzy Świerkot
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Katarzyna Kolossa
- Department of Rheumatology and Connective Tissue Diseases, Jan Biziel University Hospital No. 2, Ujejskiego 75, 85-168 Bydgoszcz, Poland
| | - Bartosz Bugaj
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Monika Chaszczewska-Markowska
- Laboratory of Clinical Immunogenetics and Pharmacogenetics, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, R. Weigla 12, 53-114 Wroclaw, Poland
| | - Sławomir Jeka
- Department of Rheumatology and Connective Tissue Diseases, Jan Biziel University Hospital No. 2, Ujejskiego 75, 85-168 Bydgoszcz, Poland
- Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Jagiellońska 15, 85-067 Bydgoszcz, Poland
| | - Katarzyna Bogunia-Kubik
- Laboratory of Clinical Immunogenetics and Pharmacogenetics, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, R. Weigla 12, 53-114 Wroclaw, Poland
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Early Improvements in Disease Activity Indices Predict Long-Term Clinical Remission Suggested by the Treat-to-Target Strategy in Patients with Ankylosing Spondylitis Receiving TNF-α Inhibitor Treatment. J Clin Med 2021; 10:jcm10184279. [PMID: 34575390 PMCID: PMC8469764 DOI: 10.3390/jcm10184279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 08/29/2021] [Accepted: 09/16/2021] [Indexed: 01/12/2023] Open
Abstract
This study evaluated the possibility of clinical remission suggested by the treat-to-target strategy and identified predictors of clinical remission in 139 patients with ankylosing spondylitis (AS) receiving tumor necrosis factor-α inhibitors (TNFi). Clinical remission criteria selected were AS Disease Activity Score Inactive Disease (ASDAS-ID) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) < 2 with normal C-reactive protein (CRP) levels (BASDAI-CRP). The longitudinal relationship between clinical parameters and clinical remission was assessed using generalized estimating equations (GEEs). Responders to ASDAS-ID and BASDAI-CRP increased from 32.4% to 68.9% and from 39.9% to 75.2% at months 3 and 33, respectively. Responders to ASDAS-ID and BASDAI-CRP almost overlapped. In the univariable GEE model, age and 3-month improvement in BASDAI, ASDAS-CRP, physician and patient global assessments, and spinal pain predicted clinical remission achievement, while the presence of syndesmophytes predicted ASDAS-CRP achievement, and normalized CRP at 3 months was associated with BASDAI-CRP achievement. Multivariable GEE analysis revealed age (odds ratio (OR): 0.67; 95% confidence interval (CI), 0.49–0.93) and 3-month BASDAI improvement (OR: 1.70; CI, 1.19–2.41) as independent predictors of ASDAS-ID achievement and age (OR: 0.69; CI, 0.54–0.89), 3-month BASDAI improvement (OR: 2.00; CI, 1.45–2.76), and normalized CRP at 3 months (OR: 3.72; CI, 1.39–9.95) as independent predictors of BASDAI-CRP achievement.
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Chen L, Wang Y, Sun L, Yan J, Mao H. Nanomedicine Strategies for Anti-Inflammatory Treatment of Noninfectious Arthritis. Adv Healthc Mater 2021; 10:e2001732. [PMID: 33870656 DOI: 10.1002/adhm.202001732] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 03/09/2021] [Indexed: 02/06/2023]
Abstract
Noninfectious arthritis (NIA) comprises a class of chronic and progressive inflammatory disorders that require early-stage management to prevent disease progression. The most common forms include osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and gouty arthritis. Current treatments involve nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs and glucocorticoids to alleviate clinical symptoms, although regular use of these can result in a high risk of chronic kidney disease and heart failure, as well as severe adverse gastrointestinal effects. Nanomedicine offers unique opportunities to address these challenges and improve therapeutic efficacy due to its ability to deliver therapeutics locally in a sustained manner, thus extending the half-life, improving bioavailability, and reducing the side effects of these agents. This review includes a comprehensive analysis of the mechanisms of various treatment options for NIA and highlights recent progress and emerging strategies in treating NIA with nanomedicine platforms, particularly related to long-term biosafety and nonspecific targeting in designing nanomedicine delivery systems.
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Affiliation(s)
- Long Chen
- Department of Orthopedics Guizhou Provincial People's Hospital Guiyang Guizhou 550000 China
- Translational Tissue Engineering Center Johns Hopkins School of Medicine Baltimore MD 21287 USA
- Institute for NanoBioTechnology Johns Hopkins University Baltimore MD 21218 USA
| | - Yuanzheng Wang
- Department of Orthopedics Guizhou Provincial People's Hospital Guiyang Guizhou 550000 China
| | - Li Sun
- Department of Orthopedics Guizhou Provincial People's Hospital Guiyang Guizhou 550000 China
| | - Jerry Yan
- Institute for NanoBioTechnology Johns Hopkins University Baltimore MD 21218 USA
- Department of Biomedical Engineering School of Medicine Johns Hopkins University Baltimore MD 21205 USA
| | - Hai‐Quan Mao
- Translational Tissue Engineering Center Johns Hopkins School of Medicine Baltimore MD 21287 USA
- Institute for NanoBioTechnology Johns Hopkins University Baltimore MD 21218 USA
- Department of Biomedical Engineering School of Medicine Johns Hopkins University Baltimore MD 21205 USA
- Department of Materials Science and Engineering Whiting School of Engineering Johns Hopkins University Baltimore MD 21218 USA
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5
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Li X, Zhou W, Li Z, Guan F. Hsa_circ_0056558 regulates cyclin-dependent kinase 6 by sponging microRNA-1290 to suppress the proliferation and differentiation in ankylosing spondylitis. Autoimmunity 2021; 54:114-128. [PMID: 33685301 DOI: 10.1080/08916934.2021.1894417] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The aims of this study was to investigate the influences of hsa_circ_0056558/miR-1290/CDK6 axis in ankylosing spondylitis (AS). The differentially expressed has_circ_0056558 and miR-1290 in AS tissue were analysed based on RNA-seq data and microarray data, respectively. qRT-PCR was performed for detection of relative expression levels of hsa_circ_0056558, miR-1290, CDK6, osteogenic differentiation markers (Runx2 and Osterix) and other inflammatory factors (TNF-α, IL-1β, and IL-6). Western blotting analysis was conducted to test the protein levels of CDK6, osteogenic differentiation markers (Runx2 and Osterix), and PI3K/AKT/NF-κB pathway-associated proteins. CCK8 assay and flow cytometry were conducted to determine cell proliferation and cell apoptotic ability, respectively. Targeted relationships were predicted by bioinformatic analysis and verified by dual-luciferase reporter assay. The differentiation of fibroblast cells was analysed by alkaline phosphatase (ALP) activity assay. Our findings revealed that the expression levels of both circ_0056558 and CDK6 in AS tissue were significantly higher than that in normal samples. Besides, hsa_circ_0056558 could suppress cell proliferation and differentiation by facilitating CDK6 expression and suppressing miR-1290 expression in AS. Over-expression of miR-1290 negatively regulated CDK6 expression to enhance cell proliferation. The protein levels of p-AKT, p-NF-κB p65, and p-IκBα were promoted by hsa_circ_0056558 or CDK6 over-expression while suppressed by miR-1290 up-regulation. In conclusion, our study demonstrated that hsa_circ_0056558 and CDK6 suppressed cell proliferation and differentiation while enhanced cell apoptosis by competitive binding to miR-1290 in AS, which might be possibly achieved by PI3K/AKT/NF-κB pathway, providing us novel therapeutic strategy for AS.
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Affiliation(s)
- Xia Li
- Rheumatology and Immunology Department, The Second People's Hospital of Liaocheng, The Second Hospital of Liaocheng Affiliated to Shandong First Medical University, Linqing, P.R. China
| | - Wenjing Zhou
- Liaocheng Dongchangfu District Maternal and Child Health Hospital, Liaocheng, P.R. China
| | - Zhen Li
- Department of Orthopedics, Liaocheng Dongchangfu District Chinese Medicine Hospital, Liaocheng, P.R. China
| | - Fei Guan
- Rheumatology and Immunology Department, The Second People's Hospital of Liaocheng, The Second Hospital of Liaocheng Affiliated to Shandong First Medical University, Linqing, P.R. China
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Diena D, Priora M, Barreca A, Parisi S, Colla L, Biancone L, Fusaro E. Double Glomerulonephritis in a Patient with Ankylosing Spondylitis Treated with Biologic Agent: Extrarticolar Involvement or Anti-Tumor Necrosis Factor Alpha Injury? A Case-Based Review. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2020; 13:1179547620974672. [PMID: 33281463 PMCID: PMC7683916 DOI: 10.1177/1179547620974672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/24/2020] [Indexed: 11/15/2022]
Abstract
With the widespreading use of biologic drugs, reports of renal injury are increasing, most of which belong to the spectrum of secondary autoimmune syndromes. We present the case of a young man affected by Ankylosing Spondylitis, treated with tumor necrosis factor alpha inhibitors (Anti-TNF) that develop a peculiar renal damage: a coexistence of 2 glomerulonephritis due to different noxae, an IgA nephropaty with a Membranous nephropathy. The first one probably related to the rheumatologic disease, the second one related to Anti-TNF. Despite the underlying mechanisms, the renal involvement both related to Ankylosing Spondylitis and secondary to biologic treatment are currently rare and not predictable. Regular control of renal function and urinalysis during treatment with anti-TNF is mandatory. A concomitant treatment with Disease Modifying Anti Rheumatic Drugs or eventually a low dose of steroids may prevent the formation of anti-drug antibodies and could limit the renal damage related to this phenomenon.
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Affiliation(s)
- Davide Diena
- Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, University of Turin, Italy University Hospital "Città della Salute e della Scienza," Turin, Italy
| | - Marta Priora
- Division of Rheumatology, University Hospital "Città della Salute e della Scienza," Turin, Italy
| | - Antonella Barreca
- Division of Pathology, Department of Medical Sciences, University Hospital "Città della Salute e della Scienza," Turin, Italy
| | - Simone Parisi
- Division of Rheumatology, University Hospital "Città della Salute e della Scienza," Turin, Italy
| | - Loredana Colla
- Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, University of Turin, Italy University Hospital "Città della Salute e della Scienza," Turin, Italy
| | - Luigi Biancone
- Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, University of Turin, Italy University Hospital "Città della Salute e della Scienza," Turin, Italy
| | - Enrico Fusaro
- Division of Rheumatology, University Hospital "Città della Salute e della Scienza," Turin, Italy
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Cetin SY, Calik BB, Ayan A, Kabul EG. The effectiveness of 10-Tai Chi movements in patients with ankylosing spondylitis receiving anti-tumor necrosis factor α therapy: A randomized controlled trial. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zou YC, Yan LM, Gao YP, Wang ZY, Liu G. miR-21 may Act as a Potential Mediator Between Inflammation and Abnormal Bone Formation in Ankylosing Spondylitis Based on TNF-α Concentration-Dependent Manner Through the JAK2/STAT3 Pathway. Dose Response 2020; 18:1559325819901239. [PMID: 32009856 PMCID: PMC6974759 DOI: 10.1177/1559325819901239] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 12/10/2019] [Accepted: 12/19/2019] [Indexed: 12/12/2022] Open
Abstract
Objective: To explore the role of microRNA (miR-21) in new bone formation in ankylosing
spondylitis (AS) as mediated by different concentration of tumor necrosis
factor-α (TNF-α). Methods: Fibroblasts isolated from the hips of patients with AS were induced to
osteogenesis. These cells were then stimulated with varying concentrations
of TNF-α. MicroRNA-21 expressions were evaluated using reverse
transcription–polymerase chain reaction (RT-PCR) and osteogenesis was
detected via Alizarin Red S (ARS) staining and measurement of alkaline
phosphatase (ALP) activity. Relative expressions of p-STAT3, Nuclear STAT3,
cytoplasm STAT3, Runx2, BMP2, osteopontin, osteocalcin, and LC3B in AS
fibroblasts were measured after exposure to different concentrations of
TNF-α. The STAT3-inhibiting small interfering RNA allowed further
exploration on its impact on miR-21 and primary miR-21 expressions. A
proteoglycan-induced arthritis (PGIA) Balb/c mouse model was established in
order to monitor sacroiliac joint (SIJ) inflammation and subsequent damage
through magnetic resonance image. Serum miR-21 and TNF-α expressions were
evaluated using RT-PCR and enzyme-linked immunosorbent assay. At week 16,
mice models were transfected intravenously with miR-21 overexpressing agomir
and miR-21 inhibiting antagomir for 7 successive days. The rate of abnormal
bone formation at SIJ was evaluated using microcomputed tomography and
hematoxylin and eosin staining at week 24. Western blot analysis enabled
quantification of STAT-3, JAK-2, and interleukin (IL)-17A expressions
present in the SIJ. Results: The in vitro miR-21 expression and osteogenesis activity were noted to be
augmented in the setting of low TNF-α concentrations (0.01-0.1 ng/mL) while
they were depressed in settings with higher TNF-α concentrations (1-10
ng/mL). Samples with the most distinct ARS manifestation and ALP activity as
well as the highest miR-21 expressions were those who received 0.1 ng/mL of
TNF-α. Primary miR-21 was found to be notable raised by Si-STAT3, while the
converse effect was seen in mature miR-21 expressions. Intravenous injection
of exogenous miR-21 contributed to new bone formation and significantly
elevated expressions of STAT3, JAK2, and IL-17 in PGIA mice. Conclusions: The results revealed that miR-21 may act as a potential mediator between new
bone formation and inflammation in AS.
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Affiliation(s)
- Yu-Cong Zou
- Department Of Rehabilitation Medicine, The Third Affiliated
Hospital, Southern Medical University, Guang Zhou, Guangdong Province, China
| | - Li-Man Yan
- Guangzhou University of Chinese Medicine, Guang Zhou, Guangdong
Province, China
| | - Yan-Ping Gao
- Department of TCM Orthopedics & Traumatology, The Third
Affiliated Hospital, Southern Medical University, Guang Zhou, Guangdong Province,
China
| | - Zhi- Yun Wang
- ShunDe Hospital, Southern Medical University, FoShan, Guangdong
Province, China
| | - Gang Liu
- Department Of Rehabilitation Medicine, The Third Affiliated
Hospital, Southern Medical University, Guang Zhou, Guangdong Province, China
- Gang Liu, Department of Rehabilitation, The
Third Affiliated Hospital, Southern Medical University, Zhongshan Road West, No.
183, Tianhe District, Guang Zhou, 510630, China.
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Sclerostin rather than Dickkopf-1 is associated with mSASSS but not with disease activity score in patients with ankylosing spondylitis. Clin Rheumatol 2018; 38:989-995. [PMID: 30443790 DOI: 10.1007/s10067-018-4356-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/30/2018] [Accepted: 10/29/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine the serum levels of Dickkopf-1 (DKK-1) and sclerostin, as well as their correlations with the structural damage assessed by modified stoke ankylosing spondylitis spine score (mSASSS) and the disease activity evaluated by ankylosing spondylitis disease activity score (ASDAS) in patients with ankylosing spondylitis (AS). METHODS Eighty-eight AS patients, 26 rheumatoid arthritis (RA) patients, and 26 age- and gender-matched healthy controls (HC) were collected from rheumatic clinic of the Second Affiliated Hospital of Zhejiang University, School of Medicine, between March 2015 and July 2015. Demographic data, parameters of ASDAS, and image evaluations of spine (i.e., mSASSS) were collected. The serum levels of DKK-1 and sclerostin were measured using commercially available ELISA kits. RESULTS Both DKK-1 and sclerostin were significantly higher in the AS patients than in the controls (1855 ± 84.58 vs. 1406 ± 99.76 pg/ml and 106 ± 6.75 vs. 62.78 ± 6.39 pmol/l, respectively, P < 0.05). The correlation analysis suggested a negative correlation between serum sclerostin and mSASSS (P = 0.019, r2 = 0.062). DKK-1 had a trend of positive correlation with mSASSS, but was not statistically significant (P > 0.05). There was no association between the serum levels of DKK-1 or sclerostin and disease activity assessed by ASDAS (P > 0.05). DKK-1 and sclerostin had a negative correlation (P = 0.013, r2 = 0.07). CONCLUSION In the present study, the expressions of serum DKK-1 and sclerostin were independent of disease activity. Sclerostin was negatively correlated with the mSASSS, which suggests that sclerostin may be a potential marker indicating the spine ossification process in AS. The specific mechanism remains to be investigated.
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Abstract
Golimumab (Simponi®), a fully human monoclonal antibody against tumour necrosis factor-alpha (TNFα), is given once monthly by subcutaneous injection. In the EU, golimumab is approved as monotherapy and/or in combination with methotrexate for the treatment of inflammatory arthritis, including rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis [comprising ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA)] in adults, and polyarticular juvenile idiopathic arthritis (pJIA) in children. These approvals were based on the observations that golimumab was generally well tolerated and conferred some or all of the following benefits in pivotal studies in these settings: reduced signs and symptoms of arthritis; improved physical functioning and health-related quality of life; and slowed radiographic progression. Of note, data from long-term extensions (LTEs) of pivotal studies in RA, PsA and AS have confirmed that the safety and efficacy of golimumab are sustained through 5 years of treatment; the long-term tolerability profile of the drug is similar to that of other TNFα inhibitors (TNFis). Like other subcutaneous TNFis, golimumab offers patients the convenience and flexibility of home-based self-injection, although it has the added potential advantage of requiring less frequent administration, in particular compared with older, first generation agents, such as etanercept and adalimumab. Thus, golimumab is an effective, generally well tolerated and potentially convenient option for the treatment of RA, PsA, AS and nr-axSpA in adults, and pJIA in children.
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Affiliation(s)
- James E Frampton
- Springer, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand.
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11
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Zhao YH, Cao YY, Zhang Q, Mei YJ, Xiao JJ, Hu SY, Li W, Li SL. Role of Diffusion-weighted and Contrast-enhanced Magnetic Resonance Imaging in Differentiating Activity of Ankylosing Spondylitis. Chin Med J (Engl) 2018; 130:1303-1308. [PMID: 28524829 PMCID: PMC5455039 DOI: 10.4103/0366-6999.206359] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Previous studies showed that combining apparent diffusion coefficient (ADC) value with the Spondyloarthritis Research Consortium of Canada (SPARCC) index value might provide a reliable evaluation of the activity of ankylosing spondylitis (AS), and that contrast-enhanced (CE) magnetic resonance imaging (MRI) is unnecessary. However, the results were based on confirming only a small random sample. This study aimed to assess the role of CE-MRI in differentiating the disease activity of AS by comparing ADC value with a large sample. Methods: A total of 115 patients with AS were enrolled in accordance with Bath AS Disease Activity Index and laboratory indices, and 115 patients were divided into two groups, including active group (n = 69) and inactive group (n = 46). SPARCC, ΔSI, and ADC values were obtained from the short tau inversion recovery (STIR), diffusion-weighted imaging (DWI), and CE-MRI, respectively. One-way analysis of variance and receiver operating characteristic analysis were performed for all parameters. Results: The optimal cutoff values (with sensitivity, specificity, respective area under the curve, positive likelihood ratio, and negative likelihood ratio) for the differentiation between active and inactive groups are as follows: SPARCC = 6 (72.06%, 82.61%, 0.836, 4.14, 0.34); ΔSI (%) = 153 (80.6%, 84.78%, 0.819, 5.3, 0.23); ADC value = 1.15 × 10−3 mm2/s (72.73%, 81.82%, 0.786, 4, 0.33). No statistical differences were found among the predictive values of SPARCC, ΔSI, and ADC. Multivariate analysis showed no significant difference between the combination of SPARCC and ADC values with and without ΔSI. Conclusions: Using large sample, we concluded that the combination of STIR and DWI would play significant roles in assessing the disease activity, and CE-MRI sequence is not routinely used in imaging of AS to avoid renal fibrosis and aggravation of kidney disease.
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Affiliation(s)
- Ying-Hua Zhao
- Department of Radiology, Third Affiliated Hospital of Southern Medical University, Orthopaedic Hospital of Guangdong Province, Guangzhou, Guangdong 510630, China
| | - Yan-Yan Cao
- Department of Rheumatology, Hospital of Integrated Traditional Chinese Medicine and Western Medicine of Southern Medical University, Guangzhou, Guangdong 510315, China
| | - Qun Zhang
- Department of Rheumatology, Third Affiliated Hospital of Southern Medical University, Orthopaedic Hospital of Guangdong Province, Guangzhou, Guangdong 510630, China
| | - Ying-Jie Mei
- Department of MR Clinical Science, Philips Healthcare, Guangzhou, Guangdong 510055, China
| | - Ji-Jie Xiao
- Department of Radiology, Third Affiliated Hospital of Southern Medical University, Orthopaedic Hospital of Guangdong Province, Guangzhou, Guangdong 510630, China
| | - Shao-Yong Hu
- Department of Radiology, Third Affiliated Hospital of Southern Medical University, Orthopaedic Hospital of Guangdong Province, Guangzhou, Guangdong 510630, China
| | - Wei Li
- Department of Radiology, Third Affiliated Hospital of Southern Medical University, Orthopaedic Hospital of Guangdong Province, Guangzhou, Guangdong 510630, China
| | - Shao-Lin Li
- Department of Radiology, Third Affiliated Hospital of Southern Medical University, Orthopaedic Hospital of Guangdong Province, Guangzhou, Guangdong 510630, China
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Walsh JA, Song X, Kim G, Park Y. Evaluation of the comorbidity burden in patients with ankylosing spondylitis treated with tumour necrosis factor inhibitors using a large administrative claims data set. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2018; 9:115-121. [PMID: 29861786 PMCID: PMC5969313 DOI: 10.1111/jphs.12212] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 12/06/2017] [Indexed: 12/17/2022]
Abstract
Objectives Comorbidity incidence rates among US patients with ankylosing spondylitis (AS) treated with tumour necrosis factor inhibitors (TNFis) are inadequately understood. This study compared the relative occurrence of comorbidities between patients with AS treated with TNFis and those not treated with TNFis. Methods Adults aged ≥18 years enrolled in the MarketScan Commercial and Medicare Supplemental databases with a diagnosis of AS between 1 January 2008 and 30 June 2015 were eligible. Patients were divided into two groups, those treated with TNFis (TNFi users) and those not treated with TNFis (TNFi nonusers) during the 12 months after the index date, defined as the date of first TNFi treatment or a randomly assigned date for TNFi nonusers. Patients had to have continuous enrolment for 24 months with no AS diagnosis or TNFi therapy pre‐index and a follow‐up period of ≥12 months postindex. The incidence of new comorbidities was evaluated in patients and adjusted for baseline characteristics. Key findings A total of 3077 TNFi users and 3830 TNFi nonusers were included. A higher proportion of TNFi users had a new diagnosis of inflammatory bowel disease (hazard ratio [HR], 2.00), including Crohn's disease (HR, 2.45) and ulcerative colitis (HR, 1.65), as well as uveitis (HR, 1.68) and sleep apnoea (HR, 1.21) after initiation of TNFi therapy than TNFi nonusers. Conclusions Patients with AS treated with TNFis had higher incidence rates of IBD, uveitis and sleep apnoea after initiation of TNFi therapy than patients not treated with TNFi therapy.
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Affiliation(s)
- Jessica A Walsh
- University of Utah and Salt Lake City Veteran Affairs Medical Center Division of Rheumatology Salt Lake City UT USA
| | - Xue Song
- Truven Health Analytics, an IBM Company Cambridge MA USA
| | - Gilwan Kim
- Truven Health Analytics, an IBM Company Cambridge MA USA
| | - Yujin Park
- Novartis Pharmaceuticals Corporation East Hanover NJ USA
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Livshits G, Kalinkovich A. Hierarchical, imbalanced pro-inflammatory cytokine networks govern the pathogenesis of chronic arthropathies. Osteoarthritis Cartilage 2018; 26:7-17. [PMID: 29074297 DOI: 10.1016/j.joca.2017.10.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/15/2017] [Accepted: 10/10/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Chronic inflammatory arthropathies, such as rheumatoid arthritis (RA), spondyloarthritis, including psoriatic arthritis (PsA), ankylosing spondyloarthritis (AS), osteoarthritis (OA), and intervertebral disc degenerative disease (DDD) constitute major public health problems that are anticipated to grow significantly as the human population ages. However, many aspects concerning the molecular mechanisms underlying their onset and progression remain unclear. DESIGN This narrative review critically analyzes the molecular mechanisms underlying the inflammation-associated pathogenesis of the aforementioned joint diseases. This includes, in particular, the major role played by several key soluble factors (such as cytokines and the associated signaling pathways, designated as "fragile nodes") produced by local cells and recruited to the joints' immune cells, whose elimination by specific drugs has dramatically improved the diseases' symptomatology and outcome in human clinical trials or in rodent arthritis models. HYPOTHESIS AND THE AIM OF THIS REVIEW We hypothesize that the pathogenesis of chronic inflammatory arthropathies is governed by hierarchical, imbalanced pro-inflammatory cytokine networks (HIPICNs) (comprising a combination of fragile nodes) that are created during the development of both autoimmune (RA, PsA, and AS) and non-autoimmune (OA and DDD) disorders. The main aim of this review is to provide evidence that despite substantial pathobiological differences between these arthropathies, the HIPICNs created are quite common, thus justifying the merging of these disorders mechanistically and suggesting that these common mechanisms exist in the onset and progression of different joint diseases.
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Affiliation(s)
- G Livshits
- Human Population Biology Research Unit, Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv 69978, Israel.
| | - A Kalinkovich
- Human Population Biology Research Unit, Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv 69978, Israel
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El polimorfismo TNF-α-308 determina las manifestaciones clínicas y la respuesta al tratamiento de la espondilitis anquilosante en la etnia china Han. Med Clin (Barc) 2017; 149:517-522. [DOI: 10.1016/j.medcli.2017.04.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/08/2017] [Accepted: 04/20/2017] [Indexed: 11/21/2022]
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Xie D, Huang L, Zhao G, Yu Y, Gao J, Li H, Wen C. Dissecting the Underlying Pharmaceutical Mechanism of Chinese Traditional Medicine Yun-Pi-Yi-Shen-Tong-Du-Tang Acting on Ankylosing Spondylitis through Systems Biology Approaches. Sci Rep 2017; 7:13436. [PMID: 29044146 PMCID: PMC5647417 DOI: 10.1038/s41598-017-13723-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 09/27/2017] [Indexed: 02/07/2023] Open
Abstract
Traditional Chinese Medicine (TCM) has been served as complementary medicine for Ankylosing Spondylitis (AS) treatment for a long time. Yun-Pi-Yi-Shen-Tong-Du-Tang (Y-Y-T) is a novel empirical formula designed by Prof. Chengping Wen. In this study, a retrospective investigation supported efficacy of Y-Y-T and then we deciphered the underlying molecular mechanism of the efficacy. Herbal ingredients and targeting proteins were collected from TCMID. PPI networks were constructed to further infer the relationship among Y-Y-T, drugs used for treating AS, differentially expressed genes of AS patients and AS disease proteins. Finally, it was suggested that TLR signaling pathway and T cell receptor signaling pathway may involve in the biological processes of AS progression and contribute to the curative effect and proteins such as JAK2, STAT3, HSP90AA1, TNF and PTEN were the key targets. Our systemic investigation to infer therapeutic mechanism of Y-Y-T for AS treatment provides a new insight in understanding TCM pharmacology.
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Affiliation(s)
- Duoli Xie
- TCM Clinical Basis Institute, Zhejiang Chinese Medicine University, 548 Binwen Road, Hangzhou, Zhejiang, 310000, China
| | - Lin Huang
- TCM Clinical Basis Institute, Zhejiang Chinese Medicine University, 548 Binwen Road, Hangzhou, Zhejiang, 310000, China
| | - Guanghui Zhao
- Guangzhou University of Chinese Medicine, Mathematical Engineering Academy of Chinese Medicine, Guangzhou, 510006, China
| | - Yiran Yu
- TCM Clinical Basis Institute, Zhejiang Chinese Medicine University, 548 Binwen Road, Hangzhou, Zhejiang, 310000, China
| | - Jiawei Gao
- TCM Clinical Basis Institute, Zhejiang Chinese Medicine University, 548 Binwen Road, Hangzhou, Zhejiang, 310000, China
| | - Haichang Li
- TCM Clinical Basis Institute, Zhejiang Chinese Medicine University, 548 Binwen Road, Hangzhou, Zhejiang, 310000, China
| | - Chengping Wen
- TCM Clinical Basis Institute, Zhejiang Chinese Medicine University, 548 Binwen Road, Hangzhou, Zhejiang, 310000, China.
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Dougados M, Maksymowych WP, Landewé RBM, Moltó A, Claudepierre P, de Hooge M, Lambert RG, Bonin R, Bukowski JF, Jones HE, Logeart I, Pedersen R, Szumski A, Vlahos B, van der Heijde D. Evaluation of the change in structural radiographic sacroiliac joint damage after 2 years of etanercept therapy (EMBARK trial) in comparison to a contemporary control cohort (DESIR cohort) in recent onset axial spondyloarthritis. Ann Rheum Dis 2017; 77:221-227. [PMID: 28970213 PMCID: PMC5867411 DOI: 10.1136/annrheumdis-2017-212008] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/01/2017] [Accepted: 09/19/2017] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To compare 2 years of radiographic sacroiliac joint (SIJ) changes in patients with recent onset axial spondyloarthritis (axSpA) receiving etanercept in a clinical trial (EMBARK) to similar patients not receiving biologics in a cohort study (DESIR). METHODS Endpoints were changes at week 104 per the modified New York (mNY) grading system in total SIJ score (primary endpoint) and net percentage of patients with progression defined three ways. Treatment effect was analysed with and without adjustment for baseline covariates. RESULTS At 104 weeks, total SIJ score improved in the etanercept group (n=154, adjusted least-squares mean change: -0.14) and worsened in the control group (n=182, change: 0.08). The adjusted difference between groups (etanercept minus control) was -0.22 (95% CI -0.38 to -0.06), p=0.008. The net percentage of patients with progression was significantly lower in the etanercept versus the control group for two of three binary endpoints: -1.9% versus 1.6% (adjusted difference for etanercept minus control: -4.7%,95% CI -9.9 to 0.5, p=0.07) for change in mNY criteria; -1.9% versus 7.8% (adjusted difference: -18.2%,95% CI -30.9 to -5.6, p=0.005) for change ≥1 grade in ≥1 SIJ; and -0.6% versus 6.7% (adjusted difference: -16.4%,95% CI -27.9 to -5.0, p=0.005) for change ≥1 grade in ≥1 SIJ, with shift from 0 to 1 or 1 to 0 considered no change. CONCLUSION Despite the slow radiographic SIJ progression rate over 2 years in axSpA, this study suggests a lower rate of progression in the SIJ with etanercept than without anti-tumour necrosis factor therapy. TRIAL REGISTRATION NUMBERS NCT01258738, NCT01648907; Post-results.
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Affiliation(s)
- Maxime Dougados
- Paris Descartes University, Rheumatology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, France
| | | | | | - Anna Moltó
- Paris Descartes University, Rheumatology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, France
| | - Pascal Claudepierre
- Universite Paris Est Creteil, EA 7379 – EpidermE, AP-HP, Service de Rhumatologie, Hopital Henri Mondor, Creteil, France
| | | | - Robert G Lambert
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Randi Bonin
- Clinical Affairs, Pfizer, Collegeville, Pennsylvania, USA
| | | | | | | | - Ron Pedersen
- Department of Biostatistics, Pfizer, Collegeville, USA
| | | | - Bonnie Vlahos
- Clinical Affairs, Pfizer, Collegeville, Pennsylvania, USA
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Ma Z, Liu X, Xu X, Jiang J, Zhou J, Wang J, Chen D, Luo S. Safety of tumor necrosis factor-alpha inhibitors for treatment of ankylosing spondylitis: A meta-analysis. Medicine (Baltimore) 2017; 96:e7145. [PMID: 28640088 PMCID: PMC5484196 DOI: 10.1097/md.0000000000007145] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 05/22/2017] [Accepted: 05/25/2017] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Ankylosing spondylitis (AS) is a chronic immune-mediated disease affecting the sacroiliac joints and the spine, manifesting with new bone formation and osteopenia. Five tumor necrosis factor-alpha (TNF-α) inhibitors (infliximab, etanercept, adalimumab, certolizumab, and golimumab) are available for the treatment of AS, however, the results for the safety of TNF-α inhibitors in the treatment of AS are not consistent. METHODS In this study, we conducted a meta-analysis to determine the safety of TNF-α inhibitors compared with placebo in reducing pain, swelling, and inflammation of AS patients. Eight relevant articles including 2049 patients were included for this meta-analysis study. We observed that the incidence of adverse events (RR = 1.22, 95% CI: 1.12-1.33; P = .501, I = 0%) and injection-site reaction (RR = 2.93, 95% CI: 2.02-4.23; P = .691, I = 0%) in AS patients' treatment with TNF-α inhibitors was significantly higher than that with placebo. RESULTS However, there was no significant difference in the incidence of serious adverse event, infection, serious infection, and discontinuations due to adverse event. TNF-α inhibitors may be a promising treatment for AS, but carries an increased incidence rate of adverse events and injection-site reaction. CONCLUSION Due to the existence of the unstable factors, further studies need to be done to verify the result of this study.
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