Clinical effect of tumor necrosis factor antagonist on refractory ankylosing spondylitis related hip joint lesions

Abstract

Objective To investigate the clinical effect of tumor necrosis factor antagonist (etanercept) on refractory ankylosing spondylitis (AS) related hip joint lesions. Methods Eighty refractory AS patients accompanied by hip diseases were divided into control group and observation group by random number method, with 40 cases in each group. The control group was treated with diclofenac sodium combined with methotrexate treatment, and the observation group was treated with etanercept combined with methotrexate treatment. The patients were followed-up for 3 years, the Harris hip score and Bath AS activity index (BASDAI), Bath AS functional index (BASFI) before and after treatment, the recurrence rate and the incidence of adverse reactions were compared. Results Three months after treatment, the Harris hip scores in both groups were significantly higher than those before treatment, but the improvement in the observation group was significantly better than that in the control group(P 0.05); the BASDAI score and BASFI score after treatment were significantly lower in the two groups than those before treatment (P<0.05); the BASDAI score and BASFI score in the observation group after treatment were significantly lower than those of the control group(P<0.05). There were 5 cases of recurrence of hip joint in the observation group within 3 years after the treatment, and the recurrence rate was 6.85%, which was significantly lower than that of the control group (18.06%), P<0.05. The incidences of adverse reactions such as medication gastrointestinal reaction, oral ulcer, headache, liver dysfunction during medication in the observation group were significantly lower than those of the control group (P<0.05). Conclusions Etanercept is effective in treatment of refratory AS related hip disease, which can significantly improve the function of hip joint, effectively control disease activity, and has long-term efficacy and safety, which is worthy of popularization and application. Key words: Tumor necrosis factor antagonists; Etanercept; Refractory ankylosing spondylitis; Hip joint lesions; Methotrexate; Diclofenac sodium