Ankylosing Spondylitis: Most Patients Don’t Switch TNF Inhibitors, Even if They Stop Working

According to a story from Healio, a recent study that was published in the scientific journal BMC Rheumatology revealed that it was uncommon for patients living with ankylosing spondylitis to switch from one TNF inhibitor to another, even if the drug was not having an impact. TNF inhibitors are a common method for treating this disease, but many patients experience treatment failure.

About Ankylosing Spondylitis (AS)

Ankylosing spondylitis is a rare form of arthritis which is characterized by long term inflammation of the spinal joints. Other joints may also be affected. The precise cause of ankylosing spondylitis has not been identified. A host of environmental and genetic factors may play a role; for example, a study found that the majority of patients in the UK presented with the HLA-B27 antigen. The onset of ankylosing spondylitis symptoms often begins in early adulthood. Symptoms may include relapsing/remitting back pain, progressive joint stiffening, fatigue, fever, and weight loss. Inflammation can spread to other parts of the body, such as the eyes, the cardiovascular system, and lungs. No cure for the disease exists, so treatment focuses on pain management and slowing disease progression. Treatment may include NSAIDs, opioids, TNF inhibitors, physical therapy, surgery, and some others. Unfortunately, most therapies can cause serious side effects with long term use. To learn more about ankylosing spondylitis, click here.

About The Study

The researchers looked at data for the years 2015-2016 from the Adelphia AS Disease Specific Program. This data included a total of 2,866 adults with ankylosing spondylitis and 640 physicians that were treating them. The researchers found that 32.8 percent of these patients had not received treatment with TNF inhibitors. Meanwhile, 58.1 percent were being treated with a TNF inhibitor for the first time; however, only 7.2 percent of patients had ever switched from one TNF inhibitor to another. 

Almost all switches were made due to a lack of efficacy in the first drug. However, it took a mean time of 11.1 months for patients to switch to the new drug. 15.4 percent of patients getting TNF treatment were considered to be ‘failing’ treatment, with these patients reporting a 44.5 percent impairment to work productivity compared to 25 percent who were responding to the treatment.

The authors noted both the significant delay in switching TNF inhibitors, but also noted that most patients that switched failed to respond to the new treatment. They recommend closer monitoring of patients and more rapid switches to different therapies when the current one does not work.

Check out the original study here.

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