Rheumatology International

, Volume 33, Issue 7, pp 1855–1864

The effect of TNF-alpha blockers on psychometric measures in ankylosing spondylitis patients: a preliminary observation

  • Ozden Arısoy
  • Cemal Bes
  • Cigdem Cifci
  • Mustafa Sercan
  • Mehmet Soy
Original Article

DOI: 10.1007/s00296-013-2671-x

Cite this article as:
Arısoy, O., Bes, C., Cifci, C. et al. Rheumatol Int (2013) 33: 1855. doi:10.1007/s00296-013-2671-x

Abstract

There is a high co-morbidity between chronic inflammatory disorders and depression. Proinflammatory cytokines like TNF-α seem to play a central role in the pathogenesis of these disorders, and its neutralization provides a potent treatment for inflammatory disorders. Few studies showed that TNF-α blockers also caused an improvement in depressive symptoms associated with these chronic inflammatory disorders. To evaluate the effectiveness of TNF-α blockers on symptoms of ankylosing spondylitis (AS), depression, anxiety and quality of life, 9 AS patients resistant to classical therapy were enrolled and followed-up at 2nd and 6th weeks after a TNF-α blocker was started. Hamilton Depression and Anxiety Scales (HAM-D, HAM-A), Hospital Depression and Anxiety Questionnaire (HAD), Quality of Life Scale (SF36) and AS severity index (BASDAI) were applied to the patients at weeks 0, 2 and 6. ESR and CRP were evaluated to monitor biological disease activity. There was a significant reduction in HAM-D (p = 0.00), HAM-A (p = 0.00), HAD anxiety scores (p = 0.02) and a significant improvement in SF36 physical function (p = 0.00), physical role limitations (p = 0.00), bodily pain (p = 0.05), general health (p = 0.01), vitality (p = 0.03) and emotional role limitations (p = 0.00) subscales, BASDAI scores (p = 0.00), ESR (p = 0.00) and CRP (p = 0.00). Change in clinical disease activity (BASDAI) was not correlated with change in depression–anxiety scores, while change in biological disease activity (CRP) was correlated with change in depression–anxiety scores. TNFα blockers may have a potential antidepressant effect besides its anti-inflammatory effect that seems to be independent of its clinical effect.

Keywords

Ankylosing spondylitisTNF-alpha blockersDepressionAnxietyQuality of lifeCytokines

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Ozden Arısoy
    • 4
  • Cemal Bes
    • 1
  • Cigdem Cifci
    • 2
  • Mustafa Sercan
    • 4
  • Mehmet Soy
    • 3
  1. 1.Department of RheumatologyBakırköy State HospitalİstanbulTurkey
  2. 2.Department of PsychiatryBeypazarı State HospitalBeypazarıTurkey
  3. 3.Department of RheumatologyHisar Intercontinental HospitalİstanbulTurkey
  4. 4.Department of Psychiatry, Medical FacultyAbant Izzet Baysal UniversityBoluTurkey