Abstract
Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease involving the axial skeleton, peripheral joints, and extra-articular manifestations like psoriasis, inflammatory bowel disease, or uveitis. A deterioration of quality of life (QoL) affects the disease management and therapeutic decision-making. This meta-analysis focused on the influence of biological drugs on the QoL in SA compared to the effects of other therapeutic modalities. We searched the databases of MedLine, Academic Search Ultimate, CINAHL Complete, and Health Source – Nursing/Academic Edition for articles related to AS treatment using the terms “ankylosing spondylitis” OR “rheumatoid spondylitis” OR “spondylitis” AND “quality of life” OR “patient-reported outcomes” OR “well-being” OR “health-related quality of life” OR “biological treatment”. The search came up with 10 English-language articles published between 2010 and 2020. Patients were evaluated with the following indexes and questionnaires: Assessment of Spondyloarthritis International Society (ASAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Quality of Life (ASQoL), 36-Item Short-Form Health Survey (SF-36), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and the Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Functional (BASFI) Indexes. We found that the QoL, assessed with the ASQoL, improved significantly better in patients treated with biological drugs when compared to those treated with other standard therapies or placebo at a 4-month follow-up. However, improvements in other disease characteristics could not be differentiated based on the therapy modality. The finding that biological drugs are superior in improving the QoL should strengthen the recommendations for their use in patients with AS.
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References
Arısoy O, Bes C, Cifci C, Sercan M, Soy M (2013) The effect of TNF-alpha blockers on psychometric measures in ankylosing spondylitis patients: a preliminary observation. Rheumatol Int 33:1855–1864
Cella D (1997) Manual of the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System. Center on Outcomes, Research and Education (CORE). Version 4. Evanston Northwestern Healthcare and Northwestern University, Evanston, IL
Doward LC, Spoorenberg A, Cook AS, Whalley D, Helliwell PS, Kay LJ, McKenna SP, Tennant A, van der Heijde D, Chamberlain MA (2003) Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis 62(1):20–26
Ertenli I, Ozer S, Kiraz S, Apras SB, Akdogan A, Karadag O, Calguneri M, Kalyoncu U (2012) Infliximab, a TNF-alpha antagonist treatment in patients with ankylosing spondylitis: the impact on depression, anxiety and quality of life level. Rheumatol Int 32(2):323–330
Fattahi MJ, Ahmadi H, Jafarnezhad-Ansariha F, Mortazavi-Jahromi SS, Rehm BHA, Cuzzocrea S, Matsuo H, Mirshafiey A (2018a) Oral administration effects of β-d-mannuronic acid (M2000) on Th17 and regulatory T cells in patients with ankylosing spondylitis. Biomed Pharmacother 100:495–500
Fattahi MJ, Jamshidi AR, Mahmoudi M, Vojdanian M, Yekaninejad MS, Jafarnezhad-Ansariha F, Ahmadi H, Rehm BHA, Matsuo H, Cuzzocrea S, Hosseini M, Hashemi SN, Aghazadeh Z, Mirshafiey A (2018b) Evaluation of the efficacy and safety of β-D-mannuronic acid in patients with ankylosing spondylitis: a 12-week randomized, placebo-controlled, phase I/II clinical trial. Int Immunopharmacol 54:112–117
Feldtkeller E, Bruckel J, Khan MA (2000) Scientific contributions of ankylosing spondylitis patient advocacy groups. Curr Opin Rheumatol 12(4):239–247
Gao X, Wendling D, Botteman MF, Carter JA, Rao S, Cifaldi M (2012) Clinical and economic burden of extra-articular manifestations in ankylosing spondylitis patients treated with anti-tumor necrosis factor agents. J Med Econ 15(6):1054–1063
Gorman JD, Sack KE, Davis JC Jr (2002) Treatment of ankylosing spondylitis by inhibition of tumor necrosis factor alpha. N Engl J Med 346(18):1349–1356
Haroon NN, Paterson JM, Li P, Inman RD, Haroon N (2015) Patients with ankylosing spondylitis have increased cardiovascular and cerebrovascular mortality: a population-based study. Ann Intern Med 163(6):409–416
Jafarnezhad-Ansariha F, Yekaninejad MS, Jamshidi A, Mansouri R, Vojdanian M, Mahmoudi M, Fattahi MJ, Hashemi SN, Rehm BHA, Matsuo H, Esposito E, Cuzzocrea S, Mirshafiey A (2018) The effects of β-D-mannuronic acid (M2000), as a novel NASID, on COX1 and COX2 activities and gene expression in ankylosing spondylitis patients and the murine monocyte/macrophage, J774 cell line. Inflammopharmacology 26(2):375–384
Jankowska-Polanska B, Uchmanowicz I, Wysocka A, Uchmanowicz B, Lomper K, Fal AM (2017) Factors affecting the quality of life of chronic dialysis patients. Eur J Pub Health 27(2):262–267
Kotsis K, Voulgari PV, Drosos AA, Carvalho AF, Hyphantis T (2014) Health-related quality of life in patients with ankylosing spondylitis: a comprehensive review. Expert Rev Pharmacoecon Outcomes Res 14(6):857–872
Lachaine J, Beauchemin C, Desjardins O (2013) Use of biological agents in the treatment of rheumatoid arthritis: an analysis of the Quebec provincial drug reimbursement program database. Value Health 3:230–231
Law L, Rehnman JB, Deminger A, Klingberg E, Jacobsson LTH, Forsblad-d’Elia H (2018) Factors related to health-related quality of life in ankylosing spondylitis, overall and stratified by sex. Arthritis Res Ther 20(1):284
Machado P, Landewé R, Braun J, Hermann KA, Baker D, van der Heijde D (2010) Both structural damage and inflammation of the spine contribute to impairment of spinal mobility in patients with ankylosing spondylitis. Ann Rheum Dis 69(8):1465–1470
Megari K (2013) Quality of life in chronic disease patients. Health Psychol Res 1(3):e27
Pathan E, Abraham S, Van Rossen E, Withrington R, Keat A, Charles PJ, Paterson E, Chowdhury M, McClinton C, Taylor PC (2013) Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in ankylosing spondylitis. Ann Rheum Dis 72(9):1475–1480
Polanski J, Jankowska-Polanska B, Rosinczuk J, Chabowski M, Szymanska-Chabowska A (2016) Quality of life of patients with lung cancer. Onco Targets Ther 9:1023–1028
Reveille JD, Weisman MH (2013) The epidemiology of back pain, axial spondyloarthritis and HLA-B27 in the United States. Am J Med Sci 345:431–436
Rohde G, Berg KH, Pripp AH, Prřven A, Haugeberg G (2020) No deterioration in health-related quality of life in patients with axial spondyloarthritis followed for 5 years in ordinary outpatient clinics in the biological treatment era. Qual Life Res 29:99–107
Stolwijk C, Boonen A, van Tubergen A, Reveille JD (2012) Epidemiology of spondyloarthritis. Rheum Dis Clin N Am 38(3):441–476
Tłustochowicz M (2011) Rytuksymab in treatment of rheumatoid arthritis. Reumatologia 49(1):55–61. (Article in Polish)
van der Heijde D, Baraliakos X, Gensler LS, Maksymowych WP, Tseluyko V, Nadashkevich O, Abi-Saab W, Tasset C, Meuleners L, Besuyen R, Hendrikx T, Mozaffarian N, Liu K, Greer JM, Deodhar A, Landewé R (2018a) Efficacy and safety of filgotinib, a selective Janus kinase 1 inhibitor, in patients with active ankylosing spondylitis (TORTUGA): results from a randomised, placebo-controlled, phase 2 trial. Lancet 392(10162):2378–2387
van der Heijde D, Cheng-Chung Wei J, Dougados M, Mease P, Deodhar A, Maksymowych WP, Van den Bosch F, Sieper J, Tomita T, Landewé R, Zhao F, Krishnan E, Adams DH, Pangallo B, Carlier H, COAST-V study group (2018b) Ixekizumab, an interleukin-17A antagonist in the treatment of ankylosing spondylitis or radiographic axial spondyloarthritis in patients previously untreated with biological disease-modifying anti-rheumatic drugs (COAST-V): 16 week results of a phase 3 randomised, double-blind, active-controlled and placebo-controlled trial. Lancet 392(10163):2441–2451
van der Heijde D, Song IH, Pangan AL, Deodhar A, van den Bosch F, Maksymowych WP, Kim TH, Kishimoto M, Everding A, Sui Y, Wang X, Chu AD, Sieper J (2019) Efficacy and safety of upadacitinib in patients with active ankylosing spondylitis (SELECT-AXIS 1): a multicentre, randomised, double-blind, placebo-controlled, phase 2/3 trial. Lancet 394(10214):2108–2117
Ward MM, Deodhar A, Akl EA et al (2016) American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis. Arthritis Rheumatol 68(2):282–298
Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483
Yang X, Fan D, Xia Q, Wang M, Zhang X, Li X, Cai G, Wang L, Xin L, Xu S, Pan F (2016) The health-related quality of life of ankylosing spondylitis patients assessed by SF-36: a systematic review and meta-analysis. Qual Life Res 25(11):2711–2723
Zhu W, He X, Cheng K, Zhang L, Chen D, Wang X, Qiu G, Cao X, Weng X (2019) Ankylosing spondylitis: etiology, pathogenesis, and treatments. Bone Res 7(22)
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Tański, W., Świątoniowska-Lonc, N., Dudek, K., Jankowska-Polańska, B. (2020). Benefit of Biological Drugs for Quality of Life in Patients with Ankylosing Spondylitis: A Systematic Review and Meta-Analysis of Clinical Trials. In: Pokorski, M. (eds) Best Practice in Health Care. Advances in Experimental Medicine and Biology(), vol 1335. Springer, Cham. https://doi.org/10.1007/5584_2020_611
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DOI: https://doi.org/10.1007/5584_2020_611
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