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

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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.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Rheumatology, Bakırköy State Hospital, İstanbul, Turkey

    Cemal Bes

  2. Department of Psychiatry, Beypazarı State Hospital, Beypazarı, Turkey

    Cigdem Cifci

  3. Department of Rheumatology, Hisar Intercontinental Hospital, İstanbul, Turkey

    Mehmet Soy

  4. Department of Psychiatry, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey

    Ozden Arısoy & Mustafa Sercan

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  1. Ozden Arısoy
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  2. Cemal Bes
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  3. Cigdem Cifci
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Correspondence to Ozden Arısoy.

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Arısoy, O., Bes, C., Cifci, C. et al. The effect of TNF-alpha blockers on psychometric measures in ankylosing spondylitis patients: a preliminary observation. Rheumatol Int 33, 1855–1864 (2013). https://doi.org/10.1007/s00296-013-2671-x

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  • DOI: https://doi.org/10.1007/s00296-013-2671-x

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