Objective To determine whether thalidomide can maintain remission after discontinuing the treatment of Inflixirnab in ankylosing spondylitis (AS ) . Methods Forty patients with active AS treated with Infliximab ( 5mg/kg ) for 26 weeks and attained an ASAS20 response at week 26.They were randomly assigned to receive thalidomide 150mgight. sulfasalazine ( SASP) 2.0g/d. AI1 patients were followed monthly for BASDAT.BASFT , PGA and spinal pain VAS.A Kaplan-Meier survival analysis was used to calculate the probability of a relapse. Results Thirty-seven patients completed the follow-up. 18 patients were treated with thalidomide, 19 patients with SASP .The mean follow-up time was 9.2 months and the longest time was 18months.At the end of the follow-up.the percentage of patients who maintained remission in the thalidomide group was 44%, which was much higher than SASP group (15% ) . Conclusion Thalidomide can successfully maintainremission of AS after discontinue Infliximab treatment.%目的 评价停英夫利昔单抗后用沙利度胺可否维持强直性脊柱炎(AS)患者病情的缓解.方法 40例经过为期26周的英夫利昔单抗(5mg/kg)治疗后达到AS疗效评价标准(ASAS20)并能定期接受随访的患者随机分为两组.第l组给予沙利度胺150mg.每日1次,晚上口服;第2组给予柳氮磺吡啶(SASP)1.0g,每日2次口服;每个月定期随访1次,随访内容包括Bath AS疾病活动性指数(BASDAI)、Bath AS功能指数(BASFI)、患者对病情的总体评价(PGA)、脊柱痛等,以病情复发作为随访终点.结果 37例患者最终完成随访,其中沙利度胺组18例,SASP组19例,平均随访时间(9±3)个月,最长随访18个月.随访结束时沙利度胺组维持病情缓解率44%(8/18),SASP组15%(3/19),沙利度胺组的维持缓解率高于SASP组(P=0.0166).结论 沙利度胺有助于停用英夫利昔单抗后维持AS患者病情的缓解.
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