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Bisphosphonates vs infliximab in ankylosing spondylitis treatment

机译：双膦酸盐与英夫利昔单抗治疗强直性脊柱炎

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Objective: The objective of this study was to evaluate if the anti-inflammatory properties of bisphosphonates and their effect on bone turnover could be useful in the treatment of AS. Methods: Sixty patients were consecutively assigned in a 1:1 ratio in a 6-month open-label, single-centre study on active AS to receive monthly i.v. neridronate (100 mg) or standard infliximab (5 mg/kg) therapy. Results: A significant reduction in the mean BASDAI was observed over 6 months of either neridronate (-1.72) or infliximab (-1.62) administration. The BASFI decreased significantly at 3 and 6 months in the neridronate arm, while in the infliximab group a significant reduction at 3 months but not 6 months was observed. The 10-cm visual analogue scale for axial pain decreased significantly and comparably at 3 and 6 months in both groups. No significant differences between treatment arms for all these changes were observed at both 3 months and the final assessment. The BASMI was not significantly modified in the neridronate or infliximab group. No significant variations of BMD were observed in the infliximab group, while in patients treated with neridronate a significant increase was observed at the lumbar spine. Conclusion: High i.v. doses of the amino-bisphosphonate neridronate are as effective as infliximab therapy in reducing disease activity in AS patients, with additional benefits on BMD changes. Further studies to confirm these results over a longer time frame are warranted together with the possibility to explore the long-term efficacy of a combination of lower anti-TNF doses with bisphosphonates.
机译：目的：本研究的目的是评估双膦酸盐的抗炎特性及其对骨骼更新的影响是否可用于治疗AS。方法：在为期6个月的开放式单中心主动性AS研究中，以1：1的比例连续分配60例患者，以接受每月静脉输液。神经氨酸酯（100 mg）或标准英夫利昔单抗（5 mg / kg）治疗。结果：奈德膦酸盐（-1.72）或英夫利昔单抗（-1.62）服用6个月后，平均B​​ASDAI显着降低。奈德膦酸盐组的3和6个月时BASFI显着下降，而英夫利昔单抗组3个月时BASFI显着下降，而6个月时未观察到。两组的3个月和6个月时，轴向疼痛的10厘米视觉模拟量表均显着降低。在3个月和最终评估中，所有这些变化的治疗组之间均未观察到显着差异。神经氨酸酯或英夫利昔单抗组的BASMI没有明显改变。在英夫利昔单抗组中未观察到BMD的显着变化，而在接受神经药酸奈德膦酸盐治疗的患者中，腰椎处的BMD显着增加。结论：高i.v.剂量的氨基双膦酸酯神经氨酸酯与英夫利昔单抗治疗在减少AS患者疾病活动方面一样有效，并且对BMD变化具有额外的好处。进一步的研究证实这些结果将在更长的时间内得到保证，同时有可能探索将较低的抗TNF剂量与双膦酸盐组合使用的长期疗效。

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