A multicenter report of biologic agents for the treatment of secondary amyloidosis in Turkish rheumatoid arthritis and ankylosing spondylitis patients
Makaleler > Tam Makale · 2016
Yazarlar: Omer Nuri Pamuk, UMUT KALYONCU, Kenan AKSU, Ahmet OMMA, Yavuz Pehlivan, Yonca Cagatay, Orhan KUCUKSAHIN, Salim Donmez, Gozde Yildirim Cetin, Ridvan MERCAN, Ozun BAYINDIR, Ayse Cefle, Fatih YILDIZ, Ayse Balkarli, Levent KILIC, Necati CAKIR, Bunyamin Kisacik, Mustafa Ferhat Oksuz, Veli Cobankara, Ahmet Mesut Onat, Mehmet Sayarlioglu, Mehmet Akif Ozturk, Gulsum Emel Pamuk, Nurullah Akkoc
Rheumatology International, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Wos, 2016, cilt 36, ss 945-953
DOI: 10.1007/s00296-016-3500-9
Özet
In this multicenter, retrospective study, we evaluated the efficacy and safety of biologic therapies, including anti-TNFs, in secondary (AA) amyloidosis patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA). In addition, the frequency of secondary amyloidosis in RA and AS patients in a single center was estimated. Fifty-one AS (39M, 12F, mean age: 46.7) and 30 RA patients (11M, 19F, mean age: 51.7) with AA amyloidosis from 16 different centers in Turkey were included. Clinical and demographical features of patients were obtained from medical charts. A composite response index (CRI) to biologic therapy-based on creatinine level, proteinuria and disease activity-was used to evaluate the efficacy of treatment. The mean annual incidence of AA amyloidosis in RA and AS patients was 0.23 and 0.42/1000 patients/year, respectively. The point prevalence in RA and AS groups was 4.59 and 7.58/1000, respectively. In RA group with AA amyloidosis, effective response was obtained in 52.2 % of patients according to CRI. RA patients with RF positivity and more initial disease activity tended to have higher response rates to therapy (p values, 0.069 and 0.056). After biologic therapy (median 17 months), two RA patients died and two developed tuberculosis. In AS group, 45.7 % of patients fulfilled the criteria of good response according to CRI. AS patients with higher CRP levels at the time of AA diagnosis and at the beginning of anti-TNF therapy had higher response rates (p values, 0.011 and 0.017). During follow-up after anti-TNF therapy (median 38 months), one patient died and tuberculosis developed in two patients. Biologic therapy seems to be effective in at least half of RA and AS patients with AA amyloidosis. Tuberculosis was the most important safety concern.