Radiographic progression of ankylosing spondylitis after up to two years of treatment with etanercept

Authors

  • D. van der Heijde,

    Corresponding author
    1. Leiden University Medical Center, Leiden, The Netherlands
    • Korte Raarberg 46, 6231 KR Meerssen, The Netherlands
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    • Dr. van der Heijde has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Amgen, Centocor, Wyeth, Chugai, UCB, Roche, and Schering-Plough. Dr. Landewé has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Amgen, Bristol-Myers Squibb, Centocor, Wyeth, UCB, and Schering-Plough. Dr. Ory has received consulting fees, speaking fees, and/or honoraria (more than $10,000 each) from Amgen, Abbott, and Targeted Genetics. Drs. Ni, Lin, and Tsuji own stock or stock options in Amgen. Dr. Davis has received consulting fees, speaking fees, and/or honoraria from Abbott and Wyeth.

  • R. Landewé,

    1. University Hospital Maastricht, Maastricht, The Netherlands
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    • Dr. van der Heijde has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Amgen, Centocor, Wyeth, Chugai, UCB, Roche, and Schering-Plough. Dr. Landewé has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Amgen, Bristol-Myers Squibb, Centocor, Wyeth, UCB, and Schering-Plough. Dr. Ory has received consulting fees, speaking fees, and/or honoraria (more than $10,000 each) from Amgen, Abbott, and Targeted Genetics. Drs. Ni, Lin, and Tsuji own stock or stock options in Amgen. Dr. Davis has received consulting fees, speaking fees, and/or honoraria from Abbott and Wyeth.

  • S. Einstein,

    1. Bio-Imaging Technologies Inc., Newtown, Pennsylvania
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  • P. Ory,

    1. University of Washington, Seattle
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    • Dr. van der Heijde has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Amgen, Centocor, Wyeth, Chugai, UCB, Roche, and Schering-Plough. Dr. Landewé has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Amgen, Bristol-Myers Squibb, Centocor, Wyeth, UCB, and Schering-Plough. Dr. Ory has received consulting fees, speaking fees, and/or honoraria (more than $10,000 each) from Amgen, Abbott, and Targeted Genetics. Drs. Ni, Lin, and Tsuji own stock or stock options in Amgen. Dr. Davis has received consulting fees, speaking fees, and/or honoraria from Abbott and Wyeth.

  • D. Vosse,

    1. University Hospital Maastricht, Maastricht, The Netherlands
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  • L. Ni,

    1. Amgen Inc., Thousand Oaks, California
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    • Dr. van der Heijde has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Amgen, Centocor, Wyeth, Chugai, UCB, Roche, and Schering-Plough. Dr. Landewé has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Amgen, Bristol-Myers Squibb, Centocor, Wyeth, UCB, and Schering-Plough. Dr. Ory has received consulting fees, speaking fees, and/or honoraria (more than $10,000 each) from Amgen, Abbott, and Targeted Genetics. Drs. Ni, Lin, and Tsuji own stock or stock options in Amgen. Dr. Davis has received consulting fees, speaking fees, and/or honoraria from Abbott and Wyeth.

  • S.-L. Lin,

    1. Amgen Inc., Thousand Oaks, California
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    • Dr. van der Heijde has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Amgen, Centocor, Wyeth, Chugai, UCB, Roche, and Schering-Plough. Dr. Landewé has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Amgen, Bristol-Myers Squibb, Centocor, Wyeth, UCB, and Schering-Plough. Dr. Ory has received consulting fees, speaking fees, and/or honoraria (more than $10,000 each) from Amgen, Abbott, and Targeted Genetics. Drs. Ni, Lin, and Tsuji own stock or stock options in Amgen. Dr. Davis has received consulting fees, speaking fees, and/or honoraria from Abbott and Wyeth.

  • W. Tsuji,

    1. Amgen Inc., Thousand Oaks, California
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    • Dr. van der Heijde has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Amgen, Centocor, Wyeth, Chugai, UCB, Roche, and Schering-Plough. Dr. Landewé has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Amgen, Bristol-Myers Squibb, Centocor, Wyeth, UCB, and Schering-Plough. Dr. Ory has received consulting fees, speaking fees, and/or honoraria (more than $10,000 each) from Amgen, Abbott, and Targeted Genetics. Drs. Ni, Lin, and Tsuji own stock or stock options in Amgen. Dr. Davis has received consulting fees, speaking fees, and/or honoraria from Abbott and Wyeth.

  • J. C. Davis Jr.

    1. University of California, San Francisco
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    • Dr. van der Heijde has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Amgen, Centocor, Wyeth, Chugai, UCB, Roche, and Schering-Plough. Dr. Landewé has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Abbott, Amgen, Bristol-Myers Squibb, Centocor, Wyeth, UCB, and Schering-Plough. Dr. Ory has received consulting fees, speaking fees, and/or honoraria (more than $10,000 each) from Amgen, Abbott, and Targeted Genetics. Drs. Ni, Lin, and Tsuji own stock or stock options in Amgen. Dr. Davis has received consulting fees, speaking fees, and/or honoraria from Abbott and Wyeth.


  • ClinicalTrials.gov identifier: NCT00356356.

  • The Rheumatology Department of the Academic Hospital Maastricht received compensation from Amgen for the use of the OASIS data set.

Abstract

Objective

To investigate the effect of etanercept therapy on radiographic progression in patients with ankylosing spondylitis (AS).

Methods

Patients with AS who had previously participated in a 24-week randomized, double-blind, placebo-controlled trial of etanercept therapy were enrolled in a 72-week open-label extension. Radiographs of the cervical and lumbar spine from patients who received etanercept (25 mg twice weekly) for up to 96 weeks were compared with radiographs from patients in a large prevalence cohort (Outcome Assessments in Ankylosing Spondylitis International Study [OASIS]) who had not been treated with anti–tumor necrosis factor α (anti-TNFα) agents. Radiographs obtained at 2 time points up to 96 weeks apart from patients in both study populations were digitized and read by 2 independent readers who were blinded with regard to patient group and sequence. The primary end point was the 96-week change in the modified Stoke AS Spine Score (mSASSS).

Results

A total of 257 patients treated with etanercept were compared with 175 unselected patients from the OASIS study. There was no significant difference in the change in the mSASSS from baseline among patients who received etanercept (mean ± SD 0.91 ± 2.45) versus those from the OASIS group (0.95 ± 3.18).

Conclusion

Unlike other inflammatory rheumatic diseases such as rheumatoid arthritis and psoriatic arthritis, structural progression in AS seems to be independent of TNF, despite the fact that TNF is responsible for the signs and symptoms due to inflammation in this disease.

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