Effect of TNF ‐inhibitor therapy on spinal structural progression in ankylosing spondylitis patients: A systematic review and meta‐analysis

AbstractTo review the effect of tumor necrosis factor ‐alpha inhibitor (TNFi) therapies on radiographic progression in ankylosing spondylitis (AS) patients as evaluated by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Pubmed, MEDLINE, EMBASE, and the Cochrane Library databases were searched from inception to August 2019. All compara tive and non‐comparative studies that evaluated the clinical effectiveness of TNFi on radiographic progression as assessed by mSASSS change at a minimum follow‐up of 1 year were included. The Newcastle–Ottawa Scale and Cochrane Collaboration Risk of Bias Tool were utilized to assess the metho dological quality. Pooled analysis was performed for continuous and binomial variables where appropriate. Inter‐rater reliability of mSASSS status and change scores were assessed with intra‐class coefficients (ICC). Twenty‐one studies were identified with a total of 4460 patients (mean age: 40 .4 years [range 25.3‐50 years]; 76% male; mean baseline mSASSS: 12.7 units [range 5.5‐19.8 units]). All studies (3 randomized and 18 observational studies) were considered to have moderate‐to‐high methodological quality. The inter‐rater reliability of mSASSS status and change scores from 14 of the 21 studies were excellent (ICC ranges, 0.91‐0.99) and moderate‐to‐excellent (ICC ranges, 0.58‐0.90), respectively. From the 21 studies, 11/21 (50%) demonstrated a delayed effect in mSASSS in AS patient administered TNFi. Whe...
Source: International Journal of Rheumatic Diseases - Category: Rheumatology Authors: Tags: REVIEW Source Type: research