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Successful Short Term Treatment of Severe Undifferentiated Spondyloarthropathy with the
Anti-Tumor Necrosis Factor-a Monoclonal
Antibody Infliximab
JAN BRANDT, HILDRUN HAIBEL, JAQUELINE REDDIG, JOACHIM SIEPER, and JÜRGEN BRAUN
ABSTRACT. Methods. Six patients with uSpA were treated with 3 infusions of infliximab in a dosage of 3 (n = 3) or 5 mg/kg (n = 3) at Weeks 0, 2, and 6. The total observational period was 12 weeks. The Bath AS Disease Activity Index (BASDAI), the Functional Index (BASFI), pain on a visual analog scale, the Bath AS Metrology Index (BASMI), and quality of life (SF-36) were assessed before, during, and after therapy. Results. Significant improvement at Day 1 after the first infusion lasting until Week 12 was reported by 5/6 patients. Improvement of >= 50% in all activity, function, pain, and swollen joint scores was observed in the patients taking 5 mg/kg. The 3 mg/kg dose was less effective, resulting in >= 15% improvement in outcome variables. Peripheral arthritis, enthesitis, and spinal symptoms improved equally. C-reactive protein dropped in 4 patients. Health related quality of life increased. No serious side effects or infections occurred. Conclusion. These observations suggest that anti-TNF-a therapy has significant short term efficacy in patients with severe uSpA. (J Rheumatol 2002;29:118-22) Key Indexing Terms:
THERAPY
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