A RECENT study found that TNF inhibitors have similar rates of adverse events and treatment response in ankylosing spondylitis (AS) regardless of whether the disease developed early or late in life.
AS typically presents in people before the age of 45, but can also emerge later in life. The study aimed to address the gap in the literature regarding the use of TNF inhibitors in late-onset AS.
The study was conducted at the University School of Medicine, led by Dr Sadettin Usly, and analysed data from the Turkish Biological Database, a nationwide registry. The analysis included 2,573 patients with young-onset AS (onset at 45 years or younger) and 281 patients with late-onset AS (onset at 45 years or older), all of whom were biologic-naïve and starting their first TNF inhibitor. Key metrics for disease activity included the Bath Ankylosing Spondylitis Disease Activity Index and the Ankylosing Spondylitis Disease Activity Score. Retention rates were measured by the duration from the start of treatment to discontinuation.
The results indicated no significant differences in treatment response or adherence between the two groups over 6 to 24 months. At 24 months, retention rates were identical at 72.9% for both cohorts, with inefficacy, adverse events, and remission being the primary reasons for discontinuation. Adverse event rates were comparable between the groups: 8.7% in young-onset and 11.7% in late-onset patients. Discontinuation in late-onset AS was linked to higher pain scores on the visual analogue scale.
The findings suggest that the management of late-onset AS patients with TNF inhibitor therapy can be similar to that of patients with young-onset AS. Future research will focus on further validation of the results by engaging more patients with late-onset AS in clinical and epidemiological studies.
Aleksandra Zurowska, EMJ
Reference
Uslu S et al. Assessing safety and efficacy of TNFi treatment in late onset ankylosing spondylitis: a TURKBIO registry study. Sci Rep. 2024;14:14194.
