Leki biologiczne w terapii zesztywniającego zapalenia stawów kręgosłupa (ZZSK) – przegląd systematyczny

Paweł Moćko¹, Paweł Kawalec¹, Katarzyna Antoniewicz², Andrzej Pilc³

Summary
Introduction. Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease that mainly affects the axial joints, including the sacroiliac joints connecting the base of the spine to the pelvis, small joints of the spine, fibrous rings and ligaments of the spine. It is predominantly a disease of progressive and leads gradually to the above-mentioned joint stiffness.
Aim. Presentation of current and alternative therapies of AS using biological drugs.
Material and methods. We identified eligible studies by searching MEDLINE, Embase and CENTRAL from inception to June 17, 2014. We included a phase III, randomized controlled trials (RCT) that compared efficacy and safety of adalimumab, etanercept, infliximab, golimumab, abatacept, certolizumab pegol, rituximab or tocilizumab compared with placebo or another active comparator in patients with AS.
Results. 10 RCT were included in our systematic review. All identified studies with placebo controls. The review of the literature did not identify any studies that met the inclusion criteria for the use of abatacept, rituximab or tocilizumab. Clinical outcomes of interest included a reduction of pain intensity, stiffness and fatigue of the spine and the improvement of the measured aspects of quality of life associated with pain and fatigue (BASDAI, BASFI and BASMI) and ASAS responses (ASAS20, ASAS40, ASAS5/6). The analysis of the safety profile showed that the most commonly reported adverse events (AEs) were: the incidence of injection site reactions, upper respiratory tract infection. Analysis also demonstrated a higher risk of AEs associated with adalimumab, etanercept, infliximab, certolizumab pegol and golimumab.
Conclusions. Adalimumab, etanercept, infliximab, golimumab or certolizumab pegol are an effective therapeutic method for patients with AS.

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