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Year : 2021  |  Volume : 18  |  Issue : 3  |  Page : 241-244

Raised inflammatory markers as predictors of response to anti-tumor necrosis factor drugs (etanercept and infliximab) in a sample of Iraqi patients with ankylosing spondylitis

1 Department of Medicine, Baaquba Teaching Hospital, Diyala, Iraq
2 Department of Medicine, Baghdad Teaching Hospital, Baghdad, Iraq
3 Department of Medicine, Merjan Teaching Hospital, Babil, Iraq

Correspondence Address:
Anmar Abdulwahhab Khaleel Al-Bayati
Department of Medicine, Merjan Teaching Hospital, Babil.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/MJBL.MJBL_27_21

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Background: Ankylosing spondylitis (AS) is a chronic systemic inflammatory disorder mainly affecting the axial skeleton, although peripheral joints, entheses, and extra-articular tissues such as eyes, heart, and lungs may also be involved. Raised inflammatory markers in patients with AS at the start of anti-tumor necrosis factor (anti-TNF) therapy are associated with more clinical response. Objectives: The aim of this article is to assess the role of raised inflammatory markers in predicting response to anti-TNF drugs in patients with AS. Materials and Methods: The prospective cohort study enrolled a total of 71 patients with AS. Nineteen patients were excluded from the study due to discontinuation of anti-TNF therapy and 52 patients continued in the study and were followed for 3 months. Results: The mean age of the patients was 35.2±9.6 years, males constitute 84.6% of them and the median disease duration was 5 (3–10) years. Univariate analysis showed that the predictors of response to anti-TNF drugs were raised baseline C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), Bath Ankylosing Spondylitis Disease Activity Index, and Bath Ankylosing Spondylitis Functional Index. Multivariate analysis showed that the only independent predictor for response to anti-TNF drugs was raised baseline CRP. The optimal cut point for CRP to predict response was >7.5 mg/L, whereas that for ESR was >32 mm/h. Conclusion: Raised inflammatory markers at baseline predict better response to anti-TNF drugs in AS patients. CRP had better prediction of response to anti-TNF drugs than ESR.

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