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HLA-B27 POZİTİFLİĞİNİN ERKEK ANKİLOZAN SPONDİLİT HASTALARINDA ANTİ-TNF TEDAVİ CEVABINA ETKİLERİ
2018
Journal:  
Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi
Author:  
Abstract:

Amaç: Anti-TNF tedavi alan erkek Ankilozan Spondilit (AS) hastalarında HLA-B27 pozitifliğinin anti-TNF tedavi etkinliği üzerindeki olası etkilerini araştırmaktır.. Materyal ve Metod:Bir yıldır anti-TNF tedavi alan 30 erkek AS hastasının verileri retrospektif olarak incelendi. Hastaların kullandığı anti-TNF tedavi ajanları, demografik veriler ve laboratuvar aktivite parametreleri kaydedildi. Hastaların ağrı düzeyleri Vizüel Analog Skala (VAS), Hastalık aktivitesi Bath ankilozan spondilit hastalık aktivite indeksi (BASHAI), fonksiyonel durum Bath ankilozan spondilit fonksiyon indeksi (BASFİ) ile değerlendirildi. Hastalar HLA-B27 (+) ve (-) olmak üzere 2 gruba ayrıldı ve hastalık aktivite ve fonksiyon parametreleri karşılaştırıldı. Bulgular: Retrospektif analize dahil edilen 30 erkek AS hastasının 11’inde HLA-B27 (+)’ti. HLA-B27 (+) hastaların yaş ortalamaları 38.18±8.18 yıl, HLA-B27 (-) hastaların yaş ortalamaları 40.57±5.89 yıldı. Grupların yaş ortalamaları açısından istatistiksel anlamlı fark yoktu (p>0.05). Ortalama hastalık süreleri açısından gruplar arasında fark yoktu (HLA-B27 (+) :15.9±7.4 yıl, HLA-B27 (-): 15.89±4.71 yıl, p>0.05). Grupların başlangıç ortalama BASHAI (HLA-B27 (+):6.15±1.41, negatif: 6.72±1.1) ve BASFİ (HLA-B27 (+) :5.59±1.9, HLA-B27(-) : 5.97±1.49) değerleri arasında da istatistiksel olarak anlamlı farklılık tespit edilmedi (p>0.05). Gruplar BASHAI ile bakılan hastalık aktivitesi açısından karşılaştırıldığında HLA-B27 pozitifliğinin 1. yıl anti-TNF etkinliğine belirgin etkisi saptanmadı (p>0.05). Bununla beraber HLA-B27 (+) hastalarda anti-TNF tedavi ile 1.yılda BASFİ ile değerlendirilen fonksiyonel parametrelerin daha belirgin olarak düzeldiği tespit edildi (p=0.016). Sonuç: HLA-B27 (+) AS hastalarında anti-TNF tedavi HLA-B27 (-) hastalara göre fonksiyonel parametrelerde 1 yılda belirgin düzelme sağladığı gözlendi. Bununla birlikte HLA-B27 pozitifliğinin AS’li hastalarda anti-TNF tedavisi ile elde edilen hastalık aktivite azalması üzerinde belirgin fark yaratmadığı gözlendi.

Keywords:

The effects of HLA-B27 positivity on anti-TNF response in male ankylosan spondylitis patients
2018
Author:  
Abstract:

Purpose: Ankylosan Spondylitis (AS) is to investigate the potential effects of HLA-B27 positivity on anti-TNF therapeutic efficacy in male patients receiving anti-TNF therapy.. Material and Method:The data of 30 male AS patients receiving anti-TNF therapy for a year were retrospective examined. Patients used anti-TNF therapeutic agents, demographic data and laboratory activity parameters were recorded. Pacient pain levels were evaluated by the Visual Analog Scale (VAS), the Bath Ankylosan Spondylite Disease Activity Index (BASHAI), the Bath Ankylosan Spondylite Function Index (BASFI) and the Bath Ankylosan Spondylite Function Index (BASFI). Patients were divided into 2 groups, HLA-B27 (+) and (-) and the activity and function parameters of the disease were compared. Results: 11 of 30 male AS patients included in the retrospective analysis were HLA-B27 (+). The average age of HLA-B27 (+) patients was 38.18±8.18 years, and the average age of HLA-B27 (-) patients was 40.57±5.89 years. There were no statistically significant differences in terms of the age average of the groups (p>0.05). There was no difference between the groups in terms of the average period of disease (HLA-B27 (+) :15.9±7.4 years, HLA-B27 (-): 15.89±4.71 years, p>0.05). There was no statistically significant difference between the starting average BASHAI (HLA-B27 (+):6.15±1.41, negative: 6.72±1.1) and BASFI (HLA-B27 (+) :5.59±1.9, HLA-B27(-) : 5.97±1.49) values (p>0.05). In comparison with BASHAI, the HLA-B27 positive activity is 1. No noticeable effect on anti-TNF activity was detected in the year (p>0.05). However, in HLA-B27 (+) patients with anti-TNF therapy, the functional parameters evaluated with BASFI in the 1st year were more significantly improved (p=0.016). Results: Anti-TNF treatment in HLA-B27 (+) AS patients was observed to have a significant improvement in functional parameters in 1 year compared to HLA-B27 (-) patients. However, the HLA-B27 positivity was not observed to make a clear difference in the reduction in disease activity obtained by anti-TNF treatment in patients with AS.

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Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi

Field :   Sağlık Bilimleri

Journal Type :   Ulusal

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Article : 394
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Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi