Six-month response to anti-TNF drugs in axial spondylarthropathy according to the fulfillment or not of New-York criteria for ankylosing spondylitis or French recommendations for anti-TNF use. A "real life" retrospective study on 175 patients.

OBJECTIVES: To assess in clinical practice the 6-month outcome in patients with axial spondylarthropathy (SpA) treated by anti-TNF, according to the fulfillment of New-York criteria (NY) for the diagnosis of ankylosing spondylitis (AS), or agreement with French recommendations (SFR) for anti-TNF use in SpA.
METHODS: Outcome could be retrospectively assessed according to the updated ASAS score (improvement of at least 50% or two units of the BASDAI) and the percentages of patients reaching at 6 month the patient BASDAI acceptable symptoms state (PASS) of 3.5.
RESULTS: A total of 175 out of 203 patients could be retrospectively assessed at 6 month. Fifty-eight percent fulfilled the NY criteria, and 81% satisfied SFR recommendations. After 6 months of anti-TNF treatment, patients with NY criteria (NY+) met the updated ASAS outcome more often than NY- (70% versus 58%) (chi-square: 0.041): reduction of BASDAI of 2.86+/-2.18 (NY+) versus 2.48+/-2.39 (NY-) (NS). PASS of 3.5 was reached in 64% (NY+) versus 49% (NY-). ASAS outcome was met in 45%/60%/69%/88% of patients with 0/1/2/>/=3 parameters to guide physician's opinion from SFR: raised ESR or CRP was present in 66%, active enthesitis or arthritis in 49%, coxitis in 13%, active or relapsing uveitis in 11%, inflammation of sacro-iliac or spine on MRI in 12%, and worsening of articular damage in 5%.
CONCLUSION: The effectiveness of TNF-blockers was slightly better in patients fulfilling the NY criteria for AS or SFR recommendations, but 58% of axial SpA not fulfilling NY criteria, and 48% of patients not satisfying French recommendations also met ASAS outcome.