<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Background &amp; Aims</bold>. Considering the ability of anti-TNF alpha drugs to lower the burden intestinal inflammation in patients with inflammatory bowel disease (IBD), and the similarity between IBD and ankylosing spondylitis (AS) regarding inflammatory intestinal involvement, we aimed to investigate the impact of anti-TNF alpha biologic therapy on subclinical intestinal inflammation in AS patients.<bold>Methods</bold>. Between January 2008 and December 2013, 38 AS patients and 23 controls were enrolled in the study and investigated with small bowel videocapsule endoscopy examination and ileocolonoscopy. Each tertile of the small bowel (proximal, mid and distal) was assessed by calculating the Lewis score based on the image stream.<bold>Results</bold>. The Lewis scores were significantly higher in the AS group compared to controls (580.9 ± 818 <italic>vs</italic>. 81 ± 121, p&lt;0.001). 16 patients (42.1%) were on anti-TNF alpha therapy (Adalimumab (n = 5), Infliximab (n = 5) or Etanercept (n = 6)).31.3% of them used NSAIDs simultaneously, compared with 77.3% of the other patients (p&lt;0.01). Their Lewis scores were lower compared to the other patients for the entire small bowel (306 ± 164 <italic>vs</italic>. 790 ± 1038, p = 0.015), its proximal and distal tertiles (238 ± 154 <italic>vs</italic>. 560 ± 543, p = 0.021, and 140 ± 189 <italic>vs</italic>. 300 ± 220, p = 0.027, respectively). The Lewis score was also lower in patients receiving Adalimumab/Infliximab compared to those on Etanercept for the entire bowel and its distal tertile (262 ± 165 <italic>vs</italic>. 380 ± 148, p = 0.069 and 62 ± 101 <italic>vs</italic>. 273 ± 236, p = 0.060, respectively).<bold>Conclusion</bold>. Anti-TNF alpha therapy in patients with AS reduces the subclinical intestinal inflammation, but the magnitude seems to depend upon the class anti-TNF alpha agent used (Clinical Trials. gov NCT00768950).</abstract>

Background & Aims. Considering the ability of anti-TNF alpha drugs to lower the burden intestinal inflammation in patients with inflammatory bowel disease (IBD), and the similarity between IBD and ankylosing spondylitis (AS) regarding inflammatory intestinal involvement, we aimed to investigate the impact of anti-TNF alpha biologic therapy on subclinical intestinal inflammation in AS patients.Methods. Between January 2008 and December 2013, 38 AS patients and 23 controls were enrolled in the study and investigated with small bowel videocapsule endoscopy examination and ileocolonoscopy. Each tertile of the small bowel (proximal, mid and distal) was assessed by calculating the Lewis score based on the image stream.Results. The Lewis scores were significantly higher in the AS group compared to controls (580.9 ± 818 vs. 81 ± 121, p<0.001). 16 patients (42.1%) were on anti-TNF alpha therapy (Adalimumab (n = 5), Infliximab (n = 5) or Etanercept (n = 6)).31.3% of them used NSAIDs simultaneously, compared with 77.3% of the other patients (p<0.01). Their Lewis scores were lower compared to the other patients for the entire small bowel (306 ± 164 vs. 790 ± 1038, p = 0.015), its proximal and distal tertiles (238 ± 154 vs. 560 ± 543, p = 0.021, and 140 ± 189 vs. 300 ± 220, p = 0.027, respectively). The Lewis score was also lower in patients receiving Adalimumab/Infliximab compared to those on Etanercept for the entire bowel and its distal tertile (262 ± 165 vs. 380 ± 148, p = 0.069 and 62 ± 101 vs. 273 ± 236, p = 0.060, respectively).Conclusion. Anti-TNF alpha therapy in patients with AS reduces the subclinical intestinal inflammation, but the magnitude seems to depend upon the class anti-TNF alpha agent used (Clinical Trials. gov NCT00768950).

Different effects of anti-TNF-alpha biologic drugs on the small bowel macroscopic inflammation in patients with ankylosing spondylitis

Internal Medicine Department, “Carol Davila” University of Medicine, Bucharest,

Gastroenterology Department, “Colentina” Clinical Hospital, Bucharest,

Internal Medicine Department, “Colentina” Clinical Hospital, Bucharest,

Rheumatology Department, “Colentina” Clinical Hospital, Bucharest,

Romanian Journal of Internal Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Background & Aims. Considering the ability of anti-TNF alpha drugs to lower the burden intestinal inflammation in patients with inflammatory bowel disease...

Different effects of anti-TNF-alpha biologic drugs on the small bowel macroscopic inflammation in patients with ankylosing spondylitis

Published Online: Mar 04, 2017

Page range: 44 - 52

Received: Nov 01, 2016

DOI: https://doi.org/10.1515/rjim-2017-0001

Keywords
Ankylosing spondylitis, Anti-TNF alpha therapy, Lewis score, Videocapsule endoscopy, Nonsteroidal anti-inflammatory drugs

© 2017 A. Chitul et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Different effects of anti-TNF-alpha biologic drugs on the small bowel macroscopic inflammation in patients with ankylosing spondylitis

Published Online: Mar 04, 2017

Page range: 44 - 52

Received: Nov 01, 2016

DOI: https://doi.org/10.1515/rjim-2017-0001

KeywordsAnkylosing spondylitis, Anti-TNF alpha therapy, Lewis score, Videocapsule endoscopy, Nonsteroidal anti-inflammatory drugs

© 2017 A. Chitul et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
Ankylosing spondylitis, Anti-TNF alpha therapy, Lewis score, Videocapsule endoscopy, Nonsteroidal anti-inflammatory drugs