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Abstract：
Clinical data on the use of tumour necrosis factor inhibitors (TNFi) in late-onset ankylosing spondylitis (LoAS) are limited. The present study aimed to evaluate efficacy, safety, and treatment adherence associated with the initial use of TNFi therapy in biologic naive patients diagnosed with LoAS. Patients whose age of onset was ≥ 45 years and < 45 years were classified as having LoAS and YoAS, respectively, based on the age of symptom onset. There were 2573 patients with YoAS and 281 LoAS. Baseline disease activity measures were similar between the groups. No significant differences were seen between the two groups in response to treatment and in remaining on the first TNFi at 6, 12 and 24 months. In the LoAS group, the analysis showed that TNFi discontinuation was linked to VAS pain score (HR 1.04; 95% CI 1.01-1.06). Patient groups had similar rates of adverse events (YoAS: 8.7% vs. LoAS: 11.7%). In both biologic naive LoAS and YoAS patients, the study showed that the initial TNFi therapy was equally effective and safe.
摘要：
在迟发性强直性脊柱炎（LoAS）中使用肿瘤坏死因子抑制剂（TNFi）的临床数据有限。本研究旨在评估疗效，安全,在诊断为LoAS的未接受生物学治疗的患者中，与初次使用TNFi治疗相关的治疗依从性。发病年龄≥45岁和<45岁的患者分为LoAS和YoAS。分别,根据症状发作的年龄。有2573例YoAS和281例LoAS患者。两组之间的基线疾病活动测量相似。两组在对治疗的反应和在6、12和24个月时保持第一次TNFi没有显着差异。在LoAS组中，分析显示,停用TNFi与VAS疼痛评分相关(HR1.04;95%CI1.01~1.06).患者组的不良事件发生率相似（YoAS：8.7%vs.LoAS：11.7%）。在生物学幼稚LoAS和YoAS患者中，研究表明,初始TNFi治疗同样有效和安全.
