Clinical Remission of Spondyloarthropathy Maintained by Sulfasalazine Combined with Thalidomide_West China Medical Journal

Authors：

 JIANGWei ^1,2 , ZHAOYi ¹ ,  LIUYi ¹ , HUChun-rong ³

1. Department of Rheumatism and Immunology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Rheumatism and Immunology, Luzhou Medical College, Luzhou, Sichuan 646000, P. R. China;
3. Department of Rheumatism and Immunology, the Ninth People's Hospital of Chongqing, Chongqing 400700, P. R. China;

Corresponding?author：

LIUYi, Email: yi2006liu@163.com

Keywords：

Spondyloarthropathy; Thalidomide; Sulfasalazine; Curative effect; Clinical remission

DOI：

10.7507/1002-0179.20150465

Video：

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Objective To investigate the efficacy of sulfasalazine combined with thalidomide in the treatment of spondyloarthropathy (SpA), and to probe whether the treatment can reach and maintain clinical remission for the patients. Method Between January 2011 and June 2013, we used a prospective, non-intervention and regular follow-up study to observe and assess 70 SpA patients on their Bath ankylosing spondylitis disease activity index, visual analogue scale score, peripheral arthritis, blood sedimentation, and C-reactive protein. All the patients had taken sulfasalazine, thalidomide and non-steroidal anti-inflammatory drugs for 24 weeks. Multivariate analysis of factors affecting the efficacy of the program was our object of this study. Results After 24 weeks, the total clinical remission rate of these patients was 72.9%. Clinical remission rate of 40 patients with short duration of SpA was 90.0%, while it was 50.0% for the other 30 patients with a non-short duration of SpA. Observation indexes before and after treatment in both groups of patients had significant differences (P<0.05). For patients with non-short duration SpA, the curative effect for female was obviously better than male, but the difference between male and female patients with short-duration SpA was not so obvious. Clinical remission rate for youth was similar with that for non-youth patients. Binary logistic regression analysis showed that whether the disease had a short duration[OR=3.408, 95%CI (1.637, 7.437), P=0.001] and whether the patients were urban residents[OR=4.163, 95%CI (2.011, 8.761), P=0.001] were statistically significant (P<0.05). Conclusions Clinical remission of spondyloarthropathy can be maintain by sulfasalazine combined with thalidomide. Clinical remission rate of the scheme is affected by duration of disease and residency except age and gender of the patients. Short duration and urban residency are independent factors for reaching clinical remission after treatment.

Citation： JIANGWei, ZHAOYi, LIUYi, HUChun-rong. Clinical Remission of Spondyloarthropathy Maintained by Sulfasalazine Combined with Thalidomide. West China Medical Journal, 2015, 30(9): 1622-1626. doi: 10.7507/1002-0179.20150465 Copy

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2.	De Stefano R, Frati E, De Quattro D, et al. Low doses of etanercept can be effective to maintain remission in ankylosing spondylitis patients[J]. Clin Rheumatol, 2014, 33(5):707-711.
3.	朱劍, 黃烽, 張江林. 沙利度胺治療強直性脊柱炎的長期療效與安全性[J]. 中華內科雜志, 2010, 49(8):667-670.
4.	于剛, 張江林. 強直性脊柱炎的治療指南介紹[J]. 中國骨與關節雜志, 2014, 3(10):763-766.
5.	Kiltz U, Heldmann F, Baraliakos X, et al. Treatment of ankylosing spondylitis in patients refractory to TNF-inhibition:are there alternatives?[J]. Curr Opin Rheumatol, 2012, 24(3):252-260.
6.	王媛, 鄭毅. 炎性腰背痛診斷標準的進展[J]. 中華風濕病學雜志, 2010, 14(5):355-356.
7.	王戰營, 郭宏崗, 張蒔, 等. 益賽普聯合沙利度胺治療難治性強直性脊柱炎15例療效分析[J]. 當代醫學, 2012, 18(30):134-135.
8.	齊海宇, 段婷, 劉瑞霞, 等. 腫瘤壞死因子-α抑制劑治療強直性脊柱炎進展[J]. 中國醫師進修雜志, 2013, 36(29):69-71.
9.	姚蓉, 倪芬, 胡海, 等. 蜂螫傷相關過敏反應患者的臨床特征及其危險因素分析[J]. 華西醫學, 2015, 30(6):1019-1022.
10.	卿平英, 劉毅. 脊柱關節病診斷和治療的相關熱點[J]. 實用醫院臨床雜志, 2011, 8(2):39-42.
11.	扈世亮. 益賽普聯合沙利度胺用于難治性強直性脊柱炎的療效研究[J]. 中國醫學創新, 2013, 22(22):32-33.
12.	Baraliakos X, Van Den Berg R, Braun J, et al. Update of the literature review on treatment with biologics as a basis for the first update of the ASAS/EULAR management recommendations of ankylosing spondylitis[J]. Rheumatology (Oxford), 2012, 51(8):1378-1387.
13.	Genre F, López-Mejías R, Rueda-Gotor J, et al. Patients with ankylosing spondylitis and low disease activity because of anti-TNF-alpha therapy have higher TRAIL levels than controls:a potential compensatory effect[J]. Mediators Inflamm, 2014:798060.
14.	Deng X, Zhang J, Zhang J, et al. Thalidomide reduces recurrence of ankylosing spondylitis in patients following discontinuation of etanercept[J]. Rheumatol Int, 2013, 33(6):1409-1413.
15.	宋書林, 蘇敏, 張慧芳. 柳氮磺吡啶聯合甲氨喋呤與聯合沙利度胺治療強直性脊柱炎療效觀察[J]. 內科急危重癥雜志, 2011, 17(6):373-374, 384.
16.	Wei JC, Chan TW, Lin HS, et al. Thalidomide for severe refractory ankylosing spondylitis:a 6-month open-label trial[J]. J Rheumatol, 2003, 30(12):2627-2631.

1. 林智明, 古潔若. 強直性脊柱炎治療現狀及其進展[J]. 國際內科學雜志, 2007, 34(1):39-42, 60.
2. De Stefano R, Frati E, De Quattro D, et al. Low doses of etanercept can be effective to maintain remission in ankylosing spondylitis patients[J]. Clin Rheumatol, 2014, 33(5):707-711.
3. 朱劍, 黃烽, 張江林. 沙利度胺治療強直性脊柱炎的長期療效與安全性[J]. 中華內科雜志, 2010, 49(8):667-670.
4. 于剛, 張江林. 強直性脊柱炎的治療指南介紹[J]. 中國骨與關節雜志, 2014, 3(10):763-766.
5. Kiltz U, Heldmann F, Baraliakos X, et al. Treatment of ankylosing spondylitis in patients refractory to TNF-inhibition:are there alternatives?[J]. Curr Opin Rheumatol, 2012, 24(3):252-260.
6. 王媛, 鄭毅. 炎性腰背痛診斷標準的進展[J]. 中華風濕病學雜志, 2010, 14(5):355-356.
7. 王戰營, 郭宏崗, 張蒔, 等. 益賽普聯合沙利度胺治療難治性強直性脊柱炎15例療效分析[J]. 當代醫學, 2012, 18(30):134-135.
8. 齊海宇, 段婷, 劉瑞霞, 等. 腫瘤壞死因子-α抑制劑治療強直性脊柱炎進展[J]. 中國醫師進修雜志, 2013, 36(29):69-71.
9. 姚蓉, 倪芬, 胡海, 等. 蜂螫傷相關過敏反應患者的臨床特征及其危險因素分析[J]. 華西醫學, 2015, 30(6):1019-1022.
10. 卿平英, 劉毅. 脊柱關節病診斷和治療的相關熱點[J]. 實用醫院臨床雜志, 2011, 8(2):39-42.
11. 扈世亮. 益賽普聯合沙利度胺用于難治性強直性脊柱炎的療效研究[J]. 中國醫學創新, 2013, 22(22):32-33.
12. Baraliakos X, Van Den Berg R, Braun J, et al. Update of the literature review on treatment with biologics as a basis for the first update of the ASAS/EULAR management recommendations of ankylosing spondylitis[J]. Rheumatology (Oxford), 2012, 51(8):1378-1387.
13. Genre F, López-Mejías R, Rueda-Gotor J, et al. Patients with ankylosing spondylitis and low disease activity because of anti-TNF-alpha therapy have higher TRAIL levels than controls:a potential compensatory effect[J]. Mediators Inflamm, 2014:798060.
14. Deng X, Zhang J, Zhang J, et al. Thalidomide reduces recurrence of ankylosing spondylitis in patients following discontinuation of etanercept[J]. Rheumatol Int, 2013, 33(6):1409-1413.
15. 宋書林, 蘇敏, 張慧芳. 柳氮磺吡啶聯合甲氨喋呤與聯合沙利度胺治療強直性脊柱炎療效觀察[J]. 內科急危重癥雜志, 2011, 17(6):373-374, 384.
16. Wei JC, Chan TW, Lin HS, et al. Thalidomide for severe refractory ankylosing spondylitis:a 6-month open-label trial[J]. J Rheumatol, 2003, 30(12):2627-2631.

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Clinical Remission of Spondyloarthropathy Maintained by Sulfasalazine Combined with Thalidomide

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