This meta- analysis shows that ETN monotherapy is effective in improving physical function and reducing disease activity in patients with AS .
Compared with SSZ , ETN markedly decreased the BASDAI and CRP levels .
Etanercept ( ETN ) has been widely applied in the treatment of ankylosing spondylitis ( AS ) .
As the use of ETN has increased , associated adverse effects have been reported frequently .
Previous meta-analyses have focused on comparing the differences in clinical outcomes between ETN and placebo ( PBO ) .
The present meta- analysis evaluated r and omised controlled trials ( RCTs ) to compare the effects of ETN and a PBO or sulfasalazine ( SSZ ) in patients with AS .
Abnormal high-expression of CD154 on T lymphocytes of ankylosing spondylitis patients is down-regulated by etanercept treatment
The pathogenesis of ankylosing spondylitis ( AS ) still remains an enigma . Although some studies have indicated the importance of T-cells and proinflammatory cytokines in the pathogenesis of the AS , it is still unknown whether co-stimulatory molecule CD154 participates in the pathogenesis of AS and how its level changes during the anti-TNF-α treatment of AS . This study is performed to evaluate the expression of CD154 in peripheral blood T-lymphocytes of patients with AS and observe the change of CD154 in etanercept-treated AS patient . We collected the peripheral blood and clinical data from 66 AS , 30 rheumatoid arthritis ( RA ) patients , and 30 healthy controls . Thirty-nine active AS patients were enrolled in a r and omized double-blind placebo-controlled trial . We followed up 37 cases that fulfilled the ASAS20 response criteria after they finished etanercept treatment till week 48 . The percentage of CD3+CD154 + in peripheral blood lymphocytes was evaluated by flow cytometry . We found that CD154 expression in AS patients was significantly higher than that in healthy volunteers and RA patients ( both P < 0.001 ) . The expressions of CD154 in AS patients at active stage or with peripheral joint involvement were significantly higher than those at stable stage or with axial involvement alone ( P = 0.005 and 0.044 , respectively ) . The expression of CD154 decreased in AS patients treated with etanercept compared with patients treated with placebo at week 6 ( P < 0.001 ) . Compared with healthy volunteers , the expression of CD154 in 16 AS patients who relapsed after finishing etanercept treatment was elevated again ( P = 0.012 ) . These findings show that co-stimulatory molecule CD154 is overexpressed on T-lymphocytes in peripheral blood of AS patients and can be down-regulated by etanercept treatment , which suggest that CD154 might be involved in the inflammatory evolvement of AS and might be a potential biomarker to monitor AS disease activity and the effect of etanercept treatment
This meta- analysis shows that ETN monotherapy is effective in improving physical function and reducing disease activity in patients with AS .
Compared with SSZ , ETN markedly decreased the BASDAI and CRP levels .
Etanercept ( ETN ) has been widely applied in the treatment of ankylosing spondylitis ( AS ) .
As the use of ETN has increased , associated adverse effects have been reported frequently .
Previous meta-analyses have focused on comparing the differences in clinical outcomes between ETN and placebo ( PBO ) .
The present meta- analysis evaluated r and omised controlled trials ( RCTs ) to compare the effects of ETN and a PBO or sulfasalazine ( SSZ ) in patients with AS .