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

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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.	朱剑, 黄烽, 张江林. 沙利度胺治疗强直性脊柱炎的长期疗效与安全性[J]. 中华内科杂志, 2010, 49(8):667-670.
4.	于刚, 张江林. 强直性脊柱炎的治疗指南介绍[J]. 中国骨与关节杂志, 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, 郑毅. 炎性腰背痛诊断标准的进展[J]. 中华风湿病学杂志, 2010, 14(5):355-356.
7.	王战营, 郭宏岗, 张莳, 等. 益赛普联合沙利度胺治疗难治性强直性脊柱炎15例疗效分析[J]. 当代医学, 2012, 18(30):134-135.
8.	齐海宇, 段婷, 刘瑞霞, 等. 肿瘤坏死因子-α抑制剂治疗强直性脊柱炎进展[J]. 中国医师进修杂志, 2013, 36(29):69-71.
9.	姚蓉, 倪芬, 胡海, 等. 蜂螫伤相关过敏反应患者的临床特征及其危险因素分析[J]. 华西医学, 2015, 30(6):1019-1022.
10.	卿平英, 刘毅. 脊柱关节病诊断和治疗的相关热点[J]. 实用医院临床杂志, 2011, 8(2):39-42.
11.	扈世亮. 益赛普联合沙利度胺用于难治性强直性脊柱炎的疗效研究[J]. 中国医学创新, 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.	宋书林, 苏敏, 张慧芳. 柳氮磺吡啶联合甲氨喋呤与联合沙利度胺治疗强直性脊柱炎疗效观察[J]. 内科急危重症杂志, 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, 古洁若. 强直性脊柱炎治疗现状及其进展[J]. 国际内科学杂志, 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. 朱剑, 黄烽, 张江林. 沙利度胺治疗强直性脊柱炎的长期疗效与安全性[J]. 中华内科杂志, 2010, 49(8):667-670.
4. 于刚, 张江林. 强直性脊柱炎的治疗指南介绍[J]. 中国骨与关节杂志, 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, 郑毅. 炎性腰背痛诊断标准的进展[J]. 中华风湿病学杂志, 2010, 14(5):355-356.
7. 王战营, 郭宏岗, 张莳, 等. 益赛普联合沙利度胺治疗难治性强直性脊柱炎15例疗效分析[J]. 当代医学, 2012, 18(30):134-135.
8. 齐海宇, 段婷, 刘瑞霞, 等. 肿瘤坏死因子-α抑制剂治疗强直性脊柱炎进展[J]. 中国医师进修杂志, 2013, 36(29):69-71.
9. 姚蓉, 倪芬, 胡海, 等. 蜂螫伤相关过敏反应患者的临床特征及其危险因素分析[J]. 华西医学, 2015, 30(6):1019-1022.
10. 卿平英, 刘毅. 脊柱关节病诊断和治疗的相关热点[J]. 实用医院临床杂志, 2011, 8(2):39-42.
11. 扈世亮. 益赛普联合沙利度胺用于难治性强直性脊柱炎的疗效研究[J]. 中国医学创新, 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. 宋书林, 苏敏, 张慧芳. 柳氮磺吡啶联合甲氨喋呤与联合沙利度胺治疗强直性脊柱炎疗效观察[J]. 内科急危重症杂志, 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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