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In patients with ankylosing spondylitis, infliximab does not inhibit structural damage, although it may have other beneficial effects, according to European and US researchers.

In patients with ankylosing spondylitis, infliximab does not inhibit structural damage, although it may have other beneficial effects, according to European and US researchers.

"Although disappointing," lead investigator Dr. Désirée van der Heijde told Reuters Health, "it is not unexpected that infliximab did not inhibit the formation of new syndesmophytes in this study as etanercept also did not inhibit this."

Dr. van der Heijde of Leiden University Medical Center, The Netherlands, and colleagues came to this conclusion after studying radiographic data on 201 AS patients who had received infliximab treatment over a period of 96 weeks.

Comparison of findings at baseline and at two years showed no changes in the median modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), according to the researchers' report In the October issue of Arthritis and Rheumatism. This was also true of an historical control cohort of 192 AS patients who had not been treated with anti-tumor necrosis factor (TNF) agents.

The proportion of patients with at least a one-point worsening in the mSASSS was virtually the same in both cohorts - 34.0 per cent and 35.2 per cent, respectively.

A possible explanation for the lack of an effect on progression, the researchers suggest, is that bone formation is the hallmark of AS, rather the proinflammatory action of TNF in predominantly destructive diseases like rheumatoid arthritis.

"On the other hand," concluded Dr. van der Heijde, "it is still very useful to prescribe TNF-blockers to patients with ankylosing spondylitis as these drugs have a major positive effect on signs and symptoms, physical function, and quality of life."

Arthritis Rheum 2008;58:3063-3070