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Open Access Highly Accessed Research article

Effectiveness of adalimumab in treating patients with ankylosing spondylitis associated with enthesitis and peripheral arthritis

Martin Rudwaleit1*, Pascal Claudepierre2, Martina Kron3, Sonja Kary3, Robert Wong45 and Hartmut Kupper3

Author Affiliations

1 Charité-University Medicine Berlin, Benjamin Franklin Campus, Medical Department I, Rheumatology, Hindenburgdamm 30, 12203 Berlin, Germany

2 Service de Rhumatologie, Hôpital Henri Mondor-APHP, Université Paris XII, avenue du Maréchal de Lattre de Tassigny 51, 94010 Créteil, France

3 Abbott GmbH & Co KG, Knollstraße 50, 67061 Ludwigshafen, Germany

4 University of Medicine and Dentistry of New Jersey, 189 New Street, New Brunswick, NJ 08901-1954, USA

5 Formerly Abbott Laboratories, Parsippany, NJ, USA

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Arthritis Research & Therapy 2010, 12:R43  doi:10.1186/ar2953

Published: 15 March 2010

Abstract

Introduction

The purpose of this study was to investigate the effectiveness of adalimumab in enthesitis and peripheral arthritis in patients with ankylosing spondylitis (AS).

Methods

Adults with active AS (Bath ankylosing spondylitis disease activity index [BASDAI] ≥ 4) received adalimumab 40 mg every other week with standard antirheumatic therapies in a 12-week, open-label study. Effectiveness in enthesitis was assessed using the Maastricht ankylosing spondylitis enthesitis score (MASES, 0-13) and by examining the plantar fascia in patients with enthesitis (≥ 1 inflamed enthesis) at baseline; effectiveness in peripheral arthritis was evaluated using tender and swollen joint counts (TJC, 0-46; SJC, 0-44) in patients with peripheral arthritis (≥ 1 swollen joint) at baseline. Overall effectiveness measures included Assessment of SpondyloArthritis International Society 20% response (ASAS20).

Results

Of 1,250 patients enrolled, 686 had enthesitis and 281 had peripheral arthritis. In 667 patients with MASES ≥ 1 at baseline, the median MASES was reduced from 5 at baseline to 1 at week 12. At week 12, inflammation of the plantar fascia ceased in 122 of 173 patients with inflammation at baseline. The median TJC in 281 patients with SJC ≥ 1 at baseline was reduced from 5 at baseline to 1 at week 12; the median SJC improved from 2 to 0. ASAS20 responses were achieved by 70.5% of 457 patients with no enthesitis and no arthritis; 71.0% of 512 patients with only enthesitis; 68.0% of 107 patients with only arthritis; and 66.7% of 174 patients with both.

Conclusions

Treatment with adalimumab improved enthesitis and peripheral arthritis in patients with active AS.

Trial registration

ClinicalTrials.gov NCT00478660.