Efficacy of Thalidomide in Ankylosing Spondylitis Relapse Induced by Reduction of Biological Agents
Objective To investigate the efficacy of thalidomide in the relapse of ankylosing spondylitis(AS)patients induced by the reduction of biological agents.Methods A total of 20 AS patients who achieved disease remission after use of full-dose biological agents[including tumor necrosis factor-α(TNF-α)fusion protein,TNF-α monoclonal antibody,secukinumab and ixekizumab]admitted to the hospital from January 2018 to December 2023 were selected.All patients experienced relapse after reducing the dosage of biological agents and received additional treatment with thalidomide for at least six months.The changes in disease activity and inflammatory indicators after different durations of treatment with thalidomide were observed.Results All patients were male,with an age of(30.10±7.60)years and a disease course of(5.10±3.27)years.The course of full-dose use of biological agents was(1.56±0.70)years,and the time from reduced use to relapse was(0.62±0.19)years.Compared with those before relapse,the patients'ankylosing spondylitis disease activity score(ASDAS),Bath ankylosing spondylitis disease activity index(BASDAI),erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)level significantly increased at relapse(P＜0.05);compared with those at relapse,the above indicators of the patients significantly decreased after using thalidomide for one,three,six months,and the decrease degree was more significant with the prolonged treatment time(P＜0.05).The median duration of treatment of nonsteroidal anti-inflammatory drugs for AS patients was 1.55(1.02,2.27)months after relapse,and the median dose of thalidomide was 75(75,100)mg;four patients(20.00％)experienced mild drowsiness but was tolerable,and no other adverse reaction occurred.Conclusion The use of thalidomide in patients with AS relapse induced by the reduction of biological agents can help quickly control disease activity with mild adverse reactions.
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