강직성 척추염 환자에서 고관절 병변에 대한 Etanercept 치료
Etanercept Treatment in Ankylosing Spondylitis Hip Lesions
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목적: 기존의 약물치료로 증상이 조절되지 않는 강직성 척추염 환자의 고관절 병변에 대해서 etanercept 사용 후의 질병 활성 및 환자 기능의 변화에 대해 알아보고자 한다. 대상 및 방법: 2008년 3월부터 2011년 12월까지 강직성 척추염으로 진단받은 53명의 환자 중, 고관절 통증을 호소하는 13명의 환자를 대상으로 하였다. 투약 직전과 투약 후 3개월째 Harris hip score, 강직성 척추염의 치료반응 및 합병증 여부를 관찰하였다. 결과: Harris hip score는 투약 전 55.6±3.4에서 3개월 87.2±4.3으로 유의하게 증가하였다(P=0.01). BASDAI/BASFI는 투약 전 평균 6.8±1.7/6.8±1.6에서 3개월째 4.4±1.8/4.3±1.1로 유의하게 감소하였다(P=0.02)/(P=0.02). ESR은 투약 전 48.4±31.5에서 3개월 20.8±19.7로 감소하였다(P=0.06). CRP는 투약 전 5.8±5.1에서 3개월 3.1±4.2으로 유의하게 감소하였다(P=0.03). 결론: 기존의 약물치료로 증상이 조절되지 않는 중증의 강직성 척추염 환자의 고관절 병변에서 etanercept는 단기간에 통증을 완화 시키는 효과를 가진 약물로 판단된다.
Abstract
Purpose: To evaluate the efficacy of etanercept in patients with an ankylosing spondylitis hip lesion. Materials and Methods: Between March 2008 and December 2011, this study evaluated 13 patients with hip lesions who were refractory to conventional therapy. The general improvement was evaluated by the Harris hip score, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI),ESR, CRP, and complications. Results: The mean Harris hip score changed from 55.6±3.4 to 87.2±4.3(P=0.01). The mean BASDAI/ BASFI decreased from 6.8±1.7/6.8±1.6 before treatment to 4.4±1.8(P=0.02)/4.3±1.1(P=0.02) after treatment. The mean ESR/CRP changed from 48.4±31.5/5.8±5.1 to 20.8±19.7(P=0.06)/3.1±4.2(P=0.03). No complications were encountered. Conclusion: These results suggest that etanercept can induce significant pain improvement in most ankylosing spondylitis hip lesions.
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