TY - JOUR
T1 - The effect of anti-TNF on renal function in patients with ankylosing spondylitis
T2 - a prospective cohort study
AU - Swart, I. A. P.
AU - Visman, I. M.
AU - Heslinga, M.
AU - van der Horst-Bruinsma, I. E.
AU - van Denderen, J. C.
AU - Nurmohamed, M. T.
N1 - Funding Information: Some of this data has been presented previously as an abstract at the 2018 EULAR conference [AB0837]. https://congress2018.eular.org/myUploadData/files/eular_abstracts_low_res.pdf Publisher Copyright: © 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background: Biologicals, such as anti-tumor necrosis factor (anti-TNF), reduce cardiovascular disease (CVD) in patients with inflammatory rheumatic diseases. Impaired renal function is a known predictor of CVD and elevated in ankylosing spondylitis (AS). Objective: To assess the effect of anti-TNF on renal function in patients with AS and whether anti-TNF use is safe in AS patients with pre-existing risk factors for renal decline. Method: Biological-naïve consecutive AS patients treated with etanercept or adalimumab were prospectively followed from 2005 to 2014. Renal function was determined by calculation of the estimated glomerular filtration rate (eGFR), estimated with the abbreviated modification of diet in renal disease (MDRD) formula. The effect of anti-TNF on eGFR was analyzed using mixed model analysis. Results: 211 AS patients were followed for a median of 156 (36–286) weeks. Overall mixed model analyses showed a significant decrease of eGFR over time (β = − 0.040, p = 0.000), although this association did not remain significant after adjustment for responding to anti-TNF, alcohol use, disease duration, body mass index (BMI), C-reactive protein (CRP), and disease activity (β = − 0.018, p = 0.094). However, patients with pre-existing risk factors for renal decline did have a significant change in eGFR over time (β = − 0.029, p = 0.006). Conclusions: We found a significant change in eGFR over time, although this small decrease was not clinically relevant. This study further demonstrates that anti-TNF does not affect renal function in AS patients with and without existing risk factors for renal decline, which means that use of anti-TNF is safe concerning renal function in patients with AS.Key Points• Previous studies showed that biologicals, such as anti-tumor necrosis factor (anti-TNF), reduce cardiovascular disease (CVD) in patients with inflammatory rheumatic diseases, such as ankylosing spondylitis (AS).• Impaired renal function is a known predictor of CVD, and also a known concern for many AS patients.• Use of anti-TNF is safe with regard to renal function in patients with AS.• The effect of anti-TNF on CVD in AS patients does not seem to be mediated by changes in renal function.
AB - Background: Biologicals, such as anti-tumor necrosis factor (anti-TNF), reduce cardiovascular disease (CVD) in patients with inflammatory rheumatic diseases. Impaired renal function is a known predictor of CVD and elevated in ankylosing spondylitis (AS). Objective: To assess the effect of anti-TNF on renal function in patients with AS and whether anti-TNF use is safe in AS patients with pre-existing risk factors for renal decline. Method: Biological-naïve consecutive AS patients treated with etanercept or adalimumab were prospectively followed from 2005 to 2014. Renal function was determined by calculation of the estimated glomerular filtration rate (eGFR), estimated with the abbreviated modification of diet in renal disease (MDRD) formula. The effect of anti-TNF on eGFR was analyzed using mixed model analysis. Results: 211 AS patients were followed for a median of 156 (36–286) weeks. Overall mixed model analyses showed a significant decrease of eGFR over time (β = − 0.040, p = 0.000), although this association did not remain significant after adjustment for responding to anti-TNF, alcohol use, disease duration, body mass index (BMI), C-reactive protein (CRP), and disease activity (β = − 0.018, p = 0.094). However, patients with pre-existing risk factors for renal decline did have a significant change in eGFR over time (β = − 0.029, p = 0.006). Conclusions: We found a significant change in eGFR over time, although this small decrease was not clinically relevant. This study further demonstrates that anti-TNF does not affect renal function in AS patients with and without existing risk factors for renal decline, which means that use of anti-TNF is safe concerning renal function in patients with AS.Key Points• Previous studies showed that biologicals, such as anti-tumor necrosis factor (anti-TNF), reduce cardiovascular disease (CVD) in patients with inflammatory rheumatic diseases, such as ankylosing spondylitis (AS).• Impaired renal function is a known predictor of CVD, and also a known concern for many AS patients.• Use of anti-TNF is safe with regard to renal function in patients with AS.• The effect of anti-TNF on CVD in AS patients does not seem to be mediated by changes in renal function.
KW - Ankylosing spondylitis
KW - Comorbidity
KW - Epidemiology
KW - Spondyloarthritis
UR - http://www.scopus.com/inward/record.url?scp=85135802170&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s10067-022-06330-9
DO - https://doi.org/10.1007/s10067-022-06330-9
M3 - Article
C2 - 35962246
SN - 0770-3198
VL - 41
SP - 3747
EP - 3752
JO - Clinical Rheumatology
JF - Clinical Rheumatology
IS - 12
ER -