부산대학교 도서관

Background: Ankylosing spondylitis (AS) is a chronic rheumatic disease associated with radiographic damage of the spine. Golimumab had consistent efficacy in controlling disease activity through 5 years but the benefit in preventing radiographic progression was obscure at 4-year. To predict radiographic progression, we analyzed baseline characteristics of AS patients in Korean population. Methods: All 68 Korean patients with AS participated in the phase 3 trial which was previously described. Radiographic evaluations were performed at baseline, week 104 and 208. Baseline modified Stoke AS spine score (mSASSS) and change in mSASSS from baseline (ΔmSASSS) were compared in the patients of Korea and other countries. Results: Korean patients had lower baseline mSASSS and maintained consistently higher retention rate to treatment (91.7% vs. 66.4%, ＜0.0001) till week 256 when compared to the patients in other countries. The baseline mSASSS and ΔmSASSS had positive correlation in Korean AS patients (Spearman’s rho ＝0.487, p＜0.0001) (Fig. 1A). Radiographic progression was more prevalent (80%) when baseline mSASSS＞10 and less common (13%) with baseline mSASSS＝0 (Fig. 1B). Conclusions: Korean patients with AS receiving golimumab had distinctive patterns of spinal lesion progression detected by simple radiograph at week 208. This bipolar pattern of progression could be predicted reliably by the initial severity of spinal lesion. Given this result, this study implicated the value of early and active treatment before appearance of overt spinal damage.