Treatment response and retention rates of bDMARDs in advanced spinal ankylosis or bamboo spine: Real-world data from the HUR-BIO registry İleri spinal ankiloz veya bambu omurga olan hastalarda bDMARD tedavi yanıtı ve ilaç devamlılığı: HUR-BIO kayıt sisteminden gerçek yaşam verileri

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Farisoğulları B., Machado P., YARDIMCI G. K., BİLGİN E., BÖLEK E. Ç., SARIYILDIZ E., ...Daha Fazla

Journal of Turkish Society For Rheumatology, cilt.18, sa.2, ss.195-203, 2026 (Scopus, TRDizin)

Özet

Objectives: To evaluate clinical characteristics, biological disease-modifying antirheumatic drugs (bDMARD) treatment response and drug retention in patients with axial spondyloarthritis (axSpA) with advanced spinal ankylosis or bamboo spine, compared with patients without syndesmophytes. Methods: Patients from the Hacettepe University Rheumatology Biologic Registry who had available cervical and lumbar radiographs were classified into three groups: advanced spinal ankylosis, bamboo spine, and a control group with at least ten-year disease duration and without syndesmophytes. Baseline characteristics, treatment responses [Bath Ankylosing Spondylitis Disease Activity Index 50 (BASDAI50) and Assessment of Spondyloarthritis International Society partial remission (ASAS-PR)], and retention of first bDMARDs were evaluated. Results: Of 770 patients, 99 had advanced spinal ankylosis, 78 had bamboo spine, and 92 constituted the control group. Patients with advanced structural damage were older, more often male, and had higher body mass index, greater smoking exposure, and more frequent hip involvement. Baseline disease activity was similar across groups. At follow-up, BASDAI50 and ASAS-PR responses were comparable among advanced spinal ankylosis, bamboo spine, and controls. Median retention of first bDMARDs did not differ significantly between groups (log-rank p=0.86). One-year retention rates were 75% (no syndesmophytes), 84% (advanced spinal ankylosis), and 78% (bamboo spine); at 5 years, retention rates were 67%, 64%, and 60%, respectively; and at 10 years, retention rates were 50%, 41%, and 43%, respectively. Median drug survival ranged from 104 to 126 months across groups. Conclusion: Patients with advanced spinal ankylosis or bamboo spine achieve meaningful clinical improvement with bDMARD therapy and demonstrate long-term drug retention comparable to that of axSpA patients without syndesmophytes, supporting the initiation and continued use of bDMARDs in this population.