Response to Tumor Necrosis Factor Inhibition in Male and Female Patients with Ankylosing Spondylitis: Data from a Swiss Cohort.

Hebeisen, Monika; Neuenschwander, Regula; Scherer, Almut; Exer, Pascale; Weber, Ulrich; Tamborrini, Giorgio; Micheroli, Raphael; Wildi, Lukas M; Zufferey, Pascal; Nissen, Michael J; Villiger, Peter; Bernhard, Jürg; Finckh, Axel; van der Horst-Bruinsma, Irene E; Sieper, Joachim; Landewé, Robert; van der Heijde, Désirée; Ciurea, Adrian (2018). Response to Tumor Necrosis Factor Inhibition in Male and Female Patients with Ankylosing Spondylitis: Data from a Swiss Cohort. The journal of rheumatology, 45(4), pp. 506-512. The Journal of Rheumatology Publishing Company Limited 10.3899/jrheum.170166

Full text not available from this repository. (Request a copy)

OBJECTIVE To investigate sex differences in connection with the effectiveness of tumor necrosis factor inhibitors (TNFi) in patients with ankylosing spondylitis (AS). METHODS A total of 440 patients with AS (294 men; 146 women) initiating a first TNFi in the prospective Swiss Clinical Quality Management Cohort were included. We evaluated the proportion of patients achieving the 20% and 40% improvement in the Assessment of Spondyloarthritis international Society criteria (ASAS20 and ASAS40) as well as Ankylosing Spondylitis Disease Activity Score (ASDAS) improvement and status scores at 1 year. Patients having discontinued TNFi were considered nonresponders. Logistic regression analyses were performed to adjust for important predictors of response. RESULTS Compared to men, female patients had lower mean C-reactive protein levels, better spinal mobility, and more peripheral disease at the start. There was no sex disparity with regard to the ASDAS, the Bath Ankylosing Spondylitis Disease Activity and Functional indices, and the quality of life. At 1 year, 52% of women and 63% of men achieved an ASAS20 response (OR 0.63, 95% CI 0.37-1.07, p = 0.09). An inactive disease status (ASDAS < 1.3) was reached by 18% of women and 26% of men (OR 0.65, 95% CI 0.32-1.27, p = 0.22). These sex differences in response to TNFi were more pronounced in adjusted analyses (OR 0.34, 95% CI 0.16-0.71, p = 0.005 for ASAS20 and OR 0.10, 95% CI 0.03-0.31, p < 0.001 for ASDAS < 1.3) and confirmed for all the other outcomes assessed. CONCLUSION In AS, fewer women respond to TNFi and women show a reduced response in comparison to men.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology, Clinical Immunology and Allergology

UniBE Contributor:

Villiger, Peter


600 Technology > 610 Medicine & health




The Journal of Rheumatology Publishing Company Limited




Burkhard Möller

Date Deposited:

17 Jul 2019 14:44

Last Modified:

17 Jul 2019 14:44

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:



Actions (login required)

Edit item Edit item
Provide Feedback