نبذة مختصرة : Background: Ankylosing spondylitis (AS) is associated with reduced renal function, possibly due to chronic inflammation or the use of nephrotoxic drugs. However, the long term effect of tumor necrosis factor (TNF) inhibitors on renal function in patients with AS has not been well established. Objectives: We therefore investigated the association of TNF inhibitors treatment and change in estimated glomerular filtration rate (GFR) using the Korean College of Rheumatology Biologics (KOBIO) registry (ClinicalTrials.gov, NCT01965132 ), a prospective nationwide biologics registry. Methods: We enrolled 1846 patients with AS in KOBIO registry and as disease controls, 471 patients with AS who did not take biologics in Kyungpook National University Hospital. The estimated glomerular filter rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) equation was evaluated in both groups. Renal insufficiency was defined as eGFR <60 mL/min/1.73 m2. Changes and differences of eGFR in each group were assessed at every follow-up year using paired t-test. Risk factors for renal function decline were identified using multivariable analysis. Results: The changes of eGFR values in patients treated with TNF inhibitors were not significantly decreased during 5 years follow up period. However, those in patients not treated with TNF inhibitors were significantly decreased. Moreover, among patients with renal insufficiency, use of TNF inhibitors did not affect further renal function deterioration during follow up period. Using multivariable logistic regression models, patients treated (versus not treated) with TNF inhibitors had a lower risk of renal function decline after 5 years follow up period (p<0.045). Conclusion: The use of TNF inhibitors was independently associated with lower risk of renal function decline and TNF inhibitors may be a safe treatment option in AS patients with renal insufficiency. Disclosure of Interests: None declared
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