HLA-B27 POZİTİFLİĞİNİN ERKEK ANKİLOZAN SPONDİLİT HASTALARINDA ANTİ-TNF TEDAVİ CEVABINA ETKİLERİ

Yıl 2018, Cilt: 51 Sayı: 2, 140 - 144, 29.08.2018

Sühan Taşkın Zeynep Alpoğuz Mehmet Onat Çakıt Melek Aykut Selçuk , Burcu Duyur Çakıt , Hakan Genç

Öz

Amaç: Anti-TNF tedavi
alan erkek Ankilozan Spondilit (AS) hastalarında HLA-B27 pozitifliğinin anti-TNF
tedavi etkinliği üzerindeki olası etkilerini araştırmaktır..

Materyal ve Metod:Bir
yıldır anti-TNF tedavi alan 30 erkek AS hastasının verileri retrospektif olarak
incelendi. Hastaların kullandığı anti-TNF tedavi ajanları, demografik veriler
ve laboratuvar aktivite parametreleri kaydedildi. Hastaların ağrı düzeyleri
Vizüel Analog Skala (VAS), Hastalık aktivitesi Bath ankilozan spondilit
hastalık aktivite indeksi (BASHAI), fonksiyonel durum Bath ankilozan spondilit
fonksiyon indeksi (BASFİ) ile değerlendirildi. Hastalar HLA-B27 (+) ve (-)
olmak üzere 2 gruba ayrıldı ve hastalık aktivite ve fonksiyon parametreleri
karşılaştırıldı.

Bulgular: Retrospektif
analize dahil edilen 30 erkek AS hastasının 11’inde HLA-B27 (+)’ti. HLA-B27 (+)
hastaların yaş ortalamaları 38.18±8.18 yıl, HLA-B27 (-)
hastaların yaş ortalamaları 40.57±5.89 yıldı.
Grupların yaş ortalamaları açısından istatistiksel anlamlı fark yoktu
(p>0.05). Ortalama hastalık süreleri açısından gruplar arasında fark yoktu
(HLA-B27 (+) :15.9±7.4 yıl, HLA-B27 (-): 15.89±4.71 yıl, p>0.05). Grupların başlangıç ortalama BASHAI (HLA-B27 (+):6.15±1.41, negatif: 6.72±1.1) ve BASFİ (HLA-B27 (+) :5.59±1.9, HLA-B27(-) : 5.97±1.49)
değerleri arasında da istatistiksel olarak anlamlı
farklılık tespit edilmedi (p>0.05). Gruplar BASHAI ile bakılan hastalık
aktivitesi açısından karşılaştırıldığında HLA-B27 pozitifliğinin 1. yıl
anti-TNF etkinliğine belirgin etkisi saptanmadı (p>0.05). Bununla beraber
HLA-B27 (+) hastalarda anti-TNF tedavi ile 1.yılda BASFİ ile değerlendirilen
fonksiyonel parametrelerin daha belirgin olarak düzeldiği tespit edildi
(p=0.016).

Sonuç: HLA-B27 (+) AS
hastalarında anti-TNF tedavi HLA-B27 (-) hastalara göre fonksiyonel
parametrelerde 1 yılda belirgin düzelme sağladığı gözlendi. Bununla birlikte HLA-B27
pozitifliğinin AS’li hastalarda anti-TNF tedavisi ile elde edilen hastalık
aktivite azalması üzerinde belirgin fark yaratmadığı gözlendi.

Anahtar Kelimeler

ankilozan spondilit, anti-tnf, tedavi, HLA B27

Kaynakça

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