Background Ankylosing spondylitis (AS) is a chronic inflammatory disease which physically, psychologically, and socially affect the patient's life.
Objectives Previous studies have reported a correlation between severity of AS and depression, anxiety, and sleep disorders. In this study we aimed to investigate the effects of infliximab on depression, anxiety and sleep disorders in patients with AS.
Methods A total of 29 AS patients whose BASDAI≥4 were enrolled. Patients were treated with intravenous infliximab (5mg/kg) at 0, 2nd and 6th week. The scores of VAS pain assessment, VAS-sleep, BASDAI, BASFI, ASQoL, mSchober, Beck depression (BDI) and Beck anxiety inventory (BAI), and the levels of chest expansion, morning stiffness, ESR, CRP were evaluated before initiation of therapy and 6 weeks after the last infusion (at 12th week).
Results There were 6 (20.7%) women and 23 (79.3%) men. There were statistically significant decrement between all measurements before and after the treatment (p<0.001 for each; Table 1). There were 25 (86.2%) patients with clinically significant depression (cut-off point 17), 20 (68.96%) patients with clinically significant anxiety (cut-off point 16) before treatment. These numbers decreased to 8 (27.58%) and 4 (13.79%) respectively at 12th week. The scores of BASDAI, VAS-sleep, BDI and BAI after 6 weeks from last dose were lower than those before the treatment. There were significant correlations between BDI and BASDAI, BASFI, chest expansion, duration of morning stiffness, ASQoL (p<0.05 for each; Table 2). BAI also significantly correlated with BDI, and ASQoL (p<0.05 for each; Table 2).
Conclusions In this study, we have shown significant improvements in VAS-sleep, BDI and BAI scores after infliximab treatment. This improvement seems to be related to healing of the disease rather than the direct effect of the drug because it was correlated with the imrovement in disease activity scores. The most significant correlation was found with ASQoL supporting the accuracy of this relation.
Persoons P, Vermeire S, Demyttenaere K et al. The impact of major depressive disorder on the short and long term outcome of Crohn's disease treatment with infliximab. Aliment Pharmacol Ther 2005;22:101-10
Disclosure of Interest None declared