Improvement of clinical and radiological manifestations of coxitis in patients with ankylosing spondylitis treated with tumor necrosis factor-α inhibitor golimumab: Results of a 24-Month prospective observation study (GO-COX Study)

Abstract

Aim: The hip joint is the most commonly affected non-axial joint in ankylosing spondylitis (AS). Data on the effects of tumor necrosis factor-α inhibitors (TNFi) in AS patients with coxitis are limited. The aim of this study was evaluation of coxitis treated with the TNFi golimumab in real-world settings.

Methods: This study was a prospective non-interventional cohort study. A total of 39 patients newly prescribed with golimumab were enrolled and followed for up to 24 months. The data collected included BASFI, BASMI, ASDAS-CRP, BASDAI indices. BASRI-hip X-ray score was assessed at baseline, and at 12 and 24 months. Magnetic resonance imaging (MRI) and ultrasound examination data were obtained at baseline, and at 6 and 12 months.

Results: Significant improvements in BASFI, BASMI, ASDAS-CRP, BASDAI scores were observed (P ≤ 0.0001), but the BASRI-hip score remained stable. After 6 months of treatment, MRI signs of joint effusion were found in a smaller percentage of patients compared with baseline (P = 0.005 for the right and P = 0.015 for the left hip joints). After 12 months, this percentage was significantly lower than at baseline for the right hip joint (P = 0.005) and numerically lower for the left hip joint (P = 0.098). Ultrasound showed a significant increase in the percentage of patients without inflammatory changes after 6 and 12 months compared with baseline (right hip joint: P = 0.026 and P = 0.045, respectively; left hip joint: P = 0.026 for both time points).

Conclusion: Golimumab therapy in AS patients with coxitis was accompanied by improvement in clinical scores, and in MRI and ultrasound findings without obvious radiographic progress.

Keywords: GO-COX; ankylosing spondylitis; coxitis; golimumab; hip joint.