TREATING ANKYLOSING SPONDYLITIS OF PATIENTS IN ADJARA REGION: WHY BIOLOGICAL THERAPY?

BACKGROUND. Ankylosing Spondylitis is an autoimmune chronic inflammatory disease of the axial/central skeleton of human body that leads to partial or complete fusion and rigidity of spine. As Ankylosing Spondylitis have its onset typically in late adolescents or middle age group, it is quite necessary to have a hold on it. Ankylosing Spondylitis was thought of having a bad prognosis earlier but in recent few years, with help of research advancement techniques a totally new and highly effective treatment known as biological therapy is used. OBJECTIVE. Our aim was to identify the outcome with biological treatment of 29 patients which got biological medication TNF (tumor necrosis factor) inhibitor Simponi (Golimumab). We evaluated the effectiveness of managing Ankylosing Spondylitis with biological therapy in Adjara region. As this is an autoimmunity disorder and it may affect any person especially the young and middle age people, everyone must be educated about getting biologic treatment as soon as possible so that they immediately get control over the disease progression. MATERIALS AND METHODS. We investigated 29 patients of Ankylosing Spondylitis (22 males and 7 females) from 24 yrs. old to 65 yrs. old age-group. We used the biological therapy with TNF-α inhibitor named Simponi (Golimumab). 50 mg of Golimumab was injected once a month subcutaneously in the beginning of therapy. We identified pain intensity, levels of CRP and ESR in all recruited patients since the first day over a period of 3 months, 6 months, and 12 months. Accordingly, doses were decreased from once a month to once in three months. The study was conducted at the clinic “Solo-med” during the period of 2022 October to 2023 December. RESULTS. The effectiveness of biological treatment with Simponi (Golimumab) is appreciated as it has shown a significant reduction in symptoms of Ankylosing Spondylitis such as the pain intensity, levels of CRP and ESR. About Pain intensity – After 3 months, light pain intensity was in about 18% of males with 14% of females and moderate pain intensity was in about 64% of males with 71% of females. It decreased and after 12 months, now moderate pain intensity was in about 22% of males and severe pain intensity was in none of the males. But in contrast, the female patients had neither severe nor moderate pain intensity rather they all had light pain intensity. About CRP – In the beginning all patients including both males and females had an increased level of CRP. It decreased and after 12 months only 9% of males and 8% of females had an increased CRP. About ESR – In the beginning 95% of males and 85% of females had an increased ESR. It decreased quickly with biological therapy and consequently after 12 months of treatment only 1 patient had increased ESR. After receiving Golimumab, 3 patients had episodes of acute rhinitis within 2 months, 2 patients had minor sneezing for 3 months as side effects, 5 patients had general weakness just after getting injection. 3 patients had urinary tract infection for 1 month as complication. And, no one had any serious complications. CONCLUSION. According to these studies, it can be said that biologics have improved the quality of life of these patients by improving body mobility, flexibility and preventing complications from internal organs. To take care of the youth, use of biological therapy is advised so that the disease do not progress any further. Biological therapy is a present-day superlative method to manage Ankylosing Spondylitis as it reaches a stable remission period and alleviates the symptoms of Ankylosing Spondylitis.