Abstract
Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the axial skeleton. The introduction of anti-TNF therapies has significantly improved clinical outcomes in AS patients.
Objective: To systematically review the clinical efficacy of anti-TNF agents in AS, comparing disease activity and functional status before and after treatment.
Methods: A systematic search was conducted across major databases up to January 2021. Studies reporting outcomes before and after anti-TNF treatment using validated measures such as BASDAI, ASAS20, and CRP were included. Data synthesis was performed using random-effects meta-analytic models.
Results: Seventeen studies with a combined sample of over 800 AS patients were included. Anti-TNF therapy resulted in significant reductions in BASDAI scores (mean difference: -2.6), CRP levels, and improvements in ASAS20 response rates. Adalimumab and infliximab demonstrated slightly higher efficacy compared to other agents. Safety profiles were acceptable across studies.
Conclusion: Anti-TNF agents substantially reduce disease activity and improve quality of life in AS patients. However, long-term structural outcomes remain inadequately studied and warrant further investigation.