Effect of Tumor Necrosis Factor Inhibitors on Hip Involvement in Ankylosing Spondylitis: Is Structural Repair Possible?

Abstract

To the Editor: We read with interest the published manuscript by Konsta et al1 assessing the prevalence of hip involvement in patients with ankylosing spondylitis (AS) and its associated factors. Hip involvement was found in 38% of cases, and it was associated with the presence of syndesmophytes and peripheral arthritis. In a previous study including patients with spondyloarthritis, we found that hip involvement was associated with disease duration over 10 years, the presence of radiographic sacroiliitis, very high disease activity (Ankylosing Spondylitis Disease Activity Score using C-reactive protein [ASDAS-CRP] ≥ 3.5), and more limited spine mobility.2 Hip involvement is a significant cause of pain and disability in patients with AS. Its therapeutic management is challenging since no treatment has demonstrated its effectiveness. Tumor necrosis factor inhibitors (TNFi) have been proven effective on … Address correspondence to Dr. M. Slouma, Department of Rheumatology, Military Hospital, Tunis 1007, Tunisia. Email:maroua.slouma{at}gmail.com.