Background: There is no systematic or large-scale study in the published literature in which the relationship between drug therapies and renal involvement in ankylosing spondylitis (AS) has been rigorously evaluated. In addition, the sensitivity of the kidneys to drugs varies significantly between races and regional populations. Therefore, the aim of the present study was to investigate the impact of drugs on renal involvement in Chinese AS patients.
Materials and methods: The clinical characteristics and biochemical data of 907 AS patients were collected and analyzed, and the differences between patients who had received drugs and those who had not were analyzed using intergroup comparisons to screen out confounding factors. Multivariate logistic regression analysis that corrected for the confounding factors explored the impact of the AS therapeutic drugs on the clinical manifestations of renal involvement.
Results: Renal involvement in Chinese AS patients increased significantly following non-steroidal anti-inflammatory drug (NSAID) or conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) monotherapy, and combination therapy with NSAIDs, csDMARDs, and TNF-α inhibitor. For AS patients, NSAID monotherapy increased the probability of hematuria 2.4-fold and the probability of mixed manifestations of renal involvement 3.0-fold. csDMARD monotherapy increased the probability of proteinuria 2.4-fold; combination therapy with NSAIDs, csDMARDs, and TNF-α inhibitor increased the probability of hematuria 4.1-fold. In addition, the study found that TNF-α inhibitor monotherapy and combination therapy with NSAIDs or csDMARDs caused no apparent impact on renal involvement in AS patients.
Conclusion: NSAID or csDMARD monotherapy may significantly increase renal involvement in Chinese AS patients. Combination therapy with TNF-α inhibitor with NSAIDs and csDMARDs should be used prudently.