Aksiyel Spondiloartrit Hastalarında Tümör Nekrozis Faktör İnhibitörleri Tedavisi Sonrası 24-Saat Ambulatuar Kan Basıncı Ölçümü ve Uyku Kalitesinin Değerlendirilmesi

Abstract

The aim of this study is to determine the changes in sleep quality and 24-hour blood pressure readings in patients with axial spondiloarthritis after treatment with anti-TNF-α therapy. Axial spondyloarthritis patients who weren’t treated with anti-TNF-α therapy yet were included into this study betweeen 01.03.2021 and 01.12.2021 at Hacettepe University Faculty of Medicine, Department of Internal Medicine, Department of Rheumatology. Disease activitiy assesment, ambulatory blood pressure measurement and sleep quality (PSQI) were assesed before ant-TNF therapy (0.month) and after anti-TNF-α therapy (3.month). In total, 28 axial spondyloarthritis patients (mean age 40±10,4, men/women:12(%42,9)/16(%57,1)) were included in to this study. The 0th and 3rd month ABPM measurements of the patients in our study were within the normotensive limits. Both disease activity scores and median PSQI scores of 8.5 (4.0-12.8) were high before the treatment and sleep quality was poor in 71% of the patients. Although there was a significant decrease in disease activity scores and a significant improvement in sleep quality in the 3rd month after treatment, no significant changes were observed in ABPM parameters such as AASI, ARV, PPI, Sleeptroughsurge and Prewaking surge compared to pre-treatment. While 46.4% of the patients were dippers before the treatment, the dipper rate after the 3rd month TNF treatment was 60.7% (n=17), but it was not statistically significant (p=0.388). While the change in nighttime systolic blood pressure reduction was statistically significant (p=0.020) in the 0th and 3rd month comparisons, no statistically significant difference was found in the change in nighttime diastolic blood pressure reduction (p=0.112). It might be possible that anti-TNF-α therapy has probably positive effects on sleep quality and night-time blood pressure reduction. The improved effect on sleep quality and increase in night-time blood pressure reduction shows us that anti-TNF-α therapy has probably modifiable effects on cardiovascular risk profile.