RESULTS OF TREATMENT BY DIFFERENT BIOLOGICAL MEDICATIONS OF PATIENTS WITH AXIAL SPONDYLOARTHRITIS IN THE ADJARA REGION

Abstract

ackground: Ankylosing Spondylitis (AS) is a chronic autoimmune inflammatory disease, that primarily affects the axial (central) skeleton of the human body. It can lead to partial or complete fusion and rigidity of the spine. Typically, Ankylosing Spondylitis begins in late adolescence or middle age, making it important to manage the condition effectively. In the past, Ankylosing Spondylitis was considered to have a poor prognosis. Delayed diagnosis is associated with more functional impairment, higher healthcare costs, and worse quality of life and work productivity outcomes in patients with AS. However, recent advancements in research have led to the development of a highly effective treatment known as biological therapy.

Aim of Study: Outcomes comparison of the axial spondylarthritis treatment using two different biological Medications and evaluation the of the biological treatment outcomes in patients who received the tumor necrosis factor (TNF) inhibitor (Golimumab ) and in patients who received the interleukin-17A (IL-17A) inhibitor (Secukinumab). The study was focused on the effectiveness of these therapies in managing axial spondyloarthritis in the Adjara Region.

Materials and Methods: We conducted two studies. Both studies aimed to assess treatment effectiveness on disease symptoms and inflammatory markers with axial spondyloarthritis patients at the Rheumatology Department of SoloMed Clinic, Batumi, Georgia. The first study, dated from October 2022 to December 2023, involved 29 patients (22 males, 7 females) aged 24–65 years, who received Golimumab, a TNF-α inhibitor. Each patient was given 50 mg of Golimumab subcutaneously once a month. In the second study (2023–2024), 30 patients (13 males, 17 females) aged 22–72 years were examined. 150 mg IL-17A inhibitor Secukinumab subcutaneously once a week for five weeks at the beginning and then once a month for a year were prescribed for them. We evaluated pain intensity, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) at baseline and at three, six, and twelve months in both studies.

Conclusion: Biological therapy with Golimumab and Secukinumab markedly improves quality of life in patients with axial spondyloarthritis by enhancing mobility and reducing inflammation. Both agents effectively lower pain intensity and normalize inflammatory markers. Secukinumab achieves faster and complete pain relief, with all patients reporting light pain at 12 months, while Golimumab shows stronger normalization of ESR and consistent CRP reduction. Both treatments are well tolerated, with only mild, transient side effects. Overall, Secukinumab appears superior for rapid symptom relief, whereas Golimumab offers slightly better long-term control of inflammatory parameters. Both represent effective and safe therapeutic options for sustained remission in axial spondyloarthritis. Early diagnosis and treatment of axial spondyloarthritis is a prerequisite for stable and long-term remission of the disease.