We read with great interest the retrospective cohort study by Kelty el al on the association between cancer diagnosis and mortality in patients with ankylosing spondylitis (AS). Patients diagnosed with AS (n = 2152) and a non- AS comparison group (n = 10 760) were included. Document of cancer diagnosis, comorbidities and mortality were extracted from medical record. The relative risk and mortality subsequent to cancer diagnosis of AS and non- AS were analyzed. This study demonstrated that AS per se has no association with cancer risk, while AS presents an association with increased risk of 5-year mortality in patients previously diagnosed with cancer. With regard to the pathophysiology of AS, human leukocyte antigen (HLA)- B27 and interleukin (IL)- 23/−17 axis plays a central role in relaying proinflammatory response and is involved in the disease severity. In the context of AS, differentiated T cells act to secret high levels of IL- 17, which can further trigger proinflammatory response in coordination with tumor necrosis- α and interferon- γ and activate osteoclasts, leading to suppression of bone regeneration. Notably, 2 phase III studies showed that anti- IL- 17 by using secukinumab exerts salient efficacy on the improvement of signs, symptoms, physical activity and disease - specific quality of life.
Date:
2023-08
Relation:
International Journal of Rheumatic Diseases. 2023 Aug;26(8):1633-1634.
