The effect of etanercept on a case of amyloidosis secondary to ankylosing spondylitis: results of 2-year follow-up.

1. Department of Physical Medicine and Rehabilitation, Konya Education and Research Hospital, Konya, Turkey 2. Department of Physical Medicine and Rehabilitation, Meram Medical School of Necmettin Erbakan University, Konya, Turkey ondary amyloidosis is seen in 5% of patients with chronic inflammatory uncontrolled diseases such as rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), fami lial Mediterranean fever (FMF) and ankylosing spondylitis (AS) and the most common clinical presentation is seen in the form of renal involvement such as renal failure and/or proteinuria. For secondary amyloidosis, no specific therapeutic regimen is avai lable and the best choice is to treat the underlying disorders. The outcomes of secondary amyloidosis can be improved by suppressing acute inflammatory responses. In several studies, patients were reported to benefit from medications such as colchicine, chlorambucil, azathioprine and methotrexate. A soluble receptor of TNF-a, etanercept, decreases amyloid deposits and improves renal function by attaching to this cytokine in circulation. In light of such data, anti-TNF-a agents may promote clinical remission in secondary amyloidosis. In our case study, the disease activity and renal function were improved in a patient with secondary amyloidosis and renal involvement due to AS with the help of a 2-year treatment of etanercept.