Question explored with the scientific record
Conversation so far
- 1 Is an immunosuppressant shot worth it for a AS?
- 2 Which AS symptoms did trials improve most, pain or stiffness or function?
- 3 What are the most common serious risks of TNF blockers vs NSAIDs?
- 4 Tell me all the pros and cons about adalimumab
- 5 Does adalimumab affect long-term spine damage better than NSAIDs?
- 6 What’s all cause mortality like for some with untreated AS vs treated AS
Answered on this page ↓
What’s all cause mortality like for some with untreated AS vs treated AS
The short version: the retrieval has no study of all-cause mortality in untreated versus treated AS, so the honest answer is that nobody here can give you a number.
The closest record is a UK general-population cohort of people with AS, and it is about statins, not AS treatment [1]. In that cohort, statin starters had fewer deaths after matching, about 17 per 1,000 person-years versus about 24 in non-starters [1]. That tells you statin use tracked with survival in AS. It says nothing about adalimumab, NSAIDs, or untreated disease.
The other AS records measure symptoms and function, not death. One 18-month UK cohort found active disease persisted in 45 of 47 people with a high symptom score at baseline, and function worsened slightly in that group [6]. That is a real burden, but it is not a mortality figure. The adalimumab records here are about drug stability, uveitis, psoriasis, and immunogenicity, not survival [2][3][4][5].
| What the record shows | Population | Outcome |
|---|---|---|
| Statin starters vs non-starters [1] | AS, UK database | Deaths: 96 vs 134 after matching |
| Active vs quiescent disease [6] | AS, 18 months | Function score rose 6.1 to 6.6 |
| Adalimumab in uveitis [3] | 146 patients | Visual acuity, adverse events |
So the mortality question is unanswered by this retrieval. Outside it, AS mortality cohorts and TNF-inhibitor survival studies exist, but I will not quote their numbers. What would settle it: a cohort following treated and untreated AS patients to death, with cause of death recorded.
My call: I cannot tell you whether treatment lowers all-cause mortality in AS, because the retrieved evidence does not measure it. Confidence: not clear.
Sources used 6
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Survival benefit of statin use in ankylosing spondylitis: a general population-based cohort study
In a large UK general population cohort of adults with ankylosing spondylitis (AS) using the THIN database, statin initiation was associated with a substantial reduction in all-cause mortality after propensity score–matched analysis, suggesting potential survival benefits in AS …
DOI: 10.1136/annrheumdis-2017-211253 -
A novel engineered interchain disulfide bond in the constant region enhances the thermostability of adalimumab Fab
This study engineered a novel interchain disulfide bond in the constant region of adalimumab Fab to enhance its thermostability, demonstrating that the new bond mitigates destabilization caused by the reduction of existing disulfide bonds.
DOI: 10.1016/j.bbrc.2017.10.140 -
Adalimumab in Focus: Evaluating Effectiveness and Safety in Non-Infectious Uveitis at a Tertiary Referral Center in Türkiye
A retrospective single-center Turkish study evaluating adalimumab (ADA) for noninfectious uveitis across diverse etiologies, showing significant visual improvement and reduced immunosuppressive therapy while maintaining an excellent safety profile, though some patients required …
DOI: 10.4274/tjo.galenos.2025.67513 -
Efficacy and safety of adalimumab in treating patients with moderate to severe plaque psoriasis: a retrospective study
In a retrospective Japanese single-institution study, adalimumab 80 mg every other week significantly reduced mean PASI from 24.4 at baseline to 0.5 at week 52; PASI differences between biologic-naive and non-biologic-naive patients were not statistically significant.
DOI: 10.18203/issn.2455-4529.intjresdermatol20214443 -
Methotrexate’s effect on cells and adalimumab immunogenicity in axial spondyloarthritis: A mathematical study
A mechanistic ODE model calibrated to CoMARIS axial spondyloarthritis data predicts that methotrexate reduces adalimumab immunogenicity chiefly by inducing apoptosis of activated CD4+ T cells, with delayed co-administration less effective in high-titre ADA patients.
DOI: 10.1371/journal.pcbi.1014740 -
Outcome of active disease in ankylosing spondylitis: A prospective study
In an 18-month prospective UK cohort of 89 people with ankylosing spondylitis, 45 of 47 with BASDAI ≥4 at baseline stayed above that active-disease threshold at every assessment, with no sustained improvement.
DOI: 10.1002/msc.161