Imagine living with ankylosing spondylitis, a chronic arthritis that stiffens your spine and joints. For many, treatment involves taking adalimumab, a powerful biologic drug, often alongside methotrexate. A recent look at data from Henan Provincial People’s Hospital examined 2,564 patients to see if this combination therapy was connected to sudden sensorineural hearing loss, a condition where hearing drops quickly without warning. The researchers found that patients who experienced this hearing loss had lived with their arthritis for longer, had higher disease activity, and took more medication over time. These differences were statistically significant, meaning they were unlikely to be random chance. However, the study design means we cannot say the drugs caused the hearing loss. It is possible that people with more severe disease are both more likely to take these strong medicines and more likely to experience hearing issues for other reasons.
Sudden sensorineural hearing loss risk factors in ankylosing spondylitis patients on adalimumab plus methotrexateCould long-term arthritis treatment raise your risk of sudden hearing loss?
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This retrospective observational study examined risk factors for sudden sensorineural hearing loss among patients with ankylosing spondylitis receiving adalimumab in combination with methotrexate. Data were drawn from 2,564 ankylosing spondylitis patients admitted to the Department of Rheumatology and Immunology at Henan Provincial People's Hospital between 2015 and 2024, from whom a case-control sample was assembled.
The case group comprised 55 patients with sudden deafness, while the control group consisted of 110 matched patients without sudden deafness. Drug exposure was quantified using the defined daily dose (DDD), hearing classification was performed according to the latest guidelines, and confounding was addressed using inverse probability of treatment weighting (IPTW). The investigators also aimed to elucidate mechanisms underlying drug synergy and ototoxicity.
Compared with controls, the case group had a longer duration of ankylosing spondylitis, a higher disease activity index, a higher dosage of medications administered, and an extended treatment duration, each reported at p < 0.05. Specific effect sizes, absolute values, and hazard or odds ratios were not reported in the available abstract text.
Safety outcomes beyond the primary endpoint, including serious adverse events, discontinuations, and overall tolerability, were not reported. The abstract did not detail funding sources, conflicts of interest, or an explicit limitations section, though the retrospective, single-center design and modest case group size inherently constrain generalizability.
For clinicians, these findings suggest an association between greater cumulative disease burden and treatment exposure and sudden sensorineural hearing loss in this population, but causality cannot be inferred from the observational design and the comparator structure used here.
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