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Treatment of ankylosing spondylitis and other spondyloarthritides
Current Opinion in Rheumatology, 06/05/09
Braun J et al. – Review highlights the new clinical studies, efficacy regarding signs and symptoms, function and quality of life, structural damage and the link between inflammation and new bone formation. The pharmacokinetics of infliximab including the formation of antibodies and the overall and long-term safety of anti-TNF agents is also discussed.
Methods- The purpose of this review was to collect all available information related to the treatment of ankylosing spondylitis (AS) published in the year 2008
- This was achieved by a systematic literature search in PubMed
- There is increasing knowledge about the short-term and long-term efficacy of anti-TNF agents
- As of now, radiographic progression of AS pts is not decelerated, in contrast to PsA
- One major difference between the two SpAs is that AS is more an osteoproliferative disease, whereas PsA is more osteodestructive
- Methotrexate offers no additional benefit for the axial symptoms in AS
- Other biologics such as efalizumab, which is used to treat psoriasis, seems to increase the frequency of arthritis
- A whole array of potential side effects has been reported
- Cardiovascular comorbidity seems to be rather important for SpA pts
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