Tumour necrosis factor inhibitors in ankylosing spondylitis

Internal Medicine Journal
M R Reed, A L Taylor

Abstract

Ankylosing spondylitis (AS) is the most common form of spondyloarthropathy. Non-steroidal anti-inflammatory medications and exercise are used to manage the chronic inflammatory spinal pain and stiffness. Up to 20% of patients have a peripheral inflammatory arthritis, which is treated with standard disease-modifying anti-rheumatic drugs especially sulfasalazine and methotrexate. Patients may also have extra-articular manifestations, such as anterior uveitis, psoriasiform skin lesions and inflammatory bowel disease. Anti-tumour necrosis (TNF) therapy has been used with great success in rheumatoid arthritis. There are now good data of the efficacy of anti-TNF therapies in the short and medium terms in AS. Etanercept, infliximab and adalimumab have been shown in randomized placebo-controlled trials of short duration to significantly reduce disease activity, including pain and stiffness as well as improving function, spinal movement and quality of life. It is hoped that long-term therapy will prevent radiologic progression and ankylosis and studies of long-term efficacy are awaited. Anti-TNF therapies are generally well tolerated in AS. It is important to screen for latent tuberculosis before the commencement of anti-TNF therapy. Th...Continue Reading

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Citations

Aug 13, 2014·Advances in Therapy·Marcello GovoniMaurizio Rossini
Apr 19, 2011·Rheumatology International·L AltanM Yurtkuran
Sep 18, 2012·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Thomas BuchheitAndrew Shaw
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Jul 4, 2012·Nature Reviews. Gastroenterology & Hepatology·Isabelle Cleynen, Séverine Vermeire
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Sep 3, 2010·The Journal of Rheumatology·Esperanza NaredoUNKNOWN Ultrasound Group of the Spanish Society of Rheumatology

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