PMID- 22855297
OWN - NLM
STAT- MEDLINE
DCOM- 20130124
LR  - 20220408
IS  - 1534-6307 (Electronic)
IS  - 1523-3774 (Linking)
VI  - 14
IP  - 5
DP  - 2012 Oct
TI  - Biologic therapies for spondyloarthritis: what is new?
PG  - 422-7
LID - 10.1007/s11926-012-0282-2 [doi]
AB  - The course of axial spondyloarthritis (axSpA), including ankylosing spondylitis 
      (AS), is strongly influenced by the degree of disease activity over time, which 
      is mainly based on inflammation, and by the impairment of function, which is 
      based on structural damage-mainly, new bone formation-and inflammation. In AS, 
      nonsteroidal anti-inflammatory agents are currently recommended as the first 
      choice of medical therapy, and there is also a clear role for regular exercise 
      and physiotherapy in order to preserve and prevent loss of spinal mobility. For 
      patients who have insufficiently responded to conventional medications, there are 
      now four biologics approved for the treatment of patients with active AS in many 
      countries, all directed against TNFalpha: infliximab, etanercept, adalimumab, and 
      golimumab; studies with certolizumab are currently ongoing. Several studies with 
      patients classified as nonradiographic axSpA have also shown a good response to 
      TNF blockers; in patients with early disease and high CRP levels, the response 
      rates were even better. Long-term studies with TNF blockers have shown declining 
      retention rates over time but sustained clinical efficacy in the patients who 
      remained on treatment. States of drug-free remission are rarely reached and only 
      for relatively short periods of time. More studies including magnetic resonance 
      imaging (MRI) are needed to further examine the lack of effect of anti-TNF 
      treatment on radiographic progression in the axial skeleton. Whether the effect 
      of an early intervention with biologics will prevent the development of bone 
      growth in patients with nonradiographic axial SpA remains to be seen. Biologics 
      other than TNF blockers are currently not recommended for the treatment of 
      patients with axSpA, because of insufficient evidence of clinically relevant 
      efficacy. The anti-IL-17a antibody secukinumab may be efficacious, on the basis 
      of a proof-of-concept trial. Finally, first data on biosimilars of TNF blockers 
      have recently been presented.
FAU - Baraliakos, Xenofon
AU  - Baraliakos X
AD  - Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Landgrafenstr. 15, 44652 Herne, 
      Germany.
FAU - Braun, Juergen
AU  - Braun J
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Rheumatol Rep
JT  - Current rheumatology reports
JID - 100888970
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Immunoglobulin Fab Fragments)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Receptors, Tumor Necrosis Factor)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 3WJQ0SDW1A (Polyethylene Glycols)
RN  - 91X1KLU43E (golimumab)
RN  - B72HH48FLU (Infliximab)
RN  - FYS6T7F842 (Adalimumab)
RN  - OP401G7OJC (Etanercept)
RN  - UMD07X179E (Certolizumab Pegol)
SB  - IM
MH  - Adalimumab
MH  - Antibodies, Monoclonal/*therapeutic use
MH  - Antibodies, Monoclonal, Humanized/therapeutic use
MH  - Antirheumatic Agents/*therapeutic use
MH  - Certolizumab Pegol
MH  - Disease Progression
MH  - Etanercept
MH  - Humans
MH  - Immunoglobulin Fab Fragments/therapeutic use
MH  - Immunoglobulin G/therapeutic use
MH  - Inflammation
MH  - Infliximab
MH  - Polyethylene Glycols/therapeutic use
MH  - Receptors, Tumor Necrosis Factor/therapeutic use
MH  - Rheumatology/trends
MH  - Spondylitis, Ankylosing/*drug therapy/pathology/physiopathology
MH  - Treatment Outcome
MH  - Tumor Necrosis Factor-alpha/antagonists & inhibitors
EDAT- 2012/08/03 06:00
MHDA- 2013/01/25 06:00
CRDT- 2012/08/03 06:00
PHST- 2012/08/03 06:00 [entrez]
PHST- 2012/08/03 06:00 [pubmed]
PHST- 2013/01/25 06:00 [medline]
AID - 10.1007/s11926-012-0282-2 [doi]
PST - ppublish
SO  - Curr Rheumatol Rep. 2012 Oct;14(5):422-7. doi: 10.1007/s11926-012-0282-2.