New treatment targets in ankylosing spondylitis and other spondyloarthritides

作者：Song In Ho; Poddubnyy Denis^*

来源：Current Opinion in Rheumatology, 2011, 23(4): 346-351.

DOI：10.1097/BOR.0b013e328346f7fb

• ankylosing spondylitis
• B-cells
• interleukin
• spondyloarthritis
• T-cells
• treatment

Purpose of review
Despite overall good efficacy of currently available treatment [nonsteroidal anti-inflammatory drugs, tumor necrosis factor (TNF) alpha inhibitors] for ankylosing spondylitis (AS) and other spondyloarthritides (SpAs), up to 40% of the treated patients do not achieve an acceptable clinical improvement during the therapy. Here we discuss the most attractive new targets, which might become an alternative for AS/SpA patients in whom anti-TNF alpha therapy has failed or is contraindicated.
Recent findings
Although B-cell depletion showed a moderate efficacy in a pilot trial in anti-TNF-naive patients with AS, inhibition of T-cell costimulation seems to be ineffective in AS but might be effective in psoriatic arthritis (PsA). Interleukin (IL)-17 blockade showed promising results in a small clinical trial in AS, anti-IL-12/23 drugs demonstrated good efficacy in PsA. Clinical trials investigating the efficacy of IL-17 blockade in PsA, as well as studies with IL-6 and IL-12/23 antagonists in AS, are currently ongoing.
Summary
IL-6, IL-17, IL-12/23 and, to a latter extend, B-cells are the most promising new targets in the treatment of AS and other SpAs.

• 出版日期2011-7