An update on the use of tumor necrosis factor alpha inhibitors in the treatment of ankylosing spondylitis

作者：Osman Mohammed S; Maksymowych Walter P

来源：Expert Review of Clinical Immunology, 2017, 13(2): 125-131.

DOI：10.1080/1744666X.2016.1218761

• Ankylosing spondylitis
• axial spondyloarthritis
• TNF alpha inhibitors
• new bone formation
• biological agents
• infliximab
• etanercept
• adalimumab
• certolizumab
• golimumab

Introduction: Ankylosing spondylitis is a chronic immune-mediated disease affecting the sacroiliac joints and the spine manifesting with new bone formation and osteopenia. Over the past decade, tumour necrosis factor alpha (TNF-) inhibitors (TNFi) have become the cornerstone for therapy in improving functional outcomes, and decreasing disease activity in patients with a marginal benefit from non-steroidal anti-inflammatory (NSAID) therapy. At this time, it remains to be determined whether these agents decrease new bone formation, although some studies have recently suggested that.Areas covered: In this review we discuss the factors that favour a good response to these agents both initially and during maintenance, and some of the more recent studies outlining strategies for dose reduction.Expert commentary: Finally, we discuss the importance of using more objective tools for disease activity, such as magnetic resonance imaging, as a complementary tool for clinical assessments in both predicting responses to treatment but also in selecting patients most suited for targeted therapy.

• 出版日期2017-2