J Korean Med Assoc.  2003 Nov;46(11):972-980. 10.5124/jkma.2003.46.11.972.

Recent Advances in the Treatment of Spondyloarthropathy

Affiliations
  • 1Department of Internal Medicine, Hanyang University College of Medicine & Hospital, Korea. dhyoo@hanyang.ac.kr

Abstract

Spondyloarthropathy is a chronic inflammatory disease involving axial joints and peripheral joints, and finally induces ankylosis of the spine. Treatment of spondyloarthropathy including ankylosing spondylitis has many limitations. Nonsteroidal anti-inflammatory drugs have played an important role in the control of pain and stiffness, however, could not inhibit the development of axial joint deformity. Although disease-modifying antirheumatic drugs, such as sulfasalazine, methotrexate, and cyclosporine, are currently used in the clinic, clinical data supporting their efficacy from randomized controlled studies are still not enough. Also the efficacy of pamidronate, thalidomide, or other potential therapeutic agents needs to be con-firmed by randomized controlled trials. Lately the introduction of inhibitors of tumor necrosis factor alpha in the rheumatic diseases has made a great advance in the management of spondyloarthropathy. Here I review the conventional and newly introduced options in the management of spondyloarthropathy.

Keyword

Ankylosing spondylitis; Psoriatic arthritis; DMARD; Pamidronate; Treatment; Tumor necrosis factor alpha

MeSH Terms

Ankylosis
Antirheumatic Agents
Arthritis, Psoriatic
Congenital Abnormalities
Cyclosporine
Joints
Methotrexate
Rheumatic Diseases
Spine
Spondylarthropathies*
Spondylitis, Ankylosing
Sulfasalazine
Thalidomide
Tumor Necrosis Factor-alpha
Antirheumatic Agents
Cyclosporine
Methotrexate
Sulfasalazine
Thalidomide
Tumor Necrosis Factor-alpha

Reference

1. Braun J, van der Heijde D, Pincus T. Novel antirheumatic therapies challenge old views on ankylosing spondylitis and other spondyloarhtritides. Clin Exp Rheumatol. 2002. 20:Suppl 20. 1–2.
2. Braun J, Pham T, Sieper J, Davis J, van der Linden S, van der Heijde D, et al. ASAS Working Group. International ASAS consensus statement for the use of anti-tumour necrosis factor agents in patients with ankylosing spondylitis. Ann Rheum Dis. 2003. 62:817–824.
Article
3. Pham T, van der Heijde D, Calin A, Khan MA, van der Linden S, Dougados M, et al. ASAS Working Group. Initiation of bio-logical agents in patients with ankylosing spondylitis : results of a Delphi study by the ASAS Group. Ann Rheum Dis. 2003. 62:812–816.
Article
4. Maksymowych WP, Inman RD, Gladman D, Thomson G, Stone M, Russell AS, et al. Spondyloarthritis Research Consortium of Canada(SPARCC). Canadian Rheumatology Association Consensus on the use of anti-tumor necrosis factor-alpha directed therapies in the treatment of spondyloarthritis. J Rheumatol. 2003. 30:1356–1363.
5. Baeten D, Kruithof E, Van den Bosch F, Van den Bossche N, Herssens A, Veys EM, et al. Systematic safety follow up in a cohort of 107 patients with spondyloarthropathy treated with infliximab : a new perspective on the role of host defence in the pathogenesis of the disease? Ann Rheum Dis. 2003. 62:829–834.
Article
6. Breban M, Vignon E, Claudepierre P, Devauchelle V, Wendling D, Dougados M, et al. Efficacy of infliximab in refractory ankylosing spondylitis : results of a six-month open-label study. Rheumatology. 2002. 41:1280–1285.
Article
7. Braun J, Brandt J, Listing J, Zink A, Alten R, Sieper J, et al. Long-term efficacy and safety of infliximab in the treatment of ankylosing spondylitis : an open, observational, extension study of a three-month, randomized, placebo-controlled trial. Arthritis Rheum. 2003. 48:2224–2233.
Article
8. Brandt J, Khariouzov A, Listing J, Haibel H, Sorensen H, Braun J, et al. Six-month results of a double-blind, placebo-controlled trial of etanercept treatment in patients with active ankylosing spondylitis. Arthritis Rheum. 2003. 48:1667–1675.
Article
9. Braun J, Sieper J. Therapy of ankylosing spondylitis and other spondyloarthritides : established medical treatment, anti-TNF-alpha therapy and other novel approaches. Arthritis Res. 2002. 4:307–321.
10. van der Horst-Bruinsma IE, Clegg DO, Dijkmans BA. Treatment of ankylosing spondylitis with disease modifying antirheumatic drugs. Clin Exp Rheumatol. 2002. 20:Suppl 28. S67–S70.
11. Miceli-Richard C, Dougados M. NSAIDs in ankylosing spondylitis. Clin Exp Rheumatol. 2002. 20:Suppl 28. S65–S66.
12. Dougados M, Dijkmans B, Khan M, Maksymowych W, van der Linden S, Brandt J. Conventional treatments for ankylosing spondylitis. Ann Rheum Dis. 2002. 61:Suppl 3. 40–50.
Article
13. Roychowdhury B, Bintley-Bagot S, Bulgen DY, Thompson RN, Tunn EJ, Moots RJ. Is methotrexate effective in ankylosing spondylitis? Rheumatology. 2002. 41:1330–1332.
Article
14. Zou JX, Braun J, Sieper J. Immunological basis for the use of TNF alpha-blocking agents in ankylosing spondylitis and immunological changes during treatment. Clin Exp Rheumatol. 2002. 20:Suppl 28. S34–S37.
15. Braun J, Baraliakos X, Golder W, Brandt J, Rudwaleit M, Van Der Heijde D, et al. Magnetic resonance imaging examinations of the spine in patients with ankylosing spondylitis, before and after successful therapy with infliximab : evaluation of a new scoring system. Arthritis Rheum. 2003. 48:1126–1136.
Article
16. Rosenbaum JT, Smith JR. Anti-TNF therapy for eye involvement in spondyloarthropathy. Clin Exp Rheumatol. 2002. 20:Suppl 28. S143–S145.
17. Davis JC Jr, Huang F, Maksymowych W. New therapies for ankylosing spondylitis : etanercept, thalidomide, and pamidronate. Rheum Dis Clin North Am. 2003. 29:481–494.
Article
18. Haibel H, Braun J, Maksymowych WP. Bisphosphonates-targeting bone in the treatment of spondyloarthritis. Clin Exp Rheumatol. 2002. 20:Suppl 28. S162–S166.
19. Maksymowych WP, Jhangri GS, Fitzgerald AA, LeClercq S, Chiu P, Russell AS, et al. A six-month randomized, controlled, double-blind, dose-response comparison of intravenous pamidronate(60 mg versus 10 mg) in the treatment of nonsteroidal antiinflammatory drug-refractory ankylosing spondylitis. Arthritis Rheum. 2002. 446:766–773.
20. Haibel H, Brandt J, Rudwaleit M, Soerensen H, Sieper J, Braun J. Treatment of ankylosing spondylitis with pamidronate. Rheumatology. 2003. 42:1018–1020.
Article
21. Ossandon A, Cassara EA, Priori R, Valesini G. Thalidomide : focus on its employment in rheumatologic diseases. Clin Exp Rheumatol. 2002. 20:709–718.
22. Huang F, Wei JC, Breban M. Thalidomide in ankylosing spondylitis. Clin Exp Rheumatol. 2002. 20:Suppl 28. S158–S161.
23. Huang F, Gu J, Zhao W, Zhu J, Zhang J, Yu DT. One-year open-label trial of thalidomide in ankylosing spondylitis. Arthritis Rheum. 2002. 47:249–254.
Article
24. Pipitone N, Kingsley GH, Manzo A, Scott DL, Pitzalis C. Current concepts and new developments in the treatment of psoriatic arthritis. Rheumatology. 2003. 42:1138–1148.
Article
25. Salvarani C, Cantini F, Olivieri I. Disease-modifying antirheumatic drug therapy for psoriatic arthritis. Clin Exp Rheumatol. 2002. 20:Suppl 28. S71–S75.
26. Sarzi-Puttini P, Santandrea S, Boccassini L, Panni B, Caruso I. The role of NSAIDs in psoriatic arthritis : evidence from a controlled study with nimesulide. Clin Exp Rheumatol. 2001. 19:Suppl 22. S17–S20.
27. Salvarani C, Cantini F, Olivieri I, Macchioni P, Padula A, Boiardi L, et al. Efficacy of infliximab in resistant psoriatic arthritis. Arthritis Rheum. 2003. 49:541–545.
Article
28. Weinberg JM, Saini R, Tutrone WD. Biologic therapy for psoriasis-the first wave : infliximab, etanercept, efalizumab, and alefacept. J Drugs Dermatol. 2002. 1:303–310.
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr