TNF-alpha inhibitors for ankylosing spondylitis

Zochling, Jane; Maxwell, Lara; Beardmore, Jil; Boonen, Annelies

doi:10.1002/14651858.cd005468

Cited by 10 publications

(5 citation statements)

References 16 publications

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“…Our study is one of the few studies evaluating the safety of systemic treatments for the prevention of HLA-B27-associated uveitis recurrences. Even if adverse events were not frequent in our patients, these treatments have short or long term adverse effects, especially anti-TNFα agents [38]. With regards to the visual prognosis, it was favourable in most patients with only 7% of long term complications (6.9% of synechiae and one case of chronic uveitis at final follow-up).…”

Section: Discussionmentioning

confidence: 61%

Impact of systemic treatments on the course of HLA-B27-associated uveitis: A retrospective study of 101 patients

et al. 2020

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To investigate the efficacy and tolerance of systemic treatments for the prevention of HLA-B27-associated acute uveitis (AU) recurrence. Methods Retrospective review of patients with HLA-B27-associated uveitis followed in our tertiary center over a 15-year period. Systemic treatments were prescribed to patients with frequent (more than 2 flares per year) or severe uveitis, according to a step-up strategy Results 101 patients (51.5% of men, 88.1% of white Europeans) with a median age of 37 years. AU was mostly recurrent (68.3%) and associated with spondyloarthritis (60.4%). After a median follow-up duration of 22 months (3-73), 37.6% of the patients have received systemic treatment. 88.5% of the patients have been treated with sulfasalazine (SSZ) for ophthalmologic purposes (23/26). Methotrexate (MTX) and anti-TNFα agents have been initiated for a rheumatologic indication in 81.8% (9/11) and 100% of the patients (13/13), respectively. The annual uveitis relapse rate significantly decreased on SSZ (0.37 recurrences/year versus baseline 2.46 recurrences/year; p<0.001) and MTX (1.54 recurrences/year versus 4.17/year; p = 0.008). Patients under ADA for ophthalmologic purposes (n = 2) did not experience any recurrence. Conclusion We report an open-label strategy to prevent the recurrences of HLA-B27-associated AU. First-line sulfasalazine reduced uveitis relapses. The use of anti-TNFα agents for ophthalmologic purposes was unnecessary with rare exceptions.

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Section: Discussionmentioning

confidence: 61%

Impact of systemic treatments on the course of HLA-B27-associated uveitis: A retrospective study of 101 patients

et al. 2020

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“…As many studies have demonstrated that TNF-α inhibitors are effective for treatment of not only advanced ankylosing spondylitis, but also its early stage, early use of TNF-α inhibitors has been recommended 2 , 3 , 4 , 5 , 6 , 10 , 11) . The ASAS guidelines (first released in 2006) recommended to use them for patients who had been diagnosed with ankylosing spondylitis according to the New York criteria and treated with more than two NSAIDs over 3 months.…”

Section: Dignosis and Medical Management Of Ankylosing Spondylitismentioning

confidence: 99%

“…Flexion contracture of the hip joint, mostly found in the advanced stage of the disease, results in rigid gait with knee joint flexion in order to maintain a standing posture. In contrast, ankylosing spondylitis involves other organs and affects the life quality of patients via accompanying dactylitis (25-50%), uveitis (25-40%), inflammatory bowel disease (26%), and psoriasis (10%) 2) . Although the etiology of the disease is yet to be elucidated, human leukocyte antigen (HLA) B27 is one of the most important factors; the prevalence rate of HLA-B27-positive patients ranges from 0.4% to 1.4% depending on patients' ethnicity 3) .…”

Section: Introductionmentioning

confidence: 99%

Medical Treatment of Ankylosing Spondylitis

Moon

Kim

2014

Hip & Pelvis

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The diagnosis of ankylosing spondylitis is often delayed due to ambiguous clinical manifestations and strict diagnostic criteria. However, imaging techniques such as magnetic resonance imaging have been found effective for the early diagnosis of non-radiographic sacroiliitis. New tumor necrosis factor alpha (TNF-α) inhibitors have good efficacy for patients with persistently high disease activity despite conventional nonsteroidal anti-inflammatory drug treatment. Thus, early diagnosis and aggressive treatments are essential for ankylosing spondylitis patients. Because many patients complain of musculoskeletal pains, especially around the sacroiliac joint area, hip specialists should be informed of up-to-date knowledge. In this review, we discuss new diagnostic criteria for ankylosing spondylitis, administration methods of TNF-α inhibitors, and the long-term follow-up results for patients treated with TNF-α inhibitors.

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“…Both the BASFI and BASDAI serve as important treatment endpoints in the rheumatology literature; failure to improve along these parameters often justifies advancement to more aggressive therapies. 14 Accepted serum markers for disease staging include Creactive protein and erythrocyte sedimentation rate. Antinuclear antibodies and liver function tests are important in patients undergoing immunological therapy.…”

Section: Disease Monitoringmentioning

confidence: 99%

“…15 The need for rapid identification of patients with AS not experiencing the benefits of TNF␣ blockade is to spare the patient any therapeutic risks. 14 The TNF␣ inhibition increases the patient's susceptibility to common upper respiratory infections and tuberculous disease; screening for Mycobacterium tuberculosis is now a prerequisite for therapy initiation. Infliximab may precipitate a positive antinuclear antibody titer, and the incidences of demyelinating disease and lupuslike syndromes, although anecdotally reported, remains unknown.…”

Section: Neurosurg Focus / Volume 24 / January 2008mentioning

confidence: 99%

Medical management of ankylosing spondylitis

Khalessi

Wang

2008

FOC

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✓ In the following literature review the authors consider the available evidence for the medical management of patients with ankylosing spondylitis (AS), and they critically assess current treatment guidelines. Medical therapy for axial disease in AS emphasizes improvement in patients' pain and overall function. First-line treatments include individualized physical therapy and nonsteroidal antiinflammatory drugs (NSAIDs) in conjunction with gastroprotective therapy. After an adequate trial of therapy with two NSAIDs exceeding 3 months or limited by medication toxicity, the patient may undergo tumor necrosis factor–α blockade therapy. Response should occur within 6–12 weeks, and patients must undergo tuberculosis screening. Evidence does not currently support the use of disease modifying antirheumatic drugs, corticosteroids, or radiotherapy in AS.

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TNF-alpha inhibitors for ankylosing spondylitis

Cited by 10 publications

References 16 publications

Impact of systemic treatments on the course of HLA-B27-associated uveitis: A retrospective study of 101 patients

Impact of systemic treatments on the course of HLA-B27-associated uveitis: A retrospective study of 101 patients

Medical Treatment of Ankylosing Spondylitis

Medical management of ankylosing spondylitis

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