Review: Antitumor necrosis factor-α-directed therapies are recommended for NSAID-refractory spondyloarthritis: COMMENTARY

Sander, Oliver
May 2004
ACP Journal Club;May/Jun2004, Vol. 140 Issue 3, p71
Academic Journal
Tumor necrosis factor (TNF)-α plays a role in the pathogenesis of many chronic inflammatory diseases. TNF-blocking therapy has been shown to be efficacious in ankylosing spondylitis and psoriatic arthritis. Consensus exists on treating active and refractory ankylosing spondylitis with both the anti-TNF-α agent infliximab and the TNF-receptor fusion protein etanercept. Etanercept has also shown efficacy in psoriatic arthritis. The study addresses several important questions in the management of spondyloarthritis. The conclusions reached by the authors are presented as a position statement on the use of anti-TNF-α-directed therapies in this group of vexing conditions. However, during scrutiny of the authors' assertions, 2 particular issues need to be recognized. First, only case-report evidence is available on the role of anti-TNF-α therapy in reactive arthritis, undifferentiated spondyloarthropathy, or arthropathy in inflammatory bowel disease. Second, switching between different anti-TNF-α agents has not been approved by drug regulatory agencies.


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