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Editorial review: how early should ankylosing spondylitis be treated with a tumor necrosis factor-blocker?
Curr Opin Rheumatol. 2010 Jul; 22(4):388-92.CO

Abstract

PURPOSE OF REVIEW

Therapy of ankylosing spondylitis with tumor necrosis factor (TNF)-blockers is very effective in about 50% of patients. The focus of this review is to discuss how early in the course of the disease patients with axial spondyloarthritis should be treated with TNF-blockers.

RECENT FINDINGS

During the last 10 years TNF-blockers were investigated in established ankylosing spondylitis. More recently clinical trials focused on early treatment including patients with axial nonradiographic spondyloarthritis. It could be shown that TNF-blockers are at least as effective in patients with axial nonradiographic spondyloarthritis when compared with established ankylosing spondylitis and that TNF-blockers are even more effective when used earlier in the course of the disease and in younger age. Some data even indicate that drug-free remission might be achieved if patients are treated earlier. Active inflammation as seen by MRI can effectively be suppressed during therapy with TNF-blockers. It has been hypothesized that early anti-inflammatory treatment is the best way to prevent ankylosis, which has to be proven in future studies.

SUMMARY

TNF-blockers can achieve a higher clinical response if ankylosing spondylitis patients and patients with nonradiographic axial spondyloarthritis are treated earlier. Whether very early treatment affects ankylosis has to be further investigated.

Authors

No affiliation info availableNo affiliation info available

Pub Type(s)

Editorial
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

20473176

Citation

Haibel, Hildrun, and Joachim Sieper. "Editorial Review: How Early Should Ankylosing Spondylitis Be Treated With a Tumor Necrosis Factor-blocker?" Current Opinion in Rheumatology, vol. 22, no. 4, 2010, pp. 388-92.
Haibel H, Sieper J. Editorial review: how early should ankylosing spondylitis be treated with a tumor necrosis factor-blocker? Curr Opin Rheumatol. 2010;22(4):388-92.
Haibel, H., & Sieper, J. (2010). Editorial review: how early should ankylosing spondylitis be treated with a tumor necrosis factor-blocker? Current Opinion in Rheumatology, 22(4), 388-92. https://doi.org/10.1097/BOR.0b013e32833aaf93
Haibel H, Sieper J. Editorial Review: How Early Should Ankylosing Spondylitis Be Treated With a Tumor Necrosis Factor-blocker. Curr Opin Rheumatol. 2010;22(4):388-92. PubMed PMID: 20473176.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Editorial review: how early should ankylosing spondylitis be treated with a tumor necrosis factor-blocker? AU - Haibel,Hildrun, AU - Sieper,Joachim, PY - 2010/5/18/entrez PY - 2010/5/18/pubmed PY - 2010/9/4/medline SP - 388 EP - 92 JF - Current opinion in rheumatology JO - Curr Opin Rheumatol VL - 22 IS - 4 N2 - PURPOSE OF REVIEW: Therapy of ankylosing spondylitis with tumor necrosis factor (TNF)-blockers is very effective in about 50% of patients. The focus of this review is to discuss how early in the course of the disease patients with axial spondyloarthritis should be treated with TNF-blockers. RECENT FINDINGS: During the last 10 years TNF-blockers were investigated in established ankylosing spondylitis. More recently clinical trials focused on early treatment including patients with axial nonradiographic spondyloarthritis. It could be shown that TNF-blockers are at least as effective in patients with axial nonradiographic spondyloarthritis when compared with established ankylosing spondylitis and that TNF-blockers are even more effective when used earlier in the course of the disease and in younger age. Some data even indicate that drug-free remission might be achieved if patients are treated earlier. Active inflammation as seen by MRI can effectively be suppressed during therapy with TNF-blockers. It has been hypothesized that early anti-inflammatory treatment is the best way to prevent ankylosis, which has to be proven in future studies. SUMMARY: TNF-blockers can achieve a higher clinical response if ankylosing spondylitis patients and patients with nonradiographic axial spondyloarthritis are treated earlier. Whether very early treatment affects ankylosis has to be further investigated. SN - 1531-6963 UR - https://www.unboundmedicine.com/medline/citation/20473176/Editorial_review:_how_early_should_ankylosing_spondylitis_be_treated_with_a_tumor_necrosis_factor_blocker L2 - http://dx.doi.org/10.1097/BOR.0b013e32833aaf93 DB - PRIME DP - Unbound Medicine ER -