Spondyloarthropathies

2011 ◽  
Author(s):  
Sandeep Bawa ◽  
Paul Wordsworth ◽  
Inoshi Atukorala
Keyword(s):  
Positive Association ◽  
Joint Involvement ◽  
Hla B27 ◽  
Resonance Imaging ◽  
Disease Modifying Antirheumatic Drugs ◽  
Peripheral Arthritis ◽  
Antirheumatic Drugs ◽  
Skeletal Involvement ◽  
Inflammatory Drugs ◽  
Necrosis Factor

♦ Spondyloarthropathies are related conditions typically associated with axial skeletal involvement, absence of rheumatoid factor, familial clustering, and a variable positive association with HLA-B27♦ Ankylosing spondylitis is the prototype with sacroiliac joint involvement being a prerequisite for diagnosis♦ Diagnosis is frequently delayed for several years but the use of magnetic resonance imaging to detect sacroiliitis greatly facilitates the establishment of an early diagnosis♦ Psoriatic arthritis, reactive arthritis, and enteropathic arthritis have prominent peripheral joint involvement with variable degrees of spinal involvement♦ Non-steroidal anti-inflammatory drugs and physical therapy are the cornerstones of management but slow-acting disease-modifying antirheumatic drugs only have a role in peripheral arthritis♦ Anti-tumour necrosis factor biologic agents have revolutionized the treatment of the spondyloarthropathies.

scholarly journals Secukinumab therapy in reactive arthritis: Report of two cases

2021 ◽  
Author(s):  
Prasanta Padhan ◽  
Debashis Maikap
Keyword(s):  
Reactive Arthritis ◽  
Tumour Necrosis ◽  
Treatment Options ◽  
Lower Limbs ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Immune Mediated ◽  
Factor Inhibitor ◽  
Inflammatory Drugs ◽  
Necrosis Factor

ABSTRACT Reactive arthritis (ReA) is an immune-mediated aseptic synovitis resulting either from genitourinary or gastrointestinal tract, commonly presenting as oligoarthritis of the lower limbs and rarely urethritis and conjunctivitis. The treatment options include nonsteroidal anti-inflammatory drugs, conventional disease-modifying antirheumatic drugs, and biologics in severe cases. We report successful use of secukinumab in two cases of chronic severe ReA who initially failed to treatment with tumour necrosis factor inhibitor.

scholarly journals Current Therapy of Rheumatoid Arthritis (part 2)

2018 ◽  
Vol 1 (2) ◽  
pp. 90
Author(s):  
Hendrata Erry Andisari
Keyword(s):  
Tumor Necrosis ◽  
Biological Agents ◽  
Current Therapy ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Conventional Dmards ◽  
Inflammatory Drugs ◽  
Disease Modifying ◽  
And Control ◽  
Necrosis Factor

<p><em>Therapy in RA has undergone many advances today and in line with knowledge of the pathogenesis of RA, the current therapeutic goal is to alter the journey and control the activity of RA disease. Several groups of drugs have been used in RA therapy including non-steroidal anti-inflammatory drugs (NSAIDs), conventional disease-modifying antirheumatic drugs (DMARDs) as well as biological agents (bDMARD), glucocorticoids and anti-pain medicines. In recent years, the development of biological agents that have specific targets for inflammatory mediators such as interleukin (IL) -1, IL-6 and Tumor Necrosis Factor (TNF) suggests a potent therapeutic effect on RA. In this article will be presented the latest biological agents as the latest therapy on RA.</em></p><p> </p><strong><em>Keyword</em></strong><em>s : conventional DMARDs, biological agents</em>

Treatment: DMARDs

2016 ◽  
Author(s):  
Denis Poddubnyy ◽  
Hildrun Haibel
Keyword(s):  
Structural Damage ◽  
Clinical Effect ◽  
Axial Spondyloarthritis ◽  
Disease Modifying Antirheumatic Drugs ◽  
Peripheral Arthritis ◽  
Antirheumatic Drugs ◽  
Positive Clinical Effect ◽  
Axial Disease ◽  
Disease Modifying ◽  
Necrosis Factor

In axial spondyloarthritis (axSpA) there is little evidence to support use of classical synthetic disease-modifying antirheumatic drugs (DMARDs), with the majority of studies performed in advanced ankylosing spondylitis. Sulfasalazine is the best investigated DMARD in axSpA. Its positive clinical effect, if any, seems to be more prominent in the presence of peripheral arthritis, although a certain proportion of patients with axial disease might benefit from sulfasalazine therapy. Available data indicate that there is no evidence that methotrexate might be effective in axial disease, and only marginal evidence exists in support of methotrexate use in case of peripheral involvement. No true disease-modifying properties (e.g. retardation of structural damage progression in the spine) have been demonstrated for DMARDs in axSpA to date. Efficacy of a combination therapy (e.g. methotrexate plus sulfasalazine) as well as benefits of methotrexate (or other DMARDs) in addition to tumour necrosis factor α‎ inhibitors in axSpA remain uncertain.

scholarly journals Recent Therapeutics Policies of Arthritis Rheumatoid (part I)

2018 ◽  
Vol 1 (1) ◽  
pp. 12
Author(s):  
Hendrata Erry Andisari
Keyword(s):  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Biological Agents ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Inflammatory Drugs ◽  
Disease Modifying ◽  
And Control ◽  
Necrosis Factor ◽  
Arthritis Rheumatoid

<p>Therapy in RA has undergone many advances today and in line with knowledge of the pathogenesis of RA, the current therapeutic goal is to alter the journey and control the activity of RA disease. Several groups of drugs have been used in RA therapy including non-steroidal anti-inflammatory drugs (NSAIDs), conventional disease-modifying antirheumatic drugs (DMARDs) as well as biological agents (bDMARD), glucocorticoids and anti-pain medicines. In recent years, the development of biological agents that have specific targets for inflammatory mediators such as interleukin (IL) -1, IL-6 and Tumor Necrosis Factor (TNF) suggests a potent therapeutic effect on RA. In this article will be presented the latest biological agents as the latest therapy on RA.</p>

scholarly journals AB0468 IS THE USE OF INTERLEUKIN 17 INHIBITORS IN SPONDYLOARTHRITIS RELATED TO THE CLINICAL MANIFESTATIONS? 12-MONTH EXPERIENCE OF ONE RHEUMATOLOGY CENTER

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1261.1-1261
Author(s):  
M. Khapsirokova ◽  
Z. Kolkhidova ◽  
S. Erdes
Keyword(s):  
Psoriatic Arthritis ◽  
Biological Therapy ◽  
Clinical Manifestations ◽  
Previous Treatment ◽  
Interleukin 17 ◽  
Disease Modifying Antirheumatic Drugs ◽  
Peripheral Arthritis ◽  
Antirheumatic Drugs ◽  
Male Patients ◽  
Necrosis Factor

Background:Therapy with interleukin 17 (iIL17) inhibitors in Russia is indicated for patients with ankylosing spondylitis (AS) or psoriatic arthritis (PSA). If standard therapy is ineffective in these diseases, both tumor necrosis factor inhibitors (iTNF) and iIL17 can be prescribed as the first biologics.Objectives:To study the clinical features of patients with spondyloarthritis (SPA) who were first prescribed iIL17 in a rheumatology center for 12 months.Methods:During the period from January to December 2019, iIL17 was initiated to 43 SPA patients. To compare the clinical picture, the study additionally included 40 SPA patients who were prescribed iTNF during the same period. The diagnosis of AS was based on the mNY criteria, and psoriatic arthritis was based on the CASPAR criteria. In the combined group of 83 patients, AS was in 52 (62.7%), and PSA – in 31; the age of patients was 39.3±10.8 years, and the duration of the disease was 15.1±8.2 years; men were 47 (56.6%).Results:In the iIL17 group, AS had 23 (53.5%) patients, and PSA – 20 (46.5%), while in the iTNF group, respectively, 29 (72.5%) and 11 (27.5%; χ2=3.2, p=0.76). Among the patients who were prescribed iIL17, men were 29 (67%), and in the iTNF group – 18 (45%; χ2=4.2, p=0.04). In terms of activity indicators (ESR, CRP, BASDAI ASDAS-CRP), patients who were prescribed iIL17 or iTNF did not differ significantly from each other. Peripheral arthritis, dactylitis, and entesitis were observed with almost the same frequency in both groups. In the iIL17 group, there were almost 2 times more patients with psoriasis (53.5% and 25.0%; p<0.05) than in group iTNF and among them, significantly more frequent the patients had previous experience of iTNF treatment (41,9% and 17.5%; p<0.05). Disease-modifying antirheumatic drugs often received patients in iTNF group (80.0% and 48.8%; p<0.05).Conclusion:Thus, in clinical practice iIL17 often prescribed for SPA male patients with psoriasis and previous treatment experience by iTNF. The activity of the disease and the presence of non-axial manifestations practically do not affect the choice of biological therapy.Disclosure of Interests:None declared.

Periodontitis Severity Affects the Clinical Response to Biological Disease-Modifying Antirheumatic Drugs in Rheumatoid Arthritis: A 1-Year Follow-up Study

2021 ◽  
Author(s):  
Tetsuo Kobayashi ◽  
Satoshi Ito ◽  
Akira Murasawa ◽  
Hajime Ishikawa ◽  
Koichi Tabeta
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Response ◽  
Activity Index ◽  
Disease Activity Index ◽  
Positive Association ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Case Definitions ◽  
Synthetic Dmards ◽  
Disease Modifying

ABSTRACT Objectives To assess whether periodontitis severity affects the clinical response to biological disease-modifying antirheumatic drugs (bDMARDs) for 1 year in rheumatoid arthritis (RA) patients. Methods Data were collected from 50 RA patients who had received corticosteroids, conventional synthetic DMARDs, or non-steroidal anti-inflammatory drugs before (baseline) and after 1 year of bDMARD therapy in a retrospective study. Rheumatologic conditions were compared between the two periodontitis severity groups according to the periodontal inflamed surface area (PISA) or Centers for Disease Control Prevention (CDC)/ American Academy of Periodontology (AAP) case definitions Results Twenty-eight patients with no or mild periodontitis showed significantly greater decreases in changes in Clinical Disease Activity Index (CDAI) and tender and swollen joint count in comparison to 22 patients with moderate and severe periodontitis (p = 0.02, p = 0.01, and p = 0.03). Both bivariate and multivariate analyses revealed a significantly positive association between the baseline CDC/AAP definitions and CDAI changes (p = 0.005 and p = 0.0038). However, rheumatologic conditions were comparable between 25 patients each in the low and high PISA groups. Conclusions Baseline periodontitis severity according to the CDC/AAP definitions is associated with the clinical response to bDMARDs for 1 year in RA patients.

Treatment: biologics

2016 ◽  
Author(s):  
Juergen Braun ◽  
Irene E. van der Horst-Bruinsma
Keyword(s):  
Biologic Agents ◽  
Classification Criteria ◽  
New Drugs ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Biologic Treatment ◽  
Insufficient Response ◽  
Axial Disease ◽  
Inflammatory Drugs ◽  
Management Recommendations

According to classification criteria, the spectrum of spondyloarthritis (SpA) covers axial SpA (axSpA), which includes non-radiographic axSpA and ankylosing spondylitis, and peripheral SpA, which overlaps with psoriatic arthritis. Management recommendations for many forms of SpA have been recently published. Treatment of patients with axSpA with active disease starts with a sufficient dose of non-steroidal anti-inflammatory drugs (NSAIDs) for at least 4 weeks and preferably longer, in combination with exercise. In case of peripheral SpA, several disease-modifying antirheumatic drugs can be given, but these are not efficacious in axial disease. In case of insufficient response to NSAIDs for axSpA, biologic treatment can be added. The biologics most commonly used are TNF-blocking agents, but some other biologic agents seem to be beneficial in axial diseases as well, such as secukinumab (an IL-17 blocker). However, these new drugs have not yet been approved for axSpA at the time of writing this chapter.

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