Spondyloarthritis: management algorithms and experience of target therapy

The article presents current data on algorithms for managing patients with the most common forms of spondylarthritis — ankylosing spondylitis, axial spondylarthritis and psoriatic arthritis, based on existing national and European recommendations. The analysis of innovative approaches to the patho‑genetic therapy of spondyloarthritis with special attention to the inhibition of interleukin‑17 using the drug secukinumab. Along with the literature data, there is a clinical experience of using secukinumab in patients with ankylosing spondylitis, axial spondyloarthritis, and psoriatic arthritis. It has been shown that secukinumab can improve the quality of treatment and achieve clinical remission in patients with high disease activity and adverse prognostic factors. In connection with the high efficacy and safety of treatment, the feasibility of using secukinumab as a first‑line biological agent with insufficient response to a standard basic drug is discussed.

Download Full-text

The Treatment of Ankylosing Spondylitis and Psoriatic Arthritis with Etanercept: A Comprehensive Review

Clinical Medicine Therapeutics ◽

10.4137/cmt.s37 ◽

2009 ◽

Vol 1 ◽

pp. CMT.S37

Author(s):

Angelique N. Collamer ◽

Daniel F. Battafarano

Keyword(s):

Psoriatic Arthritis ◽

Ankylosing Spondylitis ◽

Inflammatory Diseases ◽

Current Data ◽

Receptor Protein ◽

Randomized Controlled Clinical Trials ◽

Patient Reported ◽

Necrosis Factor

Etanercept is a dimeric recombinant soluble tumor necrosis factor (TNF) receptor protein utilized in the treatment of various inflammatory diseases, including ankylosing spondylitis and psoriatic arthritis. Etanercept binds the proinflammatory cytokine TNF and blocks its interaction with soluble TNF receptors, thus decreasing the inflammatory response. Several randomized controlled clinical trials have demonstrated the efficacy, safety and tolerability of etanercept in the treatment of both ankylosing spondylitis and psoriatic arthritis. These trials have also shown significant reductions in markers of systemic inflammation and improvements in patient-reported quality of life measures. Inhibition of radiographic progression has been established in etanercept-treated psoriatic arthritis patients, and ankylosing spondylitis patients have demonstrated decreases in bony inflammation; however, current data does not support a reduction in bone proliferation in ankylosing spondylitis patients. Concerns regarding long-term toxicity, efficacy, and cost-effectiveness considerations persist and guidelines have been published to assist the clinician with appropriate patient selection for this biologic therapy. Current data indicates etanercept therapy has been a very successful and well-tolerated therapy for numerous ankylosing spondylitis and psoriatic arthritis patients and will likely continue to be a cornerstone therapy for treatment of these challenging diseases in the foreseeable future.

Download Full-text

Golimumab in the treatment of extra-skeletal manifestations of ankylosing spondylitis

Modern Rheumatology Journal ◽

10.14412/1996-7012-2019-4-110-115 ◽

2019 ◽

Vol 13 (4) ◽

pp. 110-115

Author(s):

A. B. Demina

Keyword(s):

Ankylosing Spondylitis ◽

Observational Studies ◽

Clinical Manifestations ◽

Large Sample Size ◽

Efficacy And Safety ◽

High Efficacy ◽

Treatment Regimens ◽

Insufficient Response ◽

Inflammatory Changes

Extra-skeletal manifestations (EMs) of ankylosing spondylitis (AS) can occur and proceed in parallel with inflammatory changes in the joints and spine and often dominate in the clinical picture of AS, determining its high activity and significantly worsening the quality of life in patients. In a number of cases, EMs are characterized by an insufficient response to standard anti-inflammatory therapy for back pain, arthritis, and enthesitis; and there is a need to prescribe another class of drugs.The review highlights the results of studies evaluating the efficacy of golimumab (GLM) in treating EMs in patients with AS: uveitis (GO-EASY Study) and ulcerative colitis (UC) (PURSUIT-SC, PURSUIT-M studies). Analysis of these studies have shown the high efficacy and safety of GLM in reducing the clinical manifestations of AS and in preventing the exacerbations of uveitis and UC. However, despite the successes achieved in treating AS and its EMs, there are many unresolved issues, including those related to the elaboration of optimal treatment regimens, which required longer observational studies with a large sample size.

Download Full-text