Advances in the Treatment of Ankylosing Spondylitis

Overview

The author presents a review of new pharmacotherapeutic procedures in ankylosing spondylitis(AS). In the introduction three basic findings are mentioned: a) the prevalence of spondylarthritis(among which AS is most frequent) is higher than formerly reported, b) the effect of AS on disabilityand quality of life is the same as in rheumatoid arthritis, c) among hitherto used procedures so faronly exercise was effective and the administration of non-steroid antirheumatics, and in peripheralforms of AS sulfasalazine has a mild effect. Other DMARDs incl. MTX and corticosteroids areineffective. A quite new quality into treatment of AS was introduced by TNF blockers. Infliximaband etanercept were more effective in double blind randomized controlled studies than placebo inperipheral as well as axial forms of AS. The effect was at least as great as in the indication ofrheumatoid arthritis. Registration ofTNFblocking drugs for the indication inASmay be anticipatedat the end of 2002. A quite different approach is the administration of intravenous pamidronate inAS. The first randomized controlled trial gave promising results.

Key words:
ankylosing spondylitis, therapy, TNF blocking