Extraarticular manifestations of rheumatic diseases and the possibilities of their alleviation by biological therapy
Authors:
Š. Forejtová
Authors‘ workplace:
Revmatologický ústav Praha a Revmatologická klinika 1. LF UK, Praha
Published in:
Čes. Revmatol., 19, 2011, No. 2, p. 80-85.
Category:
Posts from Congress
Overview
Rheumatoid arthritis and ankylosing spondylitis are chronic inflammatory rheumatic diseases manifesting mainly by pain of joints and spine. Extraarticular manifestations such as involvement of entheses, skin, gut, eye, and others can be an important part of the disease. Systemic manifestations such as amyloidosis, vasculitis, more frequent occurrence of osteoporosis and accelerated development of atherosclerosis can occur simultaneously with the extraarticular manifestations. It was found that anti-TNFα therapy successfully affects the incidence of enthesitis, skin manifestations, uveitis and intestinal involvement in patients with ankylosing spondylitis, in both fully expressed and subclinical form of idiopathic inflammatory bowel disease. Patients treated with anti-TNFα antibodies were shown to have decreased incidence of uveitis compared to patients treated with etanercept. Treatment with infliximab or adalimumab is also indicated in patients with spondylarthritis with concomitant intestinal involvement. Anti-TNFα therapy in rheumatoid arthritis and ankylosing spondylitis has a beneficial effect on the increase of bone density compared to placebo treated individuals. The results from some studies and national registries imply that this therapy could reduce the incidence of cardiovascular events in comparison with untreated individuals. However, biological therapy may paradoxically cause development of autoimmune diseases, namely both organ specific and systemic diseases.
Key words:
biological therapy, anti-TNFα therapy, extraarticular manifestations, autoimmune diseases, atherosclerosis, osteoporosis
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Labels
Dermatology & STDs Paediatric rheumatology RheumatologyArticle was published in
Czech Rheumatology
2011 Issue 2
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