Efficacy of etanercept for treatment of Crohn's related spondyloarthritis but not colitis.
The seronegative spondyloarthropathies (SpAs) are associated both with clinical and subclinical colitis. Recently biological blockade with the tumour necrosis factor alpha (TNFalpha) antagonists infliximab and etanercept has been shown to be effective in the treatment of SpA. However, only infliximab is efficacious in the treatment of colitis in patients with Crohn's SpA. We report on two patients with SpA and associated Crohn's disease treated with etanercept whose arthritis showed an excellent response with complete resolution of spinal pathology, whereas their Crohn's disease persisted or flared. These findings suggest that the effect of TNFalpha blockade in SpA differs between the joint and the bowel.
Marzo-Ortega
H
H
Rheumatology Research Unit, University of Leeds, 36 Clarendon Road, Leeds LS2 9NZ, UK. medhmo@leeds.ac.uk
McGonagle
D
D
O'Connor
P
P
Emery
P
P
D000328:Adult; D003092:Colitis / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D000068800:Etanercept; D015796:HLA-B27 Antigen / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D025241:Spondylarthritis / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology; D017211:Treatment Failure
D015796:HLA-B27 Antigen; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept