title: Spondyloarthritides: evolving therapies.
abstract: TNF blockade therapy has substantially advanced the treatment of peripheral spondyloarthritides but revolutionised the treatment of severe ankylosing spondylitis. The capacity of biologic treatment to improve dramatically symptoms and quality of life in patients with spinal disease is undoubted, although important questions remain. Notable amongst these are concerns about skeletal disease modification and the true balance between costs and effectiveness. Guidelines for the biologic treatment of ankylosing spondylitis and psoriatic arthritis have been introduced in North America and Europe with considerable consensus. However, the absence of clear criteria for the diagnosis of early disease leaves the issue of biologic treatment of ankylosing spondylitis at the pre-radiographic stage unresolved. Newer biologic agents are entering the field, although superiority over TNF blockers will be difficult to demonstrate.
authors.affiliation: Rheumatology Department, Northwick Park Hospital, Harrow, Middlesex HA1 3UJ, UK. barrandrew@aol.com
authors.forename: Andrew
authors.initials: A
authors.lastname: Barr
authors.forename: Andrew
authors.initials: A
authors.lastname: Keat
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001688:Biological Products / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D017408:Guidelines as Topic; D006801:Humans; D013167:Spondylitis, Ankylosing / Q000188:drug therapy*
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products