title: New treatment targets in ankylosing spondylitis and other spondyloarthritides.
abstract: OBJECTIVE
  Despite overall good efficacy of currently available treatment [nonsteroidal anti-inflammatory drugs, tumor necrosis factor (TNF) α inhibitors] for ankylosing spondylitis (AS) and other spondyloarthritides (SpAs), up to 40% of the treated patients do not achieve an acceptable clinical improvement during the therapy. Here we discuss the most attractive new targets, which might become an alternative for AS/SpA patients in whom anti-TNFα therapy has failed or is contraindicated.
  
  
  RESULTS
  Although B-cell depletion showed a moderate efficacy in a pilot trial in anti-TNF-naïve patients with AS, inhibition of T-cell costimulation seems to be ineffective in AS but might be effective in psoriatic arthritis (PsA). Interleukin (IL)-17 blockade showed promising results in a small clinical trial in AS, anti-IL-12/23 drugs demonstrated good efficacy in PsA. Clinical trials investigating the efficacy of IL-17 blockade in PsA, as well as studies with IL-6 and IL-12/23 antagonists in AS, are currently ongoing.
  
  
  CONCLUSIONS
  IL-6, IL-17, IL-12/23 and, to a latter extend, B-cells are the most promising new targets in the treatment of AS and other SpAs.
authors.affiliation: Department of Rheumatology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Song
authors.forename: Denis
authors.initials: D
authors.lastname: Poddubnyy
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology; D002986:Clinical Trials as Topic / Q000639:trends; D016503:Drug Delivery Systems / Q000379:methods / Q000639:trends; D006801:Humans; D007378:Interleukins / Q000037:antagonists & inhibitors* / Q000378:metabolism / Q000502:physiology; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000473:pathology
chemical_list: D018501:Antirheumatic Agents; D007378:Interleukins