title: [Not Available].
abstract: Ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are common inflammatory rheumatic diseases who belong to the spectrum of the spondyloarthritides (SpA). The therapeutic options for these conditions have been rather limited in the past decades. Standard treatment consists of drug therapy with nonsteroidal anti-inflammatory agents (NSAIDs), intraarticular steroids and physiotherapy. The peripheral symptoms of SpA respond partly to treament with disease modifying anti-rheumatic drugs (DMARDs). Several findings of the last years have indicated that TNFα plays a role in the pathogenesis of the SpA. Treatment with TNFα antagonists (monoclonal antibodies and receptor fusion proteins directed against TNFα) have been successfully used in patients with rheumatoid arthritis (RA), a pathogenetically distinct form of chronic joint inflammation. After stimulating pilot studies there is now increasing evidence from randomized controlled trials that these antagonists are very efficacious in the treatment of SpA, especially of AS and PsA, for both, axial and peripheral symptoms of disease. This therapy seems to be even more effective in SpA than in RA being comparable to the efficacy of corticosteroid therapy for polymyalgia rheumatica. There is international consensus that the availabilitiy of TNFα antagonists is a major breakthrough in the therapy of rheumatic diseases.
authors.affiliation: Rheumazentrum Ruhrgebiet, Herne und Freie Universität, Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Braun
authors.forename: B
authors.initials: B
authors.lastname: Manger