title: Impact of biological therapy on spondyloarthritis.
abstract: OBJECTIVE
  In this review, we focus on the clinical and radiological aspects related to the biological therapy of ankylosing spondylitis (AS), axial spondyloarthritis (SpA) and psoriatic arthritis (PsA).
  
  
  METHODS
  A review was carried out in the main medical databases to evaluate the available literature.
  
  
  RESULTS
  Even if there is emerging interest for the role of biological agents other than tumour necrosis factor (TNF)-α inhibitors in spondyloarthritis, anti-TNF-α treatment is currently the only effective therapy for patients in whom conventional therapy with non-steroideal anti-inflammatory drugs (NSAIDs) has failed. Nevertheless, the potential impact of earlier treatment and the best drugs or combinations of drugs for preventing radiographic progression in SpA are yet to be determined.
  
  
  CONCLUSIONS
  Anti-TNF-α treatment is currently used with efficacy in the greater part of patients with SpA. In these patients, availability of biological treatment is limited on the bases of potential toxicity and cost. On the basis of clinical trials, biologics other than TNF-α inhibitors can currently not be recommended for the treatment of SpA.
authors.affiliation: Rheumatology Clinic "Mario Carrozzo", Department of Medical and Surgical Sciences, University of Foggia Medical School, "D'Avanzo" Hospital, Viale degli Aviatori 1, 71100, Foggia, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Maruotti
authors.forename: Francesco Paolo
authors.initials: FP
authors.lastname: Cantatore
mesh_terms: D001691:Biological Therapy; D006801:Humans; D011859:Radiography; D025241:Spondylarthritis / Q000000981:diagnostic imaging / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D014409:Tumor Necrosis Factor-alpha