title: Inefficacy or paradoxical effect? Uveitis in ankylosing spondylitis treated with etanercept.
abstract: Ankylosing spondylitis (AS) is presented with axial and peripheral articular involvement. Uveitis is a severe and rather specific manifestation of AS. Biologics targeting tumor necrosis factor (TNF) α are effective on both articular and ocular manifestations of disease. The occurrence of uveitis in patients that never had eye involvement or the relapse of uveitis is described during anti-TNF α treatment. The frequency of these events is slightly higher during therapy with etanercept. The available TNF α blockers show different pharmacokinetics and pharmacodynamics yielding different biological effects. There is an ongoing debate whether uveitis during anti-TNF α has to be considered as paradoxical effect or an inadequate response to therapy. Here, we present a case report and review what the evidences for the two hypotheses are.
authors.affiliation: Rheumatology Unit, Department of Medicine, General Hospital of Bolzano, Lorenz Boehler Street No. 5, 39100 Bolzano, Italy.
authors.forename: Bernd
authors.identifier: 0000-0001-6930-7260
authors.initials: B
authors.lastname: Raffeiner
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Padova, 35128 Padova, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Ometto
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Padova, 35128 Padova, Italy.
authors.forename: Livio
authors.identifier: 0000-0003-3743-4905
authors.initials: L
authors.lastname: Bernardi
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Padova, 35128 Padova, Italy.
authors.forename: Costantino
authors.initials: C
authors.lastname: Botsios
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Padova, 35128 Padova, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Punzi