title: Biologics in spondyloarthritis: TNFα inhibitors and other agents.
abstract: TNFα inhibitors are currently the only class of biological agent that has proven to be effective in the treatment of patients with ankylosing spondylitis and/or spondyloarthritis (SpA). These agents have been shown to control inflammatory pain of the axial skeleton, peripheral clinical manifestations, certain extra-articular manifestations as well as systemic and spinal MRI inflammation. Conversely, they are unable to slow radiographic progression in the spine. Since around 20-30% of patients with SpA are considered as nonmajor responders to TNFα inhibitors, there is a need for alternative therapies. Biological agents that target IL-1, IL-6, B cells and costimulatory pathways are not effective in SpA. Conversely, novel biological agents blocking IL-23 or IL-17 are promising in SpA, especially secukinumab, an anti-IL-17A monoclonal antibody.
authors.affiliation: Clinical Investigation Center Biotherapy, INSERM CIC-1431, FHU INCREASE, University Hospital of Besançon, Besançon, France.|Department of Rheumatology, University Hospital of Besançon, Besançon, France.|Department of Therapeutics & EA 4266 'Pathogens and Inflammation', SFR FED 4234, University of Franche-Comté, Besançon, France.
authors.forename: Éric
authors.initials: É
authors.lastname: Toussirot
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D001402:B-Lymphocytes / Q000276:immunology / Q000473:pathology; D006801:Humans; D007375:Interleukin-1 / Q000037:antagonists & inhibitors / Q000276:immunology; D015850:Interleukin-6 / Q000276:immunology; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology; D000093242:Interleukin-6 Inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D000093242:Interleukin-6 Inhibitors; C508600:IL6 protein, human; C555450:secukinumab
keywords: IL-17; IL-23; TNFα inhibitors; biological agents; spondyloarthritis