Marzo-Ortega H, McGonagle D, O'Connor P, Emery P
Rheumatology Research Unit, University of Leeds, 36 Clarendon Road, Leeds LS2 9NZ, UK.
Ann Rheum Dis. 2003 Jan;62(1):74-6. doi: 10.1136/ard.62.1.74.
The seronegative spondyloarthropathies (SpAs) are associated both with clinical and subclinical colitis. Recently biological blockade with the tumour necrosis factor alpha (TNFalpha) antagonists infliximab and etanercept has been shown to be effective in the treatment of SpA. However, only infliximab is efficacious in the treatment of colitis in patients with Crohn's SpA. We report on two patients with SpA and associated Crohn's disease treated with etanercept whose arthritis showed an excellent response with complete resolution of spinal pathology, whereas their Crohn's disease persisted or flared. These findings suggest that the effect of TNFalpha blockade in SpA differs between the joint and the bowel.
血清阴性脊柱关节病(SpAs)与临床和亚临床结肠炎均相关。最近,使用肿瘤坏死因子α(TNFα)拮抗剂英夫利昔单抗和依那西普进行生物阻断已被证明对SpA治疗有效。然而,仅英夫利昔单抗对克罗恩病性SpA患者的结肠炎治疗有效。我们报告了两名使用依那西普治疗的SpA合并克罗恩病患者,他们的关节炎显示出极佳反应,脊柱病变完全消退,而他们的克罗恩病持续存在或复发。这些发现表明,TNFα阻断在SpA中的作用在关节和肠道之间存在差异。