Rios Rodriguez Valeria, Poddubnyy Denis
Department of Gastroenterology, Infectiology and Rheumatology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Germany.
Department of Gastroenterology, Infectiology and Rheumatology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany.
Ther Adv Musculoskelet Dis. 2017 Aug;9(8):197-210. doi: 10.1177/1759720X17706454. Epub 2017 May 9.
Nonradiographic axial spondyloarthritis (SpA) and radiographic SpA (also known as ankylosing spondylitis) are currently considered as two stages or forms of one disease (axial SpA). The treatment with tumor necrosis factor-α (TNFα) inhibitors has been authorized for years for ankylosing spondylitis. In recent years, most of the anti-TNFα agents have also been approved for the treatment of nonradiographic axial SpA by the European Medicines Agency (EMA) and similar authorities in many countries around the world (but not in the US), increasing the number of possible therapies for this indication. Data from several clinical trials have demonstrated the good efficacy and safety profiles from those anti-TNFα agents. Presently, a large number of patients achieve a satisfactory clinical control with the current therapies, however, there remains a percentage refractory to nonsteroidal anti-inflammatory drugs (NSAIDs) and TNFα inhibitors; therefore, several new drugs are currently under investigation. In 2015, the first representative of a new class of biologics [an interleukin (IL)-17 inhibitor] secukinumab, was approved for the treatment of ankylosing spondylitis; a clinical trial in nonradiographic axial SpA is currently underway. In this review, we discuss the recent data on efficacy and safety of TNFα-inhibitors focusing on the treatment of nonradiographic axial SpA.
非放射学轴性脊柱关节炎（SpA）和放射学SpA（也称为强直性脊柱炎）目前被视为一种疾病（轴性SpA）的两个阶段或形式。肿瘤坏死因子-α（TNFα）抑制剂多年来已被批准用于治疗强直性脊柱炎。近年来，大多数抗TNFα药物也已被欧洲药品管理局（EMA）及世界上许多国家的类似机构批准用于治疗非放射学轴性SpA（但在美国未获批），这增加了针对该适应症的可能治疗方法的数量。多项临床试验的数据已证明这些抗TNFα药物具有良好的疗效和安全性。目前，大量患者通过现有疗法实现了令人满意的临床控制，然而，仍有一定比例的患者对非甾体抗炎药（NSAIDs）和TNFα抑制剂无效；因此，目前有几种新药正在研究中。2015年，一类新型生物制剂[白细胞介素（IL）-17抑制剂]的首个代表药物司库奇尤单抗被批准用于治疗强直性脊柱炎；一项针对非放射学轴性SpA的临床试验正在进行中。在本综述中，我们讨论了TNFα抑制剂在治疗非放射学轴性SpA方面的近期疗效和安全性数据。
