Article information
Abstract
Anti-TNFα agents represent an outstanding advance in the symptomatic control of patients with ankylosing spondylitis presenting an inadequate response to non-steroidal anti-inflammatory drugs. Anti-TNFα antagonists have demonstrated efficacy and safety in the long-term but continuous therapy is needed for an adequate control of symptoms. After the failure to a first anti-TNFα agent, the use of a second TNFα antagonist seems to be effective and safe. Despite the fast and continuous suppression of bone inflammation, demonstrated by magnetic resonance imaging, the beneficial effect of treatment with TNFα antagonists on the radiological evolution has not been demonstrated to date in ankylosing spondylitis. It seems that insights into new therapeutic molecular targets implicated in the process of ossification are needed.
Keywords:
Ankylosing spondylitis
Anti-TNFα therapy
Structural damage
Resumen
Los agentes anti-TNFα han representado un notable avance en el control sintomático de los pacientes con espondilitis anquilosante y respuesta inadecuada a AINE. Los antagonistas del TNFα son eficaces y seguros a largo plazo pero es necesario su uso continuado para un adecuado control sintomático. Tras el fracaso a uno de ellos, el uso de un segundo agente anti-TNFα parece ser eficaz y seguro. Aún no se ha demostrado un efecto beneficioso del tratamiento con antagonistas del TNFα sobre la evolución radiológica en la espondilitis anquilosante, a pesar de la desaparición rápida y mantenida de la inflamación ósea, evidenciada mediante RM. Parece necesario explorar nuevas dianas moleculares implicadas en el proceso de osificación.
Palabras clave:
Espondilitis anquilosante
Terapia anti-TNFα
Daño estructural
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