[Current status of therapeutic approaches in spondyloarthropathies]

Anti-TNF therapy seems to be highly effective in AS. Based on the available results, this treatment seems to be at least as effective as in RA. Furthermore, because no other treatments are available for AS--in contrast to RA or psoriatic arthritis--infliximab might even become a first-line immuno-suppressive treatment in patients with severe, active AS. A dosage of 5 mg/kg seems to be required and intervals between 6-12 weeks seem to be necessary depending on the disease activity. It remains to be shown what the long-term effects are, whether the patients benefit from long-term therapy and whether radiological progression and ankylosis can be stopped. Allergy, lupus-like diseases and tuberculosis are rare side effects which need to be addressed. At first glance, the possible benefits of anti-TNF therapy seem to outweigh these shortcomings.