[Anti-TNF-alpha treatment--an effective complement in spondyloarthropathy]

Nine patients with spondylarthropathy (SpA) (6 with ankylosing spondylitis and 3 with psoriatic arthritis) who had not responded properly to conventional DMARD therapy were treated with 3 infusions (at 0, 2 and 6 weeks) of the TNF alpha inhibitor infliximab (3 mg/kg), in combination with methotrexate. To measure the effect of treatment, patients were evaluated before as well as 8 and 12 weeks after treatment with respect to disease activity (BASDAI), function (BASFI), mobility (BASMI) and global well-being in the past week (BASG1) as well as the past 6 months (BASG2). BASDAI, BASFI, BASMI and BASG1 improved significantly, with the most pronounced effect during the first 8 weeks. Also, ESR and CRP decreased significantly from baseline to 12 weeks after treatment. We conclude that infliximab is an effective therapy in SpA which does not respond sufficiently to conventional DMARD therapy. Best response to treatment was found after the first treatment regimen with regard to both effect and effect duration. Most patients responding to and tolerating anti-TNF alpha treatment needed one infliximab infusion every 8th week (3 mg/kg) to control disease activity and symptoms. Further studies are warranted to evaluate long-term outcome of anti-TNF alpha treatment in patients with SpA.