[Current therapy with TNFalpha blocking agents for ankylosing spondylitis and undifferentiated spondyloarthritis]

The Spondyloarthritides (SpA) comprise a group of inflammatory rheumatic diseases which mostly affect the spine and the larger peripheral joints. The most common entities in this group are ankylosing spondylitis (AS) and undifferentiated spondyloarthritis (uSpA). Treatments with disease-modifying or remission-inducing properties for patients with AS are so far not available. However, in the light of relevant individual and socioeconomic consequences this is an unmet medical need. Recently, etanercept in addition to infliximab has shown substantial efficacy which might even be disease controlling. For both TNFalpha blocking agents, large randomized placebo-controlled trials have proven their efficacy with an acceptable profile of adverse events. In open trials these drugs also work in patients with uSpA. There is some hope now that the TNFalpha blocking agents could stop the development of AS in patients starting with uSpA.