Anticytokine therapy in non-rheumatoid arthritis indications in 2009

To review the current uses of antitumor necrosis factor alpha (TNFalpha) therapies for non-rheumatoid arthritis inflammatory joint diseases. Emphasis is given to important questions regarding long-term use of anti-TNFalpha therapies.

TNFalpha blockade is one of the anticytokine therapies with major impact in the treatment of rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and juvenile idiopathic arthritis among the inflammatory joint diseases. As a result of the impressive response to TNFalpha inhibitors, new agents continue to be developed and a few are currently being tested in phase III trials. The evaluation of a potential relationship between inflammation and structural damage in ankylosing spondylitis has been an important focus of recent studies and will likely result in a better understanding and use of anti-TNFalpha therapy. Other aspects of treatment such as long-term safety and selection of patients who will likely have a major response have been evaluated in recent studies and will continue to be important topics in future research.

As TNFalpha inhibitors have been a major advance in the treatment of a number of inflammatory joint diseases and have been widely available in clinical practice, future research will need to continuously assess longitudinal efficacy and safety.