[The pharmacotherapy of spondyloarthritis]

The objectives of treatment of spondyloarthritis are to improve functional status, diminish pain, prevent structural deterioration and reach drug free remission of disease. Nonsteroidal antiinflammatory drugs are the cornerstone of pharmacological intervention for ankylosing spondylitis, rapidly reducing pain and stiffness, and possibly modifying natural course of disease when given continuously. Conventional disease-modifying antirheumatic drugs which have been shown to be effective in the treatment of rheumatoid arthritis, have no proven such efficacy in spondyloarthritis. TNF-alpha blockade is highly effective in targeting the different disease features (axial disease, peripheral arthritis, enthesitis, and extra-articular features such as psoriasis or uveitis). There is no current evidence for the efficacy of other biological therapies in ankylosing spondylitis and psoriatic arthritis and every effort must be made to use TNF-alpha antagonists optimally.