[How to optimize the antiTNF alpha therapy in spondylitis?].

Area of Science:

• Rheumatology
• Immunology

Background:

• Tumor necrosis factor-alpha (TNF-alpha) inhibitors represent a significant advancement in treating spondyloarthropathies.
• These therapies demonstrate superior safety and efficacy compared to treatments for rheumatoid arthritis.
• Disease-modifying anti-rheumatic drugs (DMARDs) are valuable, particularly for axial spondyloarthropathies, especially when non-steroidal anti-inflammatory drugs fail in up to 30% of patients.

Purpose of the Study:

• To review the current use of anti-TNF-alpha agents in spondyloarthropathies.
• To evaluate evidence-based strategies for optimizing the rational application of these treatments.

Main Methods:

• Literature review of clinical studies and evidence on anti-TNF-alpha therapy.
• Analysis of treatment response, survival rates, and side effect profiles.
• Examination of cost-effectiveness and patient selection criteria.

Main Results:

• Anti-TNF-alpha inhibitors show high response and survival rates in spondyloarthropathies.
• DMARDs are effective, especially in axial forms, offering an alternative when NSAIDs are insufficient.
• Consideration of drug cost and potential side effects is crucial for optimizing therapy.

Conclusions:

• Anti-TNF-alpha therapy is a cornerstone in managing spondyloarthropathies.
• Rational use strategies are essential due to the expense and potential adverse effects of these drugs.
• Further research into optimizing patient selection and treatment protocols is warranted.