Screening for latent TB in patients with inflammatory arthritis who will be starting TNFα inhibitors is important to prevent complications of TB-reactivation. However, currently there is no ‘gold standard’ for the diagnosis of latent TB.
Approval for golimumab (which will by marketed under the trade name Simponi) was granted this week by the U.S. Food and Drug Administration. The drug received approval for the treatment of moderate to severe RA (in conjunction with methotrexate), active psoriatic arthritis (as monotherapy or with methotrexate), and active ankylosing spondylitis at a dose of [...]
TNF-α blockade in patients with ankylosing spondylitis (AS) has been shown to improve clinical symptoms of disease and physical function. However, a benefit in reducing the incidence or severity of axial ankylosis has not been demonstrated. In fact, qualified observational data has suggested that radiographic progression of ankylosis and inflammation may be unrelated in AS. [...]
Tumor necrosis factor alpha (TNF-a) is a highly inflammatory cytokine with an important role in coordinating the inflammatory response seen in the axial skeleton of patients with ankylosing spondylitis (AS). Two biologic inhibitors of this cytokine, etanercept (Enbrel) and infliximab (Remicade), have been shown to be effective at reducing the subjective symptoms and reducing the systemic inflammatory response in AS in randomized clinical trials.
Infliximab (Remicade®) is now approved in Europe for the treatment of ankylosing spondylitis (AS) patients who have severe axial symptoms, elevated serological markers of inflammatory activity and who have had an inadequate response to conventional therapy.