Pharmacological treatment of spondyloarthritis: exploring the effectiveness of nonsteroidal anti-inflammatory drugs, traditional disease-modifying antirheumatic drugs and biological therapies

Caso, Francesco; Costa, Luisa; Puente, Antonio Del; Minno, Matteo Nicola Dario Di; Lupoli, Gelsy Arianna; Scarpa, Raffaele; Peluso, Rosario

doi:10.1177/2040622315608647

Cited by 21 publications

(13 citation statements)

References 104 publications

(182 reference statements)

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“…The joint space is physically close to the growth zone of the condylar head, and evolutionarily it is a distinct synovial joint with a unique biochemical makeup. Moreover, there is precedent for the observation of relative responsiveness to therapy with other joints, e.g., the inability of traditional DMARDs to treat axial spondyloarthritis despite some effectiveness with these medications in the management of peripheral disease [ 45 ]. There may also be differences in the biology of arthritis in that joint; as an illustration, one study showed different epigenetic changes of fibroblast-like synoviocytes in the knee as compared to the hip of patients with rheumatoid arthritis [ 46 ].…”

Section: Methodsmentioning

confidence: 99%

Temporomandibular joint arthritis in juvenile idiopathic arthritis, now what?

et al. 2018

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BackgroundArthritis involving the temporomandibular joint (TMJ) complicates 40 - 96% of cases of juvenile idiopathic arthritis (JIA), potentially leading to devastating changes to form and function. Optimal evaluation and management of this joint remains a matter of ongoing discussion.MethodsWe performed a PubMed search for all articles with keywords “temporomandibular” and “arthritis”, covering the dates 2002 through February 28, 2018. A separate PubMed search was performed for all articles with keywords “temporomandibular joint”, “arthritis”, and “treatment” covering the same dates.FindingsThe TMJ is a particularly challenging joint to assess, both clinically and with imaging studies. Clinical assessment of the TMJ is hampered by the low sensitivity of joint pain as well as the absence of physical exam findings early in the disease process. As with all joints, plain radiography and computed tomography only detect arthritic sequelae. Additionally, there is mixed data on the sensitivity of ultrasound, leaving magnetic resonance imaging (MRI) as the optimal diagnostic modality. However, several recent studies have shown that non-arthritic children can have subtle findings on MRI consistent with TMJ arthritis, such as joint effusion and contrast enhancement. Consequently, there has been an intense effort to identify features that can be used to differentiate mild TMJ arthritis from normal TMJs, such as the ratio of the enhancement within the TMJ itself compared to the enhancement in surrounding musculature. With respect to treatment of TMJ arthritis, there is minimal prospective data on medical therapy of this complicated joint. Retrospective studies have suggested that the response to medical therapy of the TMJ may lag behind that of other joints, prompting use of intraarticular (IA) therapy. Although most studies have shown short-term effectiveness of corticosteroids, the long-term safety of this therapy on local growth as well as on the development of IA heterotopic bone have prompted recommendations to limit use of IA corticosteroids. Severe TMJ disease from JIA can also be managed non-operatively with splints in a growing child, as well as with surgery.ConclusionIn this review, we summarize literature on the diagnosis and management of TMJ arthritis in JIA and suggest a diagnostic and therapeutic algorithm for children with refractory TMJ arthritis.

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Section: Methodsmentioning

confidence: 99%

Temporomandibular joint arthritis in juvenile idiopathic arthritis, now what?

et al. 2018

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“…Studies have shown that NSAIDs are associated with mild or poor responses in elderly SpAs patients and corticosteroids are not strongly recommended because of the risk of serious long-term adverse effects, such as hypertension, diabetes, osteoporosis, skin atrophy, and cataracts. 186 Moreover, csDMARDs effectiveness and safety derived from randomized placebo-controlled trials (RCTs) and longitudinal observational cohorts are scarce and mainly focused on methotrexate and sulfasalazine. 187 Esposito et al 188 retrospectively evaluated the effectiveness and safety of subcutaneous etanercept and adalimumab in 89 elderly patients with PsO and PsA, aged between 65 and 82 years (mean age 69.7 years).…”

Section: Discussionmentioning

confidence: 99%

<p>An Update for the Clinician on Biologics for the Treatment of Psoriatic Arthritis</p>

Chimenti¹,

D’Antonio²,

Conigliaro³

et al. 2020

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Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy typically associated with psoriasis (PsO). The pathogenesis is strictly related to the association among the presence of genetic risk alleles and innate and acquired immune response with dramatic consequences on bone remodeling. Clinically, PsA patients may present heterogenicity of articular and periarticular manifestations that may be associated with the presence of comorbidities making treatment decision challenging in patients management. The identification of patient-targeted therapies is still a critical issue. Actually, several biological and synthetic drugs are promising in terms of efficacy and safety profile. National and international treatment recommendations support clinicians in the decision of the best treatment, although they may have limits basically related to updates and different outcomes included in the clinical studies evaluated. The aim of this narrative review is therefore to give guidance for clinicians for PsA patients treatment. For this purpose, we evaluated evidence on biological therapies efficacy used for PsA treatment. Specifically, we reviewed data on biological therapies, Janus kinases (JAK) inhibitors, and drugs with a new mechanism of action that are part of the treatment pipeline. The concept of "switching" and "swapping" is also described, as well as data concerning special populations such as pregnant women and elderly patients.

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“…• Anti-TNF ajanlar romatoid artrit (RA), ankilozan spondilit (AS), psoriyatik artrit (PsA) ve juvenil idiyopatik artrit (JIA) gibi çeflitli romatizmal hastal›klar›n tedavisinde yayg›n olarak kullan›lmaktad›r. [11][12][13][14] • IL-1β inhibisyonu yapan biyolojik tedavi ajanlar› bafll›ca ailesel Akdeniz atefli (FMF) gibi otoinflamatuvar hastal›klar›n ve baz› J‹A olgular›n›n tedavisinde kullan›lmaktad›r. [5] • IL-6 inhibisyonu yapan TCZ bafll›ca RA tedavisinde ve JIA'n›n sistemik ve poliartiküler formlar›n›n tedavisinde kullan›lmaktad›r.…”

Section: Biyolojik Tedavi Ajanlar› Etkilerini Nas›l Göstermektedir?unclassified

“…Dolay›s›yla anti-TNF ajanlar bu hastal›klar›n tedavisinde baflar›yla kullan›labilmektedir. [4,[11][12][13][14] Gerçekten de, çeflitli anti-TNF ajanlar›n bu hastal›klarda etkinli¤i ve güvenlili-¤i çeflitli klinik çal›flmalarda gösterilmifltir. Bu nedenle, anti-TNF ajanlar›n romatoloji prati¤indeki baflar›s›n›n, di¤er biyolojik tedavilere öncülük etti¤i ve teflvik edici oldu¤u söylenebilir.…”

Section: Tümör Nekrotizan Faktör ‹Nhibitörleriunclassified