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Spondyloarthritides.
MedLine Citation:
PMID:  22265264     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The most important clinical features of the spondyloarthritides (SpA) are not only inflammatory back pain (IBP) but also peripheral (enthesitis) and extra-articular symptoms. For clinical purposes, two forms related to the predominant clinical manifestation - axial and peripheral SpA - and five subgroups- ankylosing spondylitis (AS), SpA associated with psoriasis and inflammatory bowel disease (IBD), reactive arthritis and undifferentiated SpA - are differentiated. Axial SpA including AS is the most frequent subtype of SpA, followed by psoriatic arthritis and undifferentiated SpA, while reactive arthritis and IBD-related SpA are less frequent. The prevalence of SpA has been shown to be similar to rheumatoid arthritis. The outcome of the disease is influenced by the degree of disease activity over time, which is mainly related not only to inflammation but also on the structural damage (new bone formation) that occurs over time. Treatment options for patients with SpA have been limited for decades. Non-steroidal anti-inflammatory agents are currently considered first choice, since they have shown good amelioration of symptoms in SpA patients especially when suffering by the typical symptom of IBP. Furthermore, there is a clear role for regular physiotherapy in AS to prevent loss of spinal mobility. For patients who have insufficiently responded to conventional therapies, four anti-tumour necrosis factor (TNF) agents are available and are approved for the treatment of patients with active AS: infliximab, etanercept, adalimumab and golimumab. As far as it stands now, TNF blockers seem to have no influence on new bone formation in AS.
Authors:
Xenofon Baraliakos; Juergen Braun
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Best practice & research. Clinical rheumatology     Volume:  25     ISSN:  1532-1770     ISO Abbreviation:  Best Pract Res Clin Rheumatol     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-01-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101121149     Medline TA:  Best Pract Res Clin Rheumatol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  825-42     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
Affiliation:
Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Landgrafenstr. 15, 44652 Herne, Germany.
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