Tumor necrosis factor-α blockade in ankylosing spondylitis a potent but expensive anti-inflammatory treatment or true disease modification 英文参考文献.docVIP

Available online /contents/7/3/121 Commentary Tumor necrosis factor-α blockade in ankylosing spondylitis: a potent but expensive anti-inflammatory treatment or true disease modification? Filip Van den Bosch, Filip De Keyser, Herman Mielants and Eric M Veys University Hospital, Department of Rheumatology, Gent, Belgium Corresponding author: Filip Van den Bosch, filip.vandenbosch@ugent.be Published: 11 April 2005 Arthritis Research Therapy 2005, 7:121-123 (DOI 10.1186/ar1742) This article is online at /content/7/3/121 ? 2005 BioMed Central Ltd See related research by Baraliakos et al., /content/7/3/R439 Abstract several questions remain with regard to the use of these biological therapies in SpA. Blocking tumor necrosis factor-α either with monoclonal antibodies or with soluble receptor constructs has been proven to be effective with an acceptable safety profile in patients with rheumatoid arthritis, and more recently also in the diseases belonging to the spondyloarthropathy concept. Nevertheless multiple questions still remain unresolved especially concerning longer-term treatment. Data from a recent manuscript by Baraliakos and colleagues seem to indicate that at least for the vast majority of ankylosing spondylitis patients treatment with infliximab can not be withdrawn, if one wants to control disease activity in a continuous way. Although still unproven, this might be of crucial importance with regard to structure modification and prevention of ankylosis in this chronic inflammatory disorder. First, long-term data on safety and efficacy of these compounds are scarce. More specifically, for infliximab, which has to be given by way of an intermittent intravenous perfusion, we still have no definitive knowledge of the optimal re-treatment strategy (dose and interval), especially with regard to cost-effectiveness. Second, almost no information