spondyloarthritides evolving therapiesspondyloarthritides进化疗法.pdfVIP

Barr and Keat Arthritis Research Therapy 2010, 12:221 /content/12/6/221 R E V I E W Spondyloarthritides: evolving therapies Andrew Barr* and Andrew Keat classic radiographic change, is a continuum from a pre- Abstract radiographic phase to a radiographic phase – the whole TNF blockade therapy has substantially advanced continuum being appropriately referred to as Axial SpA the treatment of peripheral spondyloarthritides but [1]. During the radiographic phase, skeletal lesions are revolutionised the treatment of severe ankylosing probably irreversible and may progress independently of spondylitis. The capacity of biologic treatment to ongoing infl ammation; conversely, the opportunities for improve dramatically symptoms and quality of life in prevention or reduction of skeletal damage may be found patients with spinal disease is undoubted, although during the pre-radiographic phase, although recog nition important questions remain. Notable amongst these of disease at this time is problematic. At this early stage, are concerns about skeletal disease modii cation and acute infl ammatory lesions may be wide spread and the true balance between costs and ef ectiveness. fl uctuating throughout the spine [2,3]; the transformation Guidelines for the biologic treatment of ankylosing of these acute lesions to more chronic fatty bone and spondylitis and psoriatic arthritis have been introduced entheseal lesions may be what promotes the formation of in North America and Europe with considerable