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Biologics in spondyloarthritis: TNFα inhibitors and other agents

    Éric Toussirot

    *Author for correspondence:

    E-mail Address: etoussirot@chu-besancon.fr

    Clinical Investigation Center Biotherapy, INSERM CIC-1431, FHU INCREASE, University Hospital of Besançon, Besançon, France

    Department of Rheumatology, University Hospital of Besançon, Besançon, France

    Department of Therapeutics & EA 4266 ‘Pathogens and Inflammation’, SFR FED 4234, University of Franche-Comté, Besançon, France

    Published Online:https://doi.org/10.2217/imt.15.28

    TNFα inhibitors are currently the only class of biological agent that has proven to be effective in the treatment of patients with ankylosing spondylitis and/or spondyloarthritis (SpA). These agents have been shown to control inflammatory pain of the axial skeleton, peripheral clinical manifestations, certain extra-articular manifestations as well as systemic and spinal MRI inflammation. Conversely, they are unable to slow radiographic progression in the spine. Since around 20–30% of patients with SpA are considered as nonmajor responders to TNFα inhibitors, there is a need for alternative therapies. Biological agents that target IL-1, IL-6, B cells and costimulatory pathways are not effective in SpA. Conversely, novel biological agents blocking IL-23 or IL-17 are promising in SpA, especially secukinumab, an anti-IL-17A monoclonal antibody.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

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