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Rheumatology Advance Access originally published online on February 17, 2007
Rheumatology 2007 46(6):899-901; doi:10.1093/rheumatology/kem012
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

EDITORIALS

Anti-tumour necrosis factor therapy for ankylosing spondylitis—unresolved issues

R. N. Jois1, K. Gaffney1 and A. Keat2

1Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich and 2Department of Rheumatology, Northwick Park Hospital, Harrow, UK

Correspondence to: Dr Ramesh N. Jois. E-mail: rammi09@yahoo.com

The first 150 words of the full text of this article appear below.

The management of ankylosing spondylitis (AS) has been revolutionized by the introduction of anti-tumour necrosis factor (TNF) drugs. The long-standing need for an effective treatment for AS seems to have been met at least partially and at a price. There is ample evidence that treatment with infliximab, etanercept and adalimumab reduces pain and stiffness, greatly enhances the sense of well-being and improves functional outcome in patients with long-standing AS [1–3]. Moreover, this symptomatic improvement is accompanied by a significant degree of reduction in spinal inflammation as detected by magnetic resonance imaging [4–6]. There is no doubt then that, for the first time ever, the outlook for people with AS is radically better. But, in spite of such good news it is clear that much important ground work has not been done—for good reasons—so that critical, unresolved questions remain. The answers to these are all the more . . . [Full Text of this Article]

Who should we treat?

Access to treatment

Should we treat AS early?

How long should treatment continue?

Will the benefits of treatment justify the costs?

Conclusion


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