A new therapy offers hopeful perspectives for patients suffering from spondyloarthropathy

Spondyloarthropathies are rheumatic infectious diseases affecting the spinal column and peripheral joints and tendons. These diseases either occur as such (Bechterew`s disease or ankylosing spondylitis), or are combined with skin psoriasis, inflammatory intestinal diseases (Crohn`s disease and ulcerating colitis), and eye infection (uveitis).

These diseases effect about 1% of total world population and often develop into seriously debilitating conditions with complete stiffening of the spinal column and destruction of the peripheral joints (hips, knees, wrists and/or fingers). Thus far, treatment of these diseases has been limited to the administration of non-steroid anti-inflammatory drugs, which may have a benevolent effect on the subjective complaints of pain, but does not effect the evolution of the disease.

Tumor Necrosis Factor is a small molecule (a cytokine) which is released by the disposal cells (macrophages) of the immune systems at sites where the inflammation occurs and which, in case of spondyloarthropathy, induces changes in the bone, joints and tendons.
Two years ago the Department of Rheumatology of the University of Ghent, Belgium, initiated an open study involving the treatment of 21 patients suffering from various forms of these diseases with intravenous injections of a monoclonal antibody targeting the Tumor Nacrosis Factor (Infliximab). The results were impressive not only with regard to the complaints, but also with regard to the symptoms of infection of the spinal column and the peripheral sites, and the infection factors measured in the blood. These results were confirmed in a double blind study involving 40 other patients, the data that were published in the March 6, 2002 issue of Arthritis and Rheumatology, the leading scientific journal in the area of rheumatology.

The conclusion of the study can be summarized as follows. The authors report the successful results of a double-blind placebo-controlled study with Infliximab on several sub-types of spondyloarthropathies. For the first time, we have an effective therapeutic option for severe cases. Long-term results (more than 1 year) of patients treated in the initial open study were already disclosed in a previous publication. The future of patients suffering from spondyloarthropathy is hopeful. It seems as if all requirements have been met to allow us to hope that this treatment will be able to prevent the stiffening of the spinal column and the destruction of the peripheral joints, and that the quality of life of these patients will improve considerably.

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