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Inhibiting Progression: Can TNF-a Inhibitors Reduce Radiographic Progression in Ankylosing Spondylitis (AS)?

by Chris Miller | Posted on 07/15/2013

Consensus on the effectiveness of TNF-a inhibitors has been evolving and changing each year since they were introduced over a decade ago. But the biggest question has yet to be decisively answered: Can the TNF-a inhibitors slow or halt disease progression in AS?

The latest study published in Arthritis & Rheumatism concludes that they appear to do so when they are used to treat ankylosing spondylitis.

TNF-a inhibitors are medications that target and attempt to block TNF-alpha in the body. TNF-alpha is a cytokine involved in the inflammatory process. Excess amounts of TNF-alpha have been associated with various forms of inflammatory arthritis. These medications are either injected or, in the case of remicade, given by an IV.

Currently, there are four anti-TNF therapies used in the US that have an indication from the Food and Drug Administration (FDA) to treat AS (presented in order of initial FDA approval):

  • Enbrel (etanercept)
  • Remicade (infliximab)
  • Humira (adalimumab)
  • Simponi (golimumab)

The new study, "The Impact of TNF-inhibitors on radiographic progression in Ankylosing Spondylitis" looked at the "effect of Tumor Necrosis Factor-Alpha (TNF)-inhibitors on progressive spine damage in Ankylosing Spondylitis (AS) patients" by examining x-rays of patients over time.

The authors conclude that, "TNF-inhibitors appear to reduce radiographic progression in AS, especially with early initiation and longer duration of follow up." Thus, it appears that better results are achieved when the TNF-a inhibitors are started earlier.

Resources & Further Reading

About the writer: Chris Miller is the Director of Programs at the Spondylitis Association of America and is Editor-in-Chief of SAA's news magazine, Spondylitis Plus. He has been at SAA for nine years.

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