지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
초록· 키워드
오류제보하기
Nonsteroidal anti-inflammatory drugs (NSAIDs) have been the first choice of treatment for axial spondyloarthritis (axSpA); cyclooxygenase (COX)-2 inhibitors reduce both inflammation and bone formation. When NSAID treatment fails, tumor necrosis factor inhibitors (TNFis) can be used to treat active axSpA, but, presently, TNFis cannot completely prevent radiographic progression. Theoretically, as TNF is a strong pro-inflammatory cytokine triggering bone resorption, TNFis should stimulate bone formation. Recently, it was discovered that the IL-23/-17 axis is associated with enthesitis development and bone formation in a mouse model. The anti-IL-23 monoclonal antibody ustekinumab has been approved as treatment for moderate-to-severe plaque psoriasis and psoriatic arthritis. However, in axSpA patients, ustekinumab effectiveness was low and a phase 3 clinical trial was terminated. The anti-IL-17A monoclonal antibody secukinumab has been approved as treatment for moderate-to-severe plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis. In a 3-year extension of the MEASURE 1 observational study, the mean change in modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) from baseline to week 104 was 0.30 ± 2.53 among patients with evaluable X-rays originally randomized to secukinumab (n = 168). Such patients exhibited less radiographic progression compared to other TNFi studies. Several new drugs are in clinical trials exploring their effects on axSpA; these include ixekizumab (an anti-IL-17A monoclonal antibody), brodalumab (an anti-IL-17 receptor monoclonal antibody), and the Janus kinase (JAK) inhibitors tofacitinib and upadacitinib. The IL-23/-17 axis is important in terms of axSpA inflammation and bone formation. However, to date, no drug has completely prevented radiographic progression in axSpA patients.
목차
등록된 정보가 없습니다.
참고문헌 (16)
참고문헌 신청
Dougados M / 2011 / Spondyloarthritis / Lancet 377:2127~2137
van der Linden S / 1984 / Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria / Arthritis Rheum 27:361~368
Rudwaleit M / 2009 / The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection / Ann Rheum Dis 68:777~783
Rudwaleit M / 2011 / The assessment of spondyloarthritis international society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general / Ann Rheum Dis 70:25~31
Wanders A / 2005 / Nonsteroidal antiinflammatory drugs reduce radiographic progression in patients with ankylosing spondylitis: a randomized clinical trial / Arthritis Rheum 52:1756~1765
van der Linden S / 1984 / Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria / Arthritis Rheum 27:361~368
Rudwaleit M / 2009 / The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection / Ann Rheum Dis 68:777~783
Rudwaleit M / 2011 / The assessment of spondyloarthritis international society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general / Ann Rheum Dis 70:25~31
Wanders A / 2005 / Nonsteroidal antiinflammatory drugs reduce radiographic progression in patients with ankylosing spondylitis: a randomized clinical trial / Arthritis Rheum 52:1756~1765
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