Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Aug;9(8):197-210.
doi: 10.1177/1759720X17706454. Epub 2017 May 9.

Tumor Necrosis Factor-α (TNFα) Inhibitors in the Treatment of Nonradiographic Axial Spondyloarthritis: Current Evidence and Place in Therapy

Affiliations
Free PMC article
Review

Tumor Necrosis Factor-α (TNFα) Inhibitors in the Treatment of Nonradiographic Axial Spondyloarthritis: Current Evidence and Place in Therapy

Valeria Rios Rodriguez et al. Ther Adv Musculoskelet Dis. .
Free PMC article

Abstract

Nonradiographic axial spondyloarthritis (SpA) and radiographic SpA (also known as ankylosing spondylitis) are currently considered as two stages or forms of one disease (axial SpA). The treatment with tumor necrosis factor-α (TNFα) inhibitors has been authorized for years for ankylosing spondylitis. In recent years, most of the anti-TNFα agents have also been approved for the treatment of nonradiographic axial SpA by the European Medicines Agency (EMA) and similar authorities in many countries around the world (but not in the US), increasing the number of possible therapies for this indication. Data from several clinical trials have demonstrated the good efficacy and safety profiles from those anti-TNFα agents. Presently, a large number of patients achieve a satisfactory clinical control with the current therapies, however, there remains a percentage refractory to nonsteroidal anti-inflammatory drugs (NSAIDs) and TNFα inhibitors; therefore, several new drugs are currently under investigation. In 2015, the first representative of a new class of biologics [an interleukin (IL)-17 inhibitor] secukinumab, was approved for the treatment of ankylosing spondylitis; a clinical trial in nonradiographic axial SpA is currently underway. In this review, we discuss the recent data on efficacy and safety of TNFα-inhibitors focusing on the treatment of nonradiographic axial SpA.

Keywords: TNFα; spondyloarthritis; treatment.

Conflict of interest statement

Conflict of interest statement: VR: none declared; DP: received grant/research support from AbbVie, MSD, Novartis, Pfizer; consultant for: AbbVie, BMS, Boehringer, MSD, Novartis, Pfizer, and UCB; speakers bureau: AbbVie, BMS, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, and UCB.

Figures

Figure 1.
Figure 1.
ASAS40 response rates to tumor necrosis factor inhibitors (A) and active-drug-to-placebo response ratio (B) in the target population (with elevated CRP and/or positive MRI at baseline) of patients with nonradiographic axial spondyloarthritis from the placebo-controlled phases of the phase III trials. *Week 12 for adalimumab, etanercept, and certolizumab pegol (200 mg every 2 weeks), week 16 for golimumab. Different studies, no head-to-head comparisons. AxSpA, axial spondyloarthritis; ASAS, Assessment of Spondyloarthritis International Society; CRP, C-reactive protein; MRI, magnetic resonance imaging; nr-axSpA, nonradiographic axial spondyloarthritis; TNF, tumour necrosis factor.

Similar articles

See all similar articles

Cited by 2 articles

Feedback