I farmaci biologici nelle malattie infiammatorie articolari:
3 - spondilite anchilosante
Marta Priora, Richard Borrelli, Francesco Cattel, Angela Laganà, Maria Bruzzone, Clara Lisa Peroni, Marco Scarati, Simone Parisi, Cristina Realmuto, Enrico Fusaro
Ankylosing Spondylitis (AS) is a chronic inflammatory rheumatic disorder which mainly affects the axial skeleton, especially its tendons, ligaments and entheses. If left untreated it can progress its damage and lead to a worsening in the quality of life. The therapy for AS consists of a combination of non-pharmacologic and pharmacologic treatments. The therapeutic goal is not only to relieve pain tied to inflammation but also to limite the progression of the disease. In order to obtain such effects, an appropriate physiokinesitherapy, NSAIDs and COX-2 inhibitors are often used in the early stages of the disease. Disease Modifying Anti Rheumatic Drugs (DMARDs) and glucocorticoids are only useful in relieving pain in peripheral joints which are uncommonly involved in the AS. Biological drugs (TNFα-inhibitors) are to be used in patients diagnosed with AS according to the New York Criteria whose disorder has been continuous for at least a month and not likely to respond to NSAIDs. TNFα-inhibitors have a considerable financial impact, especially since AS is a chronic disorder affecting young people. However, the cost of such drugs indirectly allows to save money by reducing both absenteeism in the workplace and indirect costs tied to AS.
Key words: Ankylosing spondylitis, Disease Modifying Anti Rheumatic Drugs, biologic therapy, integrated approach