Aktueller Stand der Therapie der axialen Spondyloarthritis mit biologischen DMARDs

F. Proft; D. Poddubnyy

doi:10.1055/s-0037-1618415

Arthritis und Rheuma, Inhaltsverzeichnis

Arthritis und Rheuma 2017; 37(02): 104-110
DOI: 10.1055/s-0037-1618415

Neues zur rheumatologischen Pharmakotherapie – biologische DMARDs

Schattauer GmbH

Aktueller Stand der Therapie der axialen Spondyloarthritis mit biologischen DMARDs

Current status of biological DMARD therapies in axial spondyloarthritis

F. Proft

¹Abteilung für Rheumatologie, Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin

,

D. Poddubnyy

¹Abteilung für Rheumatologie, Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin

› Institutsangaben

Abstract

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Zusammenfassung

Innerhalb der vergangenen Jahre konnten eindeutige Ziele für die Therapie der axSpA definiert werden. Einerseits sind die Verrin gerung der Krankheitsaktivität sowie andererseits die Verhinderung struktureller Schäden als Therapieziele in den Fokus gerückt. NSAR bilden, immer in Kombination mit nichtmedikamentösen Maßnahmen, das Gerüst der grundlegenden Therapiestrategie. Sollten sich diese als nicht ausreichend wirksam zeigen, kommt im Verlauf der Einsatz sogenannter Biologika (bDMARDs) in Frage. Derzeit sind für die Übergruppe der axSpA fünf TNF-Blocker sowie ein Antikörper gegen Interleukin (IL)-17A zugelassen, wobei einer der TNF-Blocker (Infliximab) sowie der IL-17A-Blocker Secukinumab derzeit nur für die röntgenologische Form (ankylosierende Spondylitis – AS) der axSpA die Zulas-sung besitzen. Die Erkrankungsgruppe der SpA stellt aktuell ein „Hot Topic” in der Untersuchung neuer Therapien in der Rheumatologie dar und es werden in näherer Zukunft neue zugelassene Therapiemechanismen erwartet. Der Stellenwert sowie der optimale Zeitpunkt des Einsatzes neuer „mode of actions” im Therapiealgorithmus der axSpA werden sich in der Zukunft herauskristallisieren müssen.

Summary

In the last years, major targets in the treatment of axSpA could be defined: 1) reduction of active inflammation and 2) prevention or retardation of structural damage. NSAIDs in combination with non-pharmacological procedures are the first-line therapy. If this standard treatment fails, therapy with bDMARDs should be considered. Currently there are five TNF-inhibitors and one monoclonal antibody against IL-17A available in Europe for the treatment of axSpA, while up to date infliximab as one of the TNF-inhibitors and Secukinumab as the anti-IL-17A antibody have the approval only for the radiographic form (AS) of axSpA. SpA is currently a “hot-topic” in clinical trials in the field of rheumatology and new therapeutic options are in the pipeline and will be available in the nearer future. The exact role of new therapies in the treatment algorithm in axSpA still has to be defined.

Schlüsselwörter

Axiale Spondyloarthritis - axSpA - ankylosierende Spondylitis - Biologika

Keywords

Axial spondyloarthritis - axSpA - ankylosing spondylitis - bDMARD

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Referenzen

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