Medikamentöse Therapie der Spondylitis ankylosans

Summary

The group of spondyloarthritides (SpA) consists of ankylosing spondylitis and the subgroups psoriatic arthritis, arthritis related to inflammatory bowel disease, reactive arthritis and undifferentiated peripheral arthritis. The classification criteria of „The Assessments in Ankylosing Spondylitis International Society“ (ASAS) aims to differentiate between axial and peripheral disease. In this work, it was seeked to differentiate pharmacological treatment in this respect. Focus was thereby set on two main treatment principles: reduction of prostaglandin synthesis by blockade of cyclooxygenase-2 (COX-2) either by conventional non-steroidal antiinflammatory drugs (NSAID) or selective COX-2-Inhibitors, as well as by blockade of the proinflammatory cytokine tumor-necrosis-factor-α via so-called biologicals.

Zusammenfassung

Zu den Spondylarthropathien (SpA) gehören neben der ankylosierenden Spondylitis (AS) auch die Subgruppen Psoriasis-Arthritis, SpA bei chronisch entzündlichen Darmerkrankungen, reaktive Arthritis und undifferenzierte periphere Arthritis. Durch die Klassifikationskriterien der „Assessments in Ankylosing Spondylitis International Society“ (ASAS) wird eine Unterscheidung in axiale und periphere Erkrankung getroffen. Ziel dieser Übersichtsarbeit ist es, die medikamen töse Therapie der SpA in diesem Kontext zu erarbeiten. Ein Fokus wurde hierbei auf zwei wichtige Wirkprinzipien gelegt: Hemmung der Prostaglandinsynthese durch Blockade der Cyclo-oxygenase-2 (COX-2) mittels konventioneller nichtsteroidaler Antirheumatika und selektiver COX-2-Hemmer sowie Blockade des proinflammatorischen Zytokins Tumor-Nekrose-Faktor-α durch sogenannte Biologika.

Schlüsselwörter

Spondylarthropathien - NSAR - TNF-α-Blocker

Keywords

Spondyloarthritides - NSAID - TNF-α-inhibitor

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